Pediatrics 2 Flashcards
S/s of coarctation of the aorta (991)
Coarctation is narrowing of the lumen of the aorta. This results in increased pressure to the head and upper extremities, with lower pressure in the lower extremities.
BP in the arms are +20 compared to the legs, with a bounding pulse.
Treatment for iron deficiency anemia (992).
Oral iron supplements.
Iron fortified diet.
Pack RBC blood transfusion.
Why is there so much pain with sickle cell anemia (993).
Occlusion of capillaries impedes blood flow creating pain in joints.
Methods to avoid sickle cell crisis (994)
Avoid situations leading to hypoxia and sickling.
Infection, dehydration, emotional stress, and strenuous activity.
What would the results of a blood test for a hemophiliac patient yield (995)
Normal PT, INR, and platelet count.
Increased PTT time and missing Factors VIII and IX.
What is pediculosis capitis (1058)
Common head lice. The mites suck blood on the scalp. They spread by direct contact and does not jump.
Idiopathic thrombocytopenic purpura (ITP) (996)
Decrease in platelets causes bleeding under the skin.
Platelet count will be below 20k. Petechia. Epistaxis.
Foods indicated for someone with iron deficiency anemia (993)
Meats.
Iron rich foods with citrus fruits.
S/s hydrocephalus (1043)
Widening or bulging of fontanelles, creating a separation of the cranial sutures.
Increased head circumference and frontal bossing.
Nursing intervention if you witness a child experiencing a seizure (1046)
Prevent injuries during a seizure. Padding bed rails, side rails up, assist chid to floor is sitting up, turn child’s head to the side to prevent aspiration if indicated.
S/s of eczema (atopic dermatitis) (1052)
Lesions, erythema, vesicles, papules, and oozing puss.
Noticed on cheeks, scalp, and trunk of child. Lichenification.
Medical treatment for patent ductus arteriosis (987)
Use of indomethican to close opening.
Surgical placement of clip.
S/s of impetigo (1057)
Honey colored crust on the face and butt.
S/s of cellulitis (1057)
Fever, malaise, erythmatous, warm, painful.
S/s of tinea pedis (1057)
Athlete’s foot. Itchy, red fungal infection of the feet especially between the toes.
S/s of candidiasis (1056)
Pustules, white and yellow, curdle patch, thrush.
Treatment for candidiasis (1057)
Nystatin
Medication to be avoided when the child has a viral infection
Aspirin, because it can lead to Reye’s syndrome.
S/s of meningitis (1041)
Opisthotones (arched back), nuchal rigidity (stiff neck), fever, vomiting, headache, irritability, photophobia, seizures, high pitched crying, bulging fontanelles, Kernig’s sign, Brudzinski sign.
Diagnostic test for hydrocephalus (1043)
Measurement of the head circumference is the most indicative marker.
Also ICP, CT, MRI.
Parent teaching for child with VP (ventricular peritoneal) shunt (1044)
Observe for signs of ICP. Place child on non-operative side to avoid pressure on the shunt. Recognize signs of shunt malfunction. Transport in a ‘car bed.’
Normal blood lead levels (1049)
> 10mg/dL is considered blood poisoning.
< 10mcg/dL is non-burden.
S/s of blood lead poisoning (1049)
Pica, lowered IQ, learning disability, slowed development.
S/s of atrial septal defect (ASD) (990)
Connected L/R atrium.
Heart failure. Harsh systolic murmur.
Describe blood flow for patent ductus arteriosis (987)
High pressure aorta blood flows back into low pressure pulmonary artery.
What is transposition of the great vessels (991)
RV -> aorta
LV -> pulmonary artery
S/s of babies born with transposition of the great vessels (991)
Profound cyanosis.
Cardiomegaly on x-ray.
Tetralogy of Fallot (990)
Pulmonary stenosis.
VSD.
Right Ventricular Hypertrophy.
Overriding aorta.
Barrier to prevent diaper dermatitis (1051)
A/D Ointment.
Destin.
Zinc Oxide.
Causes of infantile eczema (1052)
Food allergies.
Abnormal skin function.
Dry skin, irritants, stress, heat, sweat, allergens.
Tinea corpus (1056)
Fungal infection of the body.
Tinea pedis (1056)
Fungal infection of the foot.
