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ABSN Cohort 19 > Peds Exam 2 > Flashcards

Peds Exam 2 Flashcards

1
Q

GI function, newborn capacity, 1 year old capacity

A

ingests, absorbs, eliminates waste
10 - 20 mL
210 - 360 mL

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2
Q

Pediatric Differences in GI (6)

A 
Poor swallowing
↑ Peristalsis
↓ metabolic functions (enzyme levels, bili conjugaiton, gluconeogenesis, etc.)
↑ metabolic rate,
↑ surface area
↑ sensitivity
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3
Q

6 Types of GI Disorders

A 
Structural
Motility
Feeding
Inflammation
Parasitic
Hepatic
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4
Q

5 Structural GI Disorders

A 
Cleft Lip/Palate
Esophageal Atresia
Tracheoesophageal Fistula
Pyloric Stenosis
GER
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5
Q

Cleft Lip/Palate WT

A

hole in lip/soft palate

immobilization and steristrip incision

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6
Q

Esophageal Atresia/Tracheoesophageal Fistula WT

A

underdeveloped esophagus and/or hole between eso and trach

maintain airway with suction, surgery needed.

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7
Q

Pyloric Stenosis WSDT

A

hypertrophy of pyloric channel r/in regurgitation/projectile vomit ↑ 3 feet from infant.
Dx with blood test/ultrasound
Tx with fluid/electrolyte balance and surgery

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8
Q

GER WST

A

gastric contents into esophagus b/c relaxation of lower sphincter r/in regurgitation, vomiting, irritability, weight loss.
Tx with thickened feeds and surgical placement of valve

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9
Q

6 Motility GI Disorders

A 
Diarrhea
Vomiting
GER
Gastroenteritis
Constipation
Encopresis (involuntary pooping r/t stress)
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10
Q

2 Types and 5 Feeding GI Disorders

A

Retention - colic (crying)/rumination (regurgitation)

Malabsorption - celiac, lactose intolerance, short bowel syndrome

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11
Q

Short Bowel Syndrone SBS W2S

A

Occurs when surgical removal of small intestines due to other dz r/in it being too short!
Newborns - necrotizing enterocolitis
Adults - Intussusception

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12
Q

5 Inflammatory GI Disorders

A 
Appendicitis
Necrotizing Enterocolotis
Mekel's Diverticulus (omphalomescenteric duct to yolk sac)
Crohns Dz
Ulcers
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13
Q

Parasitic GI Disorders Tx

A

preventative education (hand washing) and medication

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14
Q

4 Hepatic GI Disorders

A

Hyperbilirubinemia
Biliary Atresia (duct closure)
Viral Hepatitis
Cirrhosis (CT buildup in liver)

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15
Q

Omphalocele/Gastroschisis W2T

A

herniation of food through umbilical cord or protrusion of whole intestine through abdominal wall
protect organs, correct defect

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16
Q

Intussusception W2T

A

when intestine invaginates self b/c inflammation/upper respiratory infection
Tx with fluid/electrolyte balance and nasogastric tube to decompress

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17
Q

Vollvulus and Hirschsprung Disease WS

A

malrotation of intestine during 7 - 12 trimester r/in poor blood flow to bowel. MEDICAL EMERGENCY
absence of aganglionic cell, r/in obstruction, diarrhea, constipation

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18
Q

Anorectal Malformations causes VACTERL and Tx

A 
Vertebral anomaly
Anal artresia
Congenital ♥ Dz
Tracheoesophageal Fistula
Renal anomaly
Limb Defects

Ostomy w/ education

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19
Q

Hernia W3T

A

protrusion of organ through abdominal wall

Keep infant calm, VS q30min, elevate head from abdomen

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20
Q

Appendicitis, McBurney’s Point W4ST

A

inflammation of appendix r/in periumbilical cramps, pain @ point, N/V, fever.
Tx with post-op formula

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21
Q

Necrotizing Enterocolitis WS3T

A

Inflammatory dz in intestinal track which ↑ r/o SEPSIS

Assess for hypo/erthermia, jaundice, respiratory distress

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22
Q

Most UTI’s are from what bacteria?

