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Mark Klimek > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Congenital Heart Defects

A
  • “Either TRouBLe or No TRouBLe”
  • TRouBLe
    • R-L - Right to Left shunt
    • B - Blue (Acyanotic)
    • T - starts with the letter “T”
    • ex. Trunkus arteriosis, Transposition of great vessels, Tetrology of Fallot, Tricuspid stenosis, TAPZ, Left ventricular hyperplastic syndrome (exception to “T” rule)
  • No TRouBLe
    • ex. Patent foramen ovale, Ventricular Septal defect, pulmonary stenosis
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2
Q

CHD symptoms

A
  • Regardless of diagnosis - “TRouBLe”
  • Murmurs
  • Echocardiogram rx
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3
Q

Tetralogy of Fallot defects

A
  • “VarieD PictureS Of A RancH”
    • Ventricular Defect
    • Pulmonary Stenosis
    • Overriding Aorta
    • Right Hypertrophy
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4
Q

Toys

A
  • Safety considerations
    • Size (no small toys for children under 4)
    • No metal toys if oxygen is in use (sparks)
    • Beware of fomites (non-living object that harbors microorganism)
      • Worst: plush toys, stuffed animals
      • Least: plastic toys that can be disinfected
  • Always go younger because children regress when sick and you want to give them as much time to grow
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5
Q

Toys (0-6 months)

A
  • Age considerations
    • 0-6 months (sensorimotor)
      • Musical mobile (best), something large and soft
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6
Q

Toys (6-9 months)

A
  • 6-9 months (teaching object permanence)
    • Cover/uncover toy (jack in the box)(best), firm but large (wood/hard plastics allowed)
    • Peek-a-boo
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7
Q

Toys (9-12 months)

A
  • 9-12 months (vocalization)
    • Verbal toy (tickle me elmo), talking books
    • Purposeful activity with objects
      • Avoid answers for children under 9 months
        • Build, sort, stack, make, construct
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8
Q

Toys (1-3 years)

A
  • 1-3 years (toddlers) (developing gross motor skills)
    • push/pull toy (wagon)
    • Parallel play (play alongside, not with)
    • Avoid toys that require good finger dexterity
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9
Q

Toys (Preschoolers)

A
  • Fine motor skills (fingers) and balance (dance, ice skating, tumbling)
  • Cooperative play (playing with each other)
  • Like playing pretend
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10
Q

Toys (School age 7-11 years)

A
  • 3 Cs
    • Creative (give blank paper)
    • Competitive (winners/losers)
    • Collective (baseball cards/barbies)
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11
Q

Toys (Adolescents 12-18 years)

A
  • Peer group association
  • Allow adolescents to be in each other’s room unless
    • Fresh post-op (<12 hours)
    • Immunosuppressed
    • Contagious
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12
Q

Sensorimotor (0-2 years)

A
  • Characteristics
    • totally present-oriented
    • only think about what they are doing in the present
  • Teaching
    • Teach as it happens
    • Tell them what you’re doing as you’re doing it
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13
Q

Pre-Operational (3-6 years)

A
  • Preschooler
  • Characteristics
    • Fantasy-oriented, illogical, no rules
  • Teaching
    • can teach slightly ahead of time (morning of)
    • Use play, toys, and stories to teach
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14
Q

Concrete Operations (7-11 years)

A
  • Characteristics
    • Rule-oriented, no abstract thinking, can teach skills
  • Teaching
    • Can teach days ahead of time
    • teach by age-appropriate ready and demonstration
    • Role play is ok
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15
Q

Formal Operations (12-15 years)

A
  • Characteristics
    • Able to think abstractly
    • understands cause-effect
    • Think like adults emotionally
  • Teaching
    • treat like an adult
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16
Q

Poisoning

A
  • Most common in 2 years old
  • Damage to oral mucosa
    • Lye & caustic cleaners
  • Risk for seizures from
    • Drugs
    • Insecticides
17
Q

Acne

A
  • caused by P. acnes
  • Treatment (takes 4-6 for results)
    • Vitamin A
    • Antibiotics
      • Tetracycline
        • Take on empty stomach and avoid sunlight
        • use additional contraceptives
        • No dairy products
    • Retinoids (Accutane - vitamin A analog)
      • S/E
        • Inflammation of the lips
        • Causes birth defects
  • Causes
    • Hereditary, bacterial, hormonal
    • worsened by stress
  • Teaching
    • wash face 2x/day
  • Comedone (blackheads and whiteheads)
18
Q

Hospitalization & Peds

A
  • Infant fears separation from love object
  • Toddler fears separation from family
    • may engage in stalling before painful procedures
    • may require physical
  • Preschooler fears separation and mutilation
    • may require restraints during painful procedures
  • School-age child fears separation from age group
    • will physically resist the nurse
  • Adolescent fears separation from peers and loss of independence
    • will physically resist the nurse
19
Q

Otitis media

A
  • Infection of middle ear
  • S/s
    • Hearing loss
    • Feeling of fullness in ear
    • Hyperpyrexia (fever)
    • Drainage from the ear
  • Complications
    • Perforation of the ear drum
    • miningitis/mastoiditis
    • Cholesteatoma
      • cyst in the ear
  • Treatment
    • Systemic antibiotics
    • Antibiotic ear drops
    • tube in ear to drain
  • Interventions
    • no swimming, showering
20
Q

Cleft lip/palate

A
  • Cleft lip
    • lip open to the nares
    • Repaired between 10 weeks to 6 month
    • Use large-holed, soft nipples
    • Post–op
      • try to prevent crying
      • not allowed to breast
      • Wear logan bow
        • prevents stress on suture lines
        • remove gauze before feeding
        • cleanse with peroxide and saline after eating
      • never lie on abdomen
  • Cleft palate
    • roof of mouth open to nasopharynx
    • repaired between 1 and 5 years
      • One at 12-18 months
      • one at 4-5 years (delayed due to development of teeth
    • Post-op
      • can cry
      • may breast feed
  • Overview
    • Both need more frequent bubbling, burping
    • Should be fed in almost upright position
    • Long term problems with hearing, speech, and teeth
    • elbow restraints used post-op
    • rinse mouth after feeding post-op
21
Q

Epiglottitis

A
  • Most common in 1-8 years
  • Bacterial
  • S/s
    • Fever >102
    • Muffled voice
    • Drooling
    • Stridor
    • Lack of cough
    • Breathing leaning forward with flaring nostrils
    • Symptoms that precede an intubation
      • restlessness
      • Tachy
      • Retractions
  • Never put anything in the mouth
  • Treatment
    • Penicillin
    • Ampicillin
  • Prevention
    • Children 2 months and over should receive flu vaccine

Mark Klimek (21 decks)

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