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nursing practice 2 > PEDIATRIC ABNORMALS > Flashcards

PEDIATRIC ABNORMALS Flashcards

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1
Q

Causative agent of Pertussis

A

Bordatella Pertussis

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2
Q

Mode of Transmission of Petussis

A

Direct and indirect

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3
Q

Incubation period of pertussis

A

5-21 days

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4
Q

Pertussis most communicable when?

A

Catarrhal stage 1-2 weeks

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5
Q

Active artificial immunity of Pertussis

A

DPT or DTaP - 2,4,6 months of age
then 4-6 yrs old then 11-12

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6
Q

What stage is like a common cold or mild rhinitis

A

Catarrhal Stage 1-2 weeks

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7
Q

What stage is with whooping cough and 5-10 short rapid cough with deep inspiration

A

Paroxysmal stageq

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8
Q

What stage is gradual cessation of pertussis symptoms

A

Convalescent

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9
Q

MGT for Pertussis

MSHANO

A

Macrolide - Azith
Suction PRN
Hydration
Avoid cough triggers
Nutrition
O2

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10
Q

WOF (Pertussis)
PEDAS

A

Pneumonia
Emphysema or Epistaxis
Dehydration
Alkalosis, Atelectasis
Subarachnoid bleeding / Seizure

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11
Q

Pharyngitis occurs at what age?

A

5-15 y.o

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12
Q

Pharyngitis Causative agent:

A

Group A Beta Hemolytics (GABHS)

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13
Q

WOF (pharyngitis) complications

A

rheumatic fever
Glumerulonephritis

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14
Q

Classical signs of Pharyngitis
THROAT

A

Temp high
Headache
Rash: Scarla Tiniform rash
Optics
Appears ill
Throat inflamed

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15
Q

Signs and symptoms of viral pharyngitis

A

Mild, enlarged lymph nodes

Tx. only oral analgesis and gargling with warm H2O for dec. inflamm

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16
Q

Pus formation at the back of the throat that impacts airway and is a medical emergency

A

Retropharyngeal Abscess

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17
Q

S/Sx of Retropha Abscess

A

Fever
Refusal to eat
Swelling in the one side of the neck

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18
Q

What to avoid in Retropha Abscess

A

Don’t initiate gag reflex
And no tongue dep

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19
Q

Diagnostics for Retropha Abscess

A

Radiograph

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20
Q

Treatment for Retropha Abscess

A

IV Antibiotic
Hydration
Respi status: O2, RR

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21
Q

Corrective treatment for Retropha abscess

A

Tonsillectomy laser or ligation

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21
Q

Laser ton sillectomy no suture causes?

A

Hemorrhage

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21
Q

WOF for tonsillectomy (report)
3S

A

Severe pain
Swallong frequently -
Signs of Bleeding (High HR)

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21
Q

Risks for tonsillectomy
AHA

A

Aspiration
Hemorrhage
Anesthetic effect

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22
Q

Avoid after tonsillectomy
SCAR

A

Sports: Competitive
Carbonated drink
Acid
Red foods

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22
Q

Allowed after tonsillectomy
PIE

A

Popsicles
Ice chips
Ear pain (mild) for 1 weak

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23
Q

Inability of the heart to pump adequate O2 in blood

A

Heart Failure

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24
Q

Causes of Heart Failure
4D’s

A

Defects
Diseases (GABHS, Kawasaki)
Disorder
Dysfunction

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25
Q

Right sided heart failure
5E’s

A

Edema
Extremities
Eye
Enlarged Liver
Engorged JV

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26
Q

Left sided heart failure
“LUNGS RRR”

A

Lung symptoms
Use accessory muscles
Nasal flaring
Grunting
SOB

Rales
Retractions
Resp. rate (inc)

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27
Q

Treatment for Heart Failure
DAB Triad

A

Digoxin
ACE inhibitors
Betablockers

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28
Q

Sign and Symptoms of Digoxin toxicity (DDD)

A

Dizziness
Diarrhea
Decrease RR

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29
Q

If oral Digoxin was vomited?

A

No food, if vomited dont repeat
If vomit again, REPORT

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30
Q

When to take oral Digoxin

A

1 hr pre meal or 2 hrs post meal

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31
Q

Effect of Digoxin

A

+ Inotropic = High contract
- Chronotropic = Low HR

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32
Q

ACE inhibitors with diuretics WOF?

