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NUr1085 > Peds Final > Flashcards

Peds Final Flashcards

1
Q

Biliary Atresia

A

Blockage in bile ducts

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2
Q

Biliary Atresia manifestations

A

persistent or recurring neonatal jaundice
colic
clay colored stool
hepatomegaly
splenomegaly
FTT

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3
Q

Biliary Atresia Outcomes

A

cirrhosis
liver damage
early diagnosis/intervention improves outcomes

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4
Q

GI infection Causes

A

Viral: rotavirus
Bacterial: Salmonella, shigella, E. coli
Parasitic: Giardia

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5
Q

GI Infection S/S

A

diarrhea
abdominal pain
abdominal distention
nausea
vomiting

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6
Q

GI infection Management

A

Dehydration: oral hydration therapy/ Pedialyte (mild to moderate), IVF (severe)
Antibiotics: Shigella, C. diff, Giardia
Antibiotics CI: E. Coli, Salmonella
Skin care: diaper area

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7
Q

Cleft Lip

A

incomplete fusion in oral cavity

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8
Q

Cleft Palate

A

incomplete fusion of palatal plates

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9
Q

Cleft Lip/ Cleft Palate Complications

A

difficulty feeding
ear infections
hearing loss
dental issues
speech difficulties

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10
Q

Cleft Lip/ Cleft Palate Care

A

surgical closure (lip before palate, tape lip before procedure)
orthodontics for teeth
speech therapy

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11
Q

Cleft Lip/ Cleft Palate Post op Care

A

Protect operative sites:
elbow immobilizers/ restraints
avoid suctioning
avoid putting objects in mouth like pacifier, straw or hard sippy cup Diet: NPO, liquid advanced to soft diet after 3-4 days

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12
Q

Esophageal Atresia

A

failure of esophagus to develop

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13
Q

Tracheoesophageal Fistula

A

trachea and esophagus fail to separate

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14
Q

EA/ TEF S/S

A

Respiratory compromise: coughing, choking, cyanosis, aspiration, frothy saliva, nasal return of fluid
gastric distension with air

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15
Q

EA/TEF Management

A

Respiratory: maintain airway, prevent pneumonia, supine with HOB elevated, suction secretions,
GI: gastric decompression, NPO
Surgery: usually staged repair

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16
Q

Umbilical Hernia

A

bulge of organs through umbilicus

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17
Q

Umbilical Hernia Manifestations

A

pronounced protrusion of umbilicus with crying
S/S of I: intense pain, budging, firm, red

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18
Q

Umbilical Hernia Management

A

close spontaneously by age 3 or 4
surgery of incarcerated/does not closed

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19
Q

Inguinal Hernia

A

inguinal canal fails to close and intestines/ ovaries move in to canal

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20
Q

Inguinal Hernia Manifestations

A

progressive, enlargement and weakening
possible incarceration
intestinal obstruction
S/S of I: painful, firm bulge, abdominal distension, vomiting

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21
Q

Inguinal Hernia Management

A

Emergency if incarcerated/cannot be reduced
Elective if it can be reduced
No major restrictions on activity

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22
Q

Hypertrophic Pyloric Stenosis

A

Thickening of pyloric sphincter

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23
Q

Hypertrophic Pyloric Stenosis S/S

A

colic
intermittent abdominal pain
drawing legs up
currant jelly like stools (blood and mucus)
fever

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24
Q

Hypertrophic Pyloric Stenosis Management

A

NG for stomach decompression
IVF
antibiotics
enema
pain management

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25
Q

Hirschsprung’s Disease

A

Congenital absence of ganglion cells in intestine leading to inadequate motility and mechanical obstruction

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26
Q

Hirschsprung’s Disease S/S

A

failure to pass meconium within 48 hours of birth
distended abdomen
feeding intolerance
bilious vomiting

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27
Q

Hirschsprung’s Disease Management

A

pull through procedure
ostomy

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28
Q

Appendicitis

A

Obstruction of appendix leads to inflammation, compression of blood vessels (ischemia), ulceration of epithelial lining, bacterial invasion and necrosis with perforation

