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Fall 22 > Peds Exam 3 > Flashcards

Peds Exam 3 Flashcards

1
Q

What are characterstics of Meckel Diverticulum?

A

-outpuching of lower intestine
-can be born with other anomalies

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2
Q

When do symptoms appear for Meckel diverticulum?

A

Symptoms appear at 1-2 years of age and can show painless rectal bleeding

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3
Q

how do you treat Meckel diverticulum?

A

surigical repair

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4
Q

what are characterisitics of omphalocele?

A

internal organs are in the umbilical cord

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5
Q

what are nursing interventions that can be done for omphalocele?

A

-dress with saline soaked gauze and impermeable dressing
-protect the sac, prevent hypothermia and infection, and provide comfort measures and nutritional support

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6
Q

how do you treat omphalocele?

A

surgical repair

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7
Q

What are characteristics of gastroschisis?

A

-intestines are outside the body and has no sac covering organs
-intestines poke through a hole in abdominal wall near umbilicus

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8
Q

what may a child experience with gastroschisis?

A

respiratory distress because organs are resting on abdomen instead of being inside

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9
Q

What are characterisitics of cleft lip and cleft palate?

A

tissues in lip or palate are not fused

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10
Q

what are complications a child may experience with cleft lip and cleft palate?

A

feeding, ontological, dental, and speech complications

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11
Q

what are the treatments for cleft lip and cleft palate?

A

surgical repair
- Lip: 2-3 months
-Palate: 9-18 months

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12
Q

what are nursing interventions for cleft lip and cleft palate?

A

-protect suture line post op
-use specialized feeding equipment

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13
Q

what are characterstics of congential diaphragmatic hernia?

A

there is communication between thoracic and abdominal cavity (two cavities are now connected)

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14
Q

what symptoms does the infant show with congential diaphragmatic hernia?

A

-severe respiratory distress
-ausculatory changes (bowel sounds are heard in thoracic cavity)

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15
Q

how do you treat congenital diaphragmatic hernia?

A

intubation and surgical repair and requires neonatal ICU
(has high rate of death)

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16
Q

what are characteristics of Anorectal malformations?

A

stenosis, prolapse, or atresia of rectum

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17
Q

what are treatments for anorectal malformations?

A

-dilation or surgery
-can place temporary colostomy bag

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18
Q

what are nursing interventions for anorectal malformations?

A

avoid putting anything in the rectum

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19
Q

what are characteristics of esophageal atresia?

A

upper and lower parts of esophagus are disconnected

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20
Q

what are characteristics of trachesophageal fistula?

A

trachea and esophagus are connected

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21
Q

how do esophageal atresia and trachesophageal fistula present itself?

A

-frothing, bubbling at the mouth
-excessive salvation
-cyanosis
-coughing
-choking
eating will make symptoms worse

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22
Q

how do you treat esophageal atresia and trachesophogeal fistula?

A

-surgery
-g-tube
- TPN until recovered from post OP

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23
Q

how do you treat dehydration?

A

-oral rehydration for mild and moderate
-IV replacement for severe

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24
Q

Why do you need to intervene quickly for dehydration?

A

to prevent hypovolemic shock and vascular collapse

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25
Q

how do you treat nausea?

A

antiemtics

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26
Q

what is gastroenteritis?

A

acute diarrhea

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27
Q

what are causes of gastroenteritis?

A

-infection
-food sensitivity
-environmental

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28
Q

What can be done to determine cause of vomiting?

A

assess emesis to determine causes

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29
Q

what are characterisitcs of hypertrophic pyloric stenosis?

A

elongation and thickening of the pyloric muscle

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30
Q

what are symptoms of hypertrophic pyloric stenosis and when does it appear?

A

-projectile and forceful vomiting without nausea
-presents itself 3-6 weeks after birth

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31
Q

how do you treat hypertrophic stenosis?

A

surgery

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32
Q

what are characterstics of necrotizing enterocolitis?

A

mucosal and transmural (across whole intestine) necrosis in the intestine

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33
Q

what is significant of necrotizing enterocolitis?

A

most lethal disorder because intestine is dying off and cause is unknown

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34
Q

how can you diagnose nectrotizing enterocolitis?

