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4th Semester > Peds Exam 4 > Flashcards

Peds Exam 4 Flashcards

1
Q

A patient has a lazy eye (amblyopia), what can be done first to manage this condition?

A

Patching of the stronger eye, atropine drops in stronger eye.

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2
Q

A patient has congenital cataracts. What management measures should be taken?

A

Surgical removal of cataracts, sunglasses when outside.

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3
Q

A patient is diagnosed with OME. Should the nurse plan to administer antibiotics?

A

No. OME is non-infectious.

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4
Q

A child comes to the clinic and the parent states that they’ve been pulling at their ear and running a fever. What do you expect?

A

Acute otitis media.

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5
Q

How would a nurse expect to manage AOM?

A

Antibiotics. And manage ear pain and fever.

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6
Q

What are the 3 types of hearing loss?

A
  • Sensorineural: Ototoxic meds, meningitis, CMV, rubella, excessive noise.
  • Conductive: Frequent OM
  • Mixed: Both conductive and sensorineural
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7
Q

What is used to relieve pressure, provide a route for infection to leave, and is indicated in patients with frequent OM?

A

Tympanostomy tubes.

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8
Q

A patient that has tympanostomy tubes states that they love swimming. What should the nurse educate them about?

A

Wearing earplugs while swimming.

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9
Q

On assessment, the nurse finds that the patient’s red reflex is grayish (or green), what condition might the nurse suspect.

A

Glaucoma

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10
Q

When administering eardrops or inspecting TM in a patient that is 2 years old, what steps should the nurse take?

A

Pull earlobe down and back.

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11
Q

A patient with ALL complains of leg pain. Why does this make sense?

A

The issue r/t ALL occurs within the bone marrow.

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12
Q

18 month old presents w/ watery diarrhea, an asymmetric abdomen, a contender mass in right abdomen, proptosis in right eye, and elevated HVA and AMA. What do you suspect?

A

Neuroblastoma.

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13
Q

15 year old patient presents with complaints of dull R leg pain, has a limp, has erythema/ swelling around the knee and bone scan shows mass in right distal femur. What do you suspect?

A

Osteosarcoma.

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14
Q

What type of lesion is ringworm?

A

annular

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15
Q

Why is treatment different for tinea captius vs other fungal infections?

A

Topical won’t work. Must take oral griseofulvin.

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16
Q

What is associated w/ MRSA and staph, commonly occurs around nose and mouth and has pustules w/ honey colored crusts?

A

Impetigo.

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17
Q

When staph aureus infection produces a toxin causing the baby to have a burned appearance, what is this called?

A

SSSS.

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18
Q

When should sunscreen be re-applied?

A

At least every 2 hours.

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19
Q

A 15 year old child presents with areas of comedones (bumps) on forehead and cheeks and also has scattered pustules on his back with hypertrophic scarring. The nurse knows that he probably has what condition?

A

Acne Vulgaris

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20
Q

What are some history and physical cues that would support a diagnosis of acne vulgaris?

A

-Presence of comedones, pustules, hypertrophic scarring
- Oily skin and/or hair
- Hx of endocrine disorder
- Use of steroids, androgens, lithium, phenytoin, isoniazid.
- Acne worsens 2 to 7 days before start of next MP for females

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21
Q

How is acne vulgaris managed?

A

Use of topical medications as prescribed. May use tretinoin, benzoyl peroxide, clindamycin, isoretinoin (severe), and oral contraceptives.

22
Q

What education should be provided regarding acne vulgaris management?

A
  • Clean skin w/ mild soap and water BID. Shampoo hair regularly.
  • Avoid oil based cosmetics and products.
  • Avoid headbands, helmets, hats.
  • Avoid picking/ squeezing comedones.
23
Q

At what time during the day should sun exposure be limited to prevent sunburn?

A

10am to 4pm

24
Q

When providing education for a parent of a 3 month old regarding sunscreen use/ sun exposure, what teaching should be provided?

A

Child should stay out of direct sunlight and sunscreen should be used minimally until child reaches 6 months of age.

25
Q

Know signs of intentional injuries

A

Common sense tbh.

