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CA PEDIA > PEDIA - CONGENITAL DEFECTS > Flashcards

PEDIA - CONGENITAL DEFECTS Flashcards

1
Q

What are neonatal congenital defects associated with?

A

They are often linked to maternal health issues during pregnancy.

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2
Q

What are the types of congenital heart diseases mentioned?

A

Acyanotic Conditions: Ventricular Septal Defect, Atrial Septal Defect, Patent
Ductus Arteriosus, Coarctation of the Aorta.

Cyanotic conditions: Transposition of the great vessels, Tetralogy of Fallot.

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3
Q

What is a left-to-right shunt in acyanotic conditions?

A

aorta DOES NOT get
unoxygenated blood

It is when blood flows from the pressure left side of the heart to the lower
pressure right side, mixing oxygenated and blood.

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4
Q

What happens in an atrial septal defect?

A

There is an opening in the septum that causes the blood from the left atria to
be shunted into the right atria due to the septal defect

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5
Q

What is the problem in atrial septal defect?

A

The problem would be that the right atria receives
more than the usual amount of blood so it becomes
congested.

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6
Q

What is the consequence of increased blood flow to the right atrium in an atrial
septal defect?

A

It causes congestion and enlargement of the right atrium.

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7
Q

What is the stretch theory in relation to the myocardium?

A

It initiates the contraction of the heart when the myocardium is stretched due to increased
blood volume.

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8
Q

What is the earliest manifestation of congenital heart defects in infants?

A

Tachycardia , or a faster heart rate.

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9
Q

What happens to the chambers of the heart when blood becomes congested?

A

The chambers enlarge and the myocardium expands.

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10
Q

What happens to the right atrium when there is congestion?

A

It increases in size due to the returning blood.

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11
Q

What compensatory mechanism does the heart employ when there is congestion?

A

The heart beats faster , resulting in tachycardia.

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12
Q

Why might tachycardia not be alarming to doctors in newborns?

A

It is a normal response for a newborn’s heart after birth.

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13
Q

How does the heart’s ability to contract change as the baby grows older?

A

The heart rate increases as the heart compensates for its workload.

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14
Q

Which coronary artery is most dangerous to have ischemia?

A

Left anterior descending coronary artery.

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15
Q

What is the result of less blood being ejected during heart contractions?

A

It leads to congestive heart failure.

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16
Q

What characterizes a Ventricular Septal Defect ( VSD )?

A

It is a hole in the lower septum between the ventricles. AORTA is NOT getting unoxy blood.

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17
Q

What happens to blood flow in the heart due to VSD?

A

Blood flows from the left ventricle to the right ventricle due to pressure differences.

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18
Q

What is the role of the ligamentum arteriosum in PDA?

A

It connects the aorta and pulmonary artery and should not remain patent.

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19
Q

What occurs when blood from the right ventricle cannot eject properly in PDA?

A

Blood returns to the right ventricle, causing congestion.

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20
Q

What is coarctation of the aorta?

A

It is a narrowing of the aorta that impedes blood flow.

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21
Q

What unique symptoms are observed in babies with coarctation of the aorta?

A

Strong in the artery and weak pulses in the pedal and femoral
arteries.

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22
Q

What is the primary complication of acyanotic conditions?

A

Congestive heart failure ( CHF ).

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23
Q

What are the symptoms of left-sided heart failure?

A

Symptoms include dyspnea , productive cough, and pulmonary congestion.

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24
Q

What does echocardiography help identify?

A

It identifies the type and size of heart defects.

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25
Q

What should be monitored during cardiac catheterization?

A

The temperature , color, and pedal pulse of the legs.

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26
Q

What is a potential complication of cardiac catheterization?

A

Thrombus formation and possible embolism.

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27
Q

What does the retrograde approach in cardiac catheterization mean?

A

It means the catheter is inserted backward towards the heart.

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28
Q

What is the purpose of introducing contrast media dye during cardiac
catheterization?

A

To identify obstructions in the heart.

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29
Q

What happens when the catheter enters the left ventricle?

A

It allows for the administration of contrast media dye to visualize obstructions.

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30
Q

What can thrombus and emboli lead to if not addressed?

A

They can lead to pulmonary embolism.

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31
Q

What is the risk if the left anterior descending artery becomes obstructed?

A

It can lead to ischemia and infarction

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32
Q

What is more likely to close spontaneously , ASD or VSD?

A

ASD has more chances of closing on its own.

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33
Q

What is involved in open heart surgery?

A

Induction of asystole , hypothermia, and use of a bypass machine.

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34
Q

What is the purpose of cooling the body during open heart surgery?

A

It reduces the brain’s demand for oxygen.

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35
Q

What is the difference between open heart surgery and closed heart surgery?

A

Open heart surgery involves defects the heart, while closed heart surgery
involves defects the heart.

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36
Q

What is the objective of preventing congestive heart failure (CHF)?

A

If CHF can be prevented, surgery can be postponed.

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37
Q

What effect does Digoxin have on heart rate?

A

It increases the strength of contraction but decreases heart rate.

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38
Q

What should be monitored before administering Digoxin to infants?

A

Heart rate should be monitored, especially if it is below 100 bpm.

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39
Q

What is the minimum heart rate for children aged 1-4 years before administering
Digoxin?

A

At least 80 bpm.

