Pediatrics Flashcards

Question

``` VS/Assessment: Oxygen Saturation • use for? • check what to determine best location for sensor probe? consider child's ____ too • common sites? • should correlate with child's what? ```

Answer 1

* obtain a "picture" of blood oxygen level thru skin * perfusion, skin temp, edema; child's activity * fingers, toes * radial pulse

Answer 2

* nonverbal * crying * human voice and presence * touch = + effect * encourage parent to touch infant

Answer 3

* still nonverbal * vocalizations; repeating consonants "da da" * crying, facial expressions * human voice and presence (can't comprehend words) * touch thru patting/rocking/stroking * speak in gentle-toned voice, cuddle, pat, rub to calm, encourage presence of parents

Answer 4

• evolving verbal skills * 3-4 word sentences, telegraphic speech * may interpret phrases * development, family's use * preschooler ask a lot of "why" questions to everything * short attention span * limited memory * think the world revolves around them * believe that their thoughts can cause events to actually happen * think nonliving things behave just like humans * an awareness that an object still exists even when it's not in front of them * dramatic play and drawing * work

Answer 5

* use logic * others point of view; cause and effect * body functions * big vocabulary * receptive and expressive language * still common * nonverbal messages * thoughts and feelings

Answer 6

* without adult comprehension * limited * strive INDEPENDENCE * Trust and Understanding * need PRIVACY * straightforward approach; talk in private area; have a part of interview w/o parent present

Answer 7

* may feel helplessness, fear, anxiety * family may feel fear and anxiety * use gestures, picture boards, writing tablets; use ehad nods, eye blinks

Answer 8

* Signs - Use of accessory muscles, Nasal flaring, Sternal retractions, Grunting w/ respirations * any illness that affects the lungs ability to get O2 in and CO2 out * pneumonia, atelectasis, pneumothorax, pleural effusion * depends on degree of airway disease

Answer 9

infection that inflames the air sacs in one or both lungs

Answer 10

partial or complete collapse of a lung

Answer 11

air enters chest and lung collapses

Answer 12

fluid buildup between the lungs and chest

Answer 13

* viral infection * - slight to severe dyspnea, barking/brassy cough, ↑ temp * Parainfluenza, Adneovirus, RSV * barking seal!

Answer 14

* (at home) -- steam from hot showers; cool temp therapy (constrict swollen blood vessels in trachea that are causing swelling) * Nebulized epinephrine or corticosteroids

Answer 15

* has rapid onset * improvement in 10-15 mins * relapse and return of sx when epi wears off

Answer 16

* serious obstructive inflammatory process -- absence of a cough, presence of DYSPHAGIA, DROOLING, rapid progression to severe respiratory distress * H-Flu * Hib vaccine * partial/full occlusion of airway * MEDICAL EMERGENCY * the WORSE the airway obstructive * tongue depressor

Answer 17

* Respiratory Syncytial Virus; leading cause of lower resp tract illness in children <2yo; caused by acute viral infection that affects bronchioles * life-threatening! • prematurity; congenital disorders (like heart defects); smoke ---avoiding sick contacts and RSV immunizations (Synagis, RespiGam) • simple URI; nasal discharge, mild fever, wheezing, nonproductive paroxysmal cough (violent attack), tachypnea w/ flaring nares; dyspnea and retractions ---worse at 2-3 days * mild -- supportive care (hydration, antipyretics, nebulizers) * severe -- IVFs, Albuterol sulfate (Proventil), antipyretics, suction, O2 (may need intubation and mechanical ventilation)

Answer 18

• inflammation of lungs; causes -- bacterial, viral, fungal, aspiration of foreign substance s/sx • FINE CRACKLES or RHONCHI w/ COUGH (productive/nonproductive); ↓/absent breath sounds over affected lung fields; chest pain; back/abdominal pain; HIGH fever tx • ABCs, O2, fluids, abx if bacterial, supportive care for viral (hydration, antipyretics, nebulizers) teaching • have children vaccinated!!!!

