Peds test 4 Flashcards
Compression/breaths for kids and infants and how many rounds before you call 911?
30:2 and 5
What do you do if a child does not improve with repositioning in an emergency?
Start bag-valve-mask
One thing to remember about getting a pulse
always palpate or auscultate don’t trust monitor
What is bradycardia for young infant and older infant and one thing about brady in kids
less than 80
less than 60
Stat CPR if they are bradycardic
What do you do if systolic BP is low?
IV normal saline 20/mg/kg as fast as it will go
What is low systolic for
neonate
infant
1-10
60
70
70+2x the age in years
Quick neuro assessment for LOC
A lert
V responsive to Voice
P responsive to pain
U nresponsive
What three things are on the peds glasgow scale?
eye opening, motor response, verbal response
What is the score on the peds glasgow scale? and what is a good score?
3-15
15
How many points in each section of GGCS?
Eye opening- 4
motor response- 6
verbal- 5
Are kids more prone to hypo or hyper glycemia?
Hypo
upper airway causes of respiratory distress 9
burns, croup, foreign body aspiration, strangulation, reflux, epiglottitis, vasculatory ring, tracheomalacia
Lower respiratory arrest problems 8
asthma, RSV, brochiolitits, pertussis, pneumonis, pneumothorax, aspiration, reflux
Presenting characteristics of foreign body aspiration
Sudden on set of cough, wheeze, stridor
guidance for aspiration education
6months and at each visit up to five
when can kids have peanuts and popcorn?
3
SIDS age
to 1
restore fluid volume in kids with shock
20ml/kg NS over 30-40mins
what is benadryl called?
Diphenhydramine
What is the ball injury called
Tramatic cardiac arrest
during upstroke of t-wave
When is brady life threatening in an infant
under 80
what can cause brady 5 abnormal
Heart block, dig, hypoxia, head injury, hypothermia
What is super ventricular tachycardia?
What can it lead to?
What happens?
A cardiac conduction problem where the hr is very fast and irregular
heart fail
not filling
3 s/s of SVT
Change in LOC
dyspnea
poor perfusion
3 interventions for SVT
adneosine, ice to face, syn cardioversion
Patho submersion
Kid asperates poor oxygenation and retention of 02 Surfactant depleted pulmonary edema AKI-Possibility
Sepsis cold vs hot
hot increased CO with a low SVR,
cold decrease in CO with an increase in SVR
3 problems r/t submersion?
ICP, pulmonary complications, hypothermia
ABCDE-just D E
disability, exposure
Pot onset and peak
20-30min 3-4 hours
stages and days of ace poisoning
1-1
2-1-3
3-3-5
4-5-8
antidote for acetamin poisoning
N-acetylcysteine
electrocution complications 2 to remember
spinal injuries, fractures
What about edema and burns? 2
Can last 18 hours can effect lungs
burns cause 4
d co
i metabolic state
insulin resistance
i prot metabolisim
What is hypopituitarism and how does it appear on the growth chart?
GH deficiency causes alteration in metabolism of carbs, prots, fats
at or below third percentile
What are the diseases r/t the anterior pituitary gland 3
growth hormone (GH) deficiency, hyperpituitarism, and precocious puberty.
GHD manifestations 5
fat, prom forehead, high pitched voice, delayed sex, delayed dentation,
GHD diagnosis 3
bones ob xray will be two deviations below normal, Watch fro structural abnormalities, pit fun testing
What is precocious puberty
boys and girls ages of onset puberty
Sexual characteristics before norm
10-12-girls
11-14-boys
What can cause p pub 7
Tumor, brain injury, radiation, infectious encephalitis, meningitis, congenital, adrenal hyperplasia
Patho prepub
production of gonadotropin-releasing hormone stimulates HL and FSH
2 tx for prepub and what they do specifically
GnRH analog-slows
Depo-provera- reduce secretions of gonadotrophin
Congenital hypothyroidism
failure of thyroid gland to migrate during fetal development insufficient production of hormones T3 and T4
Complications of congenital hypothyroidism 4
intellectual disability, short stature, growth fail, delayed physical maturation
10 s/s graves
goiter, sleep prob, distractibility, frustrated, fatigue, diarrhea, grow fast, weight loss, tachy, exophalmos
What kind of disorder is cushings?
adrenal
s/s cushings 10
red face, CNS issues, HTN, cardiac hypertrophy, striae, ulcers, mm wasting, osteo, sexual dysfunction
course/brittle hair
Hypothyroidism
Face deformities
hypoparathyroidism
Cool skin
Hyperthyroidism
Color/texture skin
Pituitary
What causes cushings 2
One hormone?