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40
Q

What is the minimum heart rate for children aged 5-10 years before administering
Digoxin?

A

At least 70 bpm.

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41
Q

What is the minimum heart rate for adolescents before administering Digoxin?

A

At least 60 bpm.

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42
Q

How should fluid output be monitored in patients on diuretics?

A

By weighing diapers to ensure output exceeds input.

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43
Q

What medication is used to improve cardiac output?

A

Cardiac glycoside, specifically Digoxin, is used.

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44
Q

What is the purpose of diuretics like Furosemide?


A

To prevent sodium retention and promote elimination of excess fluids.

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45
Q

What is the function of ACE inhibitors like Captopril?

A

They prevent the conversion of Angiotensin I to II, controlling blood
pressure.

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46
Q

What is the role of angiotensin II in the body?

A

It is a vasoconstrictor that promotes sodium and water retention.

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47
Q

What dietary recommendation is made for patients with heart conditions?

A

A low sodium diet is recommended.

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48
Q

What type of meals are recommended for children with heart conditions?

A

Small , high-calorie , high-fat meals in frequent intervals are recommended.

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49
Q

What is a recommended activity for children to decrease oxygen demand?

A

Quiet play activities are recommended.

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50
Q

What causes children to turn blue in cyanotic conditions?

A

It is due to the body receiving unoxygenated blood.

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51
Q

What happens in transposition of the great vessels?

A

The aorta receives unoxygenated blood from the right side.

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52
Q

How is the insertion of the aorta and pulmonary artery altered in transposition of the great vessels?

A

The aorta and pulmonary artery are switched in their positions.

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53
Q

What happens to the oxygen supply after birth in a baby with transposition of the
great vessels?

A

The baby begins to receive unoxygenated blood in circulation after the umbilical cord is cut.

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54
Q

What happens to a baby with transposition of the great vessels when they cry?

A

The baby becomes bluer as they cry.

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55
Q

What is the pathway of oxygenated blood in a normal heart?

A

Oxygenated blood goes from the lungs to the left atrium, then to the left ventricle, and out through the aorta.

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56
Q

What medication is given to open the ductus arteriosus in newborns?

A

Prostaglandin E2 ( Dinoprostone )

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57
Q

What happens when prostaglandin E2 is administered to a newborn?

A

It opens the ductus arteriosus , allowing blood from the left ventricle to flow into the
aorta.

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58
Q

What is the Jatene Procedure?

A

It is an arterial switch operation performed within the first 14 days of life.

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59
Q

Why is the Jatene Procedure performed?

A

To correct the heart’s structure and ensure proper oxygenation

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60
Q

What is the first step in performing a balloon septostomy?

A

Inserting a catheter into the inferior vena cava.

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61
Q

What are the components of Tetralogy of Fallot (TOF)?

A
  • Displaced aorta (overriding)
  • Right ventricular hypertrophy (RVH)
  • Ventricular septal defect (VSD)
  • Pulmonary artery stenosis
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62
Q

What does the acronym DROP stand for in Tetralogy of Fallot?

A

D - Displaced aorta, R - Right ventricular hypertrophy, O - Opening in the septum (VSD), P - Pulmonary artery stenosis.

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63
Q

What is the consequence of the combined defects in Tetralogy of Fallot?

A

It causes cyanosis due to inadequate blood flow to the lungs.

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64
Q

Why do symptoms of Tetralogy of Fallot often disappear during quiet moments?

A

Because the oxygen demand decreases during rest.

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65
Q

What is a common symptom of Tetralogy of Fallot during activity?

A

Exertional dyspnea with central cyanosis.

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66
Q

What are “ TET “ spells and how are they relieved ?

A

They are episodes of by , which impedes blood flow to
the legs

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67
Q

What is the Schamroth technique used for?

A

To assess for clubbing of fingers.

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68
Q

What does clubbing of fingers indicate ?

A

Chronic peripheral hypoxia

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69
Q

What is the normal angle between nail beds in a healthy finger?

A

160 degrees.

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70
Q

What happens to the blood in polycythemia due to chronic hypoxia?

A

The blood thickens, increasing the risk of thrombosis.

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71
Q

What is the normal hematocrit count range in pediatric patients?

A

35-45 %

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72
Q

What is the purpose of phlebotomy in managing polycythemia?

A

To dilute the blood and reduce the risk of thrombosis

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73
Q

to increase blood flow to the pulmonary artery

A

Alpha-adrenergic agonist (Phenylephrine)

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74
Q

What are the overall objectives of nursing care for neural tube defects?

A

Protect the sac against pressure, injury, and infection
Surgical closure preferred within 24-48 hours after birth
Monitor for signs of infection

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75
Q

What is the cause of neural tube defects?


A

Inadequate intake of folic acid during pregnancy.

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76
Q

What is spina bifida?

A

A condition where there is an incomplete closure of the spinal canal.

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77
Q

What is the difference between meningocele and meningomyelocele?

A

Meningocele contains , while meningomyelocele contains ,
meninges, and spinal cord with nerves.

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78
Q

What is the preferred intervention for spina bifida?

A

Surgical closure within 24-48 hours after birth.

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79
Q

Why is it important to keep the sac moist in spina bifida patients?

A

To prevent infection and protect the exposed tissues.

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80
Q

What should be avoided when caring for a patient with spina bifida?

A

Using a diaper that can cover the sac.

