Peds Midterm Week 4 Flashcards
What environmental factors contribute to cleft lip and palate?
Maternal smoking, ETOH, Folic Acid deficiency
What drugs or chemicals contribute to cleft lip and palate?
Phenytoin (Dilantin), Valproic Acid (Depakote)
Thalidomide, Diosin (a pesticide from burning trash)
What are nursing considerations for cleft lip/palate?
Risk for altered parenting
Risk for aspiration
Risk for altered nutrition: less than body requirements
Risk for infection
What is cheiloplasty and when should it be performed on the infant?
Cleft lip repar, 10 wks, 10 lbs
What is appropriate post-op care w/ cheiloplasty?
- Suture line care (p. jelly, diluted peroxide, saline, 2. Logan Bow or butterfly)
- Avoid sucking or vigorous crying
- SUPINE OR SIDE-LYING POSTION WITH ARM RESTRAINTS
What are long term considerations for cheiloplasty?
staged repair (multiple surgeries
self-image
acceptance
feeding
What is STaphylorrhaphy?
Cleft Palate repair, 6-18 months
What post-op care is important in cleft palate repair?
4Ps: Post-op Prone (immediate recovery) Packing Protect (suture line)
What are the LT considerations for cleft palate repair?
Middle ear infections
Upper RTI
hearing screening
speech therapy
What is Gastroschisis and what causes it?
herniation of the abdominal viscera outside the abdominal cavity thru a defect in the wall to the side of the umbilicus.
Caused by: young moms, smoking, OTC (tylenol, sudafed and aspirin)
What is Omphalocele? what is it associated with?
intraabdominal contents herniated THROUGH the umbilical cord; enclosed by a translucent sac that umbilical cord inserts into.
Associated with congential anomalies such as Edwards Syndrome, Trisomy 18/21
mom >30 years old
What manifestations are seen with Esophageal Atresia and Tracheoesophageal Fistula?
Polydramnios in utero
frothy saliva, drooling
coughing, choking cyanosis, reflux thru nose, aspiration of feedings
aspiration pneumonia
What are post-op respiratory complications with EA and TEF surgery?
Ateclectasis
pneumothorax
laryngeal edema
What is the danger of a hernia?
constriction which causes impaired circulation
What is Meckels Diverticulum?
outpocketing pouch with gastric or pancreatic tissue that secrets HCl or panc enzymes and causes irritation, ulceration or abscess.
MOST COMMON CAUSE OF RECTAL BLEEDING
What is the key indicator of Meckels divertiuclum?
Bright red rectal bleeding with no pain
What is the cause of gastroesophageal reflux?
dysfunction of the lower esophageal sphincter and delay in gastric emptying
What are the S/s of GERD?
Weight loss or poor weight gain Irritability Frequent regurgitation Heartburn or Chest pain Hematemesis Dysphagia
What is Obstipation?
What is Encopresis?
- long intervals b/w stools
2. constipation with fecal soiling
What is the peak age for appendicitis?
10 to 12 years
What is pyloric stenosis and what is the key characteristic?
hypertrophy and hyperplasia of the pyloric muscle causing food not to go down GI tract and results in metabolic acidosis.
Key sign: PROJECTILE VOMITING
What are the key S/s of intussuception?
- 50% occur in 3-12 month olds and 50% in 1-2 year olds.
- Episodes of acute abdominal pain with intervals of no pain associated with peristalsis
- Later- CURRANT JELLY STOOLS and abdominal distention
What is the treatment for intussuception?
Barium, air or water soluble contrast enema under pressure sometimes reduces the invagination; other wise SURGICAL REDUCTION
What is Hirschsprung’s Disease?
Congenital Aganglionic Megacolon: absence of Parasympathetic innervation of the colon results in abscence of peristalsis.
Associated with failure of internal sphincter to relax. All causes collection of bowel contents, distention of bowel, injury to the bowel wall and enterocolits