Tinea cruris (1056)
Fungal infection of the crotch (jock itch).
Tinea capitis (1056)
Fungal infection of the head.
Non-invasive technique for correction of hip dysplasia (DDH) (1035)
Pavlik harness.
Position head of the femur into acetabulum and maintain hip abduction.
Adams test (1036)
Test for scoliosis.
Posterior postural observation of the undressed child bending forward with arms dangling. Checking for curvature, asymmetry, and rib hump.
Conditions that may encourage otitis media (1058, 1015)
Chronic ear infection from complications of cleft palate.
Complications arising from upper respiratory reinfection.
Myringotomy (1061)
Tiny incision into the ear drum to reduce pressure from middle ear infection.
Tympanostomy (1061)
In chronic otitis media, tympanostomy tubes are used to prevent hearing loss by relieving the pressure from fluid during infection.
Tubes are spontaneously rejected after 6 months.
Patient positioning for suspected ruptured tympanic membrane (1062)
Lay on the affected side helps to alleviate the pain and drain fluid if present.
Conditions which may cause recurrence of otitis media (1015)
Cleft palate.
Amblyopia
“Lazy eye”
Strabismus (1063)
“Cross eyed”
Myopia (1063)
Near-sightedness
Presbyopia (1063)
Difficulty focusing on close objects as a result of growing older (loss of muscle tone around lens).
Hyperopia (1063)
Far-sightedness
Treatments for strabismus (1063)
There is no effective treatment.
Botox into extraocular muscle.
Patching of the strong eye.
Patient teaching for PO iron supplements (992, 993)
Give with citrus fruits or juices.
Syringe towards the back of the mouth or use a straw.
Classic signs of Tetralogy of Fallot (990, 991)
Clubbing of fingers and nailbeds.
Most common cause of iron deficiency anemia (992)
Dietary cow’s milk leads to fecal occult blood loss.
Milk is a poor source of dietary iron; after 6 months the mother’s iron stores in the child are depleted and require supplementation.
What causes a normal newborn to be anemic 6 months after birth (992)
Maternal stores of iron are depleted and the baby becomes dependent on nutritional iron.
Most prevalent blood disorder in children (992)
Iron deficiency anemia
Clubfoot (talipes) (1038)
Congenital deformity of foot and ankle. Typically equinovarus with downward and inward malformation of the feet. Use of progressive casting to correct.
Correct way to administer ear drops in a 2.5 year old
Pull the pinna down and back, aligning the ear canal.
Precautions taken following cleft lip repair (1016, 1017)
Logan Bow.
Elbow SRD.
Lay infant on side or back, but not prone.
OTC ointment for diaper dermatitis (1051)
Topical glucocorticoid
S/s of childhood leukemia (997)
Anemia with pallor and fatigue.
Leukopenia, infection, and petechia.
Epiglottitis (1008)
Inflammation of the epiglottis from bacterial infection by H. influenzae.
Cystic fibrosis (1011)
Genetic disorder presents with thick mucous that obstructs the respiratory and GI tracts.
Most common fatal genetic disorder in children.
Non-irritating foods for the bowel in rehydration of a child with diarrhea (1019)
Modified BRAT diet.
Banana, rice, applesauce, toast or tea, cereal, vegetable juice, crackers, pretzels.
Pyloric stenosis (constriction of orifice) (1021)
Obstruction of the GI tract. Gastric outlet is mechanically blocked by hypertrophied pyloric muscle.
Presents with delayed gastric emptying and projectile vomiting.
Intussusception (1023)
Telescoping intestine of the ileocecal valve section. Most common intestinal obstruction in children 3-6 years old.
Presents with “currant jelly stools.”
Hirschsprung’s Disease (1024)
Megacolon. Common in trisomy 21 children. Absence of innervation of the bowel (no peristaltic waves).
Presents with intestinal obstruction and distention of the bowel.
Diagnostic test for TB in a child (1011)
Same as in an adult. Tuberculin skin test (TST) or Mantoux test.
Confirm with a positive bacterial sputum and CXR.
S/s of dehydration in an infant (1018)
Sunken eyes, sunken fontanelles, rapid weak pulse, lowered blood pressure, rapid respirations, lethargic, dry mucous membranes, and cold dry gray skin.
