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Pediatrics (RM) > Test 1: Health and safety > Flashcards

Test 1: Health and safety Flashcards

1
Q

What 2 things do you do when you observe that a child has been found near poison?

A
  • your safety

- assess child first

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2
Q

What are some physical signs of poisoning?

A
  • nausea, abdominal pain, vomiting, diarrhea
  • respiratory distress, cyanosis
  • burns of mouth and pharynx
  • seizures, change in LOC
  • shock
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3
Q

What should be done if child is poisoned?

A
  • Assess ABC’s
  • Instruct family to bring emesis, stool, etc to ER
  • ID poisonous agent
  • Determine child’s age and weight
  • Ipecac syrup
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4
Q

When should vomiting NOT be induced?

A
  • poisonings by corrosive substance

- neurological system compromised

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5
Q

What are 4 methods of removing the poison?

A

1) Ipecac syrup
2) Activated charcoal
3) Gastric lavage
4) Catharsis

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6
Q

When is gastric lavage recommended?

A
  • Neuro compromised
  • small children
  • cyanide
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7
Q

Name the antidotes for the following:

  • benzos
  • acetaminophen
  • digoxin
  • opioid (MSO4 and heroin)
A 
Benzos = flumazenil (Romazicon)
Acetaminophen = acetylcysteine (Mucomyst)
Digoxin = digoxin immune fab (Digibind)
Opioid = naloxone
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8
Q

What are some steps to prevent poisonings?

A
  • Teach!
  • Get on child’s level
  • Child resistant closures
  • Symbols on bottles
  • Locked box is the best!
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9
Q

What are some common sources of lead poisoning (plumbism)?

A

lead paint (1959 - 1980)
gasoline
unglazed pottery
folk remedies

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10
Q

What are the levels of lead requiring treatment? What percentage do children absorb?

A

10 mcg/dl or greater

50%

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11
Q

What are the effects of lead?

A
  • Failure to gain weight
  • developmental lags
  • headache
  • constipation
  • anemia (lead takes iron’s place on RBC’s)
  • renal: tubule damage
  • neuro: impulsivity, distractibility, hyperactivity, blindness, coma
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12
Q

What is the most common heavy metal poisoning?

A

Lead

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13
Q

What is a source of mercury exposure?

A

mercury thermometers

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14
Q

What is acrondynia and what is it a classic sign of?

A

painful extremities

mercury poisoning

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15
Q

What are common signs of child abuse?

A
  • unexplained fractures
  • bruises in various stages of healing
  • welts
  • cigarette burns
  • glove or sock burns
  • bite marks
  • retinal hemorrhages
  • inappropriate dress
  • unmet medical needs
  • FTT
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16
Q

What are some risk factors for child abuse?

A
  • parental history of abuse
  • teen parents
  • high need child
  • family violence
  • environment (stress, poverty, divorce, alcoholism)
17
Q

Define Munchausen by Proxy

A 
illness deception or "disease forgery"
feign illness
falsify results
exaggerate medical problem
active/passive worsen problem
18
Q

Define “enuresis”.

A

Involuntary passage of urine past the age when a child should be expected to have attained bladder control.

19
Q

What age does enuresis generally occur?

A

5 to 7 years

20
Q

Does enuresis generally occur more often in boys or girls?

A

boys

21
Q

Define “encopresis”.

A

Severe constipation that leads to an involuntary release of stool, sometimes diarrhea, b/c cause the body can no longer contain it.

22
Q

What is the patho behind encopresis?

A
  • as the stool remains in the rectum, the RECTUM RELAXES and the defecation reflex wanes
  • water reabsorption continues, fissures with pain develop, causes a cycle of PAIN AND RETENTION
  • STOOL BECOMES HARD, but mushy stool may be behind hard stool
  • RECTUM ENLARGES resulting in failure to control external sphincter
23
Q

What age does encopresis generally occur?

A

After age 4

24
Q

What are the guidelines in diagnosing encopresis?

A
  • child is 4 or older

- defecation 1 x month for 3 months

25
Q

What are some causes of encopresis?

A
  • constipation
  • digestive tract abnormalities
  • emotional
26
Q

What are some ways to mangage encopresis?

A
  • physical workup
  • support parents & child
  • bowel retraining
27
Q

What is usually the patho behind enuresis?

A

alteration in neuromuscular bladder functioning

28
Q

What are some ways to manage enuresis?

A
  • urine alarms
  • age (child’s bladder matures on own, just a little later than normal)
  • retention control training
  • motivational therapies
  • eliminate bladder irritating foods
  • drug therapy
  • support parent and child
29
Q

Common medications for enuresis:

A

ditropan (oxybutynin hcl)
dofranil (imipramine hcl)
DDAVP (desmopressin acetate)

30
Q

What are 4 methods used to overcome the withholding associated with encopresis?

A

1) enema
2) stool softener or laxative
3) mineral oil 30-75 mL BID to decrease pain
4) change retention habit (sit on toilet 5-10 min, 20-30 min after meals)

31
Q

What dietary changes can be made to manage encopresis?

A
  • limit milk intake
  • increase residue (citrucel)
  • increase water intake
32
Q

Brown Recluse Bite: What are some necessary treatments?

A
  • antibiotics
  • corticosteroids
  • pain control
  • skin grafting
33
Q

What characteristics are seen with ADHD?

A
  • inattention
  • impulsiveness
  • hyperactivity
  • social and academic consequences
34
Q

What are common co-morbidities seen with ADHD?

A

depression and learning disabilities

35
Q

What are 2 areas to address in the child with ADHD?

A

Behavioral and pharmacologic

36
Q

What meds are generally prescribed for ADHD?

A
  • Ritalin (methylphenidate)
  • Strattera (atomoxetine)
  • Concerta (extended release methylphenidate)

Pediatrics (RM) (27 decks)

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