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z Here you go, Alexis! > peds > Flashcards

peds Flashcards

1
Q

anterior fontanel closes

A

12 - 18 months

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2
Q

posterior fontanel closes

A

2 - 3 months

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3
Q

earlobe positioned to view auditory canal in child

A

down and back

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4
Q

cups of milk 15 mo toddler should consume daily

A

2 - 3

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5
Q

best friend stage occurs at what stage

A

9 - 10

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6
Q

major causes of accidents in children up to 1 year x3

A

falls
poisoning
burn

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7
Q

major cause of accidents 6 - 12 years

A

motor vehicle accident (more active)

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8
Q

school age child requires how many calories per day on average

A

2400

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9
Q

how much earlier do girls experience onset of adolescence

A

1 - 2 years

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10
Q

obtaining vitals (peds)

A

least invasive first, observe before touching/talking

RR *
HR *
BP
T

  • count for 1 full minute (irregularities)
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11
Q

temperature routes (peds) x4

A

rectal ( under 2 )
axillary ( alt to oral )
oral ( start 5 - 6 )
tympanic ( all )

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12
Q

observable signs of respiratory dysfunction (peds)

A
  • accessory muscle use
  • nasal flaring
  • circumoral pallor (around mouth)
  • sternal retraction
  • cap refill greater than 3 seconds
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13
Q

if child is grunting do what?

A

assist into position of comfort (tripoding)

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14
Q

laryngotracheobronchitis

A

most common type of croup experienced by peds admitted to hospital

primary affects kids under 5; viral

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15
Q

causative viruses of laryngotracheobronchitis

A

parainfluenza
adenovirus
RSV

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16
Q

laryngotracheobronchitis s/s

A

slight to severe dyspnea
barking / brassy cough
increased temperature

amount of distress depends on degree of airway obstruction

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17
Q

laryngotracheobronchitis treatment (mild)

A

at home

  • steam (hot showers)
  • night car rides, windows down
  • cool-temp therapy (constricts edematous blood vessels)
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18
Q

laryngotracheobronchitis treatment (severe)

A

hospitalization

nebulized epinephrine (racemic epi) = vasoconstrict edematous blood vessels

corticosteroids (decrease airway inflammation)

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19
Q

epiglottitis

A

serious obstructive inflammatory process in 2 - 5 yo

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20
Q

epiglottitis key s/s

A

absence of cough
dysphagia
rapid progression to severe resp distress

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21
Q

epiglottitis vs laryngotracheobronchitis kids

A

epiglottitis kids look worse than they sound

laryngotracheobronchitis kids sounds worse than they look

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22
Q

nebulized epinephrine

A

aka racemic epinephrine; vasoconstriction of edematous blood vessels in kids with severe laryngotracheobronchitis

rapid onset
improvement in 10 - 15 minutes
(observe for relapse; ~2 hours)

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23
Q

respiratory syncytial virus

A

acute viral infection affecting bronchioles

RSV bronchiolitis or RSV pneumonia

more serious in very young (leading cause lower resp tract illness in under 2)

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24
Q

RSV is more serious in who?

A

very young

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25
Q

leading cause of lower respiratory tract illness in children less than 2 years

A

RSV

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26
Q

RSV s/s

A

important to know onset bc will become worse on days 2 - 3

progressively worse: 
URI
snot
mild fever
dyspnea
non-prod cough
tachypnea (flaring nares)
retraction, possible wheezing
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27
Q

RSV will become worse…

A

on days 2 - 3

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28
Q

pneumonia

A

disease marked by inflammation of lungs

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29
Q

viral pneumonia (peds)

A

RSV, adenovirus, parainfluenza

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30
Q

bacterial pneumonia (peds)

A

usually strep pneumo

children under 4 = greatest % attacks

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31
Q

mycotic pneumonia (peds)

A

“walking pneumo” - mostly adolescents

mycoplasma pneumonia

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32
Q

aspiration pneumonia

A

something other than air has gotten into lungs

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33
Q

pneumonia s/s (peds)

A

fine crackles/rhonchi + cough that is prod or not

decreased or absent breath sounds

abd distension

back pain

fever (usually very high)

chest pain

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34
Q

pneumonia tx (peds)

A

depends on type

  1. ABCs always priority
  2. oxygen
  3. fluids - hydrate to move secretions
  4. abx for bacterial
  5. supportive care: hydration, antipyretics, nebulizers (appropriate for viral)
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35
Q

asthma

A

inflammation and constriction of airways resulting in obstruction

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36
Q

asthma s/s

A 
cough
sob
audible wheeze
prolonged expiratory wheeze
restless and cyanosis
37
Q

what is prolonged in asthma

A

expiratory wheeze

38
Q

most important thing in proactive care for asthma patient

A

education, especially id-ing triggers

39
Q

cystic fibrosis

A

respiratory and gi impacted
give pancreatic enzymes to improve digestion
diet: well-balanced, low fat, high calorie, high protein

40
Q

pancreatic enzymes for + how

A

cystic fibrosis

take within 30 minutes of eating, do not crush or chew

41
Q

vitamins for CF patient

A

ADEK are fat soluble but need to make them water soluble since CF kids can’t process fat

42
Q

diagnostic test for CF

A

sweat chloride

43
Q

electrolyte imbalance child with CF at risk for

A

hyponatremia

44
Q

earliest sign of CF (newborn)

A

meconium ileus (can’t pass; thick and sticky)

45
Q

CF inheritance

A

autosomal recessive

46
Q

CF stools

A

steatorrhea

47
Q

down syndrome kids prone to infection where?

