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Peds > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

signs/symptoms of Mono

A

MAIN: Fever, malaise, sore throat, white patches, and lymphadenopathy

other possible symptoms may include:
loss of appetite, headache, redness of throat, cough, chills, aches, photophobia, swollen tonsils, swollen lymph nodes, enlargement of spleen, abdominal pain, nausea

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2
Q

Mono is caused by what virus?

A

Epstein-Barr

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3
Q

Management of Mono

A

Primarily symptomatic; Lots of fluid, rest (bed rest encouraged while child is febrile), no contact sports

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4
Q

s/s Mumps

A

Mainly HUGE parotid swelling, fever, aches, malaise, possibly orchitis (testicle swelling) in boys – very painful

[Parotid swelling gives you the ear infections and earaches]

Coming back due to lack of immunizations

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5
Q

Management of Mumps

A

(supportive) Treat symptoms.
• Acetaminophen for fever
• Oral fluids
• Ice packs to testicles with support if orchitis present
• Droplet precautions for 9 days after swelling starts
Contagious for 1-7 days prior to onset of symptoms

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6
Q

Transmission route of Pinworms

A

fecal-oral

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7
Q

S/s pinworm

A

Mainly: anal itching at night & teeth grinding at night

Also: wt. loss, enuresis (involuntary urination)

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8
Q

Diagnosis of pinworm:

A

clear tape to anus during nighttime - can see adult worms.

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9
Q

Management/Tx of Pinworm:

A

mebendazole x1 (can get OTC), then repeated in 2 weeks; treat all family in household

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10
Q

Hallmark sign of rubeola (measles)

A

Kopliks spots (bluish-gray spots on buccal mucosa)

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11
Q

s/s measles (rubeola)

A

Koplik’s spots, acute rhinitis, conjunctivitis, erythematous macropapular rash,
fever, and cough

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12
Q

Mgmt/tx measles (rubeola)

A

self-limiting requiring supportive therapy – Treat symptoms

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13
Q

S/S scarlet fever

A
  • Sunburn-like rash all over
  • Fever > 101°F, aches, chills, anorexia, N & V
  • Red and swollen pharynx and lymph nodes
  • Coated tongue that becomes very red
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14
Q

Mgmt scarlet fever

A

Penicillin V, fluids, cool mist humidifier, antipyretics, popsicles ,etc

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15
Q

s/s varicella zoster (chicken pox)

A

Mainly just feel really bad (fever, aches, malaise) and severe itching of the lesions

Also may experience anorexia, abdominal pain

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16
Q

Nursing management of varicella zoster

A

Mostly supportive – treat the symptoms (itching, etc.)
Antivirals could sometimes help but not always
Airborne and contact precautions until all crusted over

CDC recommends TWO doses of chickenpox vaccine (first at 12-15 months, second at 4-6 years)

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17
Q

s/s lyme disease

A

Bull’s eye rash, fever, malaise, arthralgia (can be for life)

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18
Q

mgmt lyme disease

A 
Tick removal (COMPLETE)
Antibiotics:
       -older than 8 years - Doxycycline
       -younger than 8 years- amoxicillin
Prevention education on going into woods
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19
Q

s/s lice

A

intense itching, may see adult nits

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20
Q

how long can lice live on a host

how long can they lice off host

A

30 days on

1-3 off

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21
Q

mgmt lice

A

shampoo hair with pediculicide (permethrin), comb out nits with fine-toothed comb, wash clothing in hot water

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22
Q

s/s Fifth Disease (erythema Infectiosum)

A

“Slapped cheek” facial appearance
May have a low grade fever
Upper respiratory 2 days before rash

Lecture: “May have a little cough before rash appears”

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23
Q

mgmt 5th disease

A

comfort, droplet precautions

-Can cause aplastic crisis in sickle cell patients
-No longer contagious once rash appears
Rash will resolve in 1-3 weeks

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24
Q

Main treatment for Scarlet Fever

A

Penicillin V

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25
Q

Whooping Cough

A

Pertussis

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26
Q

Primary prevention for Measles (Rubeola)

A

Measles Vaccine

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27
Q

3 Kinds of Conjuncvitis

A

Bacterial
Viral
Allergic

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28
Q

Treatment for Bacterial conjuctivitis

A

Will usually do a culture and culture will show + for bacteria

Treat with:
Antibiotic drops or ointment (contagious until tx x 24 hrs)

