Pediatrics Flashcards
APGAR
appearance
pulse
grimace
activity
respiration
when does anterior fontanelle close
6-18 mos
when does posterior fontanelle close
2 months
unconjugated bilirubin
heme that is released from hemoglobin during RBC breakdown
transported to liver
conjugated bilirubin
converted in the liver and excreted in the stool
physiological jaundice: when does it occur
2-3 days
normal
pathologic jaundice
occurs within first 24 hours of life
indicates issue
what is kernicterus
type of brain damage due to high levels of bilirubin in the blood
what is the foramen ovale
opening b/w atria in utero
atresia
does not develop
what side of the heart has higher pressure
left usually
right to left shunt: cyanotic or acynaotic
cyanotic
deoxygenated blood getting out to the body
what does left to right shunt cause
increased pulmonary blood flow
no cyanosis
tx for PDA
indomethacin
ibuporfen
surgery
what would you provide if you wanted to keep PDA open
alprostadil
what kind of shunting are VSD and ASD
left to right
acyanotic
what kind of defect is tetralogy of fallot
cyanotic
R to left shunting
what are the four defects in TOF
VSD
pulmonary stenosis
right ventricular hypertrophy
overriding aorta
tet spell interventions
comfort and calm
knee to chest
o2
morphine
what is transposition of the great arteries
aorta and pulmonary valve are switched
signs of tranposition of great arteries
cyanosis within 1 hour
hypoplastic left heart syndrome
left sided structures didn’t develop normal - small, hypoplastic or atresia
what keeps the ductus arteriosus open
prostaglandins
surgery for hypoplastic left heart syndrome
norwood at birth
glenn at 2 months
fontan at 2 years
coarctatoin of the aorta
narrowing of the aorta
impedes blood flow to lower half of body
4 ds of epiglottitis
dysphonia
dysphagia
drooling
distress
what vaccine has been shown to decrease epiglottitis
hib
should you assess throat for patient with epiglottitis
no
what would present with a bark like, seal like, cough and stridor
croup
is croup viral or bacterial
viral
how can you treat inflammation in airway
corticosteroids
epi via nebulizer “racemic”
one of the first signs of CF?
meconium ileus
diet for CF
high calorie and high protein
when do you give enzymes to CF paitnets
within 30 minutes of every meal or snack
what is meningocele
closed spina bifida
protrusion of spinal fluid filled meninges through a vertebral defect
what is a myelomeningocele
opoen spina bifida
protrustion of a spinal fluid filled meninges and spinal cord through a vertebral defect
can babies with spina bifida sleep on their back
no need to be prone
what do you cover the opening with for spina bifida patients
moist, warm, sterile dressing
Causes of microcephaly
CMV
Rubella
Varicella
Zika
How do you postiion clef palate patients
Prone to help drain secretions
How do you position cleft lip patients
Not prone - might disturb suture line
Esophageal atresia: assessment findings
Chocking
Coughing
Cyanosis
What are the assessment findings in pyloric stenosis
Projectile vomiting right after feeding, nonbilious
Dehydration
Malnutrition
Palpable olive shaped mass
What is an omphalocele?
Congenital abnormality where abdominal contents protrude through umbilicus while remaining in the peritoneal sac
When is omphalocele diagnosed
Prenatal
By ultrasound
What is pre op mgmt for an omphalocele
Keep the exposed intestines moist
Cover with sterile gauze soaked in saline
Fluids, antibiotics
Thermoregulation1
intussuception
one part of intestine slips into another
signs of intussception
red currant jelly stools
sausage shaped mass in abdomen
n/v
green, bilious emesis
hirschspurngs
congenital aganglionic megacolon
no peristalsis w/o neurons
no stool causes megacolon
what type of genetic disorder is sickle cell
AR
tx for SCD
iv fluids
blood transfusion
oxygen
medications for pain
what is kawasaki disease
acute systemic vasculitis
strawberry tongue is a finding of what
kawasaki disease
treatment for kawasaki disease
aspirin
IVIG
what triggers reye syndrome
viral illness leadiing to acute encelphalopahty
and aspirin use during illness
how do you diagnose reye syndrome
liver biopsy due to fatty changes in liver
what do you need to do before PKU screenings
make sure they have eaten
3 fractures more common in kids
bowing
torus/buckle
greenstick
rickets: which vitamin is deficient
D
what assessment finding is associated with rickets
bow legs
pain in legs, pelvis, spine
tests for developmental dysplasia of the hip
barlow
ortolani (helps confirm barlow, abduction)
treatments for DDH
pavlik harness
spica body cast
surgery
osteomalacia imperfecta
brIttle bone disease
defect in gene making collage
IMPETIGO assessment
weeping lesion with a honey colored crust
bacterial
what chart is used for burns in kids
lund and browder chart
over what % TBSA are pediatrics needing emergency fluid replacement
10%
parkland burn formula for pediatrics
3ml x TBSA x kg = LR to be administered over 24 hours
