unit 4 Flashcards
respiratory insufficiency
increased work of breathing
respiratory failure
unable to maintain adequate oxygenation
respiratory apnea
cessation of breathing >20 sec
respiratory arrest
cessation of breathing
airway obstruction
aspiration of foreign object
asphyxation
drowning, plastic bag over head
choking
universal sign
high pitched sound
can’t speak
BRUE
brief resolved unexplained event
apena
color change
muscle change
poisoning
ingestion/exposure to toxic substance
acetaminophen
N -acetlycysteine
aspirin
vit K
charcoal
O2
iron
emesis lavage
chelation therapy
hydrocarbon
NO VOMITING
intubate before gastric decontamination
corrosive
NPO
pain meds
NO VOMITING
lead
chealaton therapy >45
(<5WNL)
foreign object
removal
pass through stool
reyes syndrome
from aspirin
encephalopathy (brain swelling) & liver swelling
sign of Increased ICP
Cushings triad (HTN, bradycardia, respiratory changes)
glasgow coma scale
lower the score the deeper the coma
head injury occurs..
MVA
bicycle/sports
falls
concussion
neuro/cognitive change
immediate
1-3wks
possible LOC
concussion/laceration
tearing of vertebral tissue
CT/MRI
permanent damage
unconscious
skull fracture
CSF leak
CNS infection
increased ICP
(-/+) glucose
seizure precaution
what to do after head injury
stabilize the spine
epidural hemorrhage
> 2yr
arterial blood
dura separate from skull
dangerous symptom free period-rapid decline
opposite side of affected area
subdural hemorrhage
<2yr
venous blood
dura and skull DONT separate
cerebral edema
swelling in the brain
cranial trauma
brain herniation
downward shift of the brain
cushions triad
hydrocephalus
imbalance of CSF in brain (too much)
absorption/production issue
VP shunt
hydrocephalus
drain to peritoneal cavity
can cause bowel perforation, infection, revision, peritonitis
neural tube defect
occulta
meningocele
myelomeningocele
occulta
dark hair, birth mark over spinal cord
dimpling
meningocele
covering of spinal cord affected
myelomeningocele
everything involved
neuro problems
seizures
abnormal neuro activity in the brain
partial/generalized
partial seizure
part of brain is affected/part of body affected
simple complex
generalized seizure
entire brain affected/entire body affected
absent (sensory)
tonic-clonic (jerking)
myoclonic
atonic
antieplitics
diastat -rectal
diazepam/lorazapam
phenobarbital(low IQ)/phenytoin(gum hyperplasia) =(take vit D & folic acid)
ketogenic diet
75% fat
20% protein
5% carbs
status epilipticus
seizure over 30 min
multiple seizure (no return to baseline)
seizure over 5 min
call 911
diastat
seizure over 30 min
irreversible brain damage
febrile seizure
6mo-5yr
peak 18mo
tonic clonic with 100.4temp
meningitis
vital and bacterial
droplet precaution
decr stimuli
hydration
decr IPC
bacterial meningitis
group B strep, nesissera meningitis, s pneumonia
antibiotics
MEDICAL EMERGENCY
viral meningitis
HIV, cytomegaly virus, herpes
treat symptoms
cerebral palsy
birth injury
hypotonic or hypertonic
spastic
ataxic
athetoid
mixed
spastic cerebral palsy
contractures
(cause stiff muscles, difficulty walking)
Ataxic cerebral palsy
difficulty with balance and perception
(causes poor coordination, unsteady gait)
Athetoid cerebral palsy
uncontrolled involuntary movements
mixed cerebral palsy
combination
urinalysis infection
protein
leukocytes
nitrates
blood
urinalysis diabetes
ketones
glucose
urinalysis hemolysis
urobilinogen
enuresis
bed wetting
issue after 5yr, twice/wk, for 3mo
UTI
urinary tract infection
upper (pyelonephritis)
lower (cystitis and urethritis)
2-6yr
