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Peds > Peds Final > Flashcards

Peds Final Flashcards

1
Q

Erikson’s Stages

A
  1. Trust vs. Mistrust (Birth-18 months)
  2. Autonomy vs. shame + doubt (18 months-3 years)
  3. Initiative vs. guilt (3-5 years)
  4. Industry vs. inferiority (5-12 years)
  5. Identity vs. Role confusion (12-18 years)
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2
Q

Isotonic dehydration

A
  • Lose electrolytes and water equally
  • Primary form in kids!!!
  • Sodium levels are normal
  • Biggest concern is shock!!
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3
Q

Hypotonic dehydration

A
  • Lose more electrolytes than water
  • Sodium levels are low (<135)
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4
Q

Hypertonic Dehydration

A
  • More water is lost than electrolytes
  • Most dangerous type of dehydration!!
  • Sodium levels are high (>150)
  • Seizures are more likely
  • Tachycardia is earliest sign of dehydration
  • For each 1% weight loss = 10mL/kg fluid resuscitation
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5
Q

Mild dehydration

A
  • Fluid loss less than 50mL/kg
  • Capillary refill less than 2 seconds
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6
Q

Moderate dehydration

A
  • Fluid loss 50-90mL/kg
  • Capillary refill 2-3 seconds
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7
Q

Severe dehydration

A
  • Fluid loss greater than or equal to 100mL/kg
  • Capillary refill greater than 3 seconds
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8
Q

Calculation of fluid requirements

A

Child who weighs 1-10kg = 100mL/kg

Child who weighs 11-20kg =
1000mL + 50mL/kg for each kg over 10 kg

Child who weighs more than 20 kg =
1500mL +20mL/kg for each kg over 20kg

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9
Q

Renal Diet

A
  • Low protein
  • Low phosphorus
  • Low sodium
  • Low potassium
  • HIGH carbs
  • HIGH calcium
    LIMIT FRESH FRUITS + VEGGIES
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10
Q

Celiac diet

A

No gluten!!
(no wheat, rye, barely, or oats)

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11
Q

Signs/Symptoms of increased ICP

A

Early:
- Headaches, diplopia (blurry vision), N/V, vertigo, seizures

Late:
- Bradycardia, decreased LOC, decreased motor response, diminished response to pain, cushing’s triad (bradycardia, HTN, irregular respirations)

Infant:
- Wide sutures, tense/bulging fontanels, high-pitched cry, setting-sun sign

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12
Q

What diet for seizure prevention?

A

ketogenic diet:
(high fat, low carb, adequate protein)

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13
Q

Wilm’s tumor Nursing care

A
  • Surgery ASAP to remove tumor, affected kidney, and adjacent adrenal gland
  • DO NOT PALPATE!!!
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14
Q

What is wilm’s tumor and what are signs and symptoms

A

AKA nephroblastoma

  • most common malignant renal and intra-abdominal tumor in childhood
  • More common in asian and black children
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15
Q

Pyloric stenosis

A

hallmark signs
- projectile vomiting
- moveable olive-shaped mass in epigastrum

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16
Q

Pertussis

A

(aka whooping cough)
symptoms:
- runny nose
- cough that becomes more severe and spasms
- flushing or cyanosis
- vomiting

treatment:
- antibiotics
- steroids

17
Q

Asthma symptoms

A
  • wheezing and dry cough
  • prolonged expiration
  • restlessness + fatigue
  • tachypnea
  • cyanosis
  • chronic use of accessory muscles for respiration can lead to barrel chest
18
Q

nursing care for asthma

A
  • assess resp. status and monitor pulse ox
  • admin. humidified oxygen prn
  • position high-fowlers and avoid cold liquids to avoid bronchospasm
  • sudden cessation of wheezing + decreased breath sounds = worsening
  • maintain IV access
19
Q