A

E. Coli

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23
Q

Neurogenic Bladder
Vesicoureteral Reflex
Hydronephrosis

A

poor nerve supply in bladder = poor sense
backflow if urine into ureters = ↑ r/o UTI
accumulation of urine in renal pelvis b/c obstruction

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24
Q

UTI 3 S/S and 4 Tx

A

ill appearance, fever, poor feeding
Assess VS, abdomen
Tx with antibiotics/pyretics and encourage fluid intake

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25
Q

Azotemia
Oliguria
Anuria
Uremia

A

Nitrogen in P
less urine
no urine
TOO MUCH URINE!!!

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26
Q

UTI 4 Lab ▲ and 2 pharmacological Tx

A

↓ filtration = ↑ BUN, Creatinine, WBC, and fever

Tx with diuretics (Lasix/furosemide) and antibiotics if UTI present

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27
Q

Acute Glomerulonephritis W

A

inflammation of kidneys

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28
Q

Acute Renal Failure WS(acute v. chronic and 3 labs)

A

acute kidney injury r/in poor filtration
Acute = dark urine, fatigue, crackles
Chronic = fatigue, N/V, failure to thrive
↑ K ↓ Na, Ca

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29
Q 
Bladder exstrophy
Hypo/Epispadias
Tight Chordee
Cryptorchidism
Testicular Torsion
A

bladder is showing
penis hole too low/high
low penis hole r/in in curvature to cut at 6 - 9 months
undescending testicles, tx with hormones/surgery
rotating balls r/in twisting, surgery or DIE

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30
Q

Hemodialysis

A

machine filtration of blood to remove excess for ppl w/ Ø kidney fx

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31
Q

Consciousness…
Alertness
Cognitive Power

A

ability to react to stimuli

ability to process and respond to data

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32
Q 
Confusion
Delirium
Lethargy
Stupor
Coma
A

disorientation to time, place, person
fear, irritability, agitation
profound slumber (mod stimulation wakes but will fall asleep easily)
deep sleep (vigorous stim wakes but will sleep when stopped)
no wakey even w/ stim

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33
Q

Glasgow Coma assesses 3 things, score, purpose

A

Eyes, Verbal, Motor (5/5) = 15/15

Level of Consciousness

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34
Q

Posturing…
Decorticate
Decerebrate

A

rigid flexion of arms, clenched fists, extended legs

rigid arms/legs straight out, toes downwards

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35
Q

Pediatric Neurologic Differences (2)

A

Top heavy, poor neck muscles = prone to injury

Excessive spinal mobility, cartilaginous vertebral bodies = ↑r/o C1 - C2 compression fracture

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36
Q

Example of…
Congenital
Aquired
Infectious Neuro Dz

A

Cerebral palsy
Head Injury
Meningitis

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37
Q

Pathologic process of neurologic Dz

A

processes ↑ ICP. Brain needs ↓ Cerebral perfusion pressure to oxygenate

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38
Q

3 Early, 3 Late, and 3 Infant S/S of Neuro Dz’s

A

headache, diplopia, sunsetting
LoC, ↑ BP, respiratory ▲
bulging fontanels, wide sutures, high-pitched cat cry

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39
Q

Seizures WHAT and 3 CAUSES

A

uncontrolled neuronal discharge r/t CNS defects caused by infections, toxins, tumors

40
Q

2 Partial Seizures

A

Simple - 1 hemisphere (▲ motor/autonomic)

Complex - 1 to both (LoC and lip smacks)

41
Q

6 Generalized Seizures

A

Abscence (petit mal) - ok posture, lip smacks
Myoclonic - involuntary muscle group movement
Clonic - opposing muscle group rhythmic contractions
Tonic - continuous contracted state
Tonic/Clonic - tonic 20 - 40 sec followed by clonic postictal/seizure
Atonic - DROP/FALL BACK HELMET PLZ

42
Q

Status Epilepticus
Febrile
Intractable Seizures

A

> 5 minutes, intermittent for >15, MEDICAL EMERGENCY
Fever + seizures, sepsis eval, dx with lumbar puncture
reqs. > 2 antiepileptic drugs