VUR
Vesicoureteral reflux
urine flows the wrong way from the bladder into ureters and kidney
congenital condition
foul smelling urine
nephrotic syndrome
excessive excretion of protein in urine
remission
ascites, periorbital edema, frothy urine
corticoid therapy, diuretics, antihypertensive
acute glomerulonephritis
glomeruli inflammation from infection
after infection
HTN, protein uria, cardiac enlargement
growth hormone deficiency
decr production of GH- not preventable
GH IM at bedtime
precocious puberty
early puberty
8 for females
9 for males
infection, or tumor
not preventable- treat ASAP gonadtropin
Cushing syndrome
too much cortisol (tumor/steroids)
moon face, buffalo hump, (-+) glucose, HTN
diabetes
total/partial deficiency of insulin
IM insulin
CHO 45-60gm/meal
Diabetics exercise
15-30g before exercise
and every 30 minutes during
DKA
ped emergency
blood sugar >330mg/dL
O2, fluid replacement, education
dermatitis (eczema)
contact with irritant
chemical, plants, metal, meds, diaper
virals
herpes 1 & 2
varicella zoster
rubella, rubeola
erythema infectiorum (fifths disease)
herpes 1&2
contagious
swollen lymph
on mouth, lips, nose, perineal, perianal
valacyclovir, acyclovir
varicella zoster
chicken pox/shingles
rash, fluid blisters
vaccine
acyclovir, no hot bath, loose clothes
rubella
German measles
direct/droplet
2-3 wk
red/blue rash
rubeola
measles
direct/droplet
10-20 days
fever spikes with rash
erythema infectiosum
fifths disease
4-21 days
droplet
HA, rash, runny nose
symptoms relief
conjunctivitis
pink-red eyes
(viral & bacterial) direct contact
viral conjunctivitis
1-2 weeks
gets better
bacterial conjunctivitis
antibiotics
gets worse
allergic conjunctivitis
clear discharge
allergy meds
impetigo
bacterial infection
toddler/preschooler
bacterial infection
crusty rash, pruritis
Muciprocin
wash clothes separate in hot water
cellulitis
inflammation of skin and subdural tissue
fungal infection
contagious
tinea capitis
tinea corpis
tinea cruris
tinea pedis
tinea capitis
ringworm of the head
(those with allergies susceptible)
tinea corpis
ringworm of the body
all ages
tinea cruritis
jock itch
adolescents
those who play sports
tinea pedis
athletes foot
scabies
endemic infestation of mites
lesions from eggs and feces planted under skin
whole family must be treated
child respiratory tract
smaller airway
incr risk of obstruction
main care for respiratory tract
oxygen
nutrition
hydration
pain/fever reduction
infection prevention
comfort
education
cystic fibrosis
increase in mucus gland secretions
more sweat
more saliva
more mucus
lifetime problem
cystic fibrosis systems
respiratory (wheeze, crackles, cyanosis)
integumentary (dry skin)
GU (intestinal issues)
reproductive(delayed development)
cystic fibrosis meds
SABA
LABA
expectorants
antibiotics
corticosteroids
pancreatic enzymes
congenital defect
at birth
cyanotic
acyanotic
acquired defects
not present at birth
from infection, hyperlipidemia, shock
congenital disorders
acyanotic defects
cyanotic defects
acyanotic defects
Increased pulmonary flow (failure to close)
obstruction to ventricle blood flow
(murmur, HF s/s, HTN)
increased pulmonary flow
atrial septal defect (we can patch)
ventricular septal defect (not complete formed)
patent ductus arteriosus (indomethacin/coils, surgery)
obstruction of ventricular flow
coarctation of aorta
pulmonary stenosis
aortic stenosis
(corrected to prevent longterm issues)
not discovered till adult hood
cyanotic defects
decr pulmonary flow
mixed blood (hole between atriums)
decreased pulmonary flow
