Peds II Flashcards
Atrial Septal deficits
“wet lungs” to much blood sent to the lungs. Can lead to respiratory infection and poor exercise tolerance.
Ventricular septal deficits
Feeding difficulties, shortness of breath, increased respiratory infections, fatigue and delayed growth can occur
dyspnea
labored breathing; shortness of breath
Tetralogy of Fallot - Decrease pulmonary blood flow
Symptoms - central cyanosis, coagulation defects, clubbing of fingers/toes, feeding difficulties, dyspnea
central cyanosis
blue/purple color of skin due to low oxygen saturation
coagulation defects
problem with the body’s blood clotting process
OT treatment for kids w/congenital heart defects are
- compromised endurance
- paced activities
- education of family in health maintenance (diet, exercise)
comorbid condition
one or more additional disorders/diseases co-occurring
Bradydysrhythmia
abnormal slow heart rate (less than 60 beats/min
may need a pacemaker
atrioventricular block
impairment between the atria and ventricles of the heart
Tachydysrhythmia
abnormal fast heart rate at 200-300 beats/min
- common in kids
- can lead to congestive heart failure
pallor
pale color of the skin caused by illness, stress or anemia
anemia
decrease in the amount of red blood cells in the blood
Acute - Respiratory distress syndrome
common in preterm infants
many infants recover after a few days
Chronic - Bronchopulmonary dysplasia
due to prolonged use of a mechanical ventilation
- airways thicken, formation of excess mucus and restricted alveolar
- greater risk of respiratory infections
Chronic - Asthma
airway constriction in the lower respiratory tract
- appear around age 5
- inhalation of irritants trigger attacks
OT treatment of Asthma
- Educate on exposure to irritants
- self-management strategies like pacing/stress management
- peer-group activities to reduce social isolation
- breathing exercises, stretching, and controlled breathing to manage attacks
Chronic - Cystic Fibrosis (CF)
- due to gene on chromosome 7
- affects multiple systems (pancreatic duct, bronchial tree, digestive tract) due to thick secretions
- chronic pulmonary disease can occur
- May cause right side of the heart to be enlarged
OT Treatment - Cystic Fibrosis
- Educate the client on the disease’s progression
- Educate on energy conservation
- Teach techniques to promote efficient breathing
Erythrocytosis
Too many red and white blood cells
Hemophilia
Absence or reduction of clotting blood proteins found mostly in men
- longer bleeding times
- three types
-signs are: excessive bleeding/bruising spontaneous bleeding and nosebleeds
Anemia
- caused by iron deficiency
- treated through diet (iron rich foods)
Sickle Cell Anemia
abnormally shaped red blood cells
- most common in african-americans
- at risk for organ damage due to blocked blood flow
- decreased energy for daily tasks
- teach pain management
Osteogenesis imperfecta (OI)
brittle bones
- educate in handling and positioning to prevent fractures
- wb monitoring activities
Marfan’s Syndrome
excessive growth at the ephipyseal plates
-walking may be delayed
Achondroplasia
stunting of ephiphyseal plate growth
the person may be 4 ft or less
-back and leg pain are common
Arthrogryposis multiplex congential
incomplete contracture of many or all of the client’s joints
- have still extremities and thickened knee/elbow joints
- muscles are underdeveloped
-OT treatment - increase/maintain ROM and strength for ADLs, splinting and serial casting
Congenital Clubfoot
Uni/bilateral forefoot adduction/supination
-Treatment - taping, casting, splinting
Congential club hand
partial or full absence of the radius
-Treatment - Cashing, static/dynamic splinting
Polydactyly
someone has excess of fingers/toes
Syndactyly
Webbing occurs between the fingers/toes
splinting and scar reduction
Bradydactyly
overly large digits
-May have issues with ADLs and fine motor skils
Microdactyly
Overly small digits
Amelia
absence of a limb or distal segment of a limb
strain - soft tissue
trauma to the muscle or muscle-tendon insertion
sprain - soft tissue
rapid swelling, heat, and impaired function to a ligament
bruise - soft tissue (contusion)
impact into the subcutaneous tissue w/skin discoloration
Juvenile Rheumatoid Arthritis (JRA)
Persistent arthritis in one or more joints
- inflammation, stiffness, contractures, and change in growth patterns.
- OT treatment - splinting, AROM/PROM, monitor joint function to prevent deformity, energy conservation, AE to lessen the stress of joints
Fracture
A broken bone
Complete Fracture
bone is broken all the way through
Comminuted fracture
bone is broke into many splintered pieces
Compound fracture
broken bone leads to an external wound w/bone protruding
Epiphyseal Fracture
The break happens between the shaft and epiphysis
Greenstick fracture
bone is partially broken and bent
-only in kids
Intrauterine Fracture
bone is broken in utero
Mild IQ between 55-70
Ability to learn academic skills at the third-seventh grade level able to work w/min support
Moderate IQ between 40-55
Academic skills at the second grade level and able to perform unskilled as well as some skilled work tasks
Severe IQ between 25-40
Able to communicate and perform some basic ADLs and health habits often needing support
Profound IQ below 25
Requires caregiver assistance for basic tasks
NDT Approach to Handwritting
-Good for kids w/poor postural control, poor automatic reactions and limited limb control, kids with tone issues and poor proximal stability.
- Promote proximal joint stability
- Improve hand function
Acquisitional Approach to Handwiriting
- Implemented in brief, daily lessons.
- Individual to each child.
- Cognitive phase: develop a cognitive strategy for the necessary motor movement.
- Associate phase: Proprioceptive feedback and visual cues.
Sensorimotor Approach to Handwriting
Various sensory experiences, media, and materials are incorporated.
-Multiple writing tools, writing surfaces, and positions for writing should be offered.
Biomechanical approach to Handwriting
- Ergonomic factors that influence writing production.
- Sitting posture, table suraces, paper position, pencil grip.
Psychosocial approach to Handwriting
- Improving self-control, coping skills, social behaviors.
- Communicating the importance of good handwriting to the child.
- Opportunities to enhance self-confidence are provided.
What is Ayres Sensory Integration?
Proximal senses are emphasized; these senses are thought to dominate a child’s early life experiences.
- vestibular
- tactile
- proprioceptive
Neurologically based concerns concerning sensory integration is?
- Optimal brain function is based on sensory input.
- A lack of sensory input at critical points in development may result in learning or behavioral disorders.
Children seeking vestibular input may appear to be? (fail to orient to the stimuli/hyporesponsivity)
Reckless or risk takers; they may need a lot to get going.
Children seeking proprioceptive input may try to get their needs by? (Fail to orient to stimuli/hyporesponsivitiy)
Engaging in rough housing and other activities that provide them with deep-pressure input or muscle resistance.
The kids may seek this type of input may be trying to regulate their experiences of touch or movement.
Tactile Defensiveness (overorient to stimuli/hyperresponsivity)
extreme reaction to tactile input, light touch may be noxious, may be extrasensitive on their face, abdomen, and palmar surfaces of their hands.
Gravitational insecurity (overorient to the stimuli/hyperresponsivity)
vestibular input, scared of movement and may move carefully and need their feet always on the ground.
What is sensory discrimination problems?
- difficulty making sense of, or interpreting, tactile input. Difficulty with visual-motor tasks and motor planning.
- fine motor manipulation skills may be delayed.
What is proprioception problems?
Not getting the information the kids need from their muscles and joints.
-Cognitive strategies can be used to help them compensate.
What is vestibular-proprioceptive probems?
Poor bilateral coordination and difficulty sequencing actions.
(a child responding to a ball being kicked to them)
