pediatrics Flashcards
normal vitals for preterm
hr 120-180
rr 50-70
bp 40-60
vitals for newborn 0-1month
hr 100-160
rr 35-55
s bp 50-70
infant 1-12m vitals
hr 80-140
rr 30-40
s bp 70-100
vitals for toddler 1-3y
hr 80-130
rr 10-30
s bp 70-110
vitals for preschool 3-6y
hr 80-110
rr 20-30
s bp 80-110
school age vitals 6-12
hr 70-100
rr 18-24
s bp 80-120
adolescent vitals
hr 60-90
rr 14-22
s bp 100-120
what chromosomal abnormalities do heart defects usually occur with
trisomy 21
trisomy 18
turners syndrome
diverge syndrome
finding with congenital heart defects
murmers
tachycardia
diaphoresis
decreased uop
fatigue
pallor
cyanosis
clubbing
hypotension
prolonged cap refill
signs of left sided heart failure
tachypnea
dyspnea
grunting
retractions
nasal flaring
cough
wheezing
signs of right sided heart failure
weight gain
enlarged liver
edema
ascites
jvd
What is ductus arteriousus
opening between pulmonary artery and aorta present in fetal circulation
interventions for ductus arteriousus
surgical interventions
repair vs palliation
cardiac assist device
pharmacologic interventions
pharmacology interventions for ductus arteriousus
digoxin
ace-inhibitors
diuretics
beta-blockers
What is alprostadil
medication that can be administered to keep the PDA open in certain heart defects
allows blood to get out to the body
what is tetralogy of fallot
congenital malformation involving four listing heart defects:
pulmonary stenosis
right ventricular hypertrophy
VSD
overriding aorta
What are TET spells
hypoxia occurring in TOF
what happens during a tet spell
begins wit irritability and hyperpnea followed by intense cyanosis leading to syncope
drop in systemic vascular resistance decreasing pulmonary blood flow
right to left shunting more deoxygenated blood out of body
get spell interventions
comfort and calm
knee to chest position
supplemental oxygen
morphia-sedation
volume
Treatment of TOF
mild can go home until ready for surgery
if critical with severe hypoxia surgery required in neonatal period
ideally repaired around 6m
what is coarctation of the aorta
congenital cardiac condition characterized by a constriction of the descending aorta
upper body finding is coartication of the aorta
bounding pulses
hypertensive
warm
pink
findings in lower extremities for cortication of the aorta
weak or absent pulses
hypotensive
pale
cool
What is transposition of the great arteries
a switch of the aorta and pulmonary artery
What is hypo plastic left heart sydrome
disorder including 4 components
mitral stenosis
atresia
aortic stenosis
coarctation
hypo plastic left ventricle
complications of cleft lip
feeding difficulties
weight loss
failure to thrive
speech and language delays
hearing issues
ear infections
aspiration
When does surgical correction of cleft lip and palate take place
lip 3-6m
palate 6-24m
post of care of cleft lip and palate
position upright for feedings
never prone for cleft lip (rip stitches)
protect sutures
elbow restrains to avoid putting things in mouth
no hard foods, straws or pacifiers
no oral or nasal suctioning
how to feed cleft lip and palat
specialized bottle
small frequent feedings
upright position
burp frequently
may take longer
monitor for aspiration
What is tracheoesphageal fistula
congenital abnormality in which there Is an opening between the trachea and esophagus
what is esophageal atesia
part of esophagus does not form
What is pyloric stenosis
hypertrophy of the circular muscle fibers of the pylorus wit a severe narrowing of the lumen
signs of pyloric stenosis
vomiting
dehydration
malnutrition
payable pylorus
What is omphalocele
abdominal contents protrude through the umbilicus while in peritoneal sack
occurs at 9-10 weeks gestation
assessment for omphalocele
visible defect
may also have cardiac defects
can affect lung sized
complications if omphalocele
hypthermia
dehydration
sepsis
What is intussusception
part of the intestine slips inside the other intestine
occurs where small intestine and large intestine meet
assessment finding intussusception
red currant jelly stools
cyclical abdominal pain
nausea
vomiting
green, bilious emesis
sausage shaped mass in abdomen
Treatment of intussusception
enema to push the intestine back out
surgery
What is epiglottitis
inflammation of epiglottis
restricts airway
haemophilus influenza type b
4 d’s of epiglottitis
dysphagia
dysphonia
drooling
distress
finding of epiglottitis
fever
difficulty swallowing
drooling
stridor
tripoding
no cough
change in loc
cherry red epiglottis