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81
Q

What is the role of positioning in the care of spina bifida patients?

A

To prevent pressure on the sac and reduce the risk of SIDS.

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82
Q

What should be done if a patient with spina bifida shows signs of infection?

A

Monitor for signs of infection and notify the healthcare provider immediately.

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83
Q

What is the purpose of monitoring hemoglobin and hematocrit counts in patients
with congenital heart defects?

A

To detect early polycythemia.

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84
Q

What is the significance of maintaining hydration in patients with polycythemia?

A

To prevent blood thickening and dehydration

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85
Q

What are the two types of fluids recommended for hydration?

A

Drinkable fluids (liquids) and eatable fluids (solids).

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86
Q

What is the recommended position during TET spells?

A

Knee-chest position or squatting.

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87
Q

How can respiratory infections affect patients with congenital heart defects?

A

They can worsen hypoxemia and reduce oxygenation.

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88
Q

What is the overall objective of nursing care for the sac?

A

To protect the sac against pressure , injury , and infection.

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89
Q

Why should the head be turned to the opposite direction when in a prone position?

A

To monitor for the risk of Sudden Infant Death Syndrome ( SIDS ).

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90
Q

What position is allowable for a baby with a sac issue?

A

Prone position, but it must be monitored closely.

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91
Q

What is a potential complication of spina bifida if not managed properly?

A

Hydrocephalus.

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92
Q

What are some signs of hydrocephalus?

A

Bulb-shaped head, bulging fontanel, high-pitched cry, and projectile vomiting.

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93
Q

How does increased intracranial pressure (ICP) affect vital signs?

A

It can cause decreased heart rate, decreased respiratory rate, and hypertension.

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94
Q

What is mannitol used for in medical management?


A

It is an osmotic diuretic given as an IV drip to promote urination.

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95
Q

What is the purpose of dexamethasone in treatment?

A

It is a steroid used as an anti-inflammatory.

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96
Q

When is a ventriculoperitoneal (VP) shunt inserted?

A

To bypass the point of obstruction and prevent CSF buildup in the brain.

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97
Q

What should be done if a baby has a sac issue but no hydrocephalus?

A

Closing of the sac is the solution.

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98
Q

What is cleft lip and how can it occur ?

A

Cleft lip can be hereditary or due to excess vitamin ADEK intake.

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99
Q

Does having a cleft lip always mean there is a cleft palate?

A

No , cleft lip and cleft palate are separate conditions that may exist individually.

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100
Q

What is the rule of 10 for cleft lip surgery?

A

The baby must be at least 10 weeks old, weigh at least 10lbs, have hemoglobin of
10 grams, and a WBC count <10,000.

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101
Q

What is the ideal age for cleft palate repair?

A

Around 8-10 months old.

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102
Q

What is the purpose of using a Haberman feeder preoperatively?

A

It helps infants who cannot suck effectively to feed better.

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103
Q

What position should a baby be in post-op after cleft lip surgery?

A

Supine position with the head tilted to the side.

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104
Q

What should be used to clean suture lines after feeding?

A

Cooled boiled water or sterile water.

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105
Q

What is the purpose of Logan’s device after surgery?

A

To prevent dehiscence and evisceration of the sutures.

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106
Q

What is the difference between cleft lip and cleft palate in terms of intervention?

A

The difference lies in the post-operative intervention required.

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107
Q

Why is it beneficial to repair cleft lip and cleft palate at different times?

A

Because as the baby , the cleft becomes smaller, making repair
easier.

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108
Q

What is the main concern when a baby has a cleft palate?

A

It can hinder speech development.

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109
Q

What is the purpose of pre-operative management for cleft palate?

A

To prepare the baby for feeding and ensure proper nutrition before surgery.

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110
Q

What should be done if a baby is 1 week old with a cleft palate?

A

Surgical intervention is needed for uranoplasty/palatoplasty.

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111
Q

What are the signs and symptoms of hydrocephalus?

A

Bulb-shaped head
Bulging fontanel
High-pitched shrill cry
Projectile vomiting
Macrocephaly (large head)
Distention of veins on the head
Changes in vital signs ( decreased HR, decreased RR, hypertension)

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112
Q

What are the stages of repair for uranoplasty/palatoplasty?

A
  1. Soft palate repair at 3-6 months
  2. Hard palate repair at 6-18 months
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113
Q

Why is it advantageous to not repair cleft lip and cleft palate simultaneously?

A

Because as the baby grows older, the cleft palate becomes smaller.

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114
Q

When should the repair of the cleft palate ideally occur?

A

Before speech development begins.

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115
Q

What are the two separate occasions for surgery if a baby is at risk?

A
  1. Close the soft palate (3 to 6 months) to lessen aspiration risk.
  2. Repair the hard palate before speech development (6 to 18 months).
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116
Q

Why is a long surgical procedure dangerous for a baby?

A

It poses a risk to the development of the brain due to prolonged sedation.

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117
Q

What is a difficulty in post-operative care of uranoplasty and palatoplasty?

A

There is a between the care plans for post-cheiloplasty and posturanoplasty.

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118
Q

What position should a patient be in after uranoplasty?

A

The patient should be in a prone position.

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119
Q

Why is the prone position recommended after surgery?

A

It promotes natural drainage of secretions.

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120
Q

What is nasal twang in speech evaluation?

