12 Health Problems in Toddlers and Preschoolers

Question 1

The result of heat transfer from one site to another. They are caused by excessive heat, but are also related to cold, chemicals, electricity and radiation.

Answer 1

Burn Injury

Question 2

____ disrupt the skin, which leads to increased fluid loss; infection; hypothermia; scarring; compromised immunity; and changes in function, appearance, and body image.

Answer 2

Burns

Question 3

_____ and _____ continue to have increased morbidity and mortality when compared to other age groups with similar injuries.

Answer 3

Young children and the elderly

Question 4

_____injuries in addition to cutaneous burns worsen the prognosis.

Answer 4

Inhalation

Question 5

Types of Burns

Answer 5

Thermal Burns
Chemical Burns
Electrical Burns
Other Burns

Question 6

Most common type of burn, usually the result of residential fires, automobile accidents, children playing with matches, improperly stored gasoline, space heater, arson, improper handling of firecracker, scalding accidents, hot irons

Answer 6

Thermal Burns

Question 7

Result from contact or ingestion, inhalation or injection of acids, alkalis, vesicants or noxious agents used in cleaning products

Answer 7

Chemical Burns

Question 7

Result from contact or ingestion, inhalation or injection of acids, alkalis, vesicants or noxious agents used in cleaning products

Answer 7

Chemical Burns

Question 8

Sunburn, cigarette burn, friction or abrasion burn

Answer 8

Other Burns

Question 9

_____ results from coagulation, protein denaturation, or ionization of cellular components

Answer 9

Tissue destruction

Question 10

Burns that do not exceed 20% of TBSA according to the Rule of Nines produces a _____

Answer 10

Local response

Question 11

Burns that exceeds 20% of TBSA according to the Rule of Nines produces a _____

Answer 11

Systemic response

Question 12

_____ is caused by the release of cytokines and
other mediators into the systemic circulation.

Answer 12

Systemic response

Question 13

The release of _____ and changes in blood flow, tissue edema, and infection, can cause progression of the burn injury.

Answer 13

local mediators

Question 14

2 level of response to Burn Injury

Answer 14

Local response
Systemic Response

Question 15

Edema results from increased capillary permeability forcing water, electrolytes into the interstitial spaces

Answer 15

Local Response

Question 16

Fluid loss from the burn-injured skin is a result of the _____

Answer 16

inflammatory response

Question 17

Circulatory alterations cause _____ in the burned area

Answer 17

capillary stasis

Question 18

_____ develop, leading tissue ischemia and necrosis causing pain and edema

Answer 18

Thrombi

Question 19

Cardiovascular changes occur, burn shock, tachycardia, tachypnea to compensate for decreasing vascular volume and increased oxygen needs

Answer 19

Systemic Response

Question 20

_____ may occur with severe edema compromises circulation and entraps nerves

Answer 20

Compartment Syndrome

Question 21

Respiratory system may be compromised by _____

Answer 21

Smoke Inhalation

Question 22

Renal changes occur, such as renal vasoconstriction, depressed _____

Answer 22

Glomerular filtration

Question 23

_____ is greatly increased - can lead to prolonged starvation and extensive energy needs

Answer 23

Metabolism

Question 24

Elevated _____ because of increased metabolism

Answer 24

body temperature

Question 25

Prone to _____ due to loss of skin and tissue integrity and immature immune system

Answer 25

infection

Question 26

Degree of Burns

Answer 26

First, Second, Third and Fourth

Question 27

Damage is limited to epidermis, causing erythema and pain

Answer 27

First Degree

Question 28

Epidermis and part of the dermis are damaged, producing blisters and mild to moderate edema and pain

Answer 28

Second Degree

Question 29

Epidermis and dermis are damaged; no blisters appear, but white, brown or black leathery tissue and thrombosed vessels are visible

Answer 29

Third Degree

Question 30

Rare and damage extends through deeply charred subcutaneous tissue to muscle and bone

Answer 30

Fourth Degree

Question 31

This is the immediate consequence of fluid loss and results in decreased perfusion and oxygen delivery.

Answer 31

Hypovolemia

Question 32

Cardiac output decreases before any significant change in blood volume is evident.

