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Pediatrics Flashcards

1
Q

Definition of growth and development

A

Growth is the physical size while development is FUNCTION and they are not always chronological to age.

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2
Q

Cephalocaudal development is

and Proxomodistal

A

Development from head down
toward to feet.

Development from center body outward to extremities

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3
Q

Play reference for children

A

its to help them learn new things, socialize and use coping skills

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4
Q

Anterior fontanel close at

Posterior Fontanel

A

12-18 months

2-3 months

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5
Q

When is it best to introduce new foods?

A

once a week because you are worried about allergies because of immature GI tract.

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6
Q

Peanuts are dangers because

A

When wet the swell and crumble, ofc allergies

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7
Q

IM injections are contraindicated

A

for children not walking because its not full developed

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8
Q

Auditory canal in young children

A

earlobe is down and back

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9
Q

how many cups of milk should a 15 month old toddler consume

A

2-3 cups

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10
Q

Best friend stage

A

9-10 years

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11
Q

leading cause of death up to 1 year age

A

Suffocation, MVA, drowning

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12
Q

Car seat regulations

A

Do not place in front passenger due to airbags
less than 20 pounds may be in middle back seat-semi reclined the best protection for their heavy head and weak neck

12-23 months convertible car seat facing forward, never place padding as it can add slack resulting in ejection

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13
Q

Booster seats

A

Used for ages 4-8 years

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14
Q

Major cause of severe accidental injury 6-12

A

MVA

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15
Q

Teach children safety about

A

stranger safety, not talking or texting anyone on the internet, social media sites or phone.

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16
Q

Growth rate at 6-12 years

A

Decreases

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17
Q

School age requires how many calories

A

2400

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18
Q

Girls experience onset of adolescence

A

1-2 years ahead boys

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19
Q

Vitals Assessment

A

Observation before touching
Use Distraction and get accurate set of vitals such as pen light or stickers talk to the parents first. Always starting with least invasive, respirations and HR (one full minute cause of immature NSystem), bp then temp. . If child is upset record the behaviour w/ the measurement.

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20
Q

Temperature

A

Rectal should be taken for infants and children but not newborn. This is contraindicated for diarrhea, rectal lesions, chemotherapy, immunosupressed and no rectum

Axillary done in all ages if oral cannot be done. Oral can start at 5 to 6 years.

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21
Q

New born birth - 1 month communication

A

Primarily nonverbal and expresses through human voice, presence and through crying. Encourage parent to touch.

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22
Q

Infants 1 month - 12 months

A

Communication is still nonverbal and repeats consonants, communicates through crying and facial expressions, human voice and presence minimal comprehension of words, patting rocking stroking, pat rub calm.

Trust vs. Mistrust Erikson
Young infants self-centered; they have little tolerance for delayed gratification. Pulling cord toys

Rolling over occurs at 5 months
Pincer grab should be established by 11 months

Comprehension of No-no 9 months
Able to say mama and dada with attachment 10 months
3-5 words 12 months

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23
Q

Toddler and Preschooler 1-5 years communication

A

Use language to express thoughts children ages 3-4 can for 3-4 word sentence called telegraphic, concrete thinkin and vocab depends on development of family use, asks why, short attn span, limited memory, they are egocentric, magical thinking, animism, object permanence , express through dramatic play and drawing

Autonomy vs. Shame and Doubt (Erikson)
Ego Centrism
Parallel Play
Fine motor: builds tower of 2 cubes, holds 2 cubes in one hand, scribbles, uses cup well but struggles with a spoon
Language: says 4-5 words, including name, points and ask for objects, understands simple commands, says 10 or more words, uses 2-3 phrases, TALKS ALL THE TIME

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24
Q

School age children 6-12 communication

A

Use logic and understands point of view, cause and effect how the body functions, big vocab, expression through thoughts and feelings.

