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OB > peds test 3 > Flashcards

peds test 3 Flashcards

1
Q

The wrong reasons for not reporting 8

A 
Someone else will
Lack of training
discipline vs abuse
lack of knowledge
fear of legal consequences
fear of loss of therapeutic relationship
CPS wont help
Biases
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2
Q

Age range for school-aged child

A

6-12 yrs

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3
Q

Weight and height for school aged kid

A

7lbs a year and 2.5 in/yr

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4
Q

When is brain growth complete?

A

10 yrs

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5
Q

four cognitive developments of a school age kid

A

Can see things from another point of view
can think through an action anticipating consequences
can classify and divide things

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6
Q

3 motor skills of school age kid

A

Ride a two wheel bike
jump rope
sports participation

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7
Q

What is the nutrition rule for school aged kids?

A

5210- 5 fruits and veggies 2 hours screen time 1 hour of active play 0 sweet beverages

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8
Q

What is the best thing to do for a kid who has a fever?

A

Hydrate them

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9
Q

Fluids and kids 4

A

Kids have more fluid than adults
need more fluid per body weight than adults they excrete more
Extracellular fluid is more with higher Na+ Cl-
don’t concentrate urine very well

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10
Q

Three abnormal signs of vomit

A

bilious, bloody, projectile

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11
Q

Explain how a virus causes diarrhea

A

Injury to absorptive surface resulting in decreased fluid absorption

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12
Q

Explain how bacteria causes diarrhea

A

Intestinal injury by invasion of mucosa and release of toxins

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13
Q

Chronic diarrhea 5 causes

A

milk/soy intolerance, giardia, tumors, ulcerative colitis, celiac

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14
Q

What should an oral rehydration solution contain?

A

75mmol/L NaCl and 13.5 g/L

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15
Q

If someone is dehydrated, why do you not want them drinking tap water?

A

It will cause hypoNa+

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16
Q

how to give oral rehydration therapy
and
What if the child vomits?

A

50-100mL/kg over 4 hours-give 1mL/kg every five mins

resume after 30mins

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17
Q

What should normal urine output be for a child?

A

1-2ml/kg/hr

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18
Q

IV replacement bolus of and time

A

20ml/kg over 30-60mins

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19
Q

What is hyper trophic pyloric stenosis?

and is it rare?

A

Circular muscle of the the pylorus becomes hypertrophied causing thickening of the pyloric canal this causes gastric outlet obstruction
yes

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20
Q

s/s of hypertrophic pyloric stenosis 5

A

non-bilious vomiting, projectile vomiting, hunger right after vomit, olive in RUQ, possible visible peristalsis

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21
Q

What is the surgery for hypertrophic pyloric stenosis?

A

pyloromyotomy

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22
Q

What is Intussusception?

A

Process where the proximal segment of the bowel telescopes into the more distal segment

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23
Q

What will intussusception cause? 6

A

edema, vascular compromise, obstruction, bowl rupture, paratenitis, Jelly stool

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24
Q

What vaccine can cause intussusception?

A

Rotavirus

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25
Q

S/s of intussusception

and one thing about it

A

Sudden cramping pain of abdomen
Severe pain with legs drawn up
vomiting/diarrhea

If the vomiting is bilious- it has perforated and is an emergency

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26
Q

What fixes intussusception?

A

Barium enema

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27
Q

A cause of appendicitis

A

obstruction of fecal matter impacted on the appendix

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28
Q

3 s/s of a appendicitis and one if it perfs

A

N/V, sm frequent lose stools, fever

pain goes away

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29
Q

what is the point for appendisitis?

A

Mcburneys point

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30
Q

2 things that would turn up on labs for appendicitis

A

Increased WBC and C-reactive protein

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31
Q

PUD 3 things

A

Erosion of GI mucosa from HCL and Pepsin. any point in GI tract, chronic

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32
Q

Manifestations of peritonitis 8

A

rebound tenderness, ab distention, rigidity, decrease bowel sounds, fever, increased pulse, bp, increase WBC

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33
Q

Functional constipation criteria one rule and 5

A 
Must meet 2 
less than 3 bowel movements a week
at least 1 episode of fecal incontinence a week
stool withholding behavior
hard or painful BM
Large poop
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34
Q

What is Encopresis?

A

Leak of lose stool around mass

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35
Q

What is Hirschsprung disease? and what is the other name for it?