43
Q

Seizure Tx 5 and 3 Dx

A

calm, airway, Øinjury, keep warm, support, document

EEG, electrolytes, MRI unless Febrile

44
Q

Meningitis WHAT and 2 Types

A

inflammation of meninges of brain
Viral b/c mumps, measles - CSF clear
Bacterial b/c upper respiratory infx, injury - CSF cloudy w/ WBC, protein, ↓ glucose

45
Q

Meningitis S/S in…
Newborn (3)
2 mo - 2 yr (4)
2 yr - adolescent (+2)

A

poor tone, weak cry, bulging fontanels = late
seizures, fevers, cat cry, nuchal rigidity
All previous + Brudzinski and Kernig sign

46
Q

Brudzinski and Kernig

A

Head forward, knees up

Can’t straighten leg @ 90º angle

47
Q

Meningitis Nursing Management (5)

A 
Seizure precautions
Isolation for 24 hrs
VS and neurochecks
Fluid monitoring
Head circumference
48
Q

Meningitis Medicaitons (4)

A

IV antibiotics - bacteria
Corticosteroids - inflammation
Anticonvulsants - seizures
Analgesics - pain

49
Q

Meningitis 2 key/fatal S/S

A

retinal hemorrhages and slow bleeds

50
Q

Meningitis 3 Post-Infection Syndromes

A

Reye’s - acute encephalopathy b/c tylenol OD/influenza
N/V, ▲ mentality, ↓ responsiveness
Gullaine-Barre - acute inflammatory demyelination of spinal roots r/in muscle weakness, areflexia
Encephalitis - inflammation of brain b/c virus (ie. West nile)

51
Q

Hydrocephalus WST and associated w/ what Dz?

A

↑ CSF in space of brain b/c obstruction flow/absorption in arachnoid space, r/in…
Bulging ANTERIOR fontanel
Sun sign
Glowy skull
Tx w/ shunt draining CSF to other part of body (red = shunt ineffective)
Associated w/ myelomeningocele

52
Q

Myelomeningocele/Myelodysplasia/Spina Bifida W3ST

A

Neural tube defect when vertebral laminae Ø close, Spinal cord protrudes back and r/in…
SAC IN BACK, latex allergies, developmental delays
Sterile moist dressing to prep for surgery

53
Q

3 Levels of Spina Bifida

A

Thoracic - leg paralysis/trunk weakness
Lumbar 1 -2 - hip control, Ø knee movement
Lumbar 3 - can flex hips/knees
LOWER THE BETTER

54
Q

Cerebral Palsy WT

A

Non-progressive impairment of MS development/function

Work with community to accomodate child

55
Q

Bachy/Plagio/Scaphocephaly

A

wide, flat back
asymmetrical
long

56
Q

Concussions r/in… 2 (+concept), important assessments 3!

A

May LoC, headache, BRICK HEAD
Assess…
Neuro, VS, report ↓ oxygenation IMMEDIATELY

57
Q

Near Drowning (3 longers, !location, and tx)

A

longer = worse prognosis
longer time w/out BLS (10 min)/pulse (25 min) = worse prognosis
↑% with infants is in bathtub
educate on safety precautions

58
Q

Mental Health

A

Sense of personal well-being, health, and psychologic stability. #2 reason for hospitalization of 10 - 21 yr olds.

59
Q

Cognition

A

▲ in thought, intelligence, and language as life progresses

60
Q

7 Mental Health Treatment Modalities

A 
Evidence-Based - studies show
Individual - child to therapist
Family - relationships
Group - relatable people
Therapeutic Strats - (see card)
Imagery - imagination
Hypnosis - tx phys. S/S, easier with kids!
61
Q

Psychodrama and Cognitive Therapy

A

role playing to ↑ understanding

recognize/counter negative thinking

62
Q

Play, Art, Cognitive Behavioral Therapy

A

dolls/fantasy to relieve stress
drawing provides objective image
promote + thinking patterns (structured environments and educate adults)

