Pediatric Assessment & Intervention Flashcards

1
Q

What are three cardiovascular structures that must close at birth?

A

The foramen ovale, ductus arteriosus and ductus venosus

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2
Q

The ductus arteriosus must close to allow blood flow to which structure?

A

lungs

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3
Q

The ductus venosus must close to allow blood flow to which structure?

A

liver

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4
Q

What does the foramen ovale connect?

A

It’s the hole between the right and left atria

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5
Q

What is the most common condition found in premature newborns?

A

Patent ductus arteriosus

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6
Q

What can patent ductus arteriosus lead to?

A

heart failure and inadequate oxygenation of the brain

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7
Q

What is atrial septal deficits characterized by?

A

an opening in the septum between the right and left atrial chambers

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8
Q

What does atrial septal deficits result in?

A

“wet lungs,” may lead to respiratory infection, heart failure due to the right ventricle working too hard and poor exercise tolerance and being small for chronological age

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9
Q

What does “wet lungs” mean?

A

too much blood sent to the lungs

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10
Q

Which heart defect may result in poor exercise tolerance and being small for chronological age?

A

atrial septal deficits

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11
Q

Which heart defect is characterized by one or more opening in the muscular or membranous portions of the ventricular septum?

A

ventricular septal deficits

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12
Q

T or F: More than 50% of ventricular septal deficits self-correct by age 5

A

True, otherwise surgery is warranted

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13
Q

Ventricular septal deficits may result in which complex and obstruction?

A

Eisenmenger’s complex or pulmonary vascular obstruction owing to prolonged exposure to increased blood flow and high pressure

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14
Q

What are some symptoms of ventricular septal deficits?

A

feeding difficulties, shortness of breath, increased perspiration, increased respiratory infections, fatigue with increased activity and delayed growth.

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15
Q

What are deficits that decrease pulmonary blood flow?

A

tetralogy of Fallot

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16
Q

What is tetralogy of Fallot characterized by?

A

pulmonary valve or artery stenosis, a ventricular septal deficit, right ventrical hypertrophy, and override of the ventricular septum.

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17
Q

What are symptoms of tetralogy of Fallot?

A

central cyanosis, coagulation defects, clubbing of fingers and toes, feeding difficulties, failure to thrive and dyspnea.

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18
Q

What is dyspnea?

A

difficult or labored breathing, SOB

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19
Q

What is central cyanosis?

A

a bluish discoloration of the skin due to increased levels of deoxygenated hemoglobin in an area around the core, lips and tongue (mucous membranes)

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20
Q

What is a deficit with mixed pulmonary blood flow?

A

transposition of great arteries

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21
Q

What is transposition of great arteries characterized by?

A

no communication between the systemic and pulmonary circulations and is a result of coexisting congenital transposition of the ventricles

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22
Q

What are some symptoms of transposition of great arteries?

A

cyanosis (bluish discoloration due to increased levels of deoxygenated hemoglobin), congestive heart failure (heart is unable to pump blood effectively) and respiratory distress (fluid build up in the lung’s air sacs, depriving organs of oxygen)

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23
Q

It is important for OTs to educate clients and family of children with congenital heart defects in what?

A

general health maintenance (e.g. diet, exercises, avoidance of smoke inhalation)

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24
Q

Children whose cardiopulmonary conditions have not resolved or been treated surgically are likely to have…

A

compromised endurance

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25
Q

Activities for children with congenital heart defects should be..

A

appropriately paced (due to low endurance) and selected with care

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26
Q

What condition is characterized by an abnormally slow heart rate (<60 beats/min)?

A

bradydysrhythmia

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27
Q

How many beats/min is considered abnormally slow?

A

<60 beats/min

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28
Q

What condition is characterized by an abnormally fast heart rate (<200-300 beats/min)?

A

Tachydysrhythmia

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29
Q

How many beats/min is considered abnormally fast?

A

<200-300 beats/min

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30
Q

What may medical intervention include for bradydysrhythmia?

A

pacemaker

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31
Q

What is the most common type of bradydysrhythmia?

A

atrioventricular block

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32
Q

Which dysrhythmia is most common in children?

A

Tachydysrhythmia

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33
Q

Which dysrhythmia can lead to congestive heart failure?

A

Tachydysrhythmia

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34
Q

What is the typical presentation of someone with Tachydysrhythmia?

A

irritability, poor eating habits and pallor

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35
Q

T or F: Conduction disturbances are most common after surgery and may be temporary.

A

True

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36
Q

Which acute respiratory condition is common in preterm infants?

A

respiratory distress syndrome

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37
Q

What is respiratory distress syndrome caused by?

A

a deficiency of surfactant, which is not produced until the 34th-36th week of gestation

38
Q

Respiratory distress syndrome results in..

A

compromised oxygen absorption and carbon dioxide elimination

39
Q

T or F: Many infants recover after a few days of medical intervention for respiratory distress syndrome, however some develop chronic lung conditions.

A

True

40
Q

What is bronchopulmonary dysplasia a result of?

A

Prolonged use of mechanical ventilation and other traumatic interventions to treat acute respiratory problems

41
Q

Bronchopulmonary dysplasia results in..

A

the airway thickening, the formation of excess mucus and restricted alveolar growth

42
Q

Children with bronchopulmonary dysplasia are at a greater risk for..

A

respiratory infections and problems

43
Q

What is asthma characterized by and what does it cause?

A

bronchial smooth muscle hyperreactivity that causes airway constriction in the lower respiratory tract, difficulty breathing and wheezing

44
Q

The first symptoms of asthma typically appear before what age?

A

age 5

45
Q

What triggers asthma attacks?