A

Nasal twang refers to the sound produced that may indicate issues after surgery.

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121
Q

What is suggested after the surgical repair of the palate?

A

It is suggested that the baby undergoes speech therapy.

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122
Q

What should be the feeding position post-operatively?

A

The feeding position should be upright.

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123
Q

Why should a straw not be used for drinking post-operatively?

A

Using a straw creates negative pressure, increasing the risk of bleeding.

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124
Q

What is atresia of the esophagus?

A

The lower and upper segments of the esophagus do not connect.
The upper end ends in a blind pouch.

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125
Q

What does the letter “H” represent in H-type tracheoesophageal fistula?

A

The “ H “ represents the trachea, esophagus, and the fistula forming an H shape.

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126
Q

What are the problems associated with tracheoesophageal fistula?

A

Aspiration
Nutritional problems due to food not reaching the stomach

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127
Q

What is the priority problem in tracheoesophageal fistula cases?

A

Aspiration is prioritized over nutritional problems.

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128
Q

How does aspiration occur in tracheoesophageal fistula?

A

Liquid goes to the trachea instead of the stomach, leading to into the lungs.

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129
Q

What are the symptoms of tracheoesophageal fistula?

A

Coughing, choking , and cyanosis during feeding

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130
Q

What does polyhydramnios indicate during pregnancy?

A

It indicates that the baby is not swallowing , leading to high levels of amniotic fluid.

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131
Q

What should suctioning be based on in newborns?

A

Suctioning should only be done when there is mucus or if the amniotic
fluid is
excessive
green.

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132
Q

What are the 3 C’s during feeding that indicate aspiration in a baby?

A

Coughing , choking , and cyanosis

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133
Q

What does coiling of the nasogastric tube indicate?

A

It indicates that the tube is not reaching the stomach due to a lack of connection.

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134
Q

What should be done for a newborn with tracheoesophageal fistula before surgery?

A

The baby should stay in the ICU to build up resistance and gain weight

135
Q

What is the pre-operative management to prevent pneumonia?

A

Consider possible risks of pneumonia
Keep the baby in an upright position (60-degree angle)

136
Q

What is aspiration pneumonia?

A

It occurs when liquid goes into the lungs, initiating a pneumonic process.

137
Q

How can aspiration pneumonia be prevented in newborns?

A

By always keeping them in an upright position.

138
Q

What is the recommended angle for keeping a newborn in an upright position?

A

60-degree angle.

139
Q

What is the purpose of using a pacifier for newborns who are NPO?

A

A allows for non-nutritive sucking, providing sucking without
nutrition

140
Q

Who proposed that one of the needs of an infant is to give pleasure of sucking?

A

Sigmund Freud.

141
Q

How is breastmilk or formula provided to newborns who cannot feed orally?

A

Through feeding, where a temporary opening is created in the
stomach.

142
Q

What is the difference between nasogastric tube and gastrostomy feeding?

A

Nasogastric tube goes through the nose , while gastrostomy goes directly into the
stomach.

143
Q

What is pyloric stenosis?

A

It is caused by hypertrophy of the muscles of the pyloric sphincter, leading to
constriction.

144
Q

What happens to food in the stomach before it exits through the pyloric sphincter?

A

Food must be digested into pieces before it can pass through the pyloric sphincter.

145
Q

What are the symptoms of pyloric stenosis?

A

Abdominal distention after feeding with peristaltic waves.
Projectile vomiting.
Dehydration due to fluid loss.
Weight loss and muscle weakness.
Palpable olive-shaped mass in the right upper quadrant (RUQ).

146
Q

What is a classic manifestation of pyloric stenosis?

A

A palpable olive-shaped mass in the right upper quadrant (RUQ).

147
Q

What is the purpose of barium swallow and barium enema?

A

Barium swallow is for upper GI, while barium enema is for lower GI.

148
Q

What is the management for pyloric stenosis?

A

Pyloromyotomy (opening pylorus) with pyloroplasty (repair).
Correct fluid and electrolyte imbalances before surgery.
Small frequent feedings of breastmilk or thickened formula.

149
Q

What should be done before surgery for pyloric stenosis?

A

Correct fluid and electrolyte imbalances first.

150
Q

What are the post-operative care instructions for a baby after pyloric stenosis
surgery?

A

Administer small amounts of oral rehydrating solution.
Burp well after feeding.
Position the baby on the right side after feeding to promote gastric emptying.
Monitor for vomiting and care for the incision site.

151
Q

What is intussusception ?

A

A condition where a portion of the small intestines telescopes into
the lumen of another.
hyperactive
It causes obstruction and can lead to severe complications.

152
Q

What are the symptoms of intussusception?

A

Spasmodic abdominal pain, blood with mucus in stool (currant jelly stool), and
bile-stained vomitus.

153
Q

What does currant jelly stool indicate?

A

It indicates the presence of blood with mucus in the stool due to intussusception.

154
Q

What does fecaloid vomitus suggest?

A

It suggests that the obstruction is in the due to the presence of fecal
materials

154
Q

What does bile-stained vomitus indicate?

A

It indicates that the obstruction is in the small intestine.

155
Q

What are the characteristics of vomitus that should be documented?

A

Color
Smell
Taste
Amount

156
Q

What should be included in documentation/charting when describing vomitus?

A

It should include color , amount , taste , and smell.