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25
Adolescents 13-18 communication
Adult comprehension, medical terms limited, strive for independence, needs privacy and building on trust and rapport, strategy is to have part of interview w/o parent in room.
26
Children with physical and development disabilities
May be unable to communicate and feel helpless, fear and this may be felt with family as well. Nursing strategies use picture boards, writing tables, head nods and eye blinks.
27
What are observable signs of resp distress in children?
Use of accessory muscle nasal flaring sternal retractions grunting w/ resp this can lead to pneumothorax , pleural effusion, pnuemonia, atelactasis.
28
What is laryngotracheobronchitis or croup?
``` viral infection (RSV) and adenovirus, result in dyspnea, barking cough, elevated temp ```
29
What is treatment of LTB?
Mild croup - stay at home Hot showers to liquefy secretions Cool temps to decrease swollen blood vessels It it does not improve use Nebulized epi it proves in 10-15 but can relapse corticosteriods
30
What is epiglottitis? Causes S/S Recommendations
Caused by Obstructive inflammatory process absence of cough, dysphagia, drooling and rapid progression of severe distress. Caused by infection of epiglotitis leading to partial or full obstruction less noise = airway obstruction. Never try to visualize with tongue depressor
31
What is RSV?
lower resp illness in children less than 2 years of age caused by an acute viral infection that affects the bronchioles.
32
What are the risk factors for RSV?
Prematurity Congenital disorders/heart defects smoke *Focus on prevention avoiding sick, and getting immunization
33
S/S of RSV
``` Begins with simple upper respiratory infection nasal discharge mild fever nonproductive *paroxysmal cough tachpnea flaring nose dyspnea and retractions worsens at 2-3 days ```
34
Treatment for RSV
mild: supportive care antipyretics severe: iv fluids albuterol antipyretics suction oxygen
35
What is pneumonia?
Inflammation of the lungs caused by viral bacterial, fungal aspiration etc.
36
S/s pneumonia
``` Fine crackles rhonchi decreased or absent breath sounds chest pain abd or back pain fever high ```
37
Txt for pneumonia
``` depends on type priority is ABC's oxygen plenty of fluids abx for bacterial supportive care : hydration, antipyretics and nebs ```
38
What is cleft palate/lip/
orofacial defect affecting oropharnx increase the risk of malnutrition and aspiration
39
Preop of cleft palate
Fed with elongated nipple or medicine dropper to prevent aspiration and burp frequently cause of air
40
Surgery of cleft lip/palate
Fix the lip first because the palate is made up of cartilage and doesnt do well usually and done at another time, also it promotes feeding and parental bonding
41
Post op cleft lip/palate
I want to make sure my priority is to protect the suter line. when going into the room the child should be supine or side lying to allow the repair and NO prone positions. Avoid putting hard and rough foods, and maintain a soft diet.
42
When can a cleft palate surgery be done?
Before speech occurs at 1-2 years old.
43
What is GERD?
back wash reflux into espophagus
44
Txt of gerd
upright position for 30 minutes, frequent burping | thickened formula.
45
What is pyloric stenosis?
Projectile vomitting during or after feeding?
46
S/s of pyloric stenosis
Assess the abdomen for "olive shaped" near epigastric region near umbilicus
47
Diagnsis of pyloric stenosis
ultrasound
48
Txt of p. stenosis
``` hydration, electrolyte i/o monitor specific gravity daily weights surgery to open sphincter up. ```
49
What is intussusception?
a piece of bowel stays forming obstruction
50
s/s and txt of intussusception and treatment
``` sudden pain pain episodes inconsolable drawing up knee cause of cramping and abd pain currant jelly poop ``` txt sometimes enema can help push it out or surgery may be done cause it can reoccur.
51
What is Hirschprung ?
Disease of mega colon that is congenital results in a mechanical obstruction
52
S/s of hirschprung? Txt
constipation, because there is no nerves / peristalsis abd distention ribbon like foul smell poop Surgery
53
What is headlice? | S/s and Treatment
Scalp itching via direct contact Treatment is antiparasitic meds
54
What are pin worms?
Intense rectal itching ``` s/s general irritability restlessness poor sleep bed wetting distractibility short attention span hand and mouth spreading and whole family should be treated ```
55
How to get specimen for diagnosis of pin worms
Tape test
56
Txt of pin worms
Mebendazole good handwashing keep finger nails short
57
Cause Mononucleosis?
Infectious kissing disease Caused by epstein barr direct intimate contact aka through drinking fountain
58
S/s of mono
sore throat fatigue swollen lymph nodes liver and spleen enlargement
59
Txt of mono
Rest analgesic, increased fluids and good nutrition | spleen will be enlarge so prevent injury
60
What is tonsillectomy and Adenoidectomy?
Surgical procedure performed for children w/ recurrent upper respiratory infections
61
Positioning and txt for tonsillectomy?
on their side, side lying , prone to prevent aspiration