Answer 19

* during fetal development * orofacial defect that affects the oropharynx and ↑ risk of malnutrition and aspiration tx --Pre-op • elongated nipple, medicine dropper -- down the side of mouth • BURP frequently; causes abdominal distention; at risk for vomiting and aspiration • CLEFT LIP; assists w/ feeding and promotes parental bonding --Post-op • protect suture line • SUPINE or SIDE-LYING --- DO NOT put in PRONE POSITION!!!! • avoid putting hard/rough foods or utensils in child's mouth; disrupts suture line --- SOFT DIET • before speech develops (between 1-2 years old)

Answer 20

* backwash or reflux of gastric contents into esophagus * aspiration of gastric contents into lungs = lead to PNEUMONIA * UPRIGHT position during feeding and 30 mins after * UPRIGHT position w/ frequent burping during feedings * YES --- thickened formula ( 1 tbsp of rice per 1 oz of formula/breast milk)

Answer 21

• disorder results in PROJECTILE VOMITING during/after a feeding s/sx • feel OLIVE-shaped mass in epigastric region near umbilicus (enlarged pylorus; PROJECTILE VOMITING b/c of pressure behind the vomitus dx • abdominal ultrasound ``` tx • hydration and electrolyte replacement; I and O; Monitor urine specific gravity; Daily weights Surgery ```

Answer 22

• a piece of bowel telescopes in on itself forming an obstruction • s/sx sudden onset (smiling → suddenly scream in pain) cramping and abdominal pain drawing up of knees inconsolability episodes of pain (HURT then becomes okay) CURRANT JELLY STOOLS (maroon color) • air-contrast, barium, ultrasound-guided saline enema ---the pressure of enema push out the telescoped area * monitor STOOLS * it might reoccur

Answer 23

* a congenital anomaly; aka aganglionic mega colon, results in MECHANICAL OBSTRUCTION * sigmoid colon (swollen/enlarged w/ narrowed rectum) s/sx • CONSTIPATION • abdominal distention • RIBBON-like stools w/ FOUL smell tx • surgery -- remove portion of bowel that's diseased

Answer 24

* scalp itching * yes, can go anywhere in the body * DIRECT CONTACT * antiparasitic meds -- often need re-treatment

Answer 25

* INTENSE RECTAL ITCHING --- general irritability, restlessness, poor sleep, bedwetting, distractibility, short attention span * hand to mouth * treated * TAPE TEST -- clear tape in rectum early AM before bm * mebendazole (Vermox) * good handwashing; keep fingernails SHORT; wash sheets and clean bathroom

Answer 26

* "the kissing disease" * sore throat, fatigue, SWOLLEN LYMPH NODES, LIVER and/or SPLEEN ENLARGEMENT * Eipstein-Barr virus * Direct intimate contact --- kids can get it from drinking from water fountain tx • rest, analgesics, ↑ fluids, good nutrition • limit participation in CONTACT SPORTS to prevent injury

Answer 27

* upper resp infections or obstructive sleep issues * place on side w/ elevated HOB or Prone position; prevent ASPIRATION * be confused with BLOOD * frequent SWALLOWING * 10 days --- scabs on surgical sites will begin to slough off 7-10 days --- no chips or rough foods for several days! * sore throat, slight ear pain * normal (↑ = infection) * foreign body in nose --- caused from infection in the area --- remove foreign body

Answer 28

• middle ear infection; BULGING, BRIGHT RED, TYMPANIC MEMBRANE; upper resp infection treatment • use ANTIBIOTICS • avoid CHEWING; need SOFT foods • teach parent -- child may not be able to hear them well • avoid SMOKE of any kind • TYMPANOSTOMY TUBES or PE (pressure equalizing) TUBES -- keep middle ear drained (temporary and it's ok when it falls out) --- wear earplugs when in bathtub or swimming ``` prevention • SITTING UP • no BOTTLE propping • gentle nose BLOWING • play "BLOWING" games (blow balloon, pinwheel) • avoid SMOKE of any kind ```

Answer 29

* genetic/inherited disease involves sx r/t exocrine glands -- involves GI system and Respiratory system * PANCREATIC ENZYMES; take within 30 MINUTES of eating; NOT CRUSHED/CHEWED * HIGH FAT, HIGH CALORIE --- usually underweight ``` s/sx • STEATORRHEA (fatty, frothy stools) • fat-soluble vitamins---do not absorb fat well; take Water-miscible forms of fat-soluble vitamins (in multi-vitamin form) to improve absorption "ADEKs" • Sweat Chloride test • meconium ileus (cannot pass meconium) • THICK and STICKY ``` • Autosomal Recessive Disorder --MUST get the gene from both parents

Answer 30

A, D, E, K

Answer 31

