Peds Exam 3 Flashcards
1
Q
What are characterstics of Meckel Diverticulum?
A
-outpuching of lower intestine
-can be born with other anomalies
2
Q
When do symptoms appear for Meckel diverticulum?
A
Symptoms appear at 1-2 years of age and can show painless rectal bleeding
3
Q
how do you treat Meckel diverticulum?
A
surigical repair
4
Q
what are characterisitics of omphalocele?
A
internal organs are in the umbilical cord
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
6
Q
how do you treat omphalocele?
A
surgical repair
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
8
Q
what may a child experience with gastroschisis?
A
respiratory distress because organs are resting on abdomen instead of being inside
9
Q
What are characterisitics of cleft lip and cleft palate?
A
tissues in lip or palate are not fused
10
Q
what are complications a child may experience with cleft lip and cleft palate?
A
feeding, ontological, dental, and speech complications
11
Q
what are the treatments for cleft lip and cleft palate?
A
surgical repair
- Lip: 2-3 months
-Palate: 9-18 months
12
Q
what are nursing interventions for cleft lip and cleft palate?
A
-protect suture line post op
-use specialized feeding equipment
13
Q
what are characterstics of congential diaphragmatic hernia?
A
there is communication between thoracic and abdominal cavity (two cavities are now connected)
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)
15
Q
how do you treat congenital diaphragmatic hernia?
A
intubation and surgical repair and requires neonatal ICU
(has high rate of death)
16
Q
what are characteristics of Anorectal malformations?
A
stenosis, prolapse, or atresia of rectum
17
Q
what are treatments for anorectal malformations?
A
-dilation or surgery
-can place temporary colostomy bag
18
Q
what are nursing interventions for anorectal malformations?
A
avoid putting anything in the rectum
19
Q
what are characteristics of esophageal atresia?
A
upper and lower parts of esophagus are disconnected
20
Q
what are characteristics of trachesophageal fistula?
A
trachea and esophagus are connected
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
22
Q
how do you treat esophageal atresia and trachesophogeal fistula?
A
-surgery
-g-tube
- TPN until recovered from post OP
23
Q
how do you treat dehydration?
A
-oral rehydration for mild and moderate
-IV replacement for severe
24
Q
Why do you need to intervene quickly for dehydration?
A
to prevent hypovolemic shock and vascular collapse
25
how do you treat nausea?
antiemtics
26
what is gastroenteritis?
acute diarrhea
27
what are causes of gastroenteritis?
-infection
-food sensitivity
-environmental
28
What can be done to determine cause of vomiting?
assess emesis to determine causes
29
what are characterisitcs of hypertrophic pyloric stenosis?
elongation and thickening of the pyloric muscle
30
what are symptoms of hypertrophic pyloric stenosis and when does it appear?
-projectile and forceful vomiting without nausea
-presents itself 3-6 weeks after birth
31
how do you treat hypertrophic stenosis?
surgery
32
what are characterstics of necrotizing enterocolitis?
mucosal and transmural (across whole intestine) necrosis in the intestine
33
what is significant of necrotizing enterocolitis?
most lethal disorder because intestine is dying off and cause is unknown
34
how can you diagnose nectrotizing enterocolitis?
air in the abdomen wall present on xray
35
what are nursing interventions for necrotizing entercolitis?
-probiotics to prevent in early phases
-strict enteric precautions and supportive care
36
what are characteristics of intussusception?
a part of the intestine prolapses and telescopes
37
what is the most common cause of obstruction in younger childrens?
intussusception
38
what are symptoms of intussusception?
-red stools
-nausea
-vomiting
39
how do you treat intussusception?
-enemas given to reduce defect
-surgery
40
what are characteristics of malrotation and volvulus?
intestine twists on itself
41
what is the most common symptom of malrotation and volvulus?
vomiting
42
what are other symptoms of malrotation and volvulus?
distended abdomen
43
how do you treat malrotation and volvulus?
emergency surgical intervention because circulation is cut off
44
what is known as inflammation of the appendix and obstruction of the appendiceal lumen?
appendicitis
45
what are symptoms of appendicitis?