A

air in the abdomen wall present on xray

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35
Q

what are nursing interventions for necrotizing entercolitis?

A

-probiotics to prevent in early phases
-strict enteric precautions and supportive care

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36
Q

what are characteristics of intussusception?

A

a part of the intestine prolapses and telescopes

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37
Q

what is the most common cause of obstruction in younger childrens?

A

intussusception

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38
Q

what are symptoms of intussusception?

A

-red stools
-nausea
-vomiting

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39
Q

how do you treat intussusception?

A

-enemas given to reduce defect
-surgery

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40
Q

what are characteristics of malrotation and volvulus?

A

intestine twists on itself

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41
Q

what is the most common symptom of malrotation and volvulus?

A

vomiting

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42
Q

what are other symptoms of malrotation and volvulus?

A

distended abdomen

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43
Q

how do you treat malrotation and volvulus?

A

emergency surgical intervention because circulation is cut off

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44
Q

what is known as inflammation of the appendix and obstruction of the appendiceal lumen?

A

appendicitis

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45
Q

what are symptoms of appendicitis?

A

-cramping around ubilicus
-pain at mcburney point
-rebound tenderness
-fever
-vomiting
-gaurding
-rigidity

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46
Q

how do you treat appendicitis?

A

surigical intervention before it ruptures

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47
Q

what are nursing interventions for appendicitis?

A

-antibiotics
-fluids
-pain control

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48
Q

if the appendix ruptures, what may occur?

A

peritonitis

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49
Q

what is known as erosion of mucosal tissue in the stomach, esophagus, or duodenum?

A

peptic ulcer disease

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50
Q

how do you treat peptic ulcer disease?

A

-proton pump inhibitors
-antibiotics

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51
Q

what is common during infancy and is expected to have reflux?

A

gastroesophageal reflux

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52
Q

An infant may have GERD if they fail to?

A

-gain weight
-show signs of respiratory syptoms

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53
Q

how do you treat Gastroesphogeal reflux?

A

-proton pump inhibitors
-histamine H2 antagonists
-have feeding interventions to prevent reflux

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54
Q

what is known as infrequent bowel movements, hard or large stools, painful defacation, and fecal incontinence?

A

constipation

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55
Q

how do you treat constipation?

A

-disimpaction
-enemas
-laxatives

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56
Q

what is voluntary or involuntary passage of stool?

A

encopresis

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57
Q

What is the difference between constipation and encopresis?

A

in encopresis child will purposefully hold stool which will lead to constipation

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58
Q

what is the most common manifestation of encopresis?

A

underwear soiling

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59
Q

what are interventions for encopresis?

A

-prevent and treat constipation
-toilet train
-high fiber diet

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60
Q

what is known as absence of ganglion cells and peristalsis?

A

hirschsprung disease

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61
Q

What are symptoms of hirschsprung disease?

A

-distended abdomen
-failure to pass meconium

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62
Q

what can hirschsprung disease lead to if left untreated?

A

enterocolitis

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63
Q

how do you treat hirschsprung disease?

A

-surgery
-temporary colostomy bag

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64
Q

what can occur after bowel removal?

A

short bowel syndrome -> not good nutrition absoprtion

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65
Q

what are symptoms of short bowel removal?

A

-severe diarrhea
-electrolyte imbalances
-dehydration

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66
Q

how do you give nutrition for short bowel syndrome?

A

parenteral or enteral

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67
Q

what is an increased risk for short bowel syndrome?

A

infection

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68
Q

what causes small and large bowel wall thickening?

A

Crohns disease

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69
Q

what causes large bowel wall thinning?

A

ulcerative colitis

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70
Q

how do you treat crohn disease and ulcerative colitis?

A

-outpatient treatment
-hospitalization for flare ups
-drugs: corticosteroids, aminosalicylates, immunosurpressants, monoclonal antibodies

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71
Q

what is known as gluten sensitive enteropathy, chronic irreversible disease with impaired fat absorption

A

celiac disease

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72
Q

what are symptoms of celiac disease?

