peds Flashcards
atopic dermatitis aka
ezema
atopic dermatoisis characteristics
pruitpus
erythema
dry skin
goals of atpic dermatitis
alleviate pruitus
keep skin hydrated
education for atopic dermatitis
- dont scratch bc it will lead to new lesions and infections
- tepid baths using gentle soap
- avoid hot baths and bubb;e baths bc it dries skin
- nails should be trimmed short and kept filed
- clothing should be soft(cotton)
- long sleeves at night
- avoid trigger factors such as heat and low humdiity
- mosilize with emollients
myopia
nearsightness so the visual acutity is reduced when viewing objects at a distance
myopia clients need to
hold objects near their face or sit near objects to see clearly
clients with myopaia report
headahces
dizz
squniting eyes to see clealu
school performance affected from eye strrain
hyperopia
viewing objects far away or sit at distance to have clear vission
color definfict
inability to preceive and diff colors such as red and green
blue and yellow
have trouble wearing matching clothes
type 1 in peds inital goal
managing childs BG (checking and giving insulin)
assess for allergies to vaccine components
neomycin
gelatin
yeast
allergy to latex
bananas
kiwis
latex balloons
who shouldnt get live vaccines
immunoscompormised (corticosteroids, chem, AIDS)
exmaples of life cavvines
varciella
MMR
rotavirus
yellow fever
misperceptions of contrindications to immunization
penicllin allergy mild ilnness (with or without temp) mild site reaction(swelling, erthyma, soreness) recent infection exposure current course of abx
caring for burn at home
-soak area brify in cool water to stop the burning process
-remove any clothing or jewlery around the burn
to avoid constriction as edema forms BUT DONT REMOVE ANY CLOTHING STUCK TO THE BURNED AREA ONLY HCP can do this
-cover with clean dry cloth
-dont apply ointments or abx bc it will intefere with assessment
-dont put ice bc it can increase tissue damage
-NO ICE, BUTTER , CREAMS SHOULD BE PLACED
cold injury signs
redness and swelling
blanched skin with hardness of the affected area
what to do when pt has cold injury
rewarm the area ASAP to restore blood flow and reduce risk of tissue damage
- rewarm at 104 F (40C) for 30 mins or until the area turns pink in case of frost bite
- the face and ears can be warmed by warm facevloths
what is contraindicated in cold injury
massging body part bc it causes tissue injury
kawasku disease treated with
aspirin
ivig
kawaski complication
coronoary artery anyerysms
kawaski and vaccines
when given IVIG therpy, it will remain in the body for 11 months and may intefere with the response to live caccines (varicella and mmr) so these live maccines should be delayed for 11 months
signs of post op bleeding in sollsillectomy
swalow
clearing throat
vomitning blood
expencted findings of tonsillectomy
white, fluid filled exudate in the throat
- halitosis (bad breath)
- low grade fever
- ear pain
pulmonic stenosis
increased pressure in the right side of the heart
-in severe, the high pressure in right side causes uno2 blood to travel through the left side
treatment for pulmonic stenosis
interventional cath
contraindication of pulmonic stensosis
diaper rash bc the yeast or bacteria on the rash could be introduced into the blood stream with arterial sticks
spected finding
loud heart murmur
npo before catherization
4-6 hours
chest tubes in peds should be assessed
every hour for color and draingage
drainge in CT that should be reported
Drainage >3 mL/kg/hr for 3 consecutive hours or >5-10 mL/kg in 1 hour
infants normal HR
90-169
what is common after surgery
hypothermia
and warmers are used to correct the clients temp
ET displaement intervention
listen to lung sounds
atrial septal defect
abnormal opening between R and L atria allow the blood of the left atrium to go into the right
sound in atrial septal
the back and forth flow b/w the two chambers causes vibration that is heard as MURMER on asuculatation
atrial septal defect charastic
systloic murmer with fixed split second heart sound
coartation of aarota signs
weak lower and stronger upper ext pulses
visual acuity is assessed in
ages 6 or older using snellen letter chart
pistion for visual acuity
10 ft from the chart and asked to read the letters
- begining with the lines of large text to small text
- both eyes should be open while one eye at a time is covered to read
- must get 4/6 letters in each line before moving to next
testing visual activity and fixation in infants
following a target usually bright colored object or human face
when to refer to opthalmic in infants
if visual fixation and following not presented by 3-4 months
viewing set of cards
color vision deficits
corneal light reflex
shining light helf 16 in from childs eyes
impetigo
high contangious
imptigo characterized by
itchy
burning
red pustules that rupture to form honey colored crusts
contangous impetigo
when treated with anx ointment or oral abx lesions are no longer contagious after 24-48 hours and heal within a wek
without abx impetigo
resolves within 2-3 wk but remain contagious until all lesions heal
decreasing tramssion of impetigo
handwashing before and after touching the infected area
- islating infected persons cloting and linens and washing them in hot water
- keeping infected persons finernails short and clean to prevent bacteria
- avoid close contact with othrts for 24-48 hours after abx intiation
- keep the affected area covered with guaze in contact with others (while at school)
impetigo lesions
soaked with warm water, saline, or burow solution and gently cleansed with mild antibacterial soap before applying abx oitment
