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Pediatrics > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

What should you ask about an infants delivery?

A
  • how they were born (vaginal or c-section)?

- Can indicate complications– neuro impairments

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2
Q

What do pediatric brachial plexus injuries normally occur due to?

A

-complications with vaginal birth

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3
Q

What 4 risk factors associated with birth can lead to brachial plexus injuries?

A

-Should dystocia (shoulder get stuck in birth canal), large for gestational age babies, prolonged labor, and breech deliveries

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4
Q

Nerve regrowth typically occurs at what rate in infants?

A

-1 mm per day

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5
Q

How long does a nerve injury in the upper arm take?

A

-4 months

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6
Q

How long does a nerve injury in the lower arm take?

A

-9 months

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7
Q

Approximately what percent of infants recover from nerve injuries?

A

-70%

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8
Q

What is the most common brachial plexus injury?

A

-Erb’s Palsy

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9
Q

Erbs palsy is casued by damage to what nerve roots?

A

-c5 and c6

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10
Q

What posture of the arm will be assumed with Erb’s Palsy?

A

-Waiters Tip

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11
Q

How does Erb’s Palsy compare to Klumpke’s Palsy?

A

-Klumpkes Palsy doesnt involve the shoulder or elbow

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12
Q

What type of posture will the arm assume with klumpkes palsy?

A

-supinated wrist, and will cause weakness of the wrist flexors, extensors and intrinsics

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13
Q

What nerve roots are involved with kulmpke’s palsy?

A

-c8 and t1

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14
Q

What is global palsy?

A

-damage to the entire brachial plexus

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15
Q

What can be caused with global palsy with a t1 avulsion?

A

-Horner’s Syndrome

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16
Q

When does surgery to repair brachial plexus injuries normally occur?

A

-between 3 and 8 months

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17
Q

What are the indications for surgery to repair a brachial plexus injury?

A

-lack of shoulder ER, no biceps or supination strength

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18
Q

When does surgery to repair brachial plexus injuries occur before 3 months?

A

-if complete paralysis or horners syndrome is present

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19
Q

What does TORCH stand for?

A

-Toxoplasmosis, Other, Rubella, Cytomegalovirus, Herpes

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20
Q

What is considered “other” in TORCH?

A

-syphillis, varicella-zoster, parvovirus b19, lyme disease, HIV

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21
Q

TORCH infections are responsible for what percent of birth defects?

A

-2 to 3%

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22
Q

What can indicate a torch infection that is now mandated to screen for in new borns?

A

-hearing loss

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23
Q

What can toxoplasmosis be acquired from?

A

-cat shit, undercooked meals, contaminated water/soil, unpasturized goat milk

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24
Q

What 4 things can toxoplasmosis cause?

A

-hydrocephalus, intracranial calcification, seizures, developmental and motor delay, intellectual disability, and blindness

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25
Q

What is syphilis not as common in infants anymore?

A

-prenatal testing is mandatory

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26
Q

What physical abnormalities are indicative of syphilis in an infant?

A

-Rash, damage to teeth and eyes

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27
Q

Where does varicella zoster lay dormant?

A

-in the dorsal root ganglion

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28
Q

What can Varicella zoster cause in infants?

A

-eye damage, CNS damage and ANS dysfunction

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29
Q

What are the signs and symptoms of an infant that is infected with HIV?

A

-Failure to thrive, yeast infection, and developmental delay

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30
Q

Will when will an infant that is actually infected with HIV test positive for it?

A

-18 months

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31
Q

An infant with a greater than average chance of morbitity or mortality is considered what?

A

-High Risk

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32
Q

What is developmental delay?

A

-The failure to acheive a skill expected of a typical infant or child

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33
Q

What is preeclampsia?

A

-a maternal condition during 20-40 weeks of gestation and 1 week post partum that results in maternal hypertension or edema

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34
Q

What is ecplamsia?

A

-results from preeclampsia and results in stroke, coma or convulsion

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35
Q

Premature birth occurs before what week of gestation?

A

-at or befroe 37 weeks

36
Q

How is gestational age counted?

A

-time since last menstral cycle

37
Q

An infant less than 5.5 lbs is considered what?

A

-Small for Gestational Age (SGA)

38
Q

What is considered low birth weight?

A

-1501 to 2500 g (3.3 to 5.5 lbs)

39
Q

What is considered very low birth weight?

A

-1000 to 1500 g (2.2 to 3.3 lbs)

40
Q

What is considered extremely low birth weight?

A

-<1000 g (<2.2 lbs)

41
Q

50% of ELBW babies have what?

A

-moderate to severe neuro disabilities

42
Q

What is a babies PCA?