Excessive use of coticosteroids and ACTH-producing adenoma
Glucocorticoid excess
What is Congenital adrenal hyperplasia?
What causes it?
which increases? 2
A group of autosomal recessive inherited disorders
insufficient supply of enzymes to make aldosterone and cortisol
adrenocorticotropic hormone excess androgens
Signs of congenital adrenal hyperplasia 3
ambiguous genitalia, short stature, testicular cancer in adults
Congenital adrenal hyperplasia crisis causes 5
hypona and hyperk hypoTN hypovolemic shock, hypoglycemia
How to determine gender with CAH
Karyotyping
Tx for CAH 3
glucocorticoid and mineralocorticoids for life
Na supplements
surg for girls at 2-6 months
s/s of acute adrenal crisis
vomiting, lethargy, feeding dif, dehydration
Age group of adolescence
11-20
when does boys height peak
14 years
Girls height in adolescence 2
rapid after menarche
ceases after 2-21/2 years
Average puberty girls
breast buds and one thing
9-15
9-11
Pubic hair after breasts
Screening tool for sexual development
tanner scale
Wisdom teeth age
17-20
Theorists adolescence 3
E-identity vs role confusion
P-formal operation-abstract
F-genital
What age group is early adolescence?
middle?
late?
12-14
14-17
17-20
HR adolescence
55-95
What assessment approach to use in teens
head to toe
Percentile Underweight healthy weight overweight obese
less than 5th percentile
5th percentile up to 85th percentile
85th to less than 95th
equal or greater to 95th
When should we start taking BP on kids
3
Most common places for kids to get cancer 4
Blood, bone, blood organs, brain
What is the most common childhood cancer
leukemia
Common manifestations of cancer 6
Anemia, infections that won’t go away, bruising, H with vomiting, gate changes, visual disturbances
Patho of leukemia
Disorder of blood marrow and lymphatic system cause proliferation of immature WBC and they take over and compete for nutrition.
What happens because of leukemia? 4
Anemia, infection, bleeding, fractures,
Leukemia infiltrates into what 8
Spleen, CNS, testes, kidneys, prostates, ovaries, GI, lungs
what are tri21 kids at risk for?
Leukemia
Acute lymphoid leukemia 2 things and 3 things it causes
Most common, normal lymphoblasts eat all nutrients,
anemia, neutropenia, thrombocytopenia
Acute myelogenous leukemia compared to all 2 and 3 things it causes
Less survival rate, adolescent more,
infection, metastasis, hemorrhage
AML s/s 4
Subcut nodules, lymphadenopathy, blue or salmon colored papular lesions, sternal tenderness
What is definitive diagnosis for leukemia?
Bone marrow aspiration
Lymphoma places 3
Nodes, spleen, thymus
Difference of Hodgkin vs nonhodgkin location
hod-closer nods non-deep node
Hodgkins vs non hodge nodes? Location? Contagious? Cells involved? Age? Associated with?
Localized, with contagious spread, reed-sternberg cells (B and T cells), bimodal distribution (any age) , Ebstine bar
What lymphoma is characterized by stage?
how many stages?
Non-hodge, 4
One thing to remember about lymphoma?
Antibiotics indefinitely
How to diagnose hodg lymphoma 1
reed-sternburg cells
non hodg diagnosis 1
bone marrow aspiration
S/s of non hodg lymphoma 4
Increased work of breathing, edema, mediastinal mass, lymphadenopathy
tx for non hodg lymph
autologous bone marrow transplant
What is neuroblastoma? 4 major signs
Solid tumor found in in neurons from embryonic neural crest cells
swollen belly, lump in chest, bone pain, bruising around the eye
Location of medulloblastoma
cerebellum
3 things about medulloblastoma
check head circumference, malignant, Seeds on intracranial pressure
Astrocytoma location 4
Cerebellum, cerebral hemisphere, thatlamus, hypothalamus
Astrocytoma 2 things
Slow insidious, not responsive to chemo
Osteosarcoma
location
age
one thing about it
metaphysis of long bones
10-25
amputation
ewing sarcoma location and age
bones
4-20
Rhabdomyosarcoma
what is it
age-2
location
Soft tissue tumor from cells that would form stiated muscle
under 6 and 10-18
can be anywhere
Wilms tumor other name and what is it? age?