A

respiratory - poor immune system

48
Q

most common type of defect associated with down syndrome

A

heart

49
Q

in peds, HF usually due to

A

congenital heart defects

50
Q

s/s early heart failure (peds)

A

increased HR at rest + with slight exertion
increased RR
scalp sweating (infants @ feeding)
fatigue
sudden weight gain (greater than 1lb/day)

FLUID RETENTION THINK HEART PROBLEMS FIRST

51
Q

main signs of digoxin toxicity

A

bradycardia, vomiting (earliest sign)

52
Q

digoxin: hold for ? in infants, children

A

infants: HR less than 110
kids: HR less than 70

53
Q

normal digoxin level

A

0.8 - 2.0

54
Q

infants rarely get more than ? of digoxin

A

1.0 mL per dose

55
Q

give digoxin to infants when?

A

1 hour before or 2 hours after feeding

56
Q

nursing considerations for digoxin admin to peds x2

A

ALWAYS check with another nurse

if 2 doses in a row missed, call provider

57
Q

good feeding schedule for a heart baby

A

q 3 hours, do not prolong feedings past 30 minutes

58
Q

blue spells aka tet spells

A

hypercyanotic spells often seen in infants with Tetralogy of Fallot

59
Q

ace-i in kids, watch for

A

decreased BP
kidney problems
cough (dry) – d/c ASAP

60
Q

treatment for tet spell

A 
infant: knee-chest position 
100% O2
morphine (sedate)
loose clothes, diapers
quiet play
no stress
respond to crying quickly
treat infections promptly (can't handle fever)
61
Q

why knee-chest position for infants with tet spell?

A

decrease venous return from LE

increase systemic resistance to divert blood to pulmonary artery (increases O2 in blood)

62
Q

polycythemia

A

increased red blood cells in response to chronic hypoxia; body senses hypoxia, increases RBC production, no more O2 to carry, blood gets thick

so many RBCs no room for platelets

63
Q

polycythemia treatment

A

hydration - keep blood thinned out

64
Q

s/s chronic hypoxia

A

clubbing (late sign)
poor growth, development
squatting

65
Q

congenital heart defects (peds)

A

structural or functional defect of heart or great vessels present at birth

classified by blood flow patterns

  • increased or decreased pulmonary blood flow
  • obstructive defects
66
Q

tetralogy of fallot

A 
Ventricular Septal Defect
Stenosis of Pulmonary Artery 
Overriding Aorta 
-- directly over VSD instead of LV
Right Ventricular Hypertrophy
67
Q

post cleft lip repair (peds)

A

on back or side-lying
- protect suture line (NOT PRONE)
clean suture with saline
elbow no nos

68
Q

best time for cleft palate repair to be done

A

before speech develops, between 1 - 2

69
Q

GER vs GERD

A

GER = passage of gastric contents into esophagus

GERD = tissue damage to respiratory structures, which can lead to pneumonia and bronchospasms

70
Q

pyloric stenosis s/s x3

A

projectile vomiting, usually after feeding
- pressure behind vomitus

olive shaped mass in epigastric region near umbilicus (enlarged pylorus)

pressure build up in stomach = pyloric ultrasound

71
Q

intussusception key s/s (peds)

A

sudden onset
cramping, intermittent abd pain, inconsolable

drawing up of knees

currant jelly stools!

72
Q

intussusception poo

A

currant jelly stools

73
Q

celiac disease

A

celiac sprue is a genetic malabsorption disorder where there is permanent intestinal intolerance to gluten

74
Q

celiac patients can’t have (mnemonic)

A

b arley
r ye
o ats
w heat

75
Q

hirschsprung’s disease

A

congenital anomaly known as aganglionic megacolon - results in mechanical obstruction; usually affects sigmoid colon

no nerves, no peristalsis = constipation + abdominal distention

remove disease bowel - give intestines time to heal (maybe 2 sx)

76
Q

hirschprung’s poo

A

foul smelling and ribbon-like

77
Q

sickle cell disease

A

hereditary disorder in which hemoglobin is partly or complete replaced with sick-shaped hgb
- reduced O2 carrying cap as result of shape

78
Q

1 tx to stop sickling process

A

HYDRATION!!

79
Q

FLACC

A 
face 
legs
activity
crying
consolability
80
Q

numerical pain scale starting at age

A

5

81
Q

hydrocephalus

A

disturbance of ventricular circulation of cerebral spinal fluid in brain; increased icp

often associated with myelomeningocele

82
Q

myelomeningocele

A

type of spina bifida, sac on the back

  • prone
  • moist sterile normal saline dressing
  • surgery ASAP
83
Q

spina bifida

A

any birth defect involving incomplete closure of the spine

84
Q

pinworms: transmission, test, treatment

A

hand to mouth
tape test (rectal itching)
whole family treatment; mebendazole

85
Q

infectious mononucleosis: causative agent

A

epstein barr virus

86
Q

positioning post tonsillectomy

A

side + elevated hob
or
prone

87
Q

tonsillectomy post-op risk for hemorrhage up to

A

10 days (scabs slough 7 - 10)

88
Q

otitis media

A

eustachian tubes (middle ear) blocked
usually follows upper respiratory infection
bulging and bright red tympanic membrane
lie on affected side to promote drainage

89
Q

cleft lip/palate epi

A

American Indians, Asians

boys

z Here you go, Alexis! (23 decks)

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