S/s of pyloric stenosis (1021, 1022)
Regurgitation and projectile vomit after feeding.
Weight loss and dehydration.
S/s of croup (1008)
Resonating, barking, cough.
Suffocative and difficulty breathing.
S/s of bronchiolitis (1010)
RSV (respiratory synctal virus).
Retractions, tachypnea, nasal flaring, coughing, wheezing, and fever.
Wilms tumor (1028, 1029)
Most common childhood tumor. Affects left kidney. Metastasizes to lungs, lymph, liver, brain, and bone.
Presents as firm abdominal mass.
S/s of umbilical hernia (1026)
Protrusion of intestine through umbilicus.
Treatment of umbilical hernia (1026)
Spontaneous closure.
Surgical closure required for >2cm.
Hernia (1025)
Protrusion of an organ, or portion, through a structural defect or weakened muscle.
How do you rehydrate a dehydrated breastfeeding baby (1019)
Pedialyte or infalyte for first 24 hours.
Resume breast feeding.
5%D saline IV for extreme cases.
Infant positioning for SIDS concern (1006)
Lay infant on their back; never prone.
Do not allow adult bed sharing; use cribs.
Percent body weight loss and dehydration (1017)
5% Mild
10% Moderate
15% Severe
Nephrosis (1026)
Presents with proteinuria, edema, hyperlipidemia, hypoproteinemia, glomerular damage, ascites, and anasarca.
-serum protein
+serum lipid
Treatment for nephrosis (1026)
Corticosteroids (Prednisone)
S/s of cystic fibrosis (1012)
Streatorrhea, rectal prolapse, vitamin K deficiency, secondary bleeding disorders, chronic cough, wheezing, excessive sputum production, hypoxia, clubbing, and barrel chest.
Complications of untreated strep throat (1007, 1028)
Bacterial strep throat can lead to tonsillitis, rheumatic fever (heart infection), and glomerulonephritis (kidney infection).
Examination never performed with suspicion of laryngotracheobronchitis (1009)
Never examine the nose, mouth, or throat because it can cause epiglottal spasms.
S/s of asthma (1013)
Wheezing and bronchial constriction.
S/s of mumps (1061)
Parotid gland edema and tenderness.
Fever, chewing elicits ear-like pain.
S/s of varicella (chicken pox) (1059)
Rash, papules, vesicles on erythmatous base, oozing, crusty.
Incubation period of varicella (chicken pox) (1059)
10 - 21 days
Treatment for itching with varicella (1059)
Apply pressure.
Use mittens.
Obtaining a sputum sample from a 3 year old (1011)
Gastric aspiration.
Children tend to ingest their mucous secretions, rather than cough them out.
Appropriate treatment for an asthmatic young person (1014)
Metered dose inhaler.
Nebulizer or aerosol.
Typical age to start immunizations
2 months old
Types of pneumonia (1005)
Bacterial
Viral
Mycoplasmal
Aspiration
S/s of pneumonia
Coughing, wheezing, respiratory distress, anorexia, malaise, lethargy, headache, fever, myalgia.
Correct order for doing an abdominal assessment
Inspection
Auscultation
Percussion
Palpation
Blood tests monitored while on Accutane
Cholesterol and triglyceride levels. These tend to be increased while on the medication.
Contraindication for Accutane
Pregnancy is contraindicated because of the high risk for birth defects.
Method of transmission measles (rubeola) (1059)
Direct contact with respiratory secretions, blood, or urine.
Method of transmission german measles (rubella) (1059)
Direct contact with nasopharyngeal secretions, fomites, and transplacental.
Method of transmission mumps (1059)
Direct contact with respiratory secretions.
Overriding aorta
A congenital heart defect where the aorta is positioned directly over a ventricular septal defect, instead of over the left ventricle.
The result is that the aorta receives some blood from the right ventricle, which reduces the amount of oxygen in the blood.
How is Hirschsprung’s disease best described (1065)
Absence of parasympathetic ganglion cells in a segment of the colon.
Condition often associated with severe infantile diarrhea (1065)
Metabolic acidosis
Spiral fractures are indications of (1065)
Child abuse
Common cystic fibrosis diagnostic test (1065)
Sweat test
Is atopic dermatitis contagious (1066)
No
Greatest risk to a hemophiliac child (1066)
Hemarthrosis