A

-steatorrhea
-abdominal distention
-malnutrition
-muscle wasting
-hypotonia

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73
Q

how do you diagnose celiac disease?

A

-tTG-IgA test

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74
Q

how do you treat celiac disease?

A

-gluten free lifestyle
-foods that may contain gluten: barley, wheat, rye

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75
Q

what is known as yellow discoloration of skin, sclera, and mucous membrane?

A

hyperbilirubinemia (jaundice)

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76
Q

how can you treat/prevent jaundice

A

Prevent: establish regular feeding pattern
Treat: phototherapy with blue light

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77
Q

what is known as progressive obstruction of he extrahepatic bile ducts?

A

biliary atresia

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78
Q

how does biliary atresia present itself?

A

presents with jaundice 2-3 weeks after birth with symptoms of:
-abdominal distention
-bruising
-bleeding
-itching
-clay colored stools

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79
Q

what is the only effective treatment for biliary atresia?

A

kasai procedure or possible liver transplant if treatment is unsuccessful

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80
Q

what is known as inflammation of the liver?

A

hepatitis

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81
Q

what causes hepatitis?

A

many causes but mostly viral

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82
Q

what type of hepatitis is in day cares?

A

hep A

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83
Q

what are symptoms of hepatitis?

A

-jaundice
-fever
-fatigue
-abdominal pain

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84
Q

how do you treat hepatitis?

A

supportive care

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85
Q

what is known as scarring of the liver?

A

cirrhosis

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86
Q

what are common causes of cirrhosis?

A

-chronic cholestasis
-inborn errors of metabolism
-chronic hepatitis

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87
Q

what are interventions for child with cirrhosis?

A

-low sodium and low protein diet
-fluid restrictions

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88
Q

Scarring of the liver puts pressure on vessels that can lead to what?

A

portal hypertension

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89
Q

what are general nursing interventions for endocrine disorders?

A

-promote self management
-promote growth and development
-promote emotional and psychosocial support

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90
Q

What results in children being smaller than other children of the same age and gender?

A

growth hormone deficiency or hypopituitarism

normal height and weight at birth but percentiles decrease with age and puberty is delayed

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91
Q

what are causes of growth hormone deficiency?

A

-genetic defects
-brain trauma
-cystic tumors

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92
Q

how do you treat growth hormone deficiency?

A

-treat with recombinant human growth hormone
-surpression of luteinizing hormone may be needed
-intramusclar injection at bedtime and teach child to self administer ASAP!!

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93
Q

what is known as excessive production of growth hormone?

A

growth hormone excess or hyperpituitarism

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94
Q

what is the most common cause of growth hormone excess?

A

pituitary adenoma

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95
Q

what are manifestations of growth hormone excess or hyperpituitarism?

A

-linear growth of 7-8 ft if growth plates are not fused
-coarseness of facial features
-excessive foot or finger growth

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96
Q

how do you treat growth hormone excess or hyperpituitarism?

A

-remove pituitary adenoma

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97
Q

how do you treat precocius puberty?

A

treat cause such as tumor removal or GnRH agonist

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98
Q

how do you treat delayed puberty?

A

short term hormonal therapy

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99
Q

what is known as kidneys cannot concentrate urine because of decreased or lack of vasopressin (ADH)?

A

diabetes insipidus (excessive fluid loss)

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100
Q

what are symptoms of diabetes insipidus?

A

-polyuria
-dehydration
-polydipsia
-nocturia
-enuresis
-increased serum sodium
-low specific gravity

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101
Q

how do you treat diabetes insipidus?

A

-intranasal or oral desmopression acetate
-low sodium and low protein diet

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102
Q

what nursing interventions can be done for diabetes insipidus?

A

ensure child has medical alert bracelet

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103
Q

what is disease is known as the inability to suppress ADH which results in excessive secretions?

A

syndrome of inappropriate ADH (SIADH)

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104
Q

what causes SIADH?

A

-heart failure
-diseased hypothalamus
-malignancy
-pulmonary disorders
-CNS disorders
-certain meds

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105
Q

what does hemodilution allow for?

A

water reaborption and urine output is decreased which leads to decreased sodium levels

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106
Q

what are manifestations of SIADH?

