Final Exam TO KNOW Flashcards
Appendicitis
Inflammation of the appendix that leads to distention and ischemia that can result in necrosis, perforation, and peritonitis or abscess formation. Process evolves over 12 hours.
Pain: Initially poorly defined periumbilical pain (earliest sign); acute onset of severe pain is not typical of acute appendicitis. A shifting of pain to the RLQ may occur after a few hours and becomes more intense, continuous, and localized.
Nausea and vomiting: Typically occurs after pain; however, in retrocecal appendicitis, this may be reversed. In gastroenteritis, vomiting precedes the pain.
Anorexia occurs (although up to 50% of children state that they are hungry).
Stool is low volume with mucus; diarrhea is atypical but can occur especially after perforation (gastroenteritis has high-volume, watery stools).
Fever is neither sensitive nor specific for appendicitis; many children present as afebrile or with low-grade fever. High fever may be associated with perforation.
How to assess for diabetes?
What labs/diagnostics to run when diabetes is suspected?
Treatment for diabetes
How would diabetes affect child growth?
- Early puberty in girls
- Delayed puberty in boys
- ## obesity
For abnormal uterine bleeding with concern for malignancy what should the NP do?
Referral to oncology
Toxic shock syndrome
A severe illness with an acute onset characterized by fever, low blood pressure, a sunburn-like body rash, and end-organ damage.
Typically presents with a rapid onset of fever, hypotension, and rash.
What is mastalgia?
also called mastodynia or breast pain, is one of the most commonly reported symptoms in women with breast concerns. Breast pain is a significant cause of anxiety, even though mastalgia is benign in 90 percent of cases.
Classified as cyclic or noncyclic, depending on whether its presence is related to the menstrual cycle. The majority of breast pain is cyclic, occurring 1 to 2 weeks prior to menses.
Should you be concerned about mastalgia?
It is considered a normal physiologic condition caused by the hormonal changes of the menstrual cycle
Fibroadenoma
A benign breast mass that is discrete, round, smooth, non-tender, and mobile.
Tissue sampling shows ductal epithelium, dense stroma, numerous elongated nuclei without fat.
What are the probable signs of pregnancy?
Uterine enlargement and Chadwick’s sign.
Self care including the following will help with what?
-● Ask for help
● Rest often
● Sleep when possible
● Stay active
● Eat well
● Self-care
● Get social support
Baby blues
The parent of an infant asks about using a probiotic medication. What will the primary care pediatric nurse practitioner tell this parent?
There is no conclusive evidence about using probiotics to treat colic
The parent of a 3 month old reports that the infant arches and gags while feeding and spits up undigested formula frequently. The infant’s weight gain has dropped to the 5th percentile from the 12th percentile. What is the best course of treatment for this infant?
Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm cylindrical object in the child’s stomach. The child is able to swallow without difficulty and is not experiencing pain. What is the correct course of treatment?
Have the parents watch for the object in the child’s stool.
A 10 year old child has had abdominal pain for 2 days, which began in the periumbilical area and then localized to the right lower quadrant. The child vomited once today and then experienced relief from pain followed by an increased fever. What is the likely diagnosis?
Appendicitis with perforation
A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school-age child with dysuria and foul smelling urine but no fever who has not had previous urinary tract infections. A culture is pending. What will the pediatric nurse practitioner do to treat this child?
Prescribe trimethoprim/sulfamethoxazole (TMP) twice daily for 3 to 5 days
A 6-month-old infant has a retractile testis that was noted at the 2-month well baby exam. What will the primary care pediatric nurse practitioner do to manage this condition?
Refer the infant to a pediatric urologist or surgeon for possible orchiopexy.
An adolescent male comes to the clinic reporting unilateral scrotal pain, nausea, and vomiting that began that morning. The primary care pediatric nurse practitioner palpates a painful, swollen testis and elicits increased pain with slight elevation of the testis (a negative Phren’s sign). What will the nurse practitioner do?
Refer the adolescent immediately to a pediatric urologist or surgeon
A 7-year-old female has recently developed pubic and axillary hair without breast development. Her bone age is consistent with her chronological age, and a pediatric endocrinologist has diagnosed idiopathic premature adrenarche. The primary care pediatric nurse practitioner will monitor this child for which condition?
Polycystic ovary syndrome
The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old
infant with congenital hypothyroidism who takes daily levothyroxine sodium and notes a recent slowing of the infant’s growth rate. What will the nurse practitioner order?
Free serum T4 and TSH levels