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29
Q

Tx for Viral conjunctivitis

A

Mainly symptomatic relief:

cool moist compress, cool water rinse

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30
Q

Tx for allergic conjunctivitis

A

Mostly Symptomatic relief
Antihistamine and/or mast cell stabilizer drops may help
Education

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31
Q

Management for periorabital cellulitis

A

Abx therapy x 7 days, warm compress

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32
Q

Common complication of Otitis Media

A

expressive speech delay

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33
Q

gold standard for asthma treatment

A

steroids

34
Q

Symptoms of Bacterial Conjunctivitis

A 
itching
burning 
yellow discharge
crusting of eyelids
really swollen conjunctiva
35
Q

Symptoms of Viral Conjunctivitis

A 
More redness of sclera (than bacterial)
Watery discharge (not as thick/yellow as bacterial)

(Allergic Conj. symptoms are similar to viral!)

36
Q

Symptoms of Acute Otitis Media (AOM)

A

fever, ear pain, fussiness, batting or tugging at ears, poor feeding, difficulty sleeping “absolute misery”

37
Q

Symptoms of Otitis Media with Effusion (OME)

A

feeling of fullness in the ear; tympanic membrane orange or opaque, bulging, may have pus sometimes

(not necessarily an infection, usually no s/s)

38
Q

Symptoms of Otitis Externa (OE)

A

“Swimmer’s Ear”

VERY painful, drainage, canal red and edematous
**Tx: abx drops

39
Q

Tx/Mgmt for Otitis Media (all)

A

Viral: resolve spontaneously; bacterial=antibiotics (amoxicillin)

Manage Pain
Treat infection 
Educate family
Myringotomy tubes may be necessary
Prevent AOM
40
Q

Common complications from OM

A

hearing loss (if constant OM), speech delays (d/t hearing loss), tympanic membrane perforation (d/t so many of them)

41
Q

Levels of Consciousness

A
  1. Full consciousness (awake, alert, oriented)
  2. Confusion (disorientation exists; alert but response inappropriate)
  3. Obtunded (limited responses to environment, falls asleep unless stimulated) – think of when people are waking up from anesthesia – they can wake up when you tell them to.
  4. Stupor (only respond to vigorous stimulation) – would have to pinch them or give painful stimuli
  5. Coma (cannot be aroused even with painful stimuli)
42
Q

Early signs of ICP

A

Vomiting (often projectile)
Blurred or double vision
Pupil reaction time decreased and unequal
Sunset eyes (sclera is showing above iris)
Change in LOC
Seizure activity

Infant: bulging and tense fontanels (if open), wide sutures, increased head circumference, dilated scalp veins, high pitch cry

43
Q

Late signs ICP

A 
Lowered LOC
Vital sign changes**
Decreased motor and sensory responses
Bradycardia
Irregular respirations
Cheyne-stokes respirations 
decerebrate or decorticate posturing
Fixed and dilated pupils
44
Q

one form of managing epilepsy that is thought to trigger biochemical changes that eliminate seizure causing short circuit signals in the brain.

A

Ketogenic Diet

45
Q

Epilepsy Treatments

A

Anticonvulsants (minimal – goal is 1 drug)
Surgery (when uncontrolled)
Ketogenic diet
Vagal nerve stimulator (“pacemaker for the brain” that resets electrical charges)

46
Q

seizure that comes on rapidly, usually with rapid rise of temperature

A

Febrile Seizure

47
Q

peak ages for febrile seizure

A

18-24 months

48
Q

Febrile seizures can be treated with..

A

rectal diazepam (can give for anxious parents)

49
Q

Tonic-clonic seizure

A

LOC occurs
May be preceded by piercing high-pitched cry
Tonic contractions (all muscles stiffen) followed by clonic contractions (arms and legs jerk rapidly)

50
Q

Myoclonic seizure

A

sudden, brief massive muscle jerks that may involve whole body or one body part
Dont usually lose consciousness (child may or may not)

51
Q

Tonic Seizure

A

Sustained stiffening of the body/4 extremtities

52
Q

Atonic Seizure

A

Sudden loss of all muscle tone

Safety issue because they can fall and really hurt themselves

53
Q

Most common seizure in childhood

A

Absence (formerly petit mal) seizures

54
Q

Absence Seizures

A

Sudden cessation of motor activity or speech with a blank facial expression or twitching of mouth/blinking of eyelids; LOC less than 30 sec/day

May go unrecognized because it looks like kid is just daydreaming

55
Q

Status epilepticus

A

prolonged or clustered seizures lasting 30 minutes or more where consciousness does not return between sz.
*medical emergency

56
Q

Treatment for status epilepticus

A

Rectal diazepam #1 treamtnet!!
Basic Life Support - ABCs
IV access: valium, diazepam, ativan
Anticonvulsants

57
Q

Seizure Triggers

A

Light flashes, loud noises, temp changes, dehydration, fatigue

58
Q

Onset of Diazepam and how long does it last?