-cramping around ubilicus
-pain at mcburney point
-rebound tenderness
-fever
-vomiting
-gaurding
-rigidity
46
how do you treat appendicitis?
surigical intervention before it ruptures
47
what are nursing interventions for appendicitis?
-antibiotics
-fluids
-pain control
48
if the appendix ruptures, what may occur?
peritonitis
49
what is known as erosion of mucosal tissue in the stomach, esophagus, or duodenum?
peptic ulcer disease
50
how do you treat peptic ulcer disease?
-proton pump inhibitors
-antibiotics
51
what is common during infancy and is expected to have reflux?
gastroesophageal reflux
52
An infant may have GERD if they fail to?
-gain weight
-show signs of respiratory syptoms
53
how do you treat Gastroesphogeal reflux?
-proton pump inhibitors
-histamine H2 antagonists
-have feeding interventions to prevent reflux
54
what is known as infrequent bowel movements, hard or large stools, painful defacation, and fecal incontinence?
constipation
55
how do you treat constipation?
-disimpaction
-enemas
-laxatives
56
what is voluntary or involuntary passage of stool?
encopresis
57
What is the difference between constipation and encopresis?
in encopresis child will purposefully hold stool which will lead to constipation
58
what is the most common manifestation of encopresis?
underwear soiling
59
what are interventions for encopresis?
-prevent and treat constipation
-toilet train
-high fiber diet
60
what is known as absence of ganglion cells and peristalsis?
hirschsprung disease
61
What are symptoms of hirschsprung disease?
-distended abdomen
-failure to pass meconium
62
what can hirschsprung disease lead to if left untreated?
enterocolitis
63
how do you treat hirschsprung disease?
-surgery
-temporary colostomy bag
64
what can occur after bowel removal?
short bowel syndrome -> not good nutrition absoprtion
65
what are symptoms of short bowel removal?
-severe diarrhea
-electrolyte imbalances
-dehydration
66
how do you give nutrition for short bowel syndrome?
parenteral or enteral
67
what is an increased risk for short bowel syndrome?
infection
68
what causes small and large bowel wall thickening?
Crohns disease
69
what causes large bowel wall thinning?
ulcerative colitis
70
how do you treat crohn disease and ulcerative colitis?
-outpatient treatment
-hospitalization for flare ups
-drugs: corticosteroids, aminosalicylates, immunosurpressants, monoclonal antibodies
71
what is known as gluten sensitive enteropathy, chronic irreversible disease with impaired fat absorption
celiac disease
72
what are symptoms of celiac disease?
-steatorrhea
-abdominal distention
-malnutrition
-muscle wasting
-hypotonia
73
how do you diagnose celiac disease?
-tTG-IgA test
74
how do you treat celiac disease?
-gluten free lifestyle
-foods that may contain gluten: barley, wheat, rye
75
what is known as yellow discoloration of skin, sclera, and mucous membrane?
hyperbilirubinemia (jaundice)
76
how can you treat/prevent jaundice
Prevent: establish regular feeding pattern
Treat: phototherapy with blue light
77
what is known as progressive obstruction of he extrahepatic bile ducts?
biliary atresia
78
how does biliary atresia present itself?
presents with jaundice 2-3 weeks after birth with symptoms of:
-abdominal distention
-bruising
-bleeding
-itching
-clay colored stools
79
what is the only effective treatment for biliary atresia?
kasai procedure or possible liver transplant if treatment is unsuccessful
80
what is known as inflammation of the liver?
hepatitis
81
what causes hepatitis?
many causes but mostly viral
82
what type of hepatitis is in day cares?
hep A
83
what are symptoms of hepatitis?