A

-water intoxication
-hyponatremia
-jugular vein distention
-increased BP
-sudden weight gain
-fluid in lungs
-concentrated urine

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107
Q

how do you treat SIADH?

A

-water and fluid restriction
-demeclocycline (reduces reabsorption of water)

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108
Q

what is known as a deficient production of thryoid hormones at birth?

A

congenital hyothyroidism

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109
Q

what are the manifestations of congenital hyothyroidism?

A

-low T3 and T4
-persistent open posterior fontanel
-thickened tongue
-dull expression
-hypotonia
-protruding abdomen*
-brady cardia

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110
Q

how do you treat congenital hyothyroidism?

A

synthetic thyroid hormone (levothryoxine)

111
Q

what is known as thyrotoxicosis?

A

hyperthyroidism

112
Q

Peak incidence of hyperthyroidism is due to?

A

graves disease during adolescent period

113
Q

what are manifestations of hyperthyroidism?

A

-hyperactivity*
-goiter
-weight loss*
-hot flashes
-tachycardia
-tremors
-expothalmos
-diplopia

114
Q

how do you treat hyperthyroidism?

A

-thyroidectomy (requires hormone replacement therapy for life)
-radioactive iodine therapy
-antithyroid medications

115
Q

what can you give for tachycardia symptoms of hyperthyroidism?

A

beta blockers

116
Q

What is known as having adrenal insufficiency resulting in deficiency of cortisol and aldosterone?

A

addisions disease

117
Q

what are causes of addisons disease?

A

-autoimmune disorder (Most common)
-tuberculosis
-fungal infections
-HIV

118
Q

what are symptoms of addisons disease?

A

-fatigue
-skin changes
-abdominal pain

119
Q

how do you treat addisons disease?

A

-oral hydrocortisone
-fludrocortisone
-increase steroid doses in times of stress

120
Q

what is essential with treating addisons disease?

A

medication compliance

121
Q

what disorder do the adrenal glands become hyperplastic due to continued adrenocorticotropic hormone secretions?

A

congenital adrenal hyperplasia

122
Q

what are symptoms of congenital adrenal hyperplasia?

A

-enlarged penis
-ambiguous genitalia
-precocious puberty
-hyponatremia
-hyperkalemia
-hypoglycemia

123
Q

how do you diagnose congenital adrenal hyperplasia?

A

typially in utero with maternal serum analysis

124
Q

how do you treat congenital adrenal hyperplasia?

A

-cortisol replacement
-corticosteroid to regulate ACTH
-increase doses during times of stress

125
Q

what is known as overproduction of cortisol?

A

cushing syndrome

126
Q

what causes cushing sydrome?

A

-ACTH tumor
-prolonged exposure to corticosteroid therapy

127
Q

what are symptoms of cushing syndrome?

A

-moon face
-pendulous abdomen with striae
-hirtuism

128
Q

how do you treat cushing syndrome?

A

-surgical removal of pituitary adenoma
-adrenal gland removal
-decrease steroid doses

129
Q

what are symptoms of T1D?

A

-weight loss
-polydipsia
-polyphagia
-polyuria
-fatigue
-blurred vision

130
Q

Type 2 diabetes may occur in what age group?

A

teenage and school aged due to increased obesity

131
Q

which type of diabetes does the pancreas produce insulin but is unable to be used in the body?

A

type 2

132
Q

what are symptoms of type 2 diabetes?

A

-acanthosis nigricans (darkening of skin)
-polydipsia
-polyphagia
-polyuria

133
Q

how do you treat T2D?

A

-increase physical activity
-diet changes
-metformin

134
Q

what is known as deficient secretion of PTH?

A

hypoparathyroidism

135
Q

what causes hypoparathyroidism?

A

accidental removal of parathyroid glands during surgery

136
Q

what are symptoms of hypoparathyoidism?

A

-hypocalcemia
-hyperphosphatemia
-seizures
-chvostek (uneven face) and trousseau signs (hand points down during BP)

137
Q

what are nursing interventions for hypoparathyroidism?

A

-manage hypocalcemia during hospital stay
-administer calcium replacement therapy for home

138
Q

calcium abnormalities can cause what?