63
Q 
Generalized Anxiety
Separation Anxiety
Panic
Obsessive Compulsive
Conversion Reaction
PTSD
School/Social Phobia
A 
uncertainty/helplessness
uneasy w/ new things > 2 weeks
unexpected attack of fear/discomfort
1 hr rituals w/ obsessive thoughts (+fx serotonin in basal ganglia)
↓ physial fx r/t neurologic/somatic dz
reliving event > 1 month post-event
fear of social interaction
64
Q

4 External forces which insult Brain Development and OVERALL FX on child

A

Drugs/alcohol
Poor nutrition
Traumatic Brain injury
Lack of emotional nurturing

Fx child’s ability to COPE

65
Q

Autism
ADD/ADHD
Depression
Bipolar/Mania

4 Nursing Managements

A

neurodevelopmental (aspergers, Rett’s, Child Disintegrative Disorder)
ADD = CNS + behavior, ADHD = hyperactivity, impulsivity
psychologic distress
extreme ▲ in affect

Evaluate risk, survey, social support, refer to resources if needed.

66
Q

2 Cognitive Alternations…
Learning Disability
Intellectual Disability

A

poor processing w/ developmental delays (NOT LOW IQ)

retarded - ↓ IQ, intellect, ↓Syndrome, and Fetal Alcohol Syndrome

67
Q

Anorexia vs. Bulimia

A

Ø eat b/c = fat

eat but PURGE b/c Ø PURGE = fat

68
Q

Munchausen by Proxy

A

when parent abuses/seeks unneeded medical attention of child r/t personality disorders

69
Q 
# bones in body, 2 examples of...
long, short, flat, irregulat
A

tibula, fibula
wrist, ankle,
skull, sternum
vertebrae, pelvic

70
Q

3 Types of Muscles example

A 
Skeletal/striated
bicep - voluntary
Smooth/short-fibered
stomach - involuntary
Cardiac/striated w/ special fx
♥ - contract/relaxation
71
Q

Pediatric Bone differences (3)

A

↑ porous, ↑ pliable = flexible
Grow from Epiphyseal plate which -> Line
Ligaments/Tendons stronger than bone until puberty

72
Q

Infant Skull skull growth time and fontanel closing time

A

Growth complete @ 2 years

Fontanels close @ 18 months

73
Q

4 Disorders of the Feet and Legs

A 
Club foot (talipes equinovarus)
Metatarsus Adductus - congenital inward turning of forefoot @ tarsometatarsal joints
Genu Valgum (knock-knees)
Genu Varum (bowlegs)
74
Q

Varus vs. Valgus

A

Inward/towards midline bending vs.

Outwar/away from midline bending

75
Q

Club foot (talipes equinovarus) W4S2T

A

foot is twisted out of normal position
Short Achilles, atrophied lower leg muscles, leg length NORMAL, Ø SOLVE WITH EXERCISE
Serial casting (▲ q1-2wks for 8-12wks)
Surgery (@ 3-12 months w/ casting for 6-12wks following)

76
Q

Club foot 3 Types of Deformity

A

Equinus - midfoot downward
Varus - hindfoot inward
Adduction - forefoot curls toward heels

77
Q

Club food post-surgical care (4) Tx

A

neuro check q2hrs
ice bags w/ elevation
pain meds q4-8hrs
popliteal/epidural blocks ok

78
Q

Genu Valgum (knock-knees) WT

A

knees close together with lower legs valgus’d
Tx with braces DAY and NIGHT

anime school girl

79
Q

Genu Varum (bowlegs) WT

A

knees widely separated w/ ankles close b/c legs varus’d

Tx with braces @ NIGHT

80
Q

Genus Valgum/Varum expectation, optional Tx, 2 common causes (with WS), and diagnoses

A

Normal until > 4-5 yrs old
Tx with osteotomy
Blount Dz - ↑ growth medial prximal tibia r/t ↓ VitD and being black
Rickets - ↓ mineralization r/t ↓ Ca and VitD (aquired but CAN be congenital via X-linked autosomal dom/reces.
Diagnose w/ radiology (MRI/CT)