-jaundice
-fever
-fatigue
-abdominal pain
84
how do you treat hepatitis?
supportive care
85
what is known as scarring of the liver?
cirrhosis
86
what are common causes of cirrhosis?
-chronic cholestasis
-inborn errors of metabolism
-chronic hepatitis
87
what are interventions for child with cirrhosis?
-low sodium and low protein diet
-fluid restrictions
88
Scarring of the liver puts pressure on vessels that can lead to what?
portal hypertension
89
what are general nursing interventions for endocrine disorders?
-promote self management
-promote growth and development
-promote emotional and psychosocial support
90
What results in children being smaller than other children of the same age and gender?
growth hormone deficiency or hypopituitarism
**normal height and weight at birth but percentiles decrease with age and puberty is delayed**
91
what are causes of growth hormone deficiency?
-genetic defects
-brain trauma
-cystic tumors
92
how do you treat growth hormone deficiency?
-treat with recombinant human growth hormone
-surpression of luteinizing hormone may be needed
-intramusclar injection at bedtime and teach child to self administer ASAP!!
93
what is known as excessive production of growth hormone?
growth hormone excess or hyperpituitarism
94
what is the most common cause of growth hormone excess?
pituitary adenoma
95
what are manifestations of growth hormone excess or hyperpituitarism?
-linear growth of 7-8 ft if growth plates are not fused
-coarseness of facial features
-excessive foot or finger growth
96
how do you treat growth hormone excess or hyperpituitarism?
-remove pituitary adenoma
97
how do you treat precocius puberty?
treat cause such as tumor removal or GnRH agonist
98
how do you treat delayed puberty?
short term hormonal therapy
99
what is known as kidneys cannot concentrate urine because of decreased or lack of vasopressin (ADH)?
diabetes insipidus (excessive fluid loss)
100
what are symptoms of diabetes insipidus?
-polyuria
-dehydration
-polydipsia
-nocturia
-enuresis
-increased serum sodium
-low specific gravity
101
how do you treat diabetes insipidus?
-intranasal or oral desmopression acetate
-low sodium and low protein diet
102
what nursing interventions can be done for diabetes insipidus?
ensure child has medical alert bracelet
103
what is disease is known as the inability to suppress ADH which results in excessive secretions?
syndrome of inappropriate ADH (SIADH)
104
what causes SIADH?
-heart failure
-diseased hypothalamus
-malignancy
-pulmonary disorders
-CNS disorders
-certain meds
105
what does hemodilution allow for?
water reaborption and urine output is decreased which leads to decreased sodium levels
106
what are manifestations of SIADH?
-water intoxication
-hyponatremia
-jugular vein distention
-increased BP
-sudden weight gain
-fluid in lungs
-concentrated urine
107
how do you treat SIADH?
-water and fluid restriction
-demeclocycline (reduces reabsorption of water)
108
what is known as a deficient production of thryoid hormones at birth?
congenital hyothyroidism
109
what are the manifestations of congenital hyothyroidism?
-low T3 and T4
-persistent open posterior fontanel
-thickened tongue
-dull expression
-hypotonia
-protruding abdomen*
-brady cardia
110
how do you treat congenital hyothyroidism?
synthetic thyroid hormone (levothryoxine)
111
what is known as thyrotoxicosis?
hyperthyroidism
112
Peak incidence of hyperthyroidism is due to?
graves disease during adolescent period
113
what are manifestations of hyperthyroidism?
-hyperactivity*
-goiter
-weight loss*
-hot flashes
-tachycardia
-tremors
-expothalmos
-diplopia
114
how do you treat hyperthyroidism?
-thyroidectomy (requires hormone replacement therapy for life)
-radioactive iodine therapy
-antithyroid medications
115
what can you give for tachycardia symptoms of hyperthyroidism?
beta blockers
116
What is known as having adrenal insufficiency resulting in deficiency of cortisol and aldosterone?
addisions disease
117
what are causes of addisons disease?