62
What indicates hemorrhaging with tonsillectomy/
frequent swallowing they are at risk for 10 days because sloughing occurs 7-10 days no chips or rough foods for several days
63
Common complaints post-op of tonsillectomy
Sore throat ear pain , low grade temp | bad breath, may also indicate foreign body caused by infection and must be removed
64
What is ottitis media?
infection middle ear bulging bright red tympanic membrane preceded by upper resp infection
65
Txt of ottitis media
Careful use of abx avoid chewing eat soft foods, children may not hear well and may require TYMPANOSTOMY TUBES , which will drain middle ear and might fall off. Children must wear earplugs in bath tub when swimming
66
Prevention of ottits media
sit up with feedings no bottle proping gentle blowing nose avoid smoke of any kind
67
What is cystic fibrosis?
Involves exocrine glands both GI and resp involved
68
Txt of CF?
Pancreatic enzymes to help improve digestion w/ meals and snack and must be given 30 min before eating no crush or chew. water miscible form of fat vit to improve absorption such as ADEK
69
Type of nutrition for CF
High fat and high calorie because they are usually underweight w/ digestive problem
70
S/S OF CF
meconium ileus with new born Steatorrhea fat frothy stool because of poor intestinal absorption, trouble with fat absorbing sections are thick and sticky
71
Diagnosis of CF
Sweat Chloride, - they are likely hyponatremic autosomal recessive disorder must get the gene from BOTH parents
72
What is down syndrome?
Trisomy 21
73
Type of infection with downs
respiratory infections because they have poor immune system
74
What is the common type of physical defect with down
congenital heart defects
75
Risk for downs
advanced maternal age, so important to aim for genetic counselling
76
What is celiac disease
intolerance to gluten malabsorption in intestines
77
Treatment of celiac
no food with gluten no BROW barley rye oats wheat Can have RCS
78
What is sickle cell?
Anemia - hgb is partly or completely replaced by abnormal hgb
79
S/s of sickle cell
pain in area involved anorexia exercise intolerance fatigue malaise
80
What is sickle cell crisis?
Decreased blood flow -> decreased oxygen -> pain
81
Txt for sickle cell
``` Bedrest HYDRATION Analgesics blood transfusions oxygen hydroxyurea - used in chemo to reduce episodes ```
82
What is duchenne muscular dystrophy
severe muscular dystrophy childhood x-linked specific to male children
83
s/s of duchenne muscular
``` lordosis waddling gait frequent falls - weak muscles toe walking gower - difficulty climbing stairs ```
84
txt of duchenne
physical therapy, optimum muscle prevent contractures steriods to help strength and resp fx support groups and palliative groups
85
What are Tet spells
hypercyanotic spells caused by heart defect teralogy of fallot
86
Cause of tet
insufficient blood flow
87
Txt for hypercyanotic tet spells
put infants knee chest position to decrease venous return and increase systemic resistance 100% oxygen morphine for sedation and monitor CO
88
Prevention of Tet
quiet play minimize stress respond to crying HF infants is usually due to congen
89
What is UTI? And how it cause
``` Common with 2-6 years caused by renal anomalies constipation bubble bath poor hygiene pin worms sexual activity female urethra is 1 1/2 inches long ```
90
S/s of UTI under two years
Nonspecific less than 2 years and may be a GI problem FTT Feed problems Vomitting/diarrhea if untreated renal tissue may be destroyed scarring = renal failure tendency to reoccur
91
S/s age over 2 of UTI
``` Frequency dysuria fever flank pain hematuria foul smelling urine ```
92
Diagnosis of UTI
Requires proper collection of urine specimen | and catheterization
93
Txt of UTI
``` Abx PO/IV teach proper wipe no bubble baths cotton underwear limited carbonated - decreases acidity ```
94
What is hydroceph
disturbance of vent circulation of CSF increasing ICP
95
S/S of hydroceph
``` bulging fontanel sunset eyes dilated scalp veins depressed or sunkey eyes irritability changes in loc highpitched cry ```
96
DX of hydroceph
head circumference until age of 3
97
Surgical treatment of hydroceph
Insertion of vp shunt to drain fluid
98
Post op care of vp shunt
measure head circum assess bulging fontanels and suture lines monitor temp supine position
99
What is hydroceph associated w/
myelomeninogcele, type of spina bifida protecting the back do not let it rupture and lie prone. cover the sack with dressing to wait for surgery
100
What is scoliosis
musculo consisting of lateral curvature idiopathic or congen
101
Contrib factors of scoliosis
heavy back packs bags carrying on hips
102
Txt of scoliosis
Observation orthosis operation
103
What is chicken pox
Caused rarely by vaccine, varicella zoster
104
Primary prevention of chicken pox and txt
Prevent infection, oat meal and baking soda
105
Parenting styles
authorization highly controlling authoritative sets reasonable limits permissing few or no restraints unconditional love little guidance indifference no limit lacks affection focused on life

SET 2 (16 decks)

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