Pediatrics

Question 1

Epiglottitis

Answer 1

Inflammation of the epiglottis, by Haemophilus influenzae type b
- restricts the airway
Assessment, 4 D’s:
- dysphagia
- dysphonia
- drooling
- distress
Intervention:
- keep the child calm
- tripod position
- encourage parents to vaccinate to prevent

Question 2

Cystic Fibrosis

Answer 2

Autosomal recessive disorder, mutation leads to a buildup of excessive mucus in the airway, leading to airway obstruction
Diagnosis:
- Meconium ileus
- Sweat Chloride test
TX:
- high calorie, high protein diet
- increased fluid intake
- monitor serial weights
- pancreatic enzymes:
give within 30 min of eating every meal and snack
- sprinkle capsules on food
- fat soluable vitamin replacement

Question 3

Meningocele (closed spina bifida)

Answer 3

protrusion of spinal fluid filled meninges through a vertebral defect
- sacral dimple or tuft of hair
Tx:
- cover the sac with a moist, warm sterile dressing
- no diapering if defect is low-keep the sac clean with a protective barrier
-prophylactic antibiotics
- prone positioning

Question 4

Myelomeningocele (open spina bifida)

Answer 4

protrusion of spinal fluid-filled meninges and the spinal cord through a vertebral defect
- sacral dimple or tuft of hair
Tx:
- cover the sac with a moist, warm sterile dressing
- no diapering if defect is low-keep the sac clean with a protective barrier
-prophylactic antibiotics
- prone positioning

Question 5

Cleft lip

Answer 5

A congenital abnormality where there is a slip, or gap, in the upper lip on one or both sides
Positioning:
- position upright for feeds
- cleft palate - can be prone post op to help drain secretions
- cleft lip should NOT be prone as this could distrub the suture line

Question 6

Pyloric stenosis

Answer 6

Hypertrophy of the circular muscle fibers of the pylorous, with a severe narrowing of the lumen
Assessment:
- vomiting (projectile), right after feeding
- palapable pylorous

Question 7

Gastroschisis

Answer 7

Congenital abnormality where the abdominal contents protrude through the umbilicus
Pre-op: keep exposed intestines moist

Question 7

Omphalocele

Answer 7

Congenital abnormality where the abdominal contents protrude through the umbilicus while remaining in the peritoneal sac
Pre-op: keep exposed intestines moist

Question 8

Intussuception

Answer 8

occurs when one part of the intestine slips inside the other intestine “telescoping”
- often occurs where the small intestine and large intestine meet
Assessment:
- red currant jelly stools
- sausage-shaped mass in abdomen

Question 8

Hirschsprung’s

Answer 8

Congenital aganglionic megacolon
- no peristalsis - stool builds up and causes a megacolon
Assessment:
- ribbon-like stool

Question 9

Reye Syndrome

Answer 9

Associated with aspirin use in pediatrics during viral illness
- choice for fever: acetaminophen and ibuprofen

Question 10

Phenylketonuria (PKU)

Answer 10

heal stick around 24-48 hours old, repeat if screening is positive
avoid foods high in protein and phenylalaine (meats, diary products, and aspartame)

Question 11

Impetigo

Answer 11

Contagious bacterial disease, Staph A,
- toxins from this bacteria produce a weeping lesion with a honey crust