A

-cardiac arrythmias
-seizures

139
Q

what do you avoid with hypoparathyroidism?

A

-IV infiltration bc calcium causes extravasation and sloughing

140
Q

what is known as excessive secretion of PTH?

A

hyperparathyroidism

141
Q

what is most common cause of hyperparathyroidism?

A

parathyroid adenoma or chronic renal failure

142
Q

what are symptoms of hyperparathyroidism?

A

-hypercalcemia
-hypophosphatemia
-bone pain
-fractures
-kidney stones

143
Q

how do you treat hyperparathyroidism?

A

-surgical excision of tumor
-vitamin D supplementation
-phosphorus binders

144
Q

what are examples of structural defects in children?

A

malformation, incomplete development, or absence of brain, CSF tracts, spinal cord, or skull
EX: craniosynostosis, deformation plagiocephaly, microcephaly

145
Q

what is known as premature fusion of one or more cranial sutures?

A

craniosynostosis

146
Q

when does craniosynostosis occur?

A

at or before birth

147
Q

how do you treat craniosynostosis?

A

surgery before 6 months with post op helmet after

148
Q

what do you assess with craniosynostosis?

A

-complete developmental history
-physical exam
-full neuro exam

149
Q

what is known as asymmetry and flattening of head from external forces?

A

deformational plagiocephaly

150
Q

deformational plagiocephaly increased with what campaign?

A

back to sleep campaign

151
Q

deformational plagiocephaly affects which side more?

A

affects right occiput more

152
Q

how do you treat deformational plagiocephaly?

A

-frequent repositioning
-orthotics

153
Q

what is known as an abnormally small head?

A

microcephaly

154
Q

what causes microcephaly?

A

primary: genetic, chromosomal, hereditary cause
Secondary: exposure to irradiation, maternal infection such as toxoplasmosis, rubella, zika, cytomegavirus, or maternal use of alcohol or tobacco

155
Q

what are manifestations for microcephaly?

A

delayed cognitive and motor development

156
Q

what does microcephaly affect?

A

brain development with no cure

157
Q

what is known as buildup of CSF in brain?

A

hydrocephalus

158
Q

how does hydrocephalus affect brain?

A

increased intracranial pressure

159
Q

what are symptoms of hydrocephalus?

A

depends on age and severity
-dilated scalp veins
-bulging fontanel, apnea, irritability
-headaches
-sunset eyes
-vomiting
-lethargy
-irritability
-decline in school performance
-gait issues
head circumference is inconsistent with normal growth

160
Q

how can you treat hydrocephalus?

A

ventriculoperitoneal (VP) shunt (will drain CSF)
- monitor for infection at site
-may need replacement as child grows
-monitor head circumference to assess patency

161
Q

What causes AVMs?

A

present at birth or symptoms occur later in life

162
Q

what are symptoms of AVMs?

A

-seizures
-headaches
-weakness
-paralysis

163
Q

how do you diagnosis an AVM?

A

-neuro and genetic testing
-MRI
-cerebral angiography

164
Q

how do you treat AVMs?

A

-creating an endovascular emobolization
-surgical resection
-radiation

165
Q

what is known as infection of meninges?

A

meningitis (viral or bacterial)

166
Q

how does meningitis present itself?

A

-fever
-headache
-stiff neck
-photophobia
-purple rash*

167
Q

how do you diagnose meningitis?

A

-lumbar puncture
-kernigs sign
-brudzinskis sign

168
Q

What are nursing interventions for septic meningitis?

A

-isolation
-IV antibiotics
-close neuro monitoring

169
Q

Those in close contact with a patient who has meningitis should be given what?

A

prophylactic antibiotics

170
Q

what is infection of meninges wit cerebral edema?

A

encephalitis

171
Q

what causes encephalitis?

A

-toxins
-fungi/bacteria
-parasites
usually associated woth mosquito bites

172
Q

a patient with encephalitis is at increased risk for?

A

-seizures
-flaccid paralysis
-headaches
-photophobia
-lethargy
-stiff neck

173
Q

how do you diagnose encephalitis?