-autoimmune disorder (Most common)
-tuberculosis
-fungal infections
-HIV
118
what are symptoms of addisons disease?
-fatigue
-skin changes
-abdominal pain
119
how do you treat addisons disease?
-oral hydrocortisone
-fludrocortisone
-increase steroid doses in times of stress
120
what is essential with treating addisons disease?
medication compliance
121
what disorder do the adrenal glands become hyperplastic due to continued adrenocorticotropic hormone secretions?
congenital adrenal hyperplasia
122
what are symptoms of congenital adrenal hyperplasia?
-enlarged penis
-ambiguous genitalia
-precocious puberty
-hyponatremia
-hyperkalemia
-hypoglycemia
123
how do you diagnose congenital adrenal hyperplasia?
typially in utero with maternal serum analysis
124
how do you treat congenital adrenal hyperplasia?
-cortisol replacement
-corticosteroid to regulate ACTH
-increase doses during times of stress
125
what is known as overproduction of cortisol?
cushing syndrome
126
what causes cushing sydrome?
-ACTH tumor
-prolonged exposure to corticosteroid therapy
127
what are symptoms of cushing syndrome?
-moon face
-pendulous abdomen with striae
-hirtuism
128
how do you treat cushing syndrome?
-surgical removal of pituitary adenoma
-adrenal gland removal
-decrease steroid doses
129
what are symptoms of T1D?
-weight loss
-polydipsia
-polyphagia
-polyuria
-fatigue
-blurred vision
130
Type 2 diabetes may occur in what age group?
teenage and school aged due to increased obesity
131
which type of diabetes does the pancreas produce insulin but is unable to be used in the body?
type 2
132
what are symptoms of type 2 diabetes?
-acanthosis nigricans (darkening of skin)
-polydipsia
-polyphagia
-polyuria
133
how do you treat T2D?
-increase physical activity
-diet changes
-metformin
134
what is known as deficient secretion of PTH?
hypoparathyroidism
135
what causes hypoparathyroidism?
accidental removal of parathyroid glands during surgery
136
what are symptoms of hypoparathyoidism?
-hypocalcemia
-hyperphosphatemia
-seizures
-chvostek (uneven face) and trousseau signs (hand points down during BP)
137
what are nursing interventions for hypoparathyroidism?
-manage hypocalcemia during hospital stay
-administer calcium replacement therapy for home
138
calcium abnormalities can cause what?
-cardiac arrythmias
-seizures
139
what do you avoid with hypoparathyroidism?
-IV infiltration bc calcium causes extravasation and sloughing
140
what is known as excessive secretion of PTH?
hyperparathyroidism
141
what is most common cause of hyperparathyroidism?
parathyroid adenoma or chronic renal failure
142
what are symptoms of hyperparathyroidism?
-hypercalcemia
-hypophosphatemia
-bone pain
-fractures
-kidney stones
143
how do you treat hyperparathyroidism?
-surgical excision of tumor
-vitamin D supplementation
-phosphorus binders
144
what are examples of structural defects in children?
malformation, incomplete development, or absence of brain, CSF tracts, spinal cord, or skull
EX: craniosynostosis, deformation plagiocephaly, microcephaly
145
what is known as premature fusion of one or more cranial sutures?
craniosynostosis
146
when does craniosynostosis occur?
at or before birth
147
how do you treat craniosynostosis?
surgery before 6 months with post op helmet after
148
what do you assess with craniosynostosis?
-complete developmental history
-physical exam
-full neuro exam
149
what is known as asymmetry and flattening of head from external forces?
deformational plagiocephaly
150
deformational plagiocephaly increased with what campaign?
back to sleep campaign
151
deformational plagiocephaly affects which side more?
affects right occiput more
152
how do you treat deformational plagiocephaly?
-frequent repositioning
-orthotics
153
what is known as an abnormally small head?
microcephaly
154
what causes microcephaly?
