Peds Final - Review Flashcards
how to give meds to reluctant toddler / pre schooler
-give them a choice
-mix w/ food
-reward
-change method of delivery
Coarctation of the aorta
narrowing of aortic arch distal to the ductus so all the blood gets shunted up lower will have reduced blood flow, upper get high causing headaches, nose bleeds & bounding pulses
treated w/ prostaglandin E and surgery within first 2 years
kawasaki
body wide inflammation of veins, capillaries & coronary arteries treated with high dose aspirin for anti inflam & low dose for anti platelet and IVIG if fever is caught within 10 days
CHF
failure of the heart to supple enough blood to meet needs leading to sweating, tachy, decrease BF to kdineys, low urine output, cyanosis, SOB, edema, long cap refill
how to give digoxin
-1hr before or 2hr after eating
-check apical HR for 1 min prior
-do not mix with food or fluid
-put behind teeth then oral care
when to hold digoxin
if apical pulse is <90 in infants / young kids or <70 in older kids or low K+
if missed dose, can give within 4 hrs, but longer hold
signs of digoxin toxicity
-vomiting
-nausea
-bradycarida
-anorexia
-neurological & visional dysfunction
tetralogy of fallot
1) palmonic stenosis
2) overriding aortic arch
3) VSD
4) right ventricular hypertrophy
pre op care for cath lab
-npo for 4 to 6 hrs, clarify morning meds
-assessment including ht & wt
-assess skin can’t bring with a diaper rash or cystic ache
-mark pedal pulses
post op care for cath lab
observation of color, LOC, VS, res status, distal extremities, assess dressing for bleeding, fluids, blood sugar (esp hyper) & keep flat for 4-6hrs
bacterial endocarditis
infection of the valves and inner lining of the heart (usually occurs from a picc line or dental procedure) -> manifests w/ janeway spots, osler nodes, splinter hemorrhages under nails, petechia, anorexia, joint point & murmur
transposition of the great arteries
pulmonary artery arises from left ventricle and the aorta arises from the right ventricle -> treated w/ prostaglandin E until surgery
Hypospadias immediate post op care & teaching
urethral opening is on the ventral surface of the penis, surgical correction between 6-18mo no circ before surgery-> post opt care include assessing pressure dressing for drainage, cath care and teaching no tub baths, straddle toys, and baby cannot be carried on hip
more at risk for uti
key facts for GN
-caused by untreated strep, give abx
-S/s: headache d/t htn, coke colored urinne, facial edema
-urinalysis: hematuria, proteinuria & elevated SP w/ a negative culture
-diet: no salt, low pro
-bed rest, isolation
manual BP
key facts for acute renal failure
-caused by dehy (give fluids) or toxic meds (stop med then fluids)
-dx: low urine out, edema, classic dehy signs
-labs: bun & creatinine elevated, hypo Na, hyper K, hyper Phos
-meds: albumin then lasix
UTI teaching
wipe front to back, no tight clothes, hydrate, pee after sex, potty schedule, no bubble baths, change pads frequently
VCUG is reoccurring -> if reflux founds then abx or surgery in severe cases
key facts for NS
-S/s: massive proteinuria, rapid wt gain + generalized edema, decreased urine out, normal or slightly decreased BP, hypoalbuminemia
-bed rest & no salt, high pro if edema present + isolation
-meds: steroids & loop diuretics
key facts for HUS
-hx of GI bug + V/D, edema, oliguria, elevated BP, abdominal pain
-labs: low platelets & RBCs anemia
-Prevent: wash hands/fruits/vegs, cook & temp, avoid unpasteurized dairy & fruit juices
Downs S/s + treatment
-dx: depressed nose bridge & small nose, loose skin, large protruding tongue, wide space in between big toe, delayde sexual development, constipation
-tx: suction, antihis @6mo, blow nose, mist ; persistent feeding ; support neck & swaddle for thermal reg ; fluids & fiber
ADHD
-dx: 2 people say difficult concentrating, struggling in school and social settings
-tx: behavioral therapy 1st (front of class, low distraction, short written out task list) then meds (psychostim so clinic every couple months so assess growth & BP)
-med teaching: empty stomach, 7am and noon, no med holidays
DDH + harness
head of femur is not in hip socket so harness all the time besides baths prevent sink breakdown & avoid lotions/powders
MD
meets milestones then regression around 3-5 yrs
-brainstorm and work with family to keep them independent
-work w/ the therapies
SB
-paralyzed from waist down, incon of bowel and bladder (**high risk for uti d/t in&out cathing) + bowel training
-high risk for hydrocephalus after surgery
cast care
-neuro vascular checks + skin assessments 5 Ps
-do not stick anything into cast besides fingers
-ice for itching and swelling
-NSAIDs for pain No ibuprofen
-isometric exercises on affected side
kids are scared of removal -> ear plugs, demo on self, distraction
CP
-dx by missed milestones & persistent reflexes
-keep independent as long as possible
-support use of muscle
asthma
-proper deliver of meds (control= steroids & long beta 2s, rescue= short beta 2s, bronchodi’s & mag sulfact)
-med teaching (sit up, shake, breath out, inhale & press, hold 10 sec or spacer)
-PERF chart