A

MRI

174
Q

how do you treat encephalitis?

A

-IV antibacterial/antiviral meds
-anti inflammatory
-anti epileptics

175
Q

what precautions should a person be on for encephalitis?

A

seizure precautions

176
Q

what is rapid progression of multiorgan failure with poor outcomes? This is rare and often misdiagnosed!!

A

reye syndrome

177
Q

what is reye syndrome associated with?

A

aspirin use during viral illness

178
Q

how do you treat reye syndrome?

A

collabortive treatment in ICU

179
Q

what is a patient at risk for with reye syndrome?

A

-increased bleeding
-ICP management
-cerebral edema
-increased glucose
-electrolyte abnormalities

180
Q

Aspirin should be avoided in children younger than what age?

A

19

181
Q

what are the two types of seizures?

A

focal: can have impaired awareness or be unconscious with or w/o motor activity (one hemisphere)
generalized: unconscious with or w/o motor activity (both hemispheres)

182
Q

what do seizures result in?

A

motor, sensory, and cognitive changes

183
Q

what causes seizures?

A

-structural defects
-genetics
-infection
-metabolic or autoimmune abnormalities

184
Q

what is known as recurrent, unprovoked seizures?

A

epilepsy

185
Q

how do you diagnose epilepsy?

A

-two unprovoked seizures more than 24 hours apart
-one with high chance of repeating in over the next 10 years
-epilepsy syndrome present
-CT or MRI to see if there is an electrical cause

186
Q

when is epilepsy considered resolved?

A

if no seizure is present for 10 years or has been off antiepileptic meds for 5 years

187
Q

What are considerations for a patient with epilepsy?

A

cannot drive unless considered seizure free

188
Q

what seizure medication will you administer for focal (motor onset) and generalized (tonic-clonic) seizures?

A

-carbamazepine
-valproic acid
-phenytoin
-phenobarbital

189
Q

what seizure medication will you administer with onl focal (motor onset) seizures?

A

-fosphenytoin
-gabapentin

190
Q

what seizure medication will you give for someone who has generalized (nonmotor onset) seizures?

A

ethosuximide

191
Q

what seizure medication will you give for someone who has focal (nonmotor onset) seizures?

A

topiramate

192
Q

If seizure medications are ineffective what is another treatment option?

A

vagus nerve stimulator

193
Q

what are nursing interventions for a child with seizures?

A

-administer meds
-monitor and record specifics during seizure
-put in safety precautions at home and school
-support and educate family

194
Q

what is a medical emergency and needs to be stopped immediately?

A

staus epilepticus

195
Q

what is known as prolonged seizure or series of seizures without recovery in between?

A

staus epilepticus

196
Q

in staus epilepticus, what can you do to stop seizure?

A

-IV fluids
-oxygen
-IV medications
-put patient in medically induced coma if necessary

197
Q

what are known as seizures that are triggered by high fever in children younger than 7 years old?

A

febrile seizures (body temp greater than 101.2 F)

198
Q

how do you diagnose febrile seizures?

A

EEG

199
Q

what is a primary TBI?

A

skull fracture, bleeding

200
Q

what is a secondary TBI?

A

cerebral edema, tissue ischemia

201
Q

infants and toddlers are at greatest risk for TBIs because of?

A

big head

202
Q

adolescents are at greatest risk for TBIs because of?

A

recklessness

203
Q

to determine impact of injury for TBIs what can be measured?

A

cerebral perfusion pressure

204
Q

what are nursing interventions for TBIs?

A

-assess glasgow coma scale
-monitor electrolytes

205
Q

What is #1 cause of brain damage in infants and is non accidental?

A

shaken baby syndrome

206
Q

how can you identify damage in the brain?

A

CT or MRI

207
Q

for non accidental head trauma, what is the nurses role?

A

mandated reporter and needs to put objective data in EHR

208
Q

what are headaches classified as?

A

-acute
-acute recurrent
-chronic progressive
-chronic nonprogressive

209
Q

how do you treat headaches?

A

-relaxation
-OTC meds

210
Q

what are nursing interventions for headaches?

A

encourage patients to keep a headache journal

211
Q

what is unequal refractory curvatures?