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29
Q

Appendicitis S/S

A

abdominal pain in RLQ
anorexia
vomiting
nausea
normal or elevated temp
guarding of abdomen
rebound
tenderness
increased WBC
Rovsing’s Sign

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30
Q

Appendicitis Managment

A

appendectomy
NPO
pain control
antibiotics
fluids

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31
Q

Anorectal Malformation

A

Failure of rectum to form properly either displaced or connected to urinary/reproductive tract, or missing

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32
Q

Anorectal Malformation S/S

A

Lack of stool
stool from vagina
urine from anus
constipation
obstruction
vomiting
abdominal distension

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33
Q

Omphalocele

A

herniation of abdominal contents through umbilical ring
peritoneal sac containing bowel and other viscera

34
Q

Gastroschisis

A

herniation of abdominal contents through defect in abdominal wall
no membrane covering exposed bowel

35
Q

Treatment for Omphalocele/ Gastroschisis

A

surgical repair
focus on nutrition to promote growth and development
will use silo with staged repair

36
Q

GER

A

Reflux of stomach contents into esophagus when lower esophageal sphincter fails

37
Q

GER S/S

A

spitting
vomiting
severe weight loss
FTT

38
Q

GER Managment

A

Medical: small frequent feeds, upright after feeding, thicken formula
Surgical: Nissen Fundoplication to support LES (Cannot vomit post op)
Feeding assessment: discomfort with feeds, arching of back, irritability
Growth and development assessment

39
Q

Ulcerative Colitis

A

inflammation/ulceration of mucosa and submucosa of colon and rectum

40
Q

UC S/S

A

rectal bleeding
diarrhea
abdominal pain
anorexia
weight loss
fever
anemia

41
Q

Crohn’s Disease

A

inflammation of entire GI tract and all layers of bowel wall
skip lesions

42
Q

IBD (UC/ CD) Managment

A

Focus on Nutrition
high protein
high calorie
vitamin supplement

43
Q

CD S/S

A

malabsorption
diarrhea
severe anorexia
severe weight loss
crampy abdominal pain
growth retardations
fistulas and strictures

44
Q

Constipation

A

Difficulty or infrequent passage of hard stool with straining, abdominal pain, or withholding behaviors for over 2 weeks

45
Q

Constipation S/S

A

hard stools
soiling underwear
abdominal pain and distention
irritable
loss of appetite
pain with toileting

46
Q

Encopresis

A

involuntary passage of stool after 4 years old associated with constipation and impaction

47
Q

Constipation Management

A

bowel evacuation
stool softener
regular toileting
change in diet
no punishment is indicated
child and parent needs counseling

48
Q

Sickle Cell Anemia

A

Autosomal recessive inheritance resulting in abnormal Hgb formation common in African Americans

49
Q

Sickle Cell Anemia Precipitating factors

A

factors that increase oxygen demand and alter oxygen transport:
Trauma, fever, infection, physical and emotional stress, increased viscosity due to dehydration, hypoxia, vasoconstriction

50
Q

Sickle Cell Anemia S/S

A

severe pain in hands and feet
swelling

51
Q

Sickle Cell Anemia Crisis Patho

A

abnormal formation of Hgb>
rigid sickle shaped Hgb >
obstruct blood flow >
inflammation >
tissue ischemia >
cellular death

52
Q

Sickle Cell Crisis Prevention

A

childhood vaccines (pneumococcal and meningococcal)
prophylactic penicillin from 2 moths to 5 years
hydroxyurea
good hydration
pain management

53
Q

Aplastic Anemia

A

All cell lines are simultaneously depressed (pancytopenia), marrow is “empty”

54
Q

S/S of Aplastic Anemia

A

pancytopenia:
thrombocytopenia
anemia
neutropenia

55
Q

Hemophilia Patho

A

X-linked recessive bleeding disorders to deficiency of clotting factors
carried by females, affects males