A

allergens, smoke, cold air, exercise, and the inhalation of irritants.

46
Q

An OT would educate a client with asthma regarding..

A

breathing exercises, stretching and controlled breathing to manage attacks

47
Q

T or F: An OT would teach a client with asthma self-management strategies (pacing and stress management) and encourage structured peer-group activities to reduce the likelihood of social isolation.

A

True

48
Q

What is cystic fibrosis characterized by?

A

the muscle-producing glands malfunctioning and producing secretions that are thick, viscous and lacking in water; these secretions block the pancreatic duct, the bronchial tree and digestive tract

49
Q

What is an early symptom of CF in infants?

A

blockage of the small intestine, resulting in abdominal distension

50
Q

T or F: Salty-tasting skin is a symptom of CF

A

True, it’s a result of the excessive sodium levels.

51
Q

T or F: Greasy, foul-smelling stools is a symptom of CF

A

cue pancreatic insufficiency and problems with vitamin malabsorption.

52
Q

What is the most serious complication of CF?

A

Chronic pulmonary disease

53
Q

What is chronic pulmonary disease characterized by?

A

chronic cough, wheezing and lower respiratory infections

54
Q

T or F: CF may result in an enlarged left side of the heart.

A

False, it may result in an enlarged RIGHT side of the heart, which could lead to heart failure

55
Q

What are some treatment implications for OTs working with clients with CF?

A

educate the client about disease’s progression, instruct on energy conservation, teach techniques to promote efficient breathing.

56
Q

What is a hematologic disorder characterized by too many red blood cells and elevated white blood cells, also referred to as transient leukemia?

A

Erythrocytosis

57
Q

Transient leukemia is common in one in every 150 children with what syndrome?

A

downs syndrome

58
Q

Which hematologic disorder is characterized by the absence or reduction of one of the clotting blood proteins?

A

hemophilia

59
Q

Which hematologic disorder results in longer bleeding time or bleeding episodes?

A

hemophilia

60
Q

Which type of hemophilia occurs after minor injuries?

A

moderate hemophilia

61
Q

Which type of hemophilia occurs after injuries or without an apparent cause?

A

severe hemophilia

62
Q

Which type of hemophilia may affect joints and muscles?

A

severe hemophilia

63
Q

Which type of hemophilia is usually seen after a traumatic event or injury?

A

mild hemophilia

64
Q

What are some signs of hemophilia?

A

excessive bleeding, excessive bruising, spontaneous bleeding or bleeding without a known cause and nosebleeds

65
Q

What is anemia caused by?

A

iron deficiency in the blood

66
Q

How is anemia treated?

A

through diet (i.e. iron-rich diet)

67
Q

What is sickle cell anemia caused by?

A

abnormally shaped red blood cells

68
Q

Children with sickle cell anemia demonstrate what?

A

decreased energy for daily tasks

69
Q

Children with sickle cell anemia are at risk for what?

A

organ damage resulting from blocked blood flow caused by the sickle cells

70
Q

Children with sickle cell anemia may experience what?

A

pain and require intervention for pain management

71
Q

Children with osteogensis imperfecta (OI) suffer from?

A

decreased bone disposition caused by an inability to form Type I collagen

72
Q

T or F: Multiple fractures or repeated fracture of the same bone may cause a limn to become misshapen and eventually muscularly underdeveloped.

A

True

73
Q

T or F: Minor trauma may cause a fracture in individuals with OI.

A

True

74
Q

What is the most severe form of OI?

A

Fetal

75
Q

Which form of OI causes fractures in utero and during birth with a high mortality?

A

fetal

76
Q

Which form of OI causes many fractures in early childhood with severe limb deformities and growth disturbances?

A

infantile (moderately severe)

77
Q

Which form of OI causes fractures in late childhood with bones often beginning to harden with fewer fractures occurring during puberty?

A

juvenile (least severe)

78
Q

Monitored activity that promotes _____ ______ should be encouraged for individuals with OI

A

weight bearing

79
Q

Maternal education in _______ and ________ is essential to prevent fractures

A

handling and positioning

80
Q

What is arachondactyly?

A

Marfan’s syndrome, characterized by excessive growth at the ephiphyseal plates

81
Q

Children with marfan’s syndrome present with _____

A

long and slender fingers, skull asymmetries and tall stature, may have differences in their joints, eyes and heart

82
Q

Marfan’s syndrome is associate with

A

lax and hypermobile joints and poorly developed striated muscles

83
Q

What are some common comorbidities with Marfan’s syndrome?

A

dislocation of the lenses, scoliosis, coxa vara, depressed sternum, stooped shoulders, and fragility of the blood vessels

84
Q

Which developmental milestone may be delayed for children with Marfan’s syndrome?

A

walking, all other milestones should be met

85
Q

What is achondroplasia/chrondrodystrophia?

A

dwarfism, stunting of the ephiphyseal plate growth and cartilage formation, spontaneous mutations also occur.

86
Q

People with achondroplasia’s limbs are typical in _____ but shorter in _____

A

width, length

87
Q

What are common comorbidities of achondroplasia?

A

lumbar lordosis, coxa vera and cubitus varas

88
Q

What is coxa vera?

A

Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This results in the leg being shortened, and the development of a limp.

89
Q

What is cubitus varas?

A

A deformity of the elbow resulting in a decreased carrying angle (so that, with the arm extended at the side and the palm facing forward, the forearm and hand are held at less than 5 degrees). There is deviation of the forearm toward the midline of the body.

90
Q

Pain in which two areas of the body are common in people with achondroplasia?

A

back and leg pain; becomes more pronounced in adulthood