PEDS ASSESSMENT Flashcards
What is the hole between R & L atria that must close at birth
Foramen ovale
What must close at birth to allow blood flow to the lungs?
Ductus anteriosus
What must close at birth to allow blood flow to the liver?
Ductus venosus
Defects that increase pulmonary blood flow
- Patent ductus arteriosus
- Atrial septal deficits
- Ventricular septal deficits
Patent ductus arteriosus is
Common in premature
- leads to heart failure, inadequate oxygen to brain
What causes “wet lungs”
Atrial septal deficits
Atrial septal deficits
Opening in septum between R & L atrial chambers
- wet lungs (too much blood in lungs)
- lead to respiratory infection, R ventricle working too hard —- heart failure, poor exercise tolerance, being small for age
Deficits that decrease pulmonary blood flow
Tetralogy of Fallot
Ventricular septal deficits
1+ openings in muscular/membranous portions of ventricular septum
- 50% cases of resolve by 5yrs otherwise surgery needed
- feeding difficulties, SOB, increased perspiration, increased respiratory infections, fatigue with increased activity, delayed growth
Can result in Eisenmenger’s complex of pulmonary vascular obstruction
Ventricular septal deficits
Tetralogy of Fallot
- pulmonary valve/artery stenosis, ventricular septal deficit, R ventricular hypertrophy, override of ventricular septum
- central cyanosis, coagulation deficits, clubbing of fingers/toes, feeding difficulties, failure to thrive, dyspnea
Result in feeding difficulties
Tetralogy of Fallot, ventricular septal deficits
Results in clubbing of fingers/toes
Tetralogy of Fallot
Deficits with mixed pulmonary blood flow
Transposition of great arteries
Transposition of great arteries
- no communication between systemic & pulmonary circulations
- result of coexisting congenital transposition of the ventricles
- cyanosis, congestive heart failure, respiratory distress
Result in heart failure
- transposition of great arteries
- patent ductus arteriosus
Result in cyanosis
- transposition of great arteries
- tetralogy of Fallot
Results in delayed growth
Ventricular septal deficits
Abnormally slow HR below 60 mph
Bradydysrhythmia
Pacemaker is used for
Bradydysrthemia
Abnormal fast HR more than 100 BPM
Tachydysrthymia
Tachydysrthymia results in
- can lead to CHF
- irritability, poor eating habits, pallor
Treatment for sickle cell anemia
Pain management
Treatment for osteogenesis imperfeca
- parent education in handling/positioning to prevent fx
- encourage monitored activity promoting WBering
Deficiency of surfactant
Respiratory distress syndrome
Result of prolonged mechanical ventilation use to treat acute respiratory problems
Bronchopulmonary dysplasia
Bronchial smooth muscle hyperactivity that causes airway constriction in lower respiratory tract, difficulty breathing, wheezing
Asthma
Degenerative condition caused by inherited autosomal recessive disorder related to chromosome 7 gene
Cystic fibrosis
Too many red blood cells, elevated levels of white blood cells
Erythrocytosis/ transient leukemia
- Down syndrome children
Absence/reduction of one of clottingblood proteins
Hemophilia
Bleeding episodes after traumatic events
Mild hemophilia
bleeding episodes after minor injury
Moderate hemophilia
Bleeding after injuries or without apparent cause, may affect muscles/joints
Severe hemophilia
signs of hemophilia
- Excessive bleeding
- Excessive bruising
- Spontaneous bruising/bleeding without known cause
- Nosebleeds
Iron deficiency in blood
Anemia
How is anemia treated?
Diet
Abnormally shaped red blood cells
Sickle cell anemia
Brittle bones, decreased bone deposition caused by inability to form type I collagen
OI
Most severe OT
Fetal: fx occur in utero, during birth, high mortality
Moderate severe OI
Infantile: fx in early childhood, severe limb deformity, growth disturbances
Least severe OI
Juvenile: fx in late childhood, by puberty, bones begin to harden & fewer fx occur
Excessive growth at ephiphyseal plate
Marfan’s syndrome
Presentation of marfan’s syndrome
- Long slender fingers (arachnodactyly)
- Skull asymmetries
- Tall stature
- Joint, eye, heart differences
- Lax, hyper mobile joints
- Poorly developed, striated muscles
Comorbidities of marfans
- Dislocation of lenses
- Scoliosis
- Coxa vara
- Depressed sternum
- Stooped shoulders
- Fragility of blood vessels
- Delayed walking
Stunting of epiphyseal growth plate & cartilage formation
Achondroplasia (chnondrodystrophia or dwarfism)
Presentation & comorbidities of achondroplasia
- grow less than 4ft tall
- limbs shorter in length
- prominent forehead
- small nose, jaw
Comorbidities: lumbar lordosis, coxa vara, cubitus Vargas, back and leg pain
Reduced anterior horn cells in spinal cord
Arthrogryposis multiplex congenital