Cystic fibrosis patho

A
  • increased viscosity of secretions
  • lungs atelectasis
  • clogged pancreatic ducts
  • absence of pancreatic enzymes in small intestines - unable to absorb fats/protein
20
Q

Cystic fibrosis symptoms

A
  • cough and sputum
  • dyspnea and decreased SaO2
  • crackles or wheezes
  • cyanosis
  • digital clubbing
  • bulky, frothy, foul-smelling stools (steatorrhea)
  • meconium ileus (bowel obstruction)
21
Q

Nursing care and meds for cystic fibrosis

A
  • fat soluble vitamins (A,E,D,K)
  • administer pancreatic enzymes w/ meals and snacks
  • avoid exposure to resp. infections
  • chest percussion and postural drainage
  • activity and exercise will loosen secretions
22
Q

What is the main diagnostic cystic fibrosis?

A

if before birth:
- prenatal DNA of amniotic fluid

if after birth:
- sweat test

23
Q

Vaso-occlusive crisis symptoms

A
  • pain
  • priapism
  • acute chest syndrome
  • stroke
24
Q

Hemophilia treatment

A
  • factor VIII
  • no heat therapy
  • No IM injections
  • no aspirin/NSAIDS
25
Q

kawasaki disease symptoms

A
  • high fever
  • red eyes
  • ring around iris
  • strawberry tongue
  • irritability that lasts for months
26
Q

Types of fractures

A

Bend
- ulna and fibula when there’s a fracture in the radius and tibia

Buckle
- protrusion at the end of the fracture site - usually by the epiphysis

Greenstick
- compressed side bend and makes the opposite side split - incomplete fracture

Complete
- bone is completely broken but may be held together with periosteal hinge

27
Q

symptoms of hypoglycemia vs. symptoms of hyperglycemia

A

hypoglycemia:
- shaky/dizzy
- tachycardia
- diaphoresis
- anxiety
- polyphagia
- blurry vision
- lethargy
- headache

hyperglycemia:
- 3 polys (polyphagia, polydipsia, polyuria)
- tiredness
- blurry vision
- weight loss

28
Q

NIPS pain scale

A

used from birth to 2 months

  • cry
  • facial expression
  • arms
  • legs
  • breathing pattern
  • state of arousal
29
Q

FLACC scale

A

used 2 months to 7 years

  • Face
  • Legs
  • Activity
  • Cry
  • Consolability
30
Q

FACES pain scale

A

3 years and older
(use if child is awake and able to communicate)

31
Q

Triad of hemolytic uremic syndrome

A
  1. anemia
  2. thrombocytopenia
  3. renal failure
32
Q

Hemolytic uremic syndrome etiology

A
  • primarily in 6 month to 5 years old
  • associated with e. coli
  • begins with gastro or uri
33
Q

nephrotic syndrome

A

kidney disorder that causes your body to pass too much protein into your urine

Treatment:
- low salt diet
- severe cases fluid restriction
- 25% albumin

34
Q

Babinski

A

dorsiflexion of big toe and fanning of toes - should be absent after 1 year or after beginning to walk

35
Q

CM’s of bacterial meningitis (ALL BAD)

A

kernig’s sign: stiffness in hamstrings that prevents ability to straighten the leg

Brudzinski’s sign: major stiffness in neck that causes flexion of the hips and knees when neck is flexed

36
Q

Gowers sign

A

child starts on hands and knees, then walks hands up legs to stands (associated with duchenne muscular dystrophy)

37
Q

Graves disease

A

(AKA hyperthyroidism)

Labs: low TSH, high T3 and T4

Symptoms: goiter, exophthalmos, irritability, hyperactivity, short attention span, tremors, insomnia, mood swings, poor concentration, nervousness, and decreased weight

38
Q

osteogenesis imperfecta

A

“brittle bone” disease

Symptoms: fragile bones, deformity, fractures, blue sclerae, hearing loss, hypoplastic discolored teeth

Peds (3 decks)

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