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
what are manifestations for microcephaly?
delayed cognitive and motor development
156
what does microcephaly affect?
brain development with no cure
157
what is known as buildup of CSF in brain?
hydrocephalus
158
how does hydrocephalus affect brain?
increased intracranial pressure
159
what are symptoms of hydrocephalus?
**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
how can you treat hydrocephalus?
ventriculoperitoneal (VP) shunt (will drain CSF)
- monitor for infection at site
-may need replacement as child grows
-monitor head circumference to assess patency
161
What causes AVMs?
present at birth or symptoms occur later in life
162
what are symptoms of AVMs?
-seizures
-headaches
-weakness
-paralysis
163
how do you diagnosis an AVM?
-neuro and genetic testing
-MRI
-cerebral angiography
164
how do you treat AVMs?
-creating an endovascular emobolization
-surgical resection
-radiation
165
what is known as infection of meninges?
meningitis (viral or bacterial)
166
how does meningitis present itself?
-fever
-headache
-stiff neck
-photophobia
-purple rash*
167
how do you diagnose meningitis?
-lumbar puncture
-kernigs sign
-brudzinskis sign
168
What are nursing interventions for septic meningitis?
-isolation
-IV antibiotics
-close neuro monitoring
169
Those in close contact with a patient who has meningitis should be given what?
prophylactic antibiotics
170
what is infection of meninges wit cerebral edema?
encephalitis
171
what causes encephalitis?
-toxins
-fungi/bacteria
-parasites
**usually associated woth mosquito bites**
172
a patient with encephalitis is at increased risk for?
-seizures
-flaccid paralysis
-headaches
-photophobia
-lethargy
-stiff neck
173
how do you diagnose encephalitis?
MRI
174
how do you treat encephalitis?
-IV antibacterial/antiviral meds
-anti inflammatory
-anti epileptics
175
what precautions should a person be on for encephalitis?
seizure precautions
176
what is rapid progression of multiorgan failure with poor outcomes? This is rare and often misdiagnosed!!
reye syndrome
177
what is reye syndrome associated with?
aspirin use during viral illness
178
how do you treat reye syndrome?
collabortive treatment in ICU
179
what is a patient at risk for with reye syndrome?
-increased bleeding
-ICP management
-cerebral edema
-increased glucose
-electrolyte abnormalities
180
Aspirin should be avoided in children younger than what age?
19
181
what are the two types of seizures?
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
what do seizures result in?
motor, sensory, and cognitive changes
183
what causes seizures?
-structural defects
-genetics
-infection
-metabolic or autoimmune abnormalities
184
what is known as recurrent, unprovoked seizures?
epilepsy
185
how do you diagnose epilepsy?
-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
when is epilepsy considered resolved?
if no seizure is present for 10 years or has been off antiepileptic meds for 5 years
187
What are considerations for a patient with epilepsy?
cannot drive unless considered seizure free
188
what seizure medication will you administer for focal (motor onset) and generalized (tonic-clonic) seizures?
-carbamazepine
-valproic acid
-phenytoin
-phenobarbital
189
what seizure medication will you administer with onl focal (motor onset) seizures?
-fosphenytoin
-gabapentin
190
what seizure medication will you give for someone who has generalized (nonmotor onset) seizures?
ethosuximide
191
what seizure medication will you give for someone who has focal (nonmotor onset) seizures?
topiramate
192
If seizure medications are ineffective what is another treatment option?
vagus nerve stimulator
193
what are nursing interventions for a child with seizures?
-administer meds
-monitor and record specifics during seizure
-put in safety precautions at home and school
-support and educate family
194
what is a medical emergency and needs to be stopped immediately?
staus epilepticus
195
what is known as prolonged seizure or series of seizures without recovery in between?
staus epilepticus
196
in staus epilepticus, what can you do to stop seizure?