Answer 32

Decreased cardiac output

Question 33

Forms rapidly after burn injury

Answer 33

Edema

Question 34

Circulating blood volume decreases dramatically during burn shock.

Answer 34

Decreased circulating blood volume

Question 35

Common during the first week of the acute phase, as water shifts from the interstitial space to the vascular space.

Answer 35

Hyponatremia

Question 36

Immediately after burn injury _____ results from massive cell destruction.

Answer 36

Hyperkalemia

Question 37

Loss of skin results in an inability to regulate body temperature.

Answer 37

Hypothermia

Question 38

Burns that make up _____ or more of TBSA are considered critical and require hospitalization

Answer 38

10%

Question 39

TBSA

Answer 39

Total body surface area

Question 40

Children's larger body surface areas put them at high risk for fluid volume and heat loss leading to _____

Answer 40

Dehydration

Question 41

To estimate the extent of a burn in a pediatric patient, use the _____

Answer 41

Lund and Bowder chart

Question 42

The _____is a quick way to estimate the extent of burns in adults through dividing the body into multiples of nine and the sum total of these parts is equal to the total body surface area injured

Answer 42

Rule of Nines

Question 43

This method recognizes the percentage of surface area of various anatomic parts, especially the head and the legs, as it relates to the age of the patient.

Answer 43

Lund and Browder Method

Question 44

The size of the patient’s palm, not including the surface area of the digits, is approximately 1% of the TBSA, and the patient’s palm without the fingers is equivalent to 0.5% TBSA and serves as a general measurement for all age groups.

Answer 44

Palmer Method

Question 45

Complications of Burns

Answer 45

Respiratory Complications Sepsis Burn Shock Fluid and electrolyte deficits Hypothermia Hypermetabolism Hypovolemic Shock Infections Scarring and disfigurement Contractures Multisystem organ failure

Question 46

Treatment for Minor Burns

Answer 46

Removed burned clothing Clean with mild soap and tepid water Leave blisters intact Nothing should be applied except a clean cloth that is treated with antimicrobial ointment or cream Tetanus prophylaxes is necessary if no history of immunization Mild analgesic is administered

Question 47

Moderate to severe burns

Answer 47

Requires treatment at a specialized burn center Emergency management begins with stopping the burning process and placing the child in horizontal position Establish and maintain patent airway. Initiate SPR if necessary Removed burned clothing and jewelries while keeping the child warm Cover the burn to prevent contamination Until transported to a medical facility do not let the patient eat or drink anything. IV fluids should be started and oxygen therapy provided at 100%

Question 48

Initial management in the Burn unit

Answer 48

Maintenance of adequate airway IV fluid replacement should be started as soon as possible Intubation and mechanical ventilation may be necessary Urinary catheter is inserted to measure urine output NGT is necessary to decompress the stomach, later, may be used to administer TPN IV pain medication administered Topical wound cleaning to prevent infection Tetanus prophylaxis is administered

Question 49

The acute or intermediate phase begins 48 to 72 hours after the burn injury. _____ and _____ are priorities at this stage.

Answer 49

Burn wound care and pain control

Question 50

Rehabilitation should begin immediately after the burn has occurred. _____, _____ and _____ remain priorities.

Answer 50

Wound healing, psychosocial support, and restoring maximum functional activity

Question 51

Occurs most commonly in children between ages 2 to 3 years old

Answer 51

Poisoning

Question 52

Common agents in childhood poisoning include:

Answer 52

Soap Cosmetics Detergents and Cleaners Plants OTC Drugs - vitamins, iron compounds, aspirin

Question 53

Treatment for Acetaminophen poisoning

Answer 53

Activated charcoal Acetylcysteine

Question 54

Ingestion of strong alkali such as lye, which is often contained in toilet bowl cleaners or hair care products, may cause burns and tissue necrosis in the mouth, esophagus and stomach

Answer 54

Caustic Poisoning

Question 55

Do not try to make the child _____ after ingestion because they can cause additional burning as the child vomited