157
Q

Why is it important to describe vomitus in detail?

A

It helps identify the location of an obstruction in the gastrointestinal tract.

158
Q

What is the color of bile-stained vomitus?

A

Green

159
Q

What is the role of bile in digestion?

A

Bile is needed for the emulsification of fats.

160
Q

What does fecaloid vomitus look like?

A

It is brown and smells very foul.

161
Q

What does the presence of fecaloid vomitus suggest about the obstruction?

A

It suggests that the obstruction is in the large intestine.

162
Q

How can colorectal cancer lead to fecaloid vomitus?

A

It can cause in the , preventing feces from exiting the
body.

163
Q

What is a sausage-shaped mass in the abdomen indicative of?

A

It indicates a palpable mass in the small intestine.

164
Q

What can happen if a portion of the bowel becomes intussuscepted?

A

There is a possibility for the bowel to perforate or burst

165
Q

What are the management techniques for intussusception?

A

Hydrostatic Reduction Technique (Barium or Saline)
Air (Pneumatic Insufflation)
Surgery (Manual Reduction, resection with anastomosis if necrosis is present)

166
Q

How does the hydrostatic reduction technique work?

A

It uses pressure to reduce the telescoping of the bowel

167
Q

What is the risk of using barium enema in a baby with intussusception?

A

It can be used to treat intussusception by pushing the telescoped bowel out.

168
Q

What happens if a part of the bowel is necrotic during intussusception
management?

A

It must be surgically removed to prevent further complications

169
Q

What is Hirschsprung’s disease?

A

It is a congenital condition characterized by the of
nerve supply in the large intestines.

170
Q

What is the consequence of the absence of ganglion cells in Hirschsprung’s disease?

A

It leads to the absence of peristalsis in the affected segment of the intestine.

171
Q

What is the genetic basis of Hirschsprung’s disease?

A

It is associated with an abnormal gene on Chromosome 10.

172
Q

What are the early signs of Hirschsprung’s disease?

A

Delayed meconium passage within the first 24 to 48 hours after birth.

173
Q

What are the late signs of Hirschsprung’s disease?

A

Constipation , ribbon-like or pellet-like stool, abdominal distention, and weight loss.

174
Q

What is the purpose of a rectal exam in diagnosing Hirschsprung’s disease?

A

To check for the presence of fecal material in the rectum.

175
Q

What is the definitive diagnostic test for Hirschsprung’s disease?

A

Rectal biopsy.

176
Q

What is the pre-operative management for a baby with Hirschsprung’s disease?

A

Promote elimination with stool softeners and normal saline enemas.

177
Q

What is the management for an imperforate anus?

A

Colostomy in the nursery as a palliative measure.

178
Q

What are the signs of an imperforate anus?

A

Absence of meconium and inability to insert a rectal thermometer.

179
Q

What is the compensatory mechanism in males with an imperforate anus?

A

Greenish urine may indicate a recto-vesical fistula.

180
Q

What is the management step for males with an imperforate anus?

A

Corrective surgery should be scheduled before 1 year of age.

181
Q

What is the cause of pharyngitis/tonsillitis?

A

It is caused by Group A Beta Hemolytic Streptococcal Infection.

182
Q

What are the potential sequelae of streptococcal infection?

A

Rheumatic fever, rheumatic heart disease, and glomerulonephritis.

183
Q

Why is surgery not advised during the acute inflammatory stage of tonsillitis?

A

Because the tonsils are highly vascular and may bleed

184
Q

Why is it important to complete the antibiotic dosage for GABHS infection?

A

To ensure all microorganisms are eliminated and prevent resistance.

185
Q

What are some complications that may arise from infection?

A

Rheumatic fever, rheumatic heart disease, and glomerulonephritis

186
Q

Why is surgery not advised during the acute inflammatory stage of tonsillitis?

A

Because the tonsils are highly vascular and can bleed

187
Q

What is the recommended course of action before scheduling a tonsillectomy?

A

Complete a full course of antibiotics

188
Q

What antibiotic is recommended for GABHS infection if the patient has an allergy?

A

Erythromycin

189
Q

Why is it important to complete the dosage of antibiotics prescribed by a physician?

A

To prevent the microorganisms from recovering and developing drug resistance

190
Q

What should be avoided when administering antipyretics?

A

Aspirin (ASA)

191
Q

What are the risks of not controlling fever in children?

A

It can lead to convulsions

192
Q

What is the purpose of a tepid sponge bath for a child with fever?

A

To open skin pores and promote evaporation of body heat

193
Q

Under what conditions is tonsillectomy indicated?

A

Recurrent , peritonsillar abscess, or massive causing
dyspnea

194
Q

What should be checked during pre-operative management for tonsillectomy?

A

Dental status for loose teeth and bleeding disorders

195
Q

How many deciduous teeth do children typically have?

A

20 deciduous teeth

196
Q

What position should a child be placed in while asleep to promote drainage of
secretions?

A

Prone or lateral position

197
Q

What are signs of potential bleeding after tonsillectomy?

A

Frequent swallowing and restlessness

198
Q

What type of diet should be resumed after tonsillectomy?

A

Cold , clear , non-irritating fluids

199
Q

Why is milk not advisable after tonsillectomy?

A

Because it can irritate the throat

200
Q

What is the bottom line regarding tonsillectomy?