56
Q

Hemophilia A

A

deficiency of Factor VIII

57
Q

Hemophilia B

A

deficiency of Factor IX

58
Q

Classification of Hemophilia

A

Mild: 5-40% factor activity, bleeding with severe trauma or surgery
Moderate: 2-4.9% factor activity, bleeding with trauma
Severe: <2% factor activity, spontaneous bleeding without trauma

59
Q

Hemophilia Managment

A

apply pressure
transfusion for factor replacement with severe bleeding
elevate and immobilize joint, ice
analgesic
ROM exercise atter bleeding stops to prevent contractures

60
Q

Immune Thrombocytopenic Purpura

A

hemorrhagic disorder
Acute: self limiting after a viral illness
Chronic: > 12 months

61
Q

ITP S/S

A

thrombocytopenia
purpura (discoloration caused by petechiae under skin, with no other sings of bleeding)
normal bone marrow

62
Q

ALL

A

Acute: involving immature cells that mature rapidly
Lymphoblastic: B and T cells
Leukemia: Unrestricted proliferations of WBCS that infiltrate and replace normal tissues and depressed production of normal blood cells in the marrow

63
Q

ALL S/S

A

reflect infiltration of bone barrow by nonfunctional leukemic cells:
Decreased erythrocytes: anemia, fatigue, pale
Neutropenia: infections, repeated, fever
Decreased Platelets: increased bleeding
Cell Infiltration: bone pain, organomegaly
T-cell subtype: enlarged thymus, respiratory distress

64
Q

ALL Diagnosis

A

bone marrow aspiration or biopsy

65
Q

ALL management

A

Chemotherapy
Remissive induction: achieve remission <5% blasts in bone marrow
Consolidation: eradicate leukemic cells
Maintenance: preserve remission

66
Q

Wilms Tumor

A

primary malignant renal tumor

67
Q

Wilms Tumor S/S

A

asymptomatic abdominal mass
hematuria
malaise
hypertension

68
Q

Wilms Tumor Management

A

Surgery to completely recent tumor
Contraindication: palpation due to risk of capsule rupture
Chemo
Radiation for stage 3 and 4

68
Q

Neuroblastoma

A

Peripheral nervous system tumor arising along sympathetic chain most commonly affecting the abdomen

69
Q

Neuroblastoma S/S

A

Spine: stop crawling and waling, weakness, paralysis
Chest: trouble breathing
Abdomen: pain, distension, constipation, vomiting, diarrhea
Metastasized: black eyes, bone pain, bruises, Fever, painless

70
Q

Hodgkins and NH Lymphoma S/S

A

non-tender, painless, firm, movable, enlarged lymph nodes
low grade fever
anorexia
weight loss
night sweats
pruritus

71
Q

Hodgkins Lymphoma Diagnosis

A

biopsy for presence of Hodkin and Reed-Sternberg Cells

72
Q

Lymphoma Treatment

A

radiation, chemo
NHL: radiation only with chemo resistance

73
Q

Non-Hodgkins Lymphoma Vs Hodgkins Lymphoma

A

NHL: metastasis in bone marrow and CNS
HL: still only in lymph nodes

74
Q

General care of patient with cancer/on chemo

A

Dose calculation and verification and administration
Monitor for acute and delayed onset toxicities
Call treatment team at first sign of fever

75
Q

Mylosupression

A

Decreased bone marrow activity
S/S: neutropenia, anemia, thrombocytopenia

76
Q

Prevention of Infection with neutropenia

A

hand washing, mouth care, private room, precaution based on neutrophil count, colony stimulating factors
initiate broad spectrum antibiotic for fever during period of neutropenia

77
Q

Thrombocytopenia Management

A

platelet transfusion
avoid skin puncture
mouth care with soft toothbrush
Tylenol for pain (not aspirin)

78
Q

Anemia Managment

A

PRBC transfusion
regulate activity to manage fatigue

79
Q

N/V managment

A

Prevention is goal:
administer antiemetics 24 hours before, during and after chemo

NUr1085 (3 decks)

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