A

Congenital aganglionic megacolon

movement disorder of intestinal tract that results in obstruction.

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36
Q

What is a sign of hirschsprung disease in a newborn?

A

They don’t pass meconium in the first 24hours of life.

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37
Q

2 things to remember about Hirschsprung disease

A

due to lack of ganglion cells, it is rare

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38
Q

s/s of celiac 1

A

steatorrhea

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39
Q

How do we diagnose celiac

A

auto tissue transglumtimate IgG, intestional biopsy, genetic testing

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40
Q

diabetes 1 connects to what disease?

A

Celiac

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41
Q

What is Biliary atresia? leads to 3 is it rare?

A

no excretion of bile from liver into the duodenum
leads to cholestasis, fibrosis, and cirrhosis
no

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42
Q

How to treat biliary atresia

Time

A

Kasai procedure

w/i 45 days

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43
Q

When do kids get hep A shot?

A

12 months and 6-12 month later

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44
Q

When do kids get hep b shot?

A

at Birth and 1-2months and 6-18month

45
Q

What is associated with cleft lip and palate?5

A

Heart defects, ear malformations, skeletal deformities, genitourinary malformations, midline defects

46
Q

one complication of cleft lip

A

otitis media

47
Q

When do we start repairs of cleft lip

A

2-3 months

48
Q

What to remember about breastfeeding an cleft lip?

A

It is better for growth and better than a plastic nipple because it provides a better seal .

49
Q

Esophageal atresia and tracheoesophageal fistula is what

A

The esophagus and trachea do not separate normally during embryonic development

50
Q

What is esophageal atreasia?

A

Distal and proximal ends of esophagus don’t connect

51
Q

What is the first sign of esophageal atresia?

What are the signs after birth? 3

A

polydramnios

frothy mucus and drooling, ab distention

52
Q

TE fistula manifestations 6

A

Rattling respirations, excessive salivation and droolong and 3 c-couching choking, cyanosis.

53
Q

Esophageal atresia and TE fistula management 6

A 
Immediate surg
HOB 30-45 
NPO
IV fluids
02
Prevent respiratory distress
54
Q

What causes omphalocele and gastroschisis

and how are they detected? 2

A

Malformation of abdominal wall

During prenatal ultrasound or increased alpha-fetoprotein

55
Q

Management of omphalocele and gastroschisis?4

A

Prevent hypotherm, fluid loss, keep covered, sterile

56
Q

Infant and child urine capacity

A

30ml

270ml

57
Q

What is bladder extropy?

A

Bladder is outside of the body at birth

58
Q

How to tx bladder extropy

A

Cover with sterile gauze, antibiotics, surgery w/I 48 hours

59
Q

what is Hypospadias?

A

Urinary meatus on the underside of the penis

60
Q

One thing to remember about hypospadias and epispadias

A

don’t circumcise until after fixed

61
Q

Epispadias

A

Urinary meatus on upper surface of penis

62
Q

what is Chordee and what is associated with it?

A

Penial ventral curvature due to fibrous tether

hypospadias

63
Q

What is cryptorchid? what is the surgery called?

A

Undescended testicles

Orchiopexy

64
Q

What is hydrocele?

A

Excessive fluid in the scrotal sac

65
Q

What is an inguinal hernia?

A

Happens when in inguinal canal does not close and intestines protrude into the canal and can become incarcerated

66
Q

Epididymitis cause can cause 3

A

Bacterial usually STD

Scrotal abscess, testicular infarction, infertility

67
Q

s/s for epididymitis 6

A

Painful, edema, erythema, dysuria, fever, enlarged inguinal lymph

68
Q

Tx for epididymitis 4

A

Elevation of scrotum, cold packs, NSAIDS, antibiotics

69
Q

What is testicular torsion?

And it is….one

A

Twisting of the spermatic cord that can cut off the blood supply to the testicle
EMERGENCY

70
Q

s/s of testicular torsion 1

A

Sudden and severe pain

71
Q

How do they treat testicular Torsion

time?

A

manual detorsion but probably need surgery

6 hours-can spare testi but can’t after 12

72
Q

Phimosis

how to treat it?

A

Foreskin of penis cannot be retracted

Steroid cream

73
Q

Phimosis s/s 4

A

foul smell, smegma irritation, pruritus

74
Q

What is Paraphimosis

A

Foreskin is retracted past the glands and is immobile it becomes a tourniquet

75
Q

What can cause ambiguous genitalia?