26
Q

A parent brings her child to the ED reporting that he has not been able to sleep through the night because he is very itchy and keeps trying to scratch at his cheeks. The parent then became more concerned when he started to wheeze. On assessment the nurse notices a red rash on the cheeks with some plaques and scaling. The parent says the child is very active and usually enjoys running around playing outside. What does the nurse suspect?

A

Atopic dermatitis (eczema)

27
Q

What non-pharmacological steps can be taken to manage atopic dermatitis?

A
  • Avoid hot water and bathe BID in warm water.
  • Avoid soaps containing perfumes, dyes, fragrances
28
Q

The nurse knows that warts (verruca) are caused by what virus?

A

HPV

29
Q

What is the official name for ringworm?

A

Tinea corporus

30
Q

A patient presents with flesh colored papules on extremities and trunk. What does the nurse suspect?

A

Molloscum contagiosum

31
Q

The parent of a child with molloscum contagiosum asks about what medication they should get to treat it. How should the nurse respond?

A

Inform them that molloscum contagiosum should resolve spontaneously in around 18 months

32
Q

The nurse understand that glaucoma is a result of what?

A

Obstruction of the flow of aqueous humor

33
Q

A patient with hx of sickle cell anemia presents to the ER with complains of extreme joint pain. On assessment, the nurse finds that the child is tachycardic and tachypneic and notes dactylitis of the fingers. What condition/ complication is this patient experiencing?

A

Vaso-occlusive crisis

34
Q

What is a treatment (not anti fungal) that can be used to treat tinea versicolor?

A

Selenium sulfide shampoo weekly x4 weeks.

35
Q

Physical cues of candida vs non-candida diaper dermatitis

A
  • Non-candida: Red, shiny. Affects skin on butt, thighs, abdomen, and waist.. Usually not in creases or folds.
  • Candida: Deep red lesions, scaly, usually in creases and folds.
36
Q

What is the most important thing to do when first starting an interaction with a visually impaired child?

A

Use their name to get their attention and identify yourself before touching child.

37
Q

Patho: Over production of immature leukoblast cells (WBC) with infiltration of organs and tissues.
What is this condition?

A

Acute Lymphoblastic Leukemia (ALL)

38
Q

What is the most definitive diagnostic for confirming ALL?

A

Bone marrow aspirate. (Prolific # of blasts)

39
Q

What cells does neuroblastoma arise from?

A

Nerve cells

40
Q

A patient presents to the unit with hx of persistent fevers, recurrent infection, fatigue, pallor, and hx of unusual bleeding and bruising. During assessment, the child complains that their leg hurts. What condition might the nurse suspect?

A

ALL

41
Q

A child with history of hemophilia presents to the ED after falling off his bike. He has uncontrolled bleeding from his leg and has suspected head trauma. What is the priority intervention?

A

Administer Factor VIII asap.

42
Q

What type of sedation is used during bone marrow aspirate?

A

Conscious sedation (propofol)

43
Q

How should the nurse care for and monitor a child who has just had a bone marrow aspirate done?

A

Apply pressure to the site for 5 to 10 min then apply pressure dressing. Assess VS frequently, monitor for s/s of bleeding and infection.

44
Q

A patient is suspected to have lymphoma. What physical cues support this suspicion?

A

Painless, enlarged supraclavicular or cervical lymph nodes, reports of night sweats, recent weight loss >10%, cough, hepato/splenomegaly.

45
Q

What diagnostic finding confirms lymphoma diagnosis?

A

Lymph node biopsy is positive for Reed-Sternberg cells.

46
Q

A child is suspected to have a neuroblastoma. Where would you expect their tumor to be?

A

Abdomen. sometimes chest or retroperitoneal area.

47
Q

What diagnostic finding confirms suspicion of neuroblastoma?

A

24 hour urine shows elevated HVA and VMA.

48
Q

The nurse is caring for a child with hx of osteosarcoma. The nurse knows that these are commonly found at what 3 sites?

A

Proximal humerus, tibia, and distal femur.

49
Q

One of the treatments for osteosarcoma is limb salvage procedure. Describe this procedure.

A

Use chemotherapy to shrink tumor, then extract large pieces of bone/tissue to remove tumor, and totally replace affected bone/joint.

50
Q

What are 3 assessment findings that may indicated presence of osteosarcoma?

A

Dull bone pain, limp, limited ROM.

4th Semester (10 decks)

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