A

Low BP and hypovolemia

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33
Q

Left to right delivery of O2 blood

A

Acyanotic HD

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34
Q

Cyanotic heart dx mechanism

A

Right to Left O2 blood
Poor delivery of O2
More severe

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35
Q

Assessment of CHD
“Ang PET Mo”

A

Diaphgram then Bell
Aortic, Pulmonic, Erbs point, Tricuspid, Mitral

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36
Q

A congenital heart disease that Aorta with O2 blood from the lungs

A

Patent Ductus Arteriosus

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37
Q

Signs and Symptoms of PDA

PDS

A

Pulmonary Congestion: rales
DOB (feeding)
Systolic murmur

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38
Q

Where can systolic murmur be heard?

A

2nd ICS Left upper sternal border

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39
Q

Treatment of PDA

A

Prostaglandin = Indomethacin
Diuretics
Surgery - Cardiac cath

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40
Q

Atrial Septal Defect (Acyanotic)

Assessment: “ASD”

A

Asymptomatic: Activity intolerance

Systolic murmur

DOB: feeding

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41
Q

Diagnostic tests for ASD

A

Echocardiogram

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42
Q

Management for ASD

A

Diuretics
Device place
Defect closure (Median sternotomy with cardio pulmo bypass)

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43
Q

Most common congenital heart defect

A

VSD

44
Q

VSD closes at?

A

First 2 years of life

45
Q

Assessment of VSD
“2H2T”

A

Heart Failure
Harsh/ Holosystolic Murmur
Tachypnea
Thriving failure

46
Q

Diagnostic test for VSD

A

Echocardiogram

47
Q

MGT for VSD

A

Diuretics
Diet: High calorie
Defect closure
Dacron Patch (?)

48
Q

A combination of ASD and VSD, most common defect in trisomy 21

A

Atrioventricular Septal Defect

49
Q

More severe signs of heart failure

A

AVSD

50
Q

Mgt for AVSD

“ABCD”

A

ACE inhibitors
Band (In pulmonary artery)
Closure
Digoxin/Diuretics

51
Q

2nd most prevalent congenital heart disease

A

Transposition of the Great Arteries (ToGA)

52
Q

ToGA management?

A

Emergent! Cyanotic

53
Q

Mgt for ToGA

A

Give Prostaglandin E1 - IV
(Give patent ductus arteriosus)

Balloon atrial septostomy

Arterial Switch

54
Q

balloon atrial septostomy can be done after?

A

14 days or 2 weeks

55
Q

Arterial switch for ToGA is also called?

A

Jatene Procedure

56
Q

What to watch out for ToGA

A

Apnea
Low bp

in the first 2 hours of life

57
Q

Management ToGA

Nursing int

A

Room air
Spontaneous breathing
Initiate ventilator PRN

58
Q

4 hallmark signs of Tetralogy of Fallot

A

Pulmonic Stenosis
Overriding aorta
VSD
Right ventricular hypertrop

59
Q

Assessment of ToF

A

Systolic murmur
Hypercyanotic spell (tet)

60
Q

Tet spells are?

A

irritates the infant
Seizure that leads to death

61
Q

Primary intervention for TOF

A

Knee chest position = Increase systemic vascular resistance

62
Q

If not resolved by knee chest position

A

Go to ER while on knee chest

63
Q

Management on ER for ToF

A

Max O2
Alpha Adrenergic Agonist
(Phenylprine)
Repair

64
Q

Repair of ToF when?

A

3-6 months

65
Q

narrowing of the aorta

A

Coarctation of the Aorta

66
Q

CoAo is more common in?

A

Male

67
Q

hallmark signs of CoAo

A

Higher blood pressure in right arm

Unequal BP up to 10mmHg

68
Q

Assessment of CoAo

RUM

A

Right arm (>BP)
Unequal PR
Males

69
Q

Mgt for CoAo

and its incision site

A

Balloon/ stent angioplasty
thru cath lab

Left thoracostomy

70
Q

Mucutaneous lymph node syndrome that is prominent in Asian Males

5 yrs old below an inflammatory blood vessels

A

Kawasaki Dx

71
Q

WOF Kawasaki Dx

3

A

Coronary Aneurysm
Thrombus formation
Myocardial Infarction

72
Q

Treatment of Kawasaki dx

A

IV - Immunoglobulin
that triggers immune system

73
Q

IV immunoglobulin must be administered when?