What do you monitor after giving this drug?

A

onset 3-10 minutes; duration short (minutes)

Monitor respiratory rate and level of sedation

59
Q

1st indicator of impreovement or deterioration of neuro status

A

LOC

60
Q

Asthma meds

A
  • Leukotriene modifiers (Singulair) and combo steroid/long-acting bet agonists (Advair – Fluticasone/salmeterol) are gold standards for asthma
  • Short-acting beta agonits bronchodialators (Albuterol) great for quick relief, exercising, etc
  • Anticholinergic (Atrovent)
  • Sympathetic (Racemic Epi) when asthma attack
  • Steroids IV or PO
61
Q

S/S Cystic Fibrosis

A 
wheezing
cough
dyspnea
mucus plugs
cyanosis
barrel-shaped chest
clubbing
multiple respiratory infections
meconium ileus ***earliest recognizable sign***
62
Q

Diagnosis of CF:

A

sweat chloride test, chest x-ray, stool sample, PFT’s

63
Q

Management of CF:

A 
maintain patent airway 
prevent infection
maintain growth
promote family coping, 
high protein and caloric diet**
fluids!**
med compliance
preparing for adulthood
64
Q

Most important meds for CF patients

A

Pancreatic enzymes – must give with every meal and every snack (allow fat and proteins to be digested)

65
Q

What is croup?

A

Sudden onset (typically in the middle of the night only) of seal-like barking stridorous coughs. Very sudden

Inspiratory Stridor
Usually in boys ages 3-5

66
Q

Treatments for Croup

A

singe dose corticosteroids

racemic epinephrine aerosols

67
Q

S/S epiglottis

A

high fever, severe sore throat, muffled voice ( HOT POTATO voice) , Tripod sitting, may drool, anxious an frightened, stridor late sign, Thumb sign

68
Q

treatment of epiglottis

A

emergency tracheotomy, intubation, 100% O2

69
Q

S/S nasopharyngitis

A

Nasal inflammation, rhinorrhea, cough, sneezing, nasal voice.

70
Q

Mgmt RSV Bronchiolitis (common cold to most of us)

A

nasal suctioning, oral hydration, inhaled bronchodilator

71
Q

Prevention of RSV Bronchiolitis

A

Hand washing, disinfecting surfaces, Palivizumab (Synagis) given IM every month of the season (prevents growth of RSV)

72
Q

Diagnosis of RSV

A

Main Diagnosis: nasal swab for rapid viral-RSV***

Also, pulse ox, chest xray, blood gases

73
Q

S/S Pneumonia

A

High fever, cough, respiratory distress, chest pain, rhonchi, crackles, irritable, abdominal pain, N&V, pale color-cyanosis

74
Q

Mgmt of Pneumonia

A

Keep affected lung up, lay on unaffected side, Hydration, Antibiotics

Antipyretics, rest, CPT, O2, pulse ox

75
Q

S/S Viral pharyngitis

A

sore throat, nasal congestion

76
Q

S/S bacterial pharyngitis

A

sore throat, NO nasal symptoms

77
Q

Management pharyngitis

A

promoting comfort and providing family education; discard toothbrush after 24 hrs of abx, popsicles

Treat with Group A strep- penicillin

78
Q

Tonsillectomy Post Op Care

A 
Side-lying position
Elevate head
Assess for bleeding
Assess airway
Ice collar
ice chips, soft diet
Avoid coughing, nose blowing
79
Q

Signs of compartment syndrome

A

Uncontrollable pain out of proportion with injury and use of medication

80
Q

Treatment for clubbed feet

usually successful if started within first 9 months of life

A

serial casting

81
Q

Tests to see if child has DDH

A

Imaging

- 4mos = AP and Frog X-ray

Peds (3 decks)

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