A

astigmatism

212
Q

what is abnormal eye movement?

A

nystagmus

213
Q

what is cross eye and treated with occlusion therapy?

A

strabismus

214
Q

what eye disorder has increased in otraocular pressure?

A

infantile glaucoma

215
Q

what eye disorders cause cloudiness over corneal lens

A

congenital cataracts

216
Q

what are nursing interventions for eye disorders?

A

-determine cause
-detect early as possible
-wear corrective lenses to improve visual acuity

217
Q

what is known as obstruction of tear duct and excessive tearing?

A

nasolacrimal duct obstruction

218
Q

what are symptoms of nasolacrimal duct obstruction?

A

-red, swollen eye lids
-resembles conjuctivitis

219
Q

what is common with nasolacrimal duct obstruction?

A

infection when bacteria is not flushed out

220
Q

how do you treat nasolacrimal duct obstruction?

A

-spontaneous and usually resolves around 1 year of age
-lacrimal massage
-topical antibiotics
probe with dilatation and irrigation if massage is not working

221
Q

what is known as infection of eyelid and orbital tissues surrounding the eye?

A

periorbital cellulitis

222
Q

what are symptoms of periorbital cellulitis?

A

-swelling of eyelid
-decreased vision
-increased IOP

223
Q

what bacteria causes periorbital cellulitis?

A

methicillin resistant staph

224
Q

how do you treat periorbital cellulitis?

A

hospitalization for IV antibiotics, decongestants to decrease secretions

225
Q

what is known as inflammation of the conjuctiva of the eye?

A

conjunctivitis

226
Q

what are symptoms of conjunctivitis?

A

-red
-swollen
-irritated eyes

227
Q

how do you treat conjunctivitis?

A

oral medications or eye drops

228
Q

fluid in the eye for a patient with conjunctivitis is contangious for how many hours after treatment?

A

24-48 hours

229
Q

to help prevent further spread of conjuctivitis what should be done?

A

wash hands often and wash childs hands often

230
Q

what causes hearing deficits?

A

genetic, acquired through infection or antibiotics, or unknown cause

231
Q

how can you suspect hearing loss?

A

-startle reflex is absent
-no turn to voice or noise
-babbling at 6-7 months

232
Q

what are nursing implications during hospitalization for hearing deficits?

A

-reassess instructions and understanding
-supplement with visual and tactile methods
-use communication devices such as picture boards and common words (food, water, toilet)

233
Q

what are general nursing interventions for mental health and cognitive function?

A

-provide supportive care
-maintain a safe environment

234
Q

what is the most common learning disabilitiy in children?

A

dyslexia

235
Q

Common symptoms of learning disabilities may not appear until when?

A

until children enter formal school setting

236
Q

what are manfestations of learning disabilites?

A

-slower acquisition of language and math skills
-difficulty recognizing letters and numbers
-problem with reading comprehension

237
Q

how can you assess learning disabilities?

A

standardized testing

238
Q

how do you treat learning disabilities?

A

treat with an individualized education plan (IEP)

239
Q

what is known as a continuum of neurobiological symptoms that result in difficulty with communication, behavior, and social interactions that are present at 3 years old?

A

autism spectrum disorder

240
Q

if a child may be suspected to have autism, what may be done?

A

implement standardized developmental screenings into well child appointments?

241
Q

what are manifestations for autism spectrum disorder?

A

-stereotypy (reptitive movements)
-obsessive behavior
-difficulty with sensory integration
-echolalia (repeats words without meaning)
-avoiding eye contact

242
Q

how do you treat autism spectrum disorder?

A

-early identification
-planning education activities
-collaborate with school staff
-consult speech therapist
-use a multidisciplinary approach

243
Q

what is known as a neurobehavioral disorder characterized by inattentiveness with or w/o hyperactivity and impulsivity?

A

ADHD

244
Q

what is the patho for ADHD?

A

unclear but may be genetic

245
Q

what are symptoms of ADHD?

A

-short attention span
-impulsivity
-difficulties with movement

246
Q

how do you diagnose ADHD?