A

-Post conceptual age: Number of weeks since conception + chronological age if not reached full term yet

43
Q

What is a level I neotnatal care unit?

A

-well-baby nursery: stable infants; feed and grow babies

44
Q

What is a level II neotnatal care unit?

A

-Special Care Nursery: infants 32+ weeks, 1500+ grams or to stabilize infants prior to more specialized care– on tube feed or supplemental oxygen

45
Q

What is a level III neotnatal care unit?

A
  • infants <32 we, or <1500 grams; on ventliators
46
Q

What is a level IV neotnatal care unit?

A

-Regional NICU: most specialized medical services for complex infants

47
Q

How should you position an infant in the NICU?

A

-Head in midline, elevated to 32 degrees

48
Q

In what position is oxygenation the highest?

A

-prone

49
Q

How should you educate an infants parents to position the infant for sleep after leaving the NICU to reduce the risk of SIDS?

A

-supine

50
Q

What is the Synactive Theory?

A

-looks at babies ability to self regulate, and the babies behavior indicating the amount of stress they are in

51
Q

What is Resipratory Distress Syndomre (Aka hyaline membrane disease)?

A

-when the infants lungs do not produce enough surfactant and the alveoli collapse

52
Q

Respiratory Distress syndrome mainly occurs in infants born before what gestational age?

A

-29 weeks

53
Q

When does surfactant develop?

A

-32 weeks

54
Q

When do sufficient levels of surfactant develop?

A

-37 to 38 weeks

55
Q

What are the signs of respiratory distress syndrome?

A
  • grunting, soft tissue retractions, syanosis
56
Q

What does bronchopulmonary dysplasia result from?

A

-supplemental oxygen or ventilator use, especially longer than 11 days

57
Q

Bronchopulmonary dysplasia is more common in what babies?

A

-LBW or ELBW

58
Q

What is Meconium Aspiration Disorder?

A

-When the infants 1st poop occurs in the womb or delivery and is inhaled through amneotic fluid

59
Q

IVH is most common in infants born below what?

A

-32 weeks

60
Q

What increases the risk for IVH?

A

-Low Birth Rate

61
Q

What grades of IVH have a low risk for long term neurological deficits?

A

-Grades I and II

62
Q

What is a grade I IVH?

A

-Isolated Germinal Hemorrhage

63
Q

What is a grade II IVH?

A

-IVH with normal size ventricles

64
Q

What is a grade III IVH?

A

-IVH with Dilated ventricles

65
Q

What is a Grade IV IVH?

A

-IVH into periventricular white matter

66
Q

What is periventricular Leukomalacia cause by?

A

-Too little Cerebral blood flow

67
Q

What is the leading cause of CP?

A

-Periventricular Leukomalacia

68
Q

Periventricular leukomalacia is likely to cause diplegia or quadraplegia in the presence of what?

A

-bilateral cysts

69
Q

What is hypoxic encephalopathy caused by?

A

-decreased oxygenation and glucose due to hypoxemia

70
Q

What does mild HIE require?

A

-resuscitation

71
Q

What will the infant present like with mild HIE?

A

-May be irritable and jittery but have normal muscle tone

72
Q

What will an infant with moderate HIE recquire?

A

-resuscitation and short term assistance with respiration

73
Q

What are the signs of moderate HIE?

A

-Possible hypotonia and seizures

74
Q

What will severe HIE recquire?

A

-resuscitation and prolonged ventilation

75
Q

How will an infant with severe HIE present?

A

-severe hyotonia,decreased movement, seizures, cognitive impairments

76
Q

GERD is more common in infants with what?

A

-neurological impairments

77
Q

What is neonatal abstinence syndrome?

A

-withdrawal symptoms and neurobehaviors in infants that occurs in response to mothers taking drugs during pregnancy

78
Q

What are the symptoms of neonatal abstinence syndrome?

A

-irritability, tremors, failure to thrive, increased muscle tone

79
Q

What is necrotizing entercolitis?

A

-acute inflammation of the bowel that results in intestinal mucosal ulceration and hemorhhage

80
Q

In what infants does necrotizing entercolitis occur most common in?

A

-Preemies less than 2000G

81
Q

What does retinopathy of prematurity come from?

A

-abnormal blood vessel growth in the immature retina due to high levels of supplemental oxygen

82
Q

What can hyerbilirubinemia cause if untreated?

A

-damage to the basal ganglia and cause athetosis

83
Q

What is the normal HR of a newborn infant?

A

-120-180 BPM

84
Q

What is the normal RR of a newborn?

A

-40 to 60 BPM

85
Q

What is the most common test performed in the NICU?

A

-Test of Infant Motor Performance

Pediatrics (14 decks)

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