A

7-10 days acute phase

74
Q

Important health teaching for Kawasaki

A

Delay vaccines, Continuous echocardiogram to look for aneurysm

75
Q

Acute phase of Kawasaki Dx

A

High constant fever of 39 for more than 5 days and can be relieved only by ibuprofen

76
Q

Subacute phase of Kawasaki
(2-3 weeks)

A

Edema
Erhythema - Feets, hands and eyes

Tongue - Strawberry

77
Q

Rasher of Kawasaki can be found in?

A

Trunk, extremity with red eyes

78
Q

Inflammation of joints, heart and vessels

And what is its causative agent?

A

Rheumatic fever
CA: GABHS

79
Q

Rheumatic fever can be at age?

A

6-15 years old,

10 days after pharyngitis

80
Q

Assessment for Rheumatic fever

Major: JONES
Minor: TAPES

A

Joint pains
O: Carditis
Nodules (SC)
Erythema Marginatum
Sydenham Chorea

Temp (38.5)
ASO titer high
PR interval prolonged
ESR, CRP

81
Q

Definitive sign of RF

A

Erythema Marginatum

82
Q

Most serious symptom of RF

A

Carditis

83
Q

Mgt for RF

A

IM/Oral Penicillin for 10 days
NSAID: Phenobarbital
For chorea: Diazepam

84
Q

AGE is a viral or bacterial?

A

viral

85
Q

A complication from which body tries to excrete vomiting or diarrhea

A

AGE

86
Q

Vomiting with no stomach content also called?

A

Dry retching

87
Q

MGT for AGE

“SOAPI”

A

SFF
ORS
Anti emetic
Pedialyte
IVF

88
Q

IVF for pedia

A

24 yellow

89
Q

Timing of breastfeeding

A
  1. Per demand
  2. 2-3 hrs
  3. if SFF, q30 mins for 10 mins
90
Q

Assessment of Dehydration for Infant “FES”

A

Fontanelle: Sunken
Eyes: Sunken
Skin turgor: Poor
N- 2-3 secs

91
Q

skin turgor must be done in which part of the infant?

A

Abdomen area

92
Q

Bulging fontanelle can also be caused by?

A

Hydrocephalus
Increase ICP

93
Q

Diarrhea caused by infection can be caused by

A

Protozoa
Virus
Bacteria

94
Q

Pyloric Stenosis can be caused

A

Hypertrophy
Hyperplasia

95
Q

Assessment of Pyloric stenosis
“STENOSIS”

A

Sign of Dehydration
TEtany
No bile vomitus
Olive sized lump
Sour smelling
Immediately after feeding (vomit)
Strong/Forceful vomit

96
Q

TEtany in pyloric stenosis can be caused by?

A

Low calcium

97
Q

Olived size lump in pyloric can be found in

A

upper central region of abdomen

palpated while eating

98
Q

Strong forceful vomiting projectile how far?

A

3-4 ft

99
Q

Diagnostic tool for pyloric stenosis

A

UTZ and Endoscopy

100
Q

Mgt for Pyloric stenosis

A

NPO but give pacifier
IV: D5Nss
Give Ca and K
Pylorotomy

101
Q

WOF when giving Ca and K

A

Ensure that child has voided

102
Q

Post op health teaching for Pylorotomy

A

Infection, incision on the diaper area

103
Q

telecoscoping of one portion of the intestine

A

Intussusception

104
Q

Intussusception can be found most in?

A

Distal ileum and proximal colon

105
Q

Intussusception is at ages?

A

6 months to 2 yrs

106
Q

Cause of intussusception

A

75% idiopathic
Lead point - diverticulum, hypertrophy

107
Q

Assessment for Intussy

DDD RR

A

Distended abdomen
Draw up legs
Disappears then reappear

Red currant jelly like stool
Reappear in 15 mins

108
Q

Mgt of Intussy

A

Surgical emergency
Water soluble/barium enema

air instillation

109
Q

Air instillation is for?

A

pneumatic insuffocation to reduce necrosis

110
Q

Hirschsprungs dx hallmark signs

A

Aganglionic
Mega colon
Ribbon like stools

111
Q

Assessment for Hirsch

A

6-12 mos
Undernourished
No Bowel movement for 1 week

112
Q

Dx for Hirsch

A

Rectal exam - No stool
UTZ
Barium Enema - w/ caution

nursing practice 2 (5 decks)

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