A

It should be avoided unless absolutely necessary due to the presence of antibodies

201
Q

What is the cause of spasmodic croup (laryngotracheobronchitis)?

A

Virus

202
Q

What are the symptoms of laryngotracheobronchitis ?

A

Hoarseness, inspiratory stridor, and fever

203
Q

What is the relationship between laryngospasm and recurrent coughing?

A

Recurrent coughing can lead to laryngospasm , causing respiratory distress

204
Q

What should be avoided to prevent laryngospasm during an attack?

A

Avoid respiratory irritants and sudden temperature changes

205
Q

What is the purpose of administering high humidity with mist therapy during asthma
attacks?

A

To humidify or liquefy secretions

206
Q

What is the cause of epiglottitis?

A

Haemophilus influenzae

207
Q

What are the signs and symptoms of epiglottitis ?

A

Drooling, dystonia, and dysphagia

208
Q

What position does a child with epiglottitis typically adopt?

A

Upright , leaning forward with chin thrust out

209
Q

What vaccine is used for the prevention of epiglottitis?

A

influenzae Type B (Hib) Vaccine

210
Q

What is the difference between bronchial asthma and COPD in adults?

A

Bronchial asthma is acute and can be cured , while COPD is chronic and not
curable

211
Q

What area is primarily affected during an asthmatic attack in children?

A

The bronchial area

212
Q

What is the role of histamine in asthma symptoms?

A

Histamine leads to changes in the air passages and causes symptoms

213
Q

What is bronchospasm and how is it related to asthma?

A

Bronchospasm is the of muscles around the , leading to difficulty breathing in asthma

214
Q

What is the nutritional benefit of egg yolk?

A

It is rich in iron.

215
Q

What can happen to a baby due to overfeeding milk?

A

Anemia can occur.

216
Q

Which foods are known to cause asthma due to allergens?

A

Chicken and peanuts.

217
Q

What are intrinsic factors in asthma?

A

They are idiopathic or inner factors related to the patient, such as stress or anxiety.

218
Q

What does histamine do in the body?

A

It leads to changes in the air passages and the body’s response.

219
Q

What is bronchospasm?

A

It is a tightening of the muscles around the air passages.

220
Q

What does histamine cause in the air passages?

A

It causes swelling of the linings and production of secretions.

221
Q

What happens to bronchioles in adults with asthma?

A

Even the alveoli can become involved.

222
Q

What is emphysema in relation to asthma?

A

It occurs when the alveoli are distended and the condition is no longer reversible.

223
Q

Why are patients taken to the hospital during an asthma attack?

A

To relieve the symptoms.

224
Q

What are the symptoms of asthma exacerbation?

A

Inflammation and edema of the airways, and accumulation of secretions

225
Q

What is allergen control in asthma management?

A

It involves skin testing followed by hyposensitization.

226
Q

What is hyposensitization?

A

It is a process to increase tolerance to allergens over three years.

227
Q

What is anaphylaxis?

A

It is a severe allergic reaction that can cause death.

228
Q

What is asthma exacerbation?

A

It is when asthma symptoms are present and the patient is symptomatic.

229
Q

What is the desired outcome during hyposensitization?

A

For the patient to experience remission or absence of symptoms.

230
Q

What should be done if a patient exacerbates during treatment?

A

Open the airways and administer medicines.

231
Q

What is the first procedure for asthma exacerbation management?

A

To inhale through nebulization.

232
Q

What type of bronchodilator is administered for asthma relief?

A

Rapid-acting bronchodilators.

233
Q

What are intravenous drugs used for in asthma management?

A

Aminophylline and steroids

234
Q

What does the administration of steroids indicate during an asthma attack?

A

It means the asthma is hard to treat and bronchodilators are insufficient.

235
Q

What are examples of steroids used in asthma treatment?

A

Prednisolone and Hydrocortisone.

236
Q

What is the position recommended for patients during asthma attacks?

A

Orthopneic position.

237
Q

Why should patients lean forward during an asthma attack

A

It helps with lung expansion and reduces chest heaviness.

238
Q

What should be promoted for hydration in asthma patients?

A

Oral fluids with aspiration precautions

239
Q

Why should milk be limited in asthma patients?

A

Milk can make secretions thicker.

240
Q

Why should vitamin C be avoided in high doses for asthma patients?

A

Higher doses can trigger asthma attacks

241
Q

What is the recommended daily allowance of vitamin C?

A

500 mg.

242
Q

What breathing exercise is recommended for asthma patients?

A

Pursed-lip breathing.

243
Q
A
244
Q

What is the purpose of pursed-lip breathing?

A

To expel carbon dioxide and prevent acidosis.

244
Q

What is rheumatic fever a complication of?

A

Streptococcal infection.

245
Q

What can effective management of rheumatic fever prevent?

A

It can prevent rheumatic heart disease.

245
Q

Who is more prone to rheumatic fever?

A

School-aged children and adolescents.

246
Q

What are common symptoms of streptococcal infection?

A

Tonsillitis , dental caries, and otitis media.

247
Q

What are the minor criteria for diagnosing rheumatic fever according to Jones
criteria?

A

CRP increased
Arthralgia
Fever
Elevated ESR
Prolonged PR interval
Anamnesis of rheumatism
Leukocytosis

248
Q

What is migratory polyarthritis?

A

It is joint pain that moves from one joint to another.