-IV fluids
-oxygen
-IV medications
-put patient in medically induced coma if necessary
197
what are known as seizures that are triggered by high fever in children younger than 7 years old?
febrile seizures (body temp greater than 101.2 F)
198
how do you diagnose febrile seizures?
EEG
199
what is a primary TBI?
skull fracture, bleeding
200
what is a secondary TBI?
cerebral edema, tissue ischemia
201
infants and toddlers are at greatest risk for TBIs because of?
big head
202
adolescents are at greatest risk for TBIs because of?
recklessness
203
to determine impact of injury for TBIs what can be measured?
cerebral perfusion pressure
204
what are nursing interventions for TBIs?
-assess glasgow coma scale
-monitor electrolytes
205
What is #1 cause of brain damage in infants and is non accidental?
shaken baby syndrome
206
how can you identify damage in the brain?
CT or MRI
207
for non accidental head trauma, what is the nurses role?
mandated reporter and needs to put objective data in EHR
208
what are headaches classified as?
-acute
-acute recurrent
-chronic progressive
-chronic nonprogressive
209
how do you treat headaches?
-relaxation
-OTC meds
210
what are nursing interventions for headaches?
encourage patients to keep a headache journal
211
what is unequal refractory curvatures?
astigmatism
212
what is abnormal eye movement?
nystagmus
213
what is cross eye and treated with occlusion therapy?
strabismus
214
what eye disorder has increased in otraocular pressure?
infantile glaucoma
215
what eye disorders cause cloudiness over corneal lens
congenital cataracts
216
what are nursing interventions for eye disorders?
-determine cause
-detect early as possible
-wear corrective lenses to improve visual acuity
217
what is known as obstruction of tear duct and excessive tearing?
nasolacrimal duct obstruction
218
what are symptoms of nasolacrimal duct obstruction?
-red, swollen eye lids
-resembles conjuctivitis
219
what is common with nasolacrimal duct obstruction?
infection when bacteria is not flushed out
220
how do you treat nasolacrimal duct obstruction?
-spontaneous and usually resolves around 1 year of age
-lacrimal massage
-topical antibiotics
probe with dilatation and irrigation if massage is not working
221
what is known as infection of eyelid and orbital tissues surrounding the eye?
periorbital cellulitis
222
what are symptoms of periorbital cellulitis?
-swelling of eyelid
-decreased vision
-increased IOP
223
what bacteria causes periorbital cellulitis?
methicillin resistant staph
224
how do you treat periorbital cellulitis?
hospitalization for IV antibiotics, decongestants to decrease secretions
225
what is known as inflammation of the conjuctiva of the eye?
conjunctivitis
226
what are symptoms of conjunctivitis?
-red
-swollen
-irritated eyes
227
how do you treat conjunctivitis?
oral medications or eye drops
228
fluid in the eye for a patient with conjunctivitis is contangious for how many hours after treatment?
24-48 hours
229
to help prevent further spread of conjuctivitis what should be done?
wash hands often and wash childs hands often
230
what causes hearing deficits?
genetic, acquired through infection or antibiotics, or unknown cause
231
how can you suspect hearing loss?
-startle reflex is absent
-no turn to voice or noise
-babbling at 6-7 months
232
what are nursing implications during hospitalization for hearing deficits?
-reassess instructions and understanding
-supplement with visual and tactile methods
-use communication devices such as picture boards and common words (food, water, toilet)
233
what are general nursing interventions for mental health and cognitive function?
-provide supportive care
-maintain a safe environment
234
what is the most common learning disabilitiy in children?
dyslexia
235
Common symptoms of learning disabilities may not appear until when?
until children enter formal school setting
236
what are manfestations of learning disabilites?
-slower acquisition of language and math skills
-difficulty recognizing letters and numbers
-problem with reading comprehension
237
how can you assess learning disabilities?
standardized testing
238
how do you treat learning disabilities?
treat with an individualized education plan (IEP)
239
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?
autism spectrum disorder
240
if a child may be suspected to have autism, what may be done?
implement standardized developmental screenings into well child appointments?
