School Age Flashcards

Question

What is the primary treatment for kids who are both: - over weight or obese - high TG or low HDL

Answer 1

Weight mgmt including: improved diet, increased physical activity

Answer 2

Otitis externa Asthma Step Pharyngitis Tinea Corporis/Capitus

Answer 3

What: inflammation of the external auditory canal Causes: swimming, putting something in the ear

Answer 4

- pain in ear, espeically tragus, aggrivated by moving the aurible - exudate in the ear canal

Answer 5

Treatment: - first figure our if the infection is above or below the TM - need TM to be intact to prescribe medication - Medication: antibiotic/sterioid drops Follow up: - f/u in 48-72 hours - may need to change treatment if it hasn't gotte better

Answer 6

Note pattern, frequency, precipitating factors and duration - Coughing, SOB, wheezing on exhalation - Chest congestion and tightness - Sputum production - Insomnia r/t SOB, coughing, or wheezing at night - Bouts of coughing/ wheezing that increase with respiratory infection - Delayed recovery after a respiratory infection - Fatigue & dyspnea upon exertion (exercise-induced asthma)

Answer 7

Tachycardia Diaphoresis Chest pain Use of accessory muscles while breathing Flaring of nares while breathing Use of abdominal muscles while breathing

Answer 8

- Tests: * Spirometry (must be older than 6, taken at rest, after a challange and after med given, measures FVC and FEV-1sec) * Exhaled Nitric Oxide Tests (increased NO levels in asthma pt.) - 3 Criteria must be met: 1. episodic symptoms of airflow obstruction are present 2. airflow obstruction is at least partially reversible 3. alternative diagnosis are excluded - Assess: * In the fall (must get flu shot and pneumo vax becuase increased risk of URI and pneumonia) * Family History: Asthma, allergy, sinusitis, rhinitis, or nasal polyps * Social History: Characteristics of home and living conditions (i.e. age, location, cooling and heating systems, wood-burning stoves, humidifiers, presence of mold and mildew and exposure to tobacco smoke). Find out triggers, schedule a comprehensive home visit/education

Answer 9

Skin: Atopic dermatitis/eczema, Manifestations of an allergic skin condition HEENT: Increased nasal secretions, Mucosal swelling, Nasal polyps Chest: Hyperexansion of the thorax, Use of accessory muscles, Hunched shoulders, Chest deformity Respiratory: Adventitious breath sounds- wheezing during normal respirations, Prolonged phase of forced exhalation

Answer 10

Allergic rhinitis Allergic Sinusitis Foreign body in trachea or bronchus Vocal chord dysfunction Vascular rings or laryngeal webs Laryngotracheomalacia Tracheal stenosis Bronchostenosis Enlarged lymph nodes Tumor in airway Cystic fibrosis Bronchopulmonary dysplasia Heart disease Aspiration from swallowing mechanism dysfunction Gastroesophageal reflux

Answer 11

Goal: control chronic symptoms and prevent acute episodes Long-term control medications * Inhaled corticosteroids * Combination inhalers- inhaled corticosteroids and a long-acting bronchodilator * Leukotriene modifiers * Cromolyn * Theophylline Rescue medications * Short-acting bronchodilators Allergy shots- immunotherapy

Answer 12

* Never use antihistamines during an acute attack; they dry up respiratory secretions and can create mucous plugs * Postural drainage: child should lie on bed with head hanging over side * Side effects of medication * How to use a metered dose inhaler, dry-powder inhaler, and peak flow meter * Avoid/minimize exposure to allergens (mold, cigarette smoke, dust mites) * Notifying child’s school personnel * Give parent written instructions including medications, use of peak flow meter, use of metered dose inhaler, and indications for returning to office * Home monitoring: child’s response to medication in the morning and at bedtime yields the best information

Answer 13

Routine: every 6 months Immediately call if: * breathing difficult worsens * skin or lips turn blue * restlessness or sleeplessness occurs * chest pain * fever develops

Answer 14

Subjective: * acute onset of sore throat * fever * dysphagia Physical Exam: * anterior swollen and tender cervical nodes * fever * purulent yellowish exudate on tonsils * tonsils and pharynx erythmatous If epiglotitis is seen (drooling and tripod position): give steroids and call 9-1-1

Answer 15

Rapid Strep test GABHS- must specify what you are looking for, may treat before results come back

Answer 16

* viral pharyngitis * infectious mononucleosis (lymphnodes will be huge and splenomegaly) * epiglottitis (emergency)

Answer 17

* Antibiotics * Tylenol- dose is weight dependent * warm saline gargles * fluids

Answer 18

“Ringworm” of the nonhairy skin: Superficial fungal infection on face, trunk, limbs S&S * red, patch areas that scale and are oval in shape- well demarcated * ususally asymptomatic or mildly itchy

Answer 19

* Topical antifungal: apply daily for 2 weeks * Oral antifungal- can lead to drug induced hepititis * educate patient on dosing and timing * educate patient on GI symptoms

Answer 20

Caution sharing clothing and towels

Answer 21

“Ringworm” or Fungal Infection of the scalp S&S * red, patch areas that scale and are oval in shape- well demarcated * CC: "My child has a spot on head without hair" * ususally asymptomatic or mildly itchy * may have enlarged anterior/posterior cervial lymphnodes

Answer 22

* Antifungal Shampoo * Oral antifungal- can lead to drug induced hepititis * educate patient on dosing and timing * educate patient on GI symptoms

Answer 23

* frequent UTOs * vagina/rectal d/c * decline in school performance * change in behavior, affect, appetite Have a plan, know your resources, know the ER's

Answer 24

* How long has it been going on? Acute, chronic, gradual? * Does it occur in all settings? * Birth history: APGAR, complications, term/premie * Family History: developmental delays, mental illness * Developmental History: meeting milestones? Drop? * Medical History: frequent ER visits * Physical Exam, including: hearing, vision, * Labs: lead poisioning, blood disorder, nutrition