81
Q

3 Disorders of the Hips

A

Developmental Dysplasia of the Hip (DDH)
Leg-Calve Perthes Dz
Slipped Capital Femoral Epiphysis

82
Q

4 Reason for DDH

A

Hip instability
Dislocation
Subluxation - partial dislocation
Dysplasia - abnormal cellular/structural development

83
Q

Primary cause DDH, gestation occurrence, and alternative cause

A

Primarily genetic
12 - 18 weeks gestation
Mild cases caused by mechanical force (breech)

84
Q

DDH 3S4T

A

↓abduction of hip, asymmetry of folds, limp
60 - 80% resolve by 2 mo. old
↓ 3 months = Palvik Hardness
↑ 6 months = Closed surgery w/ spica cast
↑ 18 months = Open/Closed surgery w/ casting + bracing

85
Q

Slipped Capital Femoral Epiphysis W2S2T and ages for ♂/♀

A

Fracture of physis r/in top of femur slipping through growth plate posteriorly
pain, asymmetry
No sitting, surgery w/ casting

♂ 10 - 16
♀ 10 - 14

86
Q

4 Disorders of the Spine W2S2T

A

Scoliosis - S or C > 10º
Torticollis - head tilt r/t cervical/visual insult
Kyphosis - hunchback
Lordosis - U shape
Unequal back, pain not normal.
Masses should be investigated, Tx with braces

87
Q

2 Disorders of the Muscles WS (with age onsets)

A

Duchennes - mutations in DMD gene r/in progressive muscle weakness ( 3 - 7 yrs old)
Muscular Dystrophy - inherited degeneration of muscles ( onset 3 y/o, immobile by 9 - 11, dead by 20 b/c respiratory failure)

88
Q

5 Disorders of the Bones/Joints WT

A

Skeletal TB - spasms, atrophy, swelling @ joints
Tx with antibiotics
Septic Arthritis - paint w/ local inflammation
Tx with antibiotics/drainage
Achondroplasia (Dwarfism) - ugly and short
Tx with self-esteem and short adaptation
Marfan Syndrome - CT manifesations r/t autosomal dominant gene (▲ cardiac, skeletal, ocular, and respiratory)
Tx Ø
Osteogenesis Imperfecta - (see card)

89
Q

Osteogenesis Imperfecta (W and 4 Types)

A

Brittle bone disease, hits both ♂♀ equally

  1. most common, fragile, blue sclerae
  2. rib involved, likely to die in utero
  3. numerous fractures, kyphoscoliosis
  4. all above + bowlegs, structural deformities that improve @ puberty
90
Q

Sprain
Fracture
Traction (2)

A

tearing of ligaments
partial/complete break in bone
Skin and Skeletal (sterile, check q4hrs)

91
Q

Cast and Brace Tx

A

Cast - 2 days to dry, elevate, check cap refil/neuro q2hr

Brace - snug, but Ø cut circulation, do as above.

92
Q

Types of Fractures

A 
Complete Transverse
Spiral
Open
Closed
Green-stick - compression
Comminuted - shatter!
93
Q

Leg-Calve Perthes Disease W3S4T

A

Self limiting avascular necrosis of femoral head r/t injury, ↑ thyroid, ↓ Somatomedin C.
Tx with traction, surgery, anti-inflammatories, and PT

94
Q

5 Stages of Leg-Calve Perthes

A

Prenecrosis - ↓ blood supply @ femoral head
Necrosis - 3 - 6 months, graphs normal, asymptomatic
Revascularization - 1 - 4 years, +graphs, pain w/ move
Bone Healing - re-ossification, pain
Remodeling - Dz over, Ø pain, ↑ joint fx

95
Q

Salter-Harris Classification (5)

A

Type 1 - plate undisturbed
Type 2 - most common, disturbance rare
Type 3 - less common, serious threat to growth
Type 4 - serious threat to growth
Type 5 - rare, crush injury arrests growth/length, deformities may result

ABSN Cohort 19 (28 decks)

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