241
what are manifestations for autism spectrum disorder?
-stereotypy (reptitive movements)
-obsessive behavior
-difficulty with sensory integration
-echolalia (repeats words without meaning)
-avoiding eye contact
242
how do you treat autism spectrum disorder?
-early identification
-planning education activities
-collaborate with school staff
-consult speech therapist
-use a multidisciplinary approach
243
what is known as a neurobehavioral disorder characterized by inattentiveness with or w/o hyperactivity and impulsivity?
ADHD
244
what is the patho for ADHD?
unclear but may be genetic
245
what are symptoms of ADHD?
-short attention span
-impulsivity
-difficulties with movement
246
how do you diagnose ADHD?
diagnose with formal evaluation and psychological testing
247
how do you treat ADHD?
-educate caregiver
-develop IEP
-pharmacotherapy
248
what medications can be given for ADHD?
-ritalin
-adderall
-focalin
249
what are side effects of ADHD medications?
-weight loss
-appetite surpression
-tachycardia
-hypertension
250
what do you monitor with ADHD during medication treatment?
serum liver and kidney function
251
what disorder has worry, fear, and anxiety extend past normal adaptive coping mechanisms and cause stress and significant impairment?
anxiety disorder
252
what causes anxiety disorder?
combination of genetics and environmental factors
253
what are symptoms of anxiety?
-abdominal pain
-nausea
-palpitations
-dyspnea
-aggression
-defiance
-vomiting
-dizziness
254
how is anxiety categorized?
-generalized anxiety disorder
-separation anxiety disorder
-panic disorder
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what are treatment options for anxiety?
-Seperation anxiety and school refusal: exposure based cognitive behavioral therapy
-SSRIs
256
administering SSRIs to pediatric population will increase risk of?
suicide
257
what is known as an eating disorder characterized by fear of gaining weight or becoming overweight?
anorexia nervosa
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what age does anorexia nervosa occur?
onset is adolescence
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what are risk factors for anorexia nervosa?
-adolescence
-perfectionist personality
-family history of eating disorder
-low self esteem
-female gender
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what are symptoms of anorexia nervosa?
-anxiety
-depression
-suicidal thoughts
-low BMI
-dehydration
-lanugo
-cold intolerance
-hypotension
-crying
-compulsive exercising
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how do you treat anorexia nervosa treatment?
-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
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what is known as an eating disorder characterized by periods of binge eating followed by periods of purging?
bulimia nervosa
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Bulimia nervosa is a result of?
poor self image and societal pressures
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what are symptoms of bulimia nervosa?
-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
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how do you treat bulimia nervosa?
treat with cognitive behavioral therapy and SSRIs
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what is known as phsyical, emotional, or sexual abuse; exposure to domestic violence; neglect?
abuse and violence
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what are risk factors for abuse and violence for caregiver?
-mental illness
-lack of knowledge
-poor self esteem
-alcohol/substance abuse
-poor coping skills
-history of being a victim of abuse
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what are risk factors for abuse and violence as environmental factor?
-low income
-unemployment
-domestic violence
-lack of support
-low education attainment
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what are symptoms of abuse and violence?
-multiple fractures in various stages of healing
-suspicious bruising
-STIs
-enuresis
-vague somatic complaints
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how to determine signs of abuse?
-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
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what is known as misinterpretation or presentation of exaggerated or absent symptoms in a child to regain entry into medical setting?
-factitious disorder imposed on on another (FDIA) or munchausen syndrome by proxy
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what are contributing factors to FDIA?
-past history of abuse
-personality disorder
-somatic symptom disorder
-pathological lying
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what are manifestations for FDIA?
-frequent medical visits for fictious symptoms
-purposeful inducement of physical symptoms
-manipulation of lab tests