* birth defect; Trisomy 21 * Respiratory infections d/t POOR IMMUNE SYSTEM * Congenital heart defects * Advanced maternal age; To inform parents of their RISK

Answer 32

• genetic disorder causing malabsorption d/t intestinal INTOLERANCE TO GLUTEN * teach it's a lifelong disorder so NO FOOD W/ GLUTEN (vegetable proteins) * Barley, Rye, Oats, Wheat * Rice, Corn, Soy

Answer 33

• hereditary form of anemia --- normal Hgb is partly/completely replaced by abnormal Hgb and sickle-shaped RBCs s/sx • PAIN in areas of involvement; Anorexia (loss of apetite); Exercise intolerance; Fatigue, malaise • ↓ Blood Flow → ↓ Oxygen → PAIN treatment • bed rest, HYDRATION, analgesics, abx, blood transfusion or packed RBCs (temporary fix), O2 (if hypoxic), Hydroxyurea (chemo med--reduce painful episodes)

Answer 34

* most common and severe muscular dystrophy; inherited as X-linked recessive trait * Male children; it's a X-linked recessive trait; early childhood 3-5 yo ``` s/sx • LORDOSIS (curvature of lower spine) • WADDLING gait • frequent falls: muscle weakness • TOE WALKING • GOWER'S SIGN (classic sign of DMD) -- climbing or walking up oneself in an effort to standing up position ``` ``` tx • physical therapy • prevent contractures • Steroids • support groups and palliative care ```

Answer 35

* "hypercyanotic" spells; childrent w/ congenital heart defect of TETRALOGY OF FALLOT * insufficient blood flow to lungs tx • 100% O2, Morphine for sedation • position -- KNEE-CHEST POSITION --- ↓ venous return from lower extremities and ↑ systemic resistance = diverts blood to pulmonary artery for oxygenation ``` prevention • QUIET play • minimize STRESS • respond to CRYING quickly • heart failure ``` • Structural defect of heart or great vessels that's present at birth

Answer 36

• very common but potentially serious infection in urinary tract --- 2-6 yo ---- females s/sx <2 yo • failure to thrive; Feeding problems, V/D • if left untreated = DESTROYED RENAL TISSUE AND SCARRING = KIDNEY FAILURE • re-occur --- family teaching is important! causes? • RENAL anomalies; • Constipation, Bubble baths, Poor hygiene, Pin worms, Sexual activity (sexual abuse) • female urethra is 1 ½ in (maturity), ¾ in young females -- ready pathway for microorganisms to invade s/sx over 2 yo • frequency, dysuria, fever, FLANK pain, hematuria, foul smelling urine diagnosis • properly collected urine specimen • CATHETERIZATION treatment • abx PO or IV ``` prevention • FRONT to BACK wiping technique • no BUBBLE BATHS • wear COTTON undies • limit CARBONATED DRINKS -- reduces acidity of urine and bacteria like ALKALINE in urinary tract ```

Answer 37

• disturbance of ventricular circulation of CSF; CSF builds up = ↑ ICP ``` s/sx • bulging FONTANELS w/ HEAD enlargement • DILATED scalp veins • DEPRESSED/SUNKEN eyes • IRRITABILITY and changes in LOC • HIGH-PITCHED cry • SETTING SUN Sign ---- can see the white all around the iris ``` Diagnosis Head circumference measure every well-child check-ups until 3 YEARS OLD Surgical treatment • insertion of VP SHUNT (ventriculoperitoneal shunt) --postop care • measure HEAD CIRCUMFERENCE • assess BULGING FONTANELS and widening cranial suture lines • monitor TEMP • SUPINE position Hydrocephalus is frequently associated with a MYELOMENINGOCELE • when infant is born w/ this type of spina bifida, protect SAC and do not let it RUPTURE • position PRONE • cover sack with a STERILE MOISTENED DRESSING ---- so it won't DRY OUT while waiting for surgery • mobility and developmental delays

Answer 38

* musculoskeletal disorder --- lateral curvature and rotation of spine * idiopathic (no cause) or congenital * heavy backpacks/suitcases; Bags; Carrying children on hips tx • Observation • Orthosis (supports and braces) • Operation (spinal fusion w/ rods)

Answer 39

* childhood communicable disease; the same virus that causes Shingles as a person gets older * vaccines recommended by CDC * prevent infection of lesions * oatmeal bath and baking soda w/ water * YES! VERY CONTAGIOUS * Varicella zoster

Answer 40

highly controlling, expects to be obeyed, inflexible rules

Answer 41

the GOOD ONE! | sets reasonable limits on behavior, encourages growing autonomy of child, open communication

Answer 42

few/no restraints, unconditional love, much freedom, little guidance, no limit setting

Answer 43

no limit setting, lacks affection for the child, focused on own life