PEDIA Flashcards
what is the disorder that have pressure inside the cranium
INCREASE ICP
normal ICP
5-15 mmHg
what indicated if >15 ICP
increased ICP
what indicates if more than 20 ICP
life threatening
what disease in neurologic disorder that has cushing’s triad
Increase ICP
how do you determine the widen pulse pressure
Subtract Diastolic from Systolic
what is the shape of anterior
diamond
what are the 2 fontanels
anterior and posterior
what is the shape of posterior
triangular
Anterior fontanel closes at
12-18 months
posterior fontanel closes at
2-3 months
What aggravate fontanels
by crying
what is the early sign of ICP
High pitched Cry/Shrill Cry
early sign of ICP in the age of child
irritability and agitation
early sign of ICP in the age of adult
restlessness
early sign of ICP in the age of geria
confusion
Initial sign of increased ICP
headache
vomiting center of the body
Chemoreceptor Trigger Zone
what is anisocoria and what it represents
-uneven pupils
-represents f brain damage
what does dilated pupil indicates in increase ICP
shock
what does constricted pupil indicates in increase ICP
narcotic overdose
how do you indicate normal pupil
PERRLA
(pupil equally round and reactive to light and accommodation)
why does sunset eyes occur in ICP
the pressure of the brain is pushing downwards
position if you have ICP
semi fowlers
what does semi fowlers purpose in increase ICP
Drain CSF → decrease fluid → decrease pressure = Decrease ICP
what is avoided if you have increase ICP
coughing and sneezing
In ICP, limit fluid intake into ____
1,200-1,500 ml/day
what are the two diuretics in increase ICP
Lasix and mannitol
mannitol is what kind of diuretics
osmotic
Lasix is what kind of diuretics
loop
Lasix is localized or generalize
localized
mannitol is localized or generalize
generalized
Lasix and Mannitol is a potassium wasting diuretic. What do you need to monitor?
Monitor hypokalemia
Decadron (Dexamethasone) is ____
-steroid, anti inflammatory
-prevention of cerebral edema
Anticonvulsants is for
prevention of seizure episodes
In ICP, why are they acidic
Stress levels
Using Decadron → GI irritants
What are the two antacids
Mg Hydroxide and Aluminum hydroxide
side effect of Mg Hydroxide
Diarrhea (Mag tatae)
side effect of Aluminum hydroxide
Constipation (Ala tae)
what is the purpose of anti coagulants
to prevent complication of thrombosis
what are the two anti coagulants
heparin and warfarin
what are the medications contraindicated in increased ICP
opiates and sedatives
opiates and sedatives can occur
Severe cardiac/Respiratory depression
what do you call the type of seizure that is generalized (mula ulo hanggang paa)
Grand Mal Seizure
Mental clouding and intoxication seziure
Psychomotor Seizure
type of seizure that is absent, blank facial expression, automatisms, lip smacking
petit mal
Tonic clonic of a group of muscle → progresses to grand mal seizure
Jacksonian Seizure
type of seizure that is high temp and wide flactuations due to
febrile seizure
what is the most dangerous type of seizure
status epilepticus
what does occur in status epilepticus
30 mins → brain damage could occur (on and off)
what is the main management in seizure
medication
last resort management for seizure
surgery
what to WOF in phenytoin
gingival hyperplasia and pinking red urine
Benzodiazepines indication
Prevents seizure episodes
medication needed when you have Refractory Seizures
→ Iminostilbenes: Carbamazepine
why does Valproates: Valproic Acid is the last resort medication
due to hepatotoxicity
Valproates: Valproic Acid is not given to pregnant women due to _____
it will cause Neural tube defects
In children with bacterial meningitis, affect yung movement because
because meninges supports and nourishes the brain
in CSF analysis, why there is cloudy urine
because of elevate WBC, protein
Pathognomonic sign in bacterial meningitis
Kernig’s and Brudzinski sign
what is the difference between Kernig’s and Brudzinski sign
Kernig’s: (K)nee → Flex → Pain in the hamstring, back, neck = (+) Kernigs
Brudzinski: (B)atok → flex → pain the back and neck = (+)brudzinski
type of head trauma wherein there is Structural alteration brought by extravasation of blood
contusion
what is the important to emphasize in Antibiotic therapy
Finish Duration to prevent drug resistance
what should be the position in opisthotonos
side lying
type of head trauma wherein there is Jarring of the brain → sudden forceful contact in a rigid skull
concussion
what position in car if <3 y/o
rear facing
what position in car if >3 y/o
Front facing/ Forward facing booster seat
Most important prognostic indicator in head trauma
assessing LOC
what to do if there is (+) cervical injury
do not move the client → Immobilize
(-) cervical injury:
Height of the bed - 30 degrees to decrease ICP
Two way in the blood flow in the heart indicates
regurgitation
Point of Intersection of aorta and pulmonary artery
ductus arteriosus
if there is one problem in the heart
acyanotic
if there is two problem in the heart
cyanotic
why there is Machinery like murmur in PATENT DUCTUS ARTERIOSUS (PDA)
Nagbabanggaan ang tunog kasi naka bukas ung ductuss arteriosus
sign of cerebral hypoxia
irritability
DOC for PATENT DUCTUS ARTERIOSUS (PDA)
INDOMETHACIN
Indication of indomethacin
facilitates closure of PDA
secondary drug for PDA
ibuprofen
what happens in septal defect
→ Na bybypass ung lungs kasi may butas
signs and symptoms in septal defect
-Fatigue → poor feeding
-Dyspnea on exertion → activity intolerance
-Failure to thrive (delayed milestones)
-signs and symptoms of heart failure
In management, suture is use when ________
hole is small
if hole is big, what is the managemet
dacron patch
In dacron patch, the tissue is the ___
Decrease rejection rate and favorable
In dacron patch, the plastic is the ___
Increase rejection rate and use when tissue is fading
in COARCTATION OF AORTA, in upper extremities - the BP is
increase
in COARCTATION OF AORTA, in lower extremities - the BP is
decrease
in COARCTATION OF AORTA, in upper extremities - the pulse is
bounding
in COARCTATION OF AORTA, in lower extremities - the pulse is
weak sometimes absent
management in coarctation in aorta
Balloon Angioplasty with coronary stenting
is stent for lifetime
yes or no
YES
how may problems in tetralogy of fallot
4 problems
what is the primary problem in tetralogy of fallot
pulmonary stenosis
What allows mixing of blood in TOF
overriding of aorta
What is the compensatory mechanism in TOF?
Right ventricular hypertrophy
how does the patient with TOF keeps alive in VSD
narerelieve yung pressure kasi dahil may butas sa septum pumupunta ung blood sa left galing sa RV
kasi kung sarado, sa RV lang napupunta lahat