wilms tumor
kidney tumor in children < 5
wilms tumor characrtssitic
normally only in one kidney
- unusal contour in childs stomach
- unsual bulging /swelling on one side of the abdomen
- might have HTN bc of exceessive prod of renin but this will require mointoring
otitis media age group
infants and children under 2
OM occurs after
resp tract infection most of the time
the eschuian tubes in infinats and young hildren
short, straight, horizontal which results in ineffective drainage and protection from resp secretions
who is at risk for OM
exposure to tabcaoo smoke due to resp inflmmation
-using pacififer or drinking from bottle when lying down
managemnt to prevent OM
eliminate smoke
- routin imm
- reducing or eliinating pacifer use after 6 months
- breast feeding can help but after 1 yr solid food should be starting
oitis externa
water in ear from swimming or bathing
neprotic syndrome
hypoalbumeia–>decreased plasma oncotic pressure
hypovolemia causing causing –> retain salt and water SO DIET WITHOUT SALT
- edema, weight GAIN, loss of app from ascities
- decrease UOP
- loss of ummunoglics–>susceptibility to infection so limit visotrs
treatment of nephrotic
corticsteroidsand other immunosuppressants (eg, cyclosporine)
Loss of appetite management (eg, making foods fun and attractive)
Infection prevention (eg, limiting social interaction until the child is in remission)
retinoblastoma
unilateral or bilateral retinal tumor
signs of retinoblastoma
white “glow “of the pupil (leukocoria)
instead of red flex
2) strabismus- misalignment of the eyes is the second most common sign
3)visual impirment -late indicattive of advacned disease
treatment of retinoblasoma
raidation
enyceleation (removal of the eye)
-fittnig of prosthesis
-sibilings undergo ocular screening and some forms are hereditary
fixed mild dilated pupil
acute glaucoma
kawasaki disease dignostic tests
none and it is not contaneous
phases of kawaski
acute- sudden onset of high fever that doesnt repspond to abx or anitpyrectics, child is irratable and fevelows swollen red feet and hands, lips wollen and cracked, tongue becomes red (strawberry)
2) subacute- skin begins to peel from hands and feet, irratable stilll
3) convlescnet- symtoms dispear, temperant returns to normal
intitial treatment of kawaski
apriin and IVIG (IV gamma globulin)
ivig
creates high plasma oncotic pressure and pulmoary edema and fluid overload develops
so mointor for HF (decrease uop, extra heart sounds, tacy, diff breathing)
acute glomerulonephritis is induced by
group A beta hemolytic strep infection of the skin or throat
manefestations of acute glomerulnepthritis
periorbital and facial/ ernalized edema
HTN
oliguria
tea colored and cloudy urine due to the presence of protein and blood
urine color in acute glomerulnepthrits
tea colored and cloudy due to protein and blood in it
recovery of acute glomernephritis
recover spontanously within days, severe HTN is a complication
most important thing in acute glomernephritis
controlloing and mointoring the BP to prevent further progression and pul edema
- I AND O is imp but not as imp as bp
- edema is imp but not as imp as bp
what is noraml in acute glomerulnephritis
hematuria
diet glomernephritis
avoiding high sodium foods and having no added salt in the died
stabmismus
corssed eye due to the weakness of eye muscle or congential prob
vision in strabmimus
the visual axes are not aligment so the brain percives 2 diff images (diplopia) and supresses the weaker image to compesnate
prognosis for strabmis
if untreated by age 4-6 permanent reduction or loss of visual acuity in the afffected eye (amblyopia) can occur
treatment of strbmisus
patch over the stronger eye or use special corrective lenses
-if non surgical is unsucessful, surgical intervnetion needed
eye drops are used commonly to treat
gluacoma
mointoring Intraocula rpressure imp in which eye
glucoma
laser surgery app treatment in
refractive errors such as myopia, hyperopia, astigmatism
complcations of CF
pulmoary0infections, hypoxemia gi- obstruct release of pancreatic enzures -malasption-nut def -reproductive- infertitliy -DM -WEIGHT LOSS
kawaski disease hallmark
irratability and can last up to 2 months
skin peeling in kawaski
normal and the skin underneath will be red and sore but its normal
kawaski dischargeq
check temp every 6 hours for first 48 hours and notify provider if the child has fever
common side effects of immunzations
mild fever (notify if temp 100.4)
soreness
redness
at the injection site
-the child might have increased fussiness and anorexia following imm but should not last for more than 24 hours
- give tylenol or iburophen to manage these sytmoms or apply warm compress to the site
sick day and DM
increase the freq of BG checks (Q 1-4 hours)
- increasing or decreasing the dose of insulin as needed basked on BG
- maintain adq hydration
- testing for urine ketons freq
eppigoitss is never seen in
vacinated child
majority of the casees of epiglottis is caused by
hib
acute otitis media manesfititations
red and bulging tympanic member
- inner ear pressure which can rupture
- pain
- fever
- rhinorrhea
- NV
when doing assessment on toddler you should use what last
otoscope bc it causes distress
insert the speculum
outer catilaginous part of the external audiotry canal and NOT into the bony part
submerision injury
evaluated immediately and observed for at least 6 hours for new or worsening respiratory failure. Changes in respiratory pattern or rate, oxygen saturation, and level of consciousness can signal impending respiratory failure, which can be life threatening.