Nephroblastoma renal tumor 3
one thing to remember about wilms tumor
don’t palpate abdomen
retinoblastoma
age
agressive
sign 3
congenital
yes
cat eye reflex vomiting H/A
2 ways that chemo works
Cell cycle specific and non specific
what is allogenic
Harvested stem cells
Complications of bone marrow transplant 7
Electrolyte imbal, membrane tox, impaired growth, fertility issues, cateracts, CV and pulm disease
When do neutropenic precautions go into effect
neutropenic count below 500
When do fetal iron stores disappear by?
4-6 months
How much milk should a children over 1 have iron
no more than 24oz a day
sign of iron deficiency anemia
spooning of nails
Poison dose for one yr old iron and lethal dose
1gm
3gm
Symptoms of iron toxicity 2
shock, cardiovascular collapse
How many stages of Iron toxicity are there? what are they?
how many days can death or injury happen?
5 Gi irritation recovery from gi irritation metabolic acidosis, dehydration, lactic acidosis hepatic fail GI healing anf scarring 3-4
tx of iron poisoning 3
whole bowl irrigation, deferoxamine, call poison control
led poisoning effects 4
one thing it can cause
bone marrow, erythroid cells, nervous system and kidneys
anemia
Where is lead found? 4
paint before 1978
soil leaded gas
glazed pottery
stained glass
s/s of led poisoning 6
anorexia, fatigue, ab pain, cns, hydrocephalus, encephalopathy,
tx for lead poisoning
chelation therapy
What tests for sickle cell and one thing about it
Hem electrophoresis and it is the law that newborns get tested
What is dactylitis?
painful swelling of hands and feet c
four infections r/t sickle cell
sepsis, meningitis, osteomyelitis, septic arthritis
What can cause sickle cell crisis 3 to remember
cold, dehydration, physical exertion
What is thalassemia
what type are we focused on
what about that type 3 things
Genetic disorder reduces production of heme
Cooley anemia
severe hemolytic anemia chronic hypoxia bone problem s
Tx for thalassemia and issue?
PRBC iron overload
What clotting factors contribute the most to clotting issues
VIII IX XI
What is a normal platelet count
150,000-300,0000
What is idiopathic thromocytopenia purpura
thought it is from?
how do kids do?
major complication?
Antibodies that destroy platelets that cause petechia, purpura, bleeding
Viral infection
most recover
hemorrhage
idiopathic thromocytopenia purpura tx 2
platelet count below 10,000 maybe corticosteroids, IVIG
What is Henoch-Schonlein purpura presents as from can cause tx
vasculitis with immunoglobulism A immune deposits that affect sm vessels in skin, gut, and kideney
usually bacterial or viral infection
nephrotic injury
corts or resolves on own
What is hemophilia
what are we concerned about?
what type to focus on
deficiency in coag disorder
bleeding is hard to stop
A
What factor is hemophilia A?
Factor 8
What is Von willebrand disease and causes what drug can help
Def in von wil factor which slight bleeding problems
desmopressin before dental work
What is juvenile idiopathic arthritis
autoimmune disorder where antibodies target the joints.
Juvenile idiopathic arth complications7
Iritis, uneven bone growth, rheu nodules, pericarditis, pericardial effusion, pleuritis, pulmonary fibrosis
Diabetes is secondary to 4 other conditions
cystic fibrosis, downs, turner, cushings
A1C for 0-3 and 3-adult
- 5
6. 5
glucose for diabetics
90-130
What kind of insulin is in insulin pump?
type
3 names
only rapid acting
aspart, lispro, glulisine
s/s of DKA 12
Fat cat, high ketones, high bs, low bicarb, dehydration, lethargy, stupor, ab pain, kussmaul respirations, air hungry, tachy, juicy fruit breath
Tx for DKA 3
hydration, insulin, electrolyte replacement
What insulin do they use for DKA
humulin R