Tetralogy of fallot
(TET blue spell, knee-chest position)
mixed blood
transposition of great ateries
truncus arteriosis
hypo plastic left heart syndrome
lanoxin/digoxin holds
infant- HR >70
child - HR >90
acquired disorders
endocarditis
rheumatic fever
Kawasakis disease
endocarditis
inflammation/infection of the heart
bacterial/fungal infection
fever, murmur, malasia
IV antibiotics
rheumatic fever
strep infections, jones criteria
rash
GABHs
jones criteria
Joint pain
O carditis
Nodules
Erythema marginatum
Sydenhams chorea
Kawasaki’s disease
4-5 day fever
red, fever, rash, conjunctivitis, mouth/lips swollen
IVIG: aspirin
fatal in not treated timely
sickle cell
cells sickle shape= vaso-occlusive
from infection, dehydration, temp changes
hydroxyurea (helps RBC shape)
almost always on antibiotics
hemophilia
factor 8 deficiency(clotting factors)
hematoma/hemorrhage risk
dehydration
mild
Infants 3-5%
child 3-4%
severe
infants >10%
children 10%
diarrhea
chronic >14 days
oral rehydration first then IV
oral ondansetron
emesis
NPO first hour after stopping vomiting
for next 4hr 5 cc every 15 min,
then 10cc
try food
rotavirus
oral fecal
vomiting and diarrhea
oral hydration first, then IV
vaccines
constipation
trouble defecating for more than 2 weeks
abdominal distention, poor appetite, n/v
juice, miralax, softeners
hirschsprungs
absence of cells in a part of the color
obstruction-no peristalsis in that part
resection
distended abdomen, bilious vomiting, feeding intolerance
GER
gastroesophageal reflux
reflux into esophagus
spitting up with force, weight loss, stop eating
(GERD is tissue damage)
raise HOB, thicken formula, Pepcid, Prevacid (starts with P)
appendicitis
if they can jump, they dont have it
RLQ (Muburney’s point) pain
rupture causes (peritonitis)
Gastroschisis
failure to close R of umbilicus, organs go through
surgical repair
smoking, alcohol use during pregnancy
cleft lip/palate
facial/palate malformations
different bottle nipple, burp frequently
surgical treatment
pyloric stenosis
narrowing between stomach and intestines
projectile vomiting, infant extremely hungry after
surgery
intussusception
intestines telescope (fold onto each other)
3mo-6yr
RED JELLY blood stools
RUP mass
celiac disease
gluten sensitivity
chronic intestinal intolerance
short bowel syndrome
previous surgical reaction
decr mucosal absorption
TPN feedings to absorb
croup
viral infection of larynx
barking cough, clear lungs, fine during day
prevent: vaccines, hygiene, smoking
prednisone, elevate HOB, humidifier
Spasmodic croup
viral
epiglottitis croup
emergency
bacterial
drooling, can’t lat flat
tripod position to breathe
intubation
tracheitis
bacterial
antibiotics
laryngotracheitis
common
viral (RSV, adenovirus)
small airways when child is sick
pharyngitis
viral & strep
sore throat, rash, vomiting, fever
exudate
droplet/contact
not contagious after 24hr
strep pharyngitis
bacterial
no cough
rheumatoid fever, scarlet fever, glomerulonephritis
amoxicillin
viral pharyngitis
viral
treat symptoms
mono
viral - epsitein virus
incubate 6-8wk
enlarge liver/spleen
penicillin/amoxicillin=rash
1wk of symptoms before testing
otitis infection
smokers, irritants, bottle fed, allergies
systemic symptoms
antibiotic/fungal ear drops
otitis media
middle ear
scar eardrum
bacterial
fever, congestion
otits infusion
just fluid in ear
otitis externa
skin infection
water sits on skin, bacteria grows
painful/swollen
RSV
droplet/contact precaution
bronchiolitis
viral-treat symptoms
maternal vaccine 32-36wk
O2 stats, HOB raised, suction, hydration