249
Q

What is chorea in the context of rheumatic fever?

A

It refers to involuntary jerks or movements

250
Q

What is erythema marginatum?

A

It is a rash that appears on the trunk.

251
Q

What are subcutaneous nodules in rheumatic fever?

A

They are palpable lumps under the skin.

252
Q

What is carditis in the context of rheumatic fever?

A

It is inflammation of the heart’s endocardium.

253
Q

What is the goal of management for rheumatic fever?

A

To decrease demand from the weakened heart.

254
Q

What is the role of penicillin in rheumatic fever management?

A

It is used to prevent further infections.

255
Q

What can happen with continuous exposure to streptococcal infection?

A

It can lead to permanent damage to the mitral valve.

256
Q

What medications are used for chorea in rheumatic fever?

A

Phenobarbital and Diazepam.

257
Q

What is the second goal of administering penicillin?

A

The second goal is the administration of penicillin.

258
Q

Why are oral NSAIDs preferred over steroidal medicine?

A

Oral NSAIDs are safer because steroids can lead to syndrome due to their
long duration of effect.

259
Q

What is the goal of administering oral NSAIDs in the context of joint inflammation?

A

The goal is to decrease the pain due to swelling.

260
Q

What is the objective related to preventing further cardiac damage?

A

The objective is to prevent further cardiac damage due to rheumatic heart disease.

261
Q

What medications are used for chorea?

A

Phenobarbital and Diazepam (Valium) are used for chorea.

262
Q

Why is it preferable for children with chorea to avoid stairs?

A

Because they may experience involuntary jerks that could lead to falls.

263
Q

What is the recommended dosage of Benzathine Penicillin for prevention of
rheumatic fever?

A

2 million units IM monthly until years old; if with valve damage, until years
old.

264
Q

What advice is given to women with rheumatic heart disease regarding pregnancy?

A

They are advised not to get pregnant while on antibiotic therapy.

265
Q

What is the effect of pregnancy on blood volume in women with rheumatic heart
disease?

A

Pregnancy can increase blood volume by to percent, putting stress on the
heart

266
Q

What can happen if a mother self-medicates during pregnancy?

A

Self-medication can lead to the development of antibiotic resistance.

267
Q

What kidney problem can occur in children due to chronic glomerulonephritis?

A

Renal failure can occur in children.

268
Q

What is glomerulonephritis?

A

Glomerulonephritis is one of the pre-renal causes of kidney problems in children.

269
Q

What is the similarity and difference between nephritis and nephrosis?

A

Both are renal problems; the difference lies in age, symptoms, and cause.

270
Q

What microorganism is associated with nephritis

A

Group A beta-hemolytic Streptococcus (GABHS).

271
Q

What symptom indicates kidney injury in nephritis?

A

Hematuria, or urinating blood, indicates kidney injury.

272
Q

What causes periorbital edema in nephritis?

A

Periorbital edema is caused by fluid retention due to kidney injury.

273
Q

What triggers the Renin-Angiotensin mechanism in response to kidney injury?

A

The kidney responds to injury by triggering the Renin-Angiotensin mechanism.

274
Q

What is an effective intervention for hypertension related to kidney injury?

A

ACE inhibitors are effective in preventing the conversion of Angiotensin I to II.

275
Q

What management strategies are recommended during the acute stage of kidney
injury?

A

CBR (complete bed rest), antihypertensives, diuretics, and antibiotics

276
Q

Why is a low protein diet recommended during the acute stage of kidney injury?

A

A protein diet is recommended because the kidneys cannot waste
products like creatinine.

277
Q

What is the importance of skin care in patients with kidney injury?

A

Good skin care is important because edematous areas are prone to injury

278
Q

What is nephrotic syndrome characterized by?

A

Nephrotic syndrome is characterized by a group of symptoms, not an inflammatory
condition.

279
Q

What is proteinuria?

A

Proteinuria is the presence of protein in urine, indicating kidney dysfunction.

280
Q

What is the etiology of nephrotic syndrome?

A

The etiology is unknown but is thought to be autoimmune.

281
Q

What happens to protein levels in the blood during nephrotic syndrome?

A

Hypoproteinemia occurs, leading to a decrease in protein levels in the blood.

282
Q

What is the effect of low plasma osmotic pressure in nephrotic syndrome?

A

Low plasma osmotic pressure leads to more edema , such as ascites and anasarca.

283
Q

What is hyperlipidemia in the context of nephrotic syndrome?

A

Hyperlipidemia is characterized by protein levels and fat levels in the
blood.

284
Q

What causes hypotension in nephrotic syndrome?

A

Hypotension occurs due to , as fluid shifts from inside the blood vessels
to outside.

285
Q

What is the management strategy for preventing bedsores in nephrotic syndrome
patients?

A

Ambulation as tolerated is recommended to prevent bedsores.

286
Q

What is the role of diuretics in nephrotic syndrome management?

A

Diuretics are used to remove excess fluids from the body.

287
Q

Why are steroids like Prednisone used in nephrotic syndrome?

A

Steroids are used as immunosuppressants in nephrotic syndrome management.

288
Q

At what age is iron deficiency anemia more common in children?

A

Iron deficiency anemia is more common in children 6 months and older.

288
Q

What dietary changes are recommended for nephrotic syndrome patients?

