Practice Qs Info Flashcards
Short-acting beta2-agonist administration frequency
Can be repeated every 20 mins for up to 3 treatments - if child doesn’t respond after steps of asthma action plan, seek medical care
VP shunt placement post-op care
Position on unoperated side or supine with HOB flat-30 degrees - HOB too high can cause too-rapid reduction of CSF
Pediculosis capitis treatment
Pediculicide shampoo and manual removal of nits
Second treatment in 7-10 days
If ineffective, do not repeat due to risks associated with repeated exposure to strong chemicals - seek medical care with PMD
Wash clothes, towels, linens in hot water and dry in hot dryer of 20 mins
Dry clean non-washable items or seal in plastic bags for 14 days
Vacuum carpets, car seats, rugs, mattresses, upholstered furniture
Soak combs, brushes, hair accessories in pediculicidal products for 1 hour or in boiling water for 10 mins
G tube dislodgement
If within 6 weeks of initial placement, must be reinserted by a provider
After 6-12 weeks, can be replaced by trained caregiver or nurse with G tube or foley catheter of comparable size
Cleft lip/palate complications
Feeding difficulties
Dental anomalies
Otitis media/hearing difficulties
Psychosocial issues
Hypoglycemia treatment
Quick administration of 15-20g of simple carbohydrate (preferably glucose) followed by complex carbohydrate and protein - protein and fat content prolong results and help prevent rebound
Simple glucose carbohydrates = glucose tablets, candies such as Sweet Tarts, Smarties, Pixie Sticks
Injectable glucagon for severe hypoglycemia
Common allergy among children with spina bifida
Latex
Children with latex allergies can show associated sensitivity to some foods like bananas, kiwis, avocados, chestnuts
Refeeding syndrome
Life-threatening complication of nutritional rehabilitation for anorexia that can occur during the first few weeks if caloric intake is increased too rapidly
Extreme fluid and electrolyte shifts can cause cardiac arrhythmias, heart failure, respiratory failure, skeletal muscle injury, delirium, seizures, and hematologic problems
Anorexia - refeeding monitoring
Electrolyte levels
VS
Fluid balance
Cardiac rhythms
Delayed bone age
Indicates epiphyseal plates are open and catch-up growth is still possible
Advanced bone age
Indicates epiphyseal plates are closer to being fused than is typical for the child’s age, and may not achieve optimal adult height
Microwaving breast milk destroys ____
Anti-infective factors and vitamin C
Healthcare services that qualify for confidentiality protection for minors
Contraception, pregnancy, HIV/STIs, substance abuse, mental health
Lead exposure prevention in old houses (pre-1978)
Wet mop hard surface floors and wipe other hard surfaces with damp cloth once a week
Avoid vacuum cleaners for hard surfaces - can spread dust - use vacuum cleaners with agitators for rugs
Children should not be present during renovation/remodeling - all surfaces should be damp mopped before they return
Avoid continuous renovation
Avoid hot water consumption - dissolves lead more quickly, contains higher levels
Pipes/faucets should be flushed if not used for 6 or more hours - run cold water for 1-2 minutes
Phenylketonuria (PKU)
Autosomal recessive trait
Lack of hepatic enzyme phenylalanine hydroxylase, which is necessary to metabolize phenylalanine (essential amino acid), results in phenylalanine build up in the bloodstream - excreted in urine, giving it a musky odor
Extremely elevated serum levels leads to progressive brain damage
Phenylketonuria (PKU) screening
Newborn screening is mandatory in all states because cognitive impairment occurs before metabolites can be detected in urine
Should be repeated within 2 weeks
Phenylketonuria (PKU) signs
Cognitive impairment
FTT, vomiting, irritability, hyperactivity, erratic behavior
Fair complexion, skin susceptible to dermatologic problems like eczema
Phenylketonuria (PKU) treatment
Restriction of dietary protein - no meats, diary products, nuts, legumes, soy products, foods/beverages containing aspartame
Phenylalanine cannot be totally eliminated from diet - is an essential amino acid necessary for growth
Cakes, cookies, candies are restricted to certain amounts - must be weighed and measured
JIA complications
Joint contractures, muscle atrophy, osteoporosis, growth delay, uveitis (inflammation of the uvea, need regular vision screenings)
Atopic dermatitis treatment
Topical immunomodulators/calcineurin inhibitors (tracrolimus, pimecrolimus) are preferred for long-term use - less adverse effects compared to topical corticosteroids, can be used on face
Pimecrolimus 1% - mild to moderate AD in children 2 years and older - no systemic accumulation or effects
Tacrolimus 0.03% and 0.1% - reserved for severe cases - can cause local burning sensation initially
Most common cause of failure to develop speech
Hearing deficit
Signs of puberty in females
Breast budding - 10 years
Pubic hair - 11 years
Height spurt - 12 years
Menarche - 13-14 years
Signs of puberty in males
Testicular enlargement - 11 years
Pubic hair - 12 years
Height spurt - 13-14 years
Early signs of carbon monoxide poisoning
Lightheadedness, nausea, headache
Intussusception diagnosis
Barium or water-soluble contrast enema - reduce invagination of the bowel segment
Tracheo-esophageal fistula
Communication between the trachea and esophagus
Present with respiratory distress and difficulty managing oral secretions
Should be NPO
Babinski reflex
Present until age 18 months - 2 years
Only infant reflex that remains after 4 months of age
Amblyopia
“Lazy eye”
Treated by patching healthy eye to make the lazy eye work
Can result in vision loss if not corrected
Phenytoin side effects
Gum hyperplasia
Hirsutism
Cushing’s triad
Hypertension, bradycardia, irregular/decreased respirations
Glasgow coma scale - head injuries
Mild = 13-15 Moderate = 9-12 Severe = ≤8
Mononucleosis
Spread through oropharyngeal secretions
Often caused by Epstein-Barr virus (EBV), CMV
Incubation period of 2-6 weeks
Hallmark manifestation = marked fatigue
Splenomegaly - avoid contact sports to prevent splenic rupture
Pertussis incubation period
6-20 days
Varicella incubation period
10-21 days
Tuberculosis treatment
Pyrazinamide, ethambutol, isoniazid, rifampin