Answer 55

Vomit

Question 56

_____ may lead to systemic signs of tachycardia, tachypnea, pallor and cyanosis

Answer 56

Loss of blood

Question 57

Diagnostic Tests for Poisoning

Answer 57

Chest radiograph Esophagoscopy Barium Swallow

Question 58

There is a high possibility that pharyngeal edema will be severe and can obstruct the airway in 20 minutes after burn, _____ may be necessary to provide patent airway

Answer 58

Intubation

Question 59

Are substances contained in products such as kerosene and furniture polish

Answer 59

Hydrocarbon Ingestion

Question 60

These substances are volatile, fumes rise from them. Their major effect if respiratory irritating

Answer 60

Hydrocarbon Ingestion

Question 61

Are frequently swallowed by small children because it is an ingredient in vitamin preparation for pregnancy

Answer 61

Iron poisoning

Question 62

When ingested, it is corrosive to the gastric mucosa and can cause gastric irritation

Answer 62

Iron poisoning

Question 63

Signs and symptoms of Poisoning

Answer 63

Nausea and vomiting Diarrhea Abdominal pain After 6 hours, these symptoms fade and the child's condition appear to improve , however, hemorrhagic necrosis of the GI tract has occurred By 12 hours, melena and hematemesis are present Lethargy, coma, cyanosis, coagulation defect and hepatic injury can occur

Question 64

_____ will be done to remove any pills not yet absorbed

Answer 64

Stomach lavage

Question 65

A _____ may be given to help the child pass enteric-coated iron pill

Answer 65

cathartic

Question 66

_____ should not be given - not effective in neutralizing iron

Answer 66

Activated charcoal

Question 67

If large dose was ingested, Chelating agent must be given - _____ - must be given IV or IM - can be excreted in the urine

Answer 67

Deferoxamine

Question 68

Interferes with RBC function by blocking the incorporation of iron into the compound that makes up the heme portion of hemoglobin

Answer 68

Lead poisoning

Question 69

Sources of ingested lead

Answer 69

Paint chips, home glazed pottery, swallowed batteries

Question 70

Diagnostic test for Lead poisoning

Answer 70

Blood lead determination

Question 71

Signs and Symptoms of Lead Poisoning

Answer 71

Asymptomatic Anorexia and abdominal pain

Question 72

Children with 20 ug/dL may be prescribed with oral chelating agent such as _____

Answer 72

Succimer

Question 73

Insecticide poisoning when swallowed, _____ may be administered

Answer 73

Activated charcoal

Question 74

Cholinesterase reactivator - are effective antidote to severe cases

Answer 74

Protapam Chloride

Question 75

Submersion injury is also knows as the "_____"

Answer 75

Silent Event

Question 76

_____ is the 3rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury-related deaths.

Answer 76

Drowning

Question 77

Children, _____ and individuals with increased access to water are most at risk of drowning.

Answer 77

males

Question 78

Globally, the highest drowning rates are among children _____ years, followed by children _____ years.

Answer 78

1–4, 5–9

Question 79

In the WHO Western Pacific Region children aged _____ die more frequently from drowning than any other cause.

Answer 79

5–14 years

Question 80

Abuse is a “_____” behavior.

Answer 80

learned

Question 81

Most common type of mistreatment: Failure to provide the child’s basic needs and care

Answer 81

Neglect

Question 82

Two types of Neglect

Answer 82

Physical, Emotional

Question 83

Contributing Factors of Neglect

Answer 83

* Lack of knowledge by caregiver * Lack of resources * Substance abuse * Can lead to elder abuse

Question 84

Any physical attack repeated or occurring just once

Answer 84

Physical Abuse

Question 85

Causes of Shaken baby Syndrome

Answer 85

* Crying baby * Maternal stress * Depression

Question 86

Signs and Symptoms of Shaken baby syndrome

Answer 86

Subdural or retinal hemorrhage without external signs

Question 87

Individuals who exhibit the characteristics of this syndrome fabricate, exaggerate, or cause illness or sickness, usually of their own child. MSBP is a form of child abuse and can prove fatal.

Answer 87

MUNCHAUSEN SYNDROME BY PROXY

Question 88

An illness that one person fabricates or induces in another person

Answer 88

MUNCHAUSEN SYNDROME BY PROXY