untreated hypothryoidism in infants can cause
intellectual disabilty
clinical manestifications of hypotryodism in infants
diff walking, lethargy
- dry skin
- hoarse cry
- brady
- poor feeding
- enalrged frontanelle
- protrudicng tongue
- umbilical hernia
- juandice
potention complicaitons of acute oitis media
hearing loss
spread of the infection
severe cases of acute oitis media is treated with
abx (amoxillcin is the standard)
when to report about otis media treamtent
if the symtoms do not improve within 48-72 hours of abx- return to HCP
clients following abx should be evaluated for what for acute media otis
screened for hearing imapirment
side effect of amoxillin
diarrhea and doesnt warrant treatment discontinuation
-if the client dev fever and abomdinal pain with the diahrea then it could be c diff
pediatric asthma can present
As night coughing until the child vomits
silent asthma sign
coughing at night
common asthma trigger
tabacoo smoke
pet dander
cockroach dees
outdoor contaminants
plyroic stensois age
2-8 wk after birth
forceful /projetile vomint
proper useage MDI
first shake MDI and attach to spacer
- exhale completely to optimatize inahlation
- place lips tightly around the mouth
- deliver single puff of me into spacer
- take slow deep breath and hold for 10 seconds
- rinse mouth, spit out the water
what age and spacer
under 12
quick acting carb for hypoglycemia
4 oz (120 mL) of a regular soft drink or fruit juice
8 oz (240 mL) of low-fat milk
1 tablespoon (15 mL) of honey or syrup
6 hard candies
Commercial dextrose products
hemolytic uremic syndrome
life threatening complication of escherichia colu diagrea and results in RBC hemolysis, low platlets, AKI
hemoytic uremic syndrome characteristic
hemolysis- results as anemia
low plalets- petechaie pr purpura
anemia (pallor), low platelets (petechiae and purpura), and acute kidney injury (low urine output).
hemolytic uremic syndrome rexpected
blood stread stool due to intestinal irration
what is discouraged in acute diahrea
high sugar and low electrlyte content
ecli is found in
contaminated food and water
dehydration in children
not life threatening as long as fluid is replendished
side effect of varicella vacc
rednes
few vesicle at the injection site (cover with small bandage to reduce risk of trans from the exudate)
-leave the bandage on till ivesicles have dried or crusted
epiglottis signs in peds
sitt up leanig forwrd drooling stridor high grade fever tacycadia tacypnea
epiglottis treatment
et tube
trach
NOT BIPAP
allergic rhinitis interventions
hepa filter (high articlate..)
- keep windows lcosed
- hypoallegic pillow and matress cover
- eliminating carpet
- mopping and vaccuming regularly with HEPA filter cavvum
- damp using wet cloth to dust furniture
ventricular septal defect
septal opening between ventricles causing L to R shunting
ventricular septal defect complications
CHF (diaphoresism tacyoneam dyspnea)
pul HTN
systolic murmur
hallmark CHF signs
diaphoesis
tacypnea
dyspnea
coartation of trh artoa results in
decreased CO
coartation of the aarota signs
elevated bp in the upper ext and dimished pressure in the lower ext
patient ductus arteriois sound
systlic muruse with machine sound can have distolic murmor too
PDA usually resolves
within 48 hours and requires no intervention in full term babies
-can be treated with surgical ligation or IV indomethacin
tetralogy of fallot
cyanotic cogential heart defect
signs of tetralogy of fallot
irratbility
clubbing of the fingers due to o2 reminaing b/w 65-86
harsh sytloic murmer
vertriclar spetal defect
disltoic murmur
mitral stenosis
arotic regurtiation
systolic ejection murmur
pulmonic stenosis
why do tet spells occur
when unoxygenated blood enters the systemic circulation reuslting in cyanosis and hypoxemia
tet spells usally occur during
stressful or paintful procedures , on waking, hunger, crying,, feeding
interventions for tet
-calm env
-soothing and quieting the baby when crying or in dsitress
-offer a pacifer
-swadding or holding the bay
=smaller feedings
-knee chest poistion
infants vs older child positioning during tet spell
infant- knee chest
older- squatting
intermittent o2 is also given if needed
clincial maestations of AOM
high ever
- ear pain
- pulling of the affected ear
- buldging red tymapnic mem
severe pain when direct pressure on the tragus or pulling of the pinna
otitis externa
4 D d epiloggtis
dysphonia (muffled voice), dysphagia (difficulty swallowing), drooling, and distressed respiratory effort.
what poistion can help epilgottis
sitting up or any cofmort poistion like tripod
atrioventricular canal defect is assoicted with
triosmy 21 (down syndrome)- loud mrumur and no action is done
pulse plethysmogrpahic waveform
look and see if the oulse ox is reading acc
accurate indicator of fluid loss or gain
clients weight
NOT i and o because insensilbe losses may be diff to track