A

Patients should have a diet high in carbohydrates , low in sodium , and low in fat.

289
Q

What is the importance of meticulous skin care in nephrotic syndrome patients?

A

Meticulous skin care is important to prevent injury in edematous areas.

289
Q

What is the purpose of IV albumin in nephrotic syndrome management?

A

IV albumin is used to help maintain protein levels in the blood.

289
Q

What is pernicious anemia associated with?

A

Pernicious anemia is associated with vitamin B12 deficiency.

289
Q

What is the recommended daily limit of milk for toddlers to prevent iron deficiency
anemia?

A

Toddlers should not exceed 30 oz of milk per day.

290
Q

What is the management strategy for introducing complementary feedings to
infants?

A

Introduce one food at a time to rule out allergies.

291
Q

What are some iron-rich foods recommended for children?

A

Cereals, egg yolk, dark green leafy vegetables, and dark meat ( meat) are
recommended.

292
Q

What is hemophilia characterized by?

A

Hemophilia is transmitted as X-linked from a carrier mother to an affected son.

293
Q

Who is affected by hemophilia?

A

Hemophilia affects males primarily.

294
Q

What symptoms indicate hemophilia in newborns?

A

Prolonged from the umbilical cord and skin petechiae are early
symptoms.

295
Q

What are later symptoms of hemophilia?

A

Later symptoms include easy bruising , easy epistaxis , and gum bleeding.

296
Q

What can happen to bones due to hemarthrosis?

A

Bones can become soft and spongy due to prolonged exposure to blood.

297
Q

What is the condition characterized by bleeding that occurs throughout a person’s
life?

A

Hemophilia

298
Q

Which joints are most often damaged by bleeding in hemophilia?

A

The hinge joints: knees, ankles, and elbows

299
Q

Why do hinge joints bleed more often than ball-and-socket joints?

A

Hinge joints have little protection from side-to-side stresses

300
Q

Which joints are classified as ball-and-socket joints?

A

The hip and shoulder joints

301
Q

What is the purpose of DDAVP in hemophilia management?

A

It is used for the lack of Factor VIII

302
Q

What types of sports should individuals with hemophilia avoid?

A

Contact sports like wrestling, basketball, and football

303
Q

What does the PRICES technique stand for in managing hemophilia?

A

P: Protect (use protective devices)
R: Rest (immobilize)
I: Ice (vasoconstriction)
C: Compress (apply pressure)
E: Elevate (above the heart)
S: Support (from healthcare professionals)

304
Q

Why should aspirin be avoided in patients with hemophilia?

A

Aspirin may cause bleeding

305
Q

What is the significance of physical therapy in hemophilia management?

A

It helps patients return to regular activities after bleeding stops

306
Q

What is the purpose of cell transplantation in hemophilia?

A

It is considered when there is no cure available

307
Q

What is the most common form of childhood cancer?

A

Leukemia

308
Q

What type of blood cells are primarily affected in leukemia?

A

White blood cells (WBC)

308
Q

What is the role of lymphocytes in the immune system?

A

Lymphocytes are responsible for phagocytosis and fighting infections

309
Q

What is the major problem caused by the presence of lymphoblasts in the body?

A

They make the body very prone to infection

310
Q

What are the forms of leukemia?

A

Lymphocytic Leukemia: Acute (ALL) or Chronic (CLL)
Myelocytic Leukemia: Acute (AML) or Chronic (CML)

311
Q

What is the primary symptom of myelocytic leukemia?

A

Infection, anemia, and bleeding

311
Q

What is the prognosis for acute lymphocytic leukemia (ALL) in children?

A

It has a great response to chemotherapy and there is a potential cure

312
Q

What is the definitive test for diagnosing leukemia?

A

Bone marrow biopsy

313
Q

What is the typical positioning for a pediatric patient during a bone marrow biopsy?

A

Prone position

314
Q

What does a complete blood count (CBC) indicate in relation to leukemia?

A

It shows values the normal range but does not definitively diagnose
leukemia

315
Q

What are the stages of leukemia management?

A
  1. Remission Induction: IV systemic chemotherapy
  2. CNS Prophylactic Therapy: Intrathecal chemotherapy
  3. or Consolidation Therapy: Regular systemic and intrathecal
    chemotherapy
    Intensification
  4. Maintenance Therapy: Regular monitoring and treatment
316
Q

What is the goal of remission induction in leukemia treatment?

A

To achieve remission through systemic chemotherapy

317
Q

Why is CNS prophylactic therapy important in leukemia treatment?

A

It prevents the spread of cancer cells to the central nervous system

318
Q

What is the ideal intervention for leukemia treatment?

A

Bone marrow transplant

319
Q

What are the challenges associated with bone marrow transplantation?

A

Compatibility issues and high expenses

320
Q

How do children’s concepts of death vary by age?

A

Below 5 years: Death is seen as reversible, like sleep
6-9 years: Death is personified and seen as reversible
Above 9 years: Death is understood as irreversible and final

321
Q

How do preschoolers perceive death?

A

As a form of sleep or reversible

322
Q

What do children aged 6-9 years associate with death?

A

They see death as a person, like the grim reaper

323
Q

What is the understanding of death for children above 9 years old?

A

They recognize it as the end of life and irreversible

324
Q

How do nurses perceive death?

A

As the beginning of new life

CA PEDIA (3 decks)

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