A

Increased androgen production in new born girls

76
Q

How long does a circumcision take to heal?

A

7-10 days

77
Q

What is a labial adhesion? when is it most common?

A

Partial or complete adherence of the labia minora

3months to 4 yrs old

78
Q

What can a labial adhesion tx 2

A

Topical estrogen cream and vaseline gel for one month

79
Q

What is Vulvovaginitis?

usually caused by 2

A

inflammation of the vagina and vulva

Bacteria or yeast overgrowth

80
Q

5 s/s of UTI that you don’t know

A

Jaundice, FTT, Respiratory distress, constipation, HTN

81
Q

What in enuresis?

A

Involuntary urination

82
Q

Nocturnal enuresis common in 2

A

Family history and boys

83
Q

tx of nocturnal enuresis 2 you don’t know

A

diet change, constipation prevention

84
Q

What are the meds used for Nocturnal enuresis 4

A

Desmopessin/ADH

ditropan drugs that decrease bladder spasms

85
Q

What is vesicoureteral reflux?

A

Retrograde flow of urine from the bladder up into ureters

86
Q

VUR testing 4

A

Culture, ultrasound, voiding cystrourethrogram , nuclear scan

87
Q

How is VUR graded?

A

1-5 5 severe

88
Q

Nephrotic synrome what is it called?

What is it?

A

Nephritis

Increased glomerular basement membrane permeability which causes abnormal loss of protein in urine.

89
Q

What to remember about congenital Nephrotic syndrome?

A

It has poor prognosis unless they get a transplant

90
Q

What would cause secondary Nephrotic syndrome? 3

A

Henoch-schnlein syndrome, Purpura, diabetes.

91
Q

Two things to remember about idiopathic nephrotic syndrome

hint-One is another name for it.

A

Most common

also called change nephrotic syndrome

92
Q

What are the complications of nephrotic syndrome 6

A

Anemia, infection, poor growth, peritonitis, thrombosis, renal failure.

93
Q

What are the manifestations of Nephrotic syndrome 5

A

EDEMA!, LUOP, Hyperlipidemia, FTT, HTN

94
Q

What is the best treatment for Nephrotic syndrome? What about vaccines with this disease?

A

Corticosteroids

No live until 2 weeks

95
Q

Acute Glomerulonephritis caused by 2

A

POST strep group a beta hemolytic strep from an antibody antigen reaction.
Staph or other infections

96
Q

Acute Glomerulonephritis can cause 2

A

Uremia and kidney failure (Both a acute and chronic)

97
Q

Acute Glomerulonephritis manifestations 7

A

hematuria, high fever, HA, CVA tenderness, HTN, perorbital edema, Elevated BUN/Creatinine

98
Q

Acute Glomerulonephritis tx 4

A

manage HTN, sodium restriction, antibiotics, No NSAIDS

99
Q

Nursing care for Acute Glomerulonephritis 6

A

Daily weights, UO, Edema care, hypertension care, neuro stat, activity restrictions.

100
Q

Hemolytic-uremic syndrome is defined as three features, what are they?
What happens before this disease?
When is this most common ages?

A
  1. Hemolytic anemia
  2. Thrombocytopenia
  3. Acute renal failure
    Usually diarrhea
    6months to 4yrs
101
Q

Bacteria causes HUS but give 3 examples

A

E coli, strep pneuminiae, shigella

102
Q

HUS progression 3 things

A

Diarrhea-Hemorrhagic colitis-triad

103
Q

What causes the triad symptoms in HUS

A

Microthrombi and ischemic changes in the organs.

104
Q

Manifestations of HUS 10

A

fever, pallor, prupura/petechia, signs of kidney failure, edema, low UO, hypervolemia, increased BP, change in LOC, Seizures.

105
Q

how long does ecoli spred?

A

up to 17 days

106
Q

How can you tell when meat is cooked

A

155 degrees, Juices are clear, meat is no longer pink

107
Q

Avoid HUS one thing

A

Avoid unpasterurized apple cider

108
Q

Acute kidney failure in kids is mostly caused from?

2

A

Hypovolemic shock or sepsis

109
Q

Tx for acute renal failure 2

A

Fluids, and treatment of underlying cause

OB (13 decks)

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