interventions for epiglottitis
iv ABX
humidified O2
intubation and ventilation
keep child calm
no interventions until airway secure
tripod position
avoid supine
HIB vaccine
NPO
what do you avoid with epiglottitis
irritating the throat
no tongue depressor
no oral thermometer
no assessing throat
characteristics of bronchilitis
most common under 2y
seasonal illness
usually caused by rev
contagious
worst on days 4-6
finding in bronchilitis
cough
fever
increased work of breathing
wet lungs
hypoxia
changes in behavior
interventions for bronchiolitis
o2
fluid and nutrition
antipyretics
analgesics
What is cystic fibrosis
autosomal recessive disorder
leads to excessive buildup of mucus in airways
leads to airway obstructive
respiratory signs of cystic fibrosis
excess mucus
frequent respiratory infections
hypoxemia
-clubbing
-cyanosis
-barrel chest
gastrointestinal signs of cystic fibrosis
intestinal obstruction
meconium ileus
large, bulky frothy, foul smelling stool
fat soluble vitamin deficiency
diabetes
integumentary signs of cystic fibrosis
salty tasting sweat
elevated chloride in sweat
how to promote nutrition and growth in cystic fibrosis
high calorie high protein diet
increased fluid intake
monitor serial weights
pancreatic enzymes 30 minutes before every meal and snack
-spinkle capsule on food
-fat soluble vitamin replacement
What is eriksons infancy stage
trust VS mistrust birth to 18 months
what is Piaget 1st cognitive stage
sensorimotor birth to two years
What happens during sensorimotor development
knowledge gain through senses and motor movement
learn through sucking grasping, looking, listening
start to understand cause and effect
object permanence at 9m
What is eriksons 2nd stage
early childhood
autonomy vs shame and doubt
what is eriksons 3rd stage
preschool
initiative vs guilt
what is eriksons 4th stage
school age industry vs inferiority
what is eriksons 5th stage
adolescence
identify vs role confusion
what is erosions 6th stage
young adulthood
intimacy vs isolation
what is eriksons 7th stage
middle adult
generatively vs stagnation
what is eriksons 8th stge
maturity
ego integrity vs despair
what Is Piagets 2nd stage
pre operational stage
2-7y
what is Piaget 3rd stage
concrete operational stage
7-11y
what is Piaget last stage
formal operational stage
12 and up
What can babies do at 3 months
make cooing noise
smile
emit disting cries for different needs
recognize familiar voices
express different pleasure vs displeasure sounds
What can babies do at six months
babble and repeat syllables
creat gurgling sounds
giggle and laugh
notice and recognize words
use voice to express pleasure or displeasure
take turns making sound
what can 9 month olds do
imitate sounds actions and gestures
recognize own name
shift gaze to objects being talked about
string together longer soudns
What can be done at 12 months
1-2 or more word sentence
understand words, requests, phrases instructions
answer simple questions nonverbally
recognize words for familiar objects
What can be done at 18 months
speak with a vocabulary of 18+ words
repeat words overheard
recognize and point to familiar objects
understand simple questions and follow directions
point to body parts when prompted
car seat safety points
rear facing until 2
use 5 point harness
retainer clip at armpit level
shoulder straps at or below shoulder level
safe sleep requirements
use firm mattress with tight fitted sheet
put on back to sleep
pacifier may be ued
avoid stiffened animals or blanket
What is included in autonomy 18m-3y
becoming potty trained
choosing own clothes
dressing self
food choices
allow for independence
what is meant by shame and doubt
punished for mistakes
doubting the child
when child isn’t allowed to make independent choices
failure in this stage leads to self doubt
what happens during pre operational stage
think symbolically but not able to use logic
focus on one area of a situation
struggles to see things from other perspectives
use hands on activities and visual aids to help develop
What Can a child do at 2
use 2 word phrases to talk about things
follow 2 step directions
vocabulary of 50+ words
can be understood by caregiver half the time
uses gestures for pretend play
make animal noises
What is meant by initiative
planning and accomplishing tasks
allow child to make own choices
set safe boundaries
what is meant by guilt
judgement
criticism
over dependence on others
failure at this stage leads to a lack of confidence and feeling of gult