A

diagnose with formal evaluation and psychological testing

247
Q

how do you treat ADHD?

A

-educate caregiver
-develop IEP
-pharmacotherapy

248
Q

what medications can be given for ADHD?

A

-ritalin
-adderall
-focalin

249
Q

what are side effects of ADHD medications?

A

-weight loss
-appetite surpression
-tachycardia
-hypertension

250
Q

what do you monitor with ADHD during medication treatment?

A

serum liver and kidney function

251
Q

what disorder has worry, fear, and anxiety extend past normal adaptive coping mechanisms and cause stress and significant impairment?

A

anxiety disorder

252
Q

what causes anxiety disorder?

A

combination of genetics and environmental factors

253
Q

what are symptoms of anxiety?

A

-abdominal pain
-nausea
-palpitations
-dyspnea
-aggression
-defiance
-vomiting
-dizziness

254
Q

how is anxiety categorized?

A

-generalized anxiety disorder
-separation anxiety disorder
-panic disorder

255
Q

what are treatment options for anxiety?

A

-Seperation anxiety and school refusal: exposure based cognitive behavioral therapy
-SSRIs

256
Q

administering SSRIs to pediatric population will increase risk of?

A

suicide

257
Q

what is known as an eating disorder characterized by fear of gaining weight or becoming overweight?

A

anorexia nervosa

258
Q

what age does anorexia nervosa occur?

A

onset is adolescence

259
Q

what are risk factors for anorexia nervosa?

A

-adolescence
-perfectionist personality
-family history of eating disorder
-low self esteem
-female gender

260
Q

what are symptoms of anorexia nervosa?

A

-anxiety
-depression
-suicidal thoughts
-low BMI
-dehydration
-lanugo
-cold intolerance
-hypotension
-crying
-compulsive exercising

261
Q

how do you treat anorexia nervosa treatment?

A

-nutritional support
-therapy
-give fluids for electrolye imbalance and monitor cardiac involvement
-treat with pediatricians, behavioral health specialists, and registered dieticians
-involve family in counseling
-focus on gradual weight gain of 2-3 pounds a week
-may need NG tube feedings

262
Q

what is known as an eating disorder characterized by periods of binge eating followed by periods of purging?

A

bulimia nervosa

263
Q

Bulimia nervosa is a result of?

A

poor self image and societal pressures

264
Q

what are symptoms of bulimia nervosa?

A

-food rituals
-uncontrollable laughing or crying inappropriately
-repeated fad dieting
-thinning hair
-brittle nails
-hypokalemia
-anemia
-calluses on backs of hands and fingers
-bradycardia
-esophageal irritation
-poor dentition

265
Q

how do you treat bulimia nervosa?

A

treat with cognitive behavioral therapy and SSRIs

266
Q

what is known as phsyical, emotional, or sexual abuse; exposure to domestic violence; neglect?

A

abuse and violence

267
Q

what are risk factors for abuse and violence for caregiver?

A

-mental illness
-lack of knowledge
-poor self esteem
-alcohol/substance abuse
-poor coping skills
-history of being a victim of abuse

268
Q

what are risk factors for abuse and violence as environmental factor?

A

-low income
-unemployment
-domestic violence
-lack of support
-low education attainment

269
Q

what are symptoms of abuse and violence?

A

-multiple fractures in various stages of healing
-suspicious bruising
-STIs
-enuresis
-vague somatic complaints

270
Q

how to determine signs of abuse?

A

-forensic medical team collects evidence
-use radiographs or CT scans to examine other signs of abuse
-nurses are mandated reporters
-prevention is best treatment
-educate caregivers on expected growth and development milestones

271
Q

what is known as misinterpretation or presentation of exaggerated or absent symptoms in a child to regain entry into medical setting?

A

-factitious disorder imposed on on another (FDIA) or munchausen syndrome by proxy

272
Q

what are contributing factors to FDIA?

A

-past history of abuse
-personality disorder
-somatic symptom disorder
-pathological lying

273
Q

what are manifestations for FDIA?

A

-frequent medical visits for fictious symptoms
-purposeful inducement of physical symptoms
-manipulation of lab tests

Fall 22 (2 decks)

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