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Pediatrics > Acute Care > Flashcards

Acute Care Flashcards

1
Q

What are the most common childhood cancers?

A
  1. Leukemia
  2. Brain tumor
  3. Lymphoma
  4. Wilms tumor
  5. Neuroblastoma
  6. Retinoblastoma
  7. Rhabdomyosarcoma
  8. Osteosarcoma
  9. Ewing sarcoma
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2
Q

How is Leukemia classified?

A
  1. Type of cancerous cell: Lymphoid vs myeloid

2. How quickly the neoplasm replicates: Acute (fast) vs. Chronic (slow)

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3
Q

What cancer accounts for 25% of cancers in children under 15?

A

Leukemia

- acute lymphoblastic leukemia = 72% of all leukemias

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4
Q

What cancer accounts for 25% of cancers in children under 10?

A

CNS tumors

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5
Q

What are the types of CNS tumors from most frequent to least frequent?

A
  1. Astrocytoma
  2. Primitive Neuroectodermal tumors - Medulloblastoma
  3. Brainstem glioma
  4. Ependymoma
  5. Craniopharyngioma
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6
Q

Develop from the primordial neural crest cells; Responsible for 50% of infant malignancies; 2/3 of kids diagnosed with neuroblastoma are under 5 - Improved survival rates in those diagnosed younger; Generally recognized as a palpable, fixed, hard mass in the neck or abdomen; Common sites: adrenal glands, sympathetic nervous system, abdominal ganglia, sympathetic ganglia of the chest or neck; Medical Treatment: surgery, chemotherapy, radiation

A

neuroblastic tumors

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7
Q

Of mesenchymal origin - Meschyme gives rise to skeletal muscle, smooth muscle, fat, fibrous tissue, bone and cartilage; Medical Treatment: neoadjuvant chemotherapy (pre-surgical), adjuvant chemotherapy (post-surgical), surgery, radiation

A

Sarcomas

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8
Q

What are the types of sarcomas?

A
  1. Osteosarcoma: bone tumor, most common in the long bones; teenagers at greatest risk
  2. Ewing sarcoma: bone tumor originating from neural crest cells; commonly effects the vertebral column, pelvis, ribs, and long bones
  3. Rhabdomyosarcoma: soft tissue sarcoma; commonly effects the head and neck, urinary and reproductive organs, extremities and trunk
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9
Q

What side effect is PT most often consulted for as a result of chemo therapy

A

Peripheral neuropathy

- usually affects TA; fibular nerve; foot drop, toe first IC

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10
Q

What locomotion and developmental skills are often worked on with PT for children in acute care?

A
  1. Walking
  2. Sit to stand
  3. Stand to sit
  4. Pull to stand
  5. Creeping
  6. Crawling
  7. Rolling
  8. Stair climbing
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11
Q

What standardized tests are used in PT for children in acute care?

A
  1. PDMS-2

2. PEDI

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12
Q

What balance and coordination activities are used in PT for children in acute care?

A
  1. Single limb stance
  2. TUDS
  3. TUG
  4. Start/stop on oral cue
  5. tandem walking
  6. Walking on uneven surfaces
  7. Dual-task activities
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13
Q

What are suggested areas of focus for PT in acute care? Frequency?

A
  1. Pain - as needed
  2. Strengthening - 3-5 d/wk
  3. Stretching - 5 d/wk to daily
  4. aerobic/ endurance - 5d/wk
  5. manual techniques - as needed
  6. motor learning principles (KP, KR, massed practice, random practice) - as needed
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14
Q

What are benefits of exercise in children with cancer?

A
  1. Improved hemoglobin
  2. Reduced duration of neutropenia and thrombocytopenia
  3. Reduced severity of diarrhea and pain
  4. Reduced duration of hospitalization
  5. Reduced reports of nausea
  6. Decreased emotional stress
  7. Improved lean body weight
  8. Improved physical performance
  9. Improved functional capacity
  10. Improved quality of life index
  11. Improved flexibility
  12. Decreased fatigue
  13. Improved concentration (attention)
  14. Increased skeletal mass
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15
Q

Is VO2 max or VO2 peak used to assess aerobic fitness in children?

A

VO2 peak

- children don’t behave the same in exercise testing as adults (uses VO2 max)

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16
Q

What is the sequence of activity that leads to restricted participation in physical activities in childhood onset conditions?

A
  1. Limitations caused by childhood onset condition
  2. hypoactivity
  3. deconditioning
  4. decreased fxn’l abilities
  5. restricted participation in PA
17
Q

What are contraindications for exercise?

A
  1. febrile
  2. uncontrolled epilepsy
  3. severe OA
18
Q

What should be at the forefront of exercise prescription in JIA?

A

joint protection

19
Q

Frequency and duration of PT services? Patient who presents with:

  • chronic impairments, known DD, medical conditions, and/ or nonrehab-based needs
  • no new documented loss of skill or new impairments, w/ little foreseeable potential for progress towards fxn’l goals
  • little to no risk for loss of skills due to presumed length of stay
  • d/c status not dependent on PT
  • possible need for assist w/ referral to OP services or clinics to meet LT needs
A

Consutl

1-2 visits total

20
Q

Frequency and duration of PT services? Patient who presents with:

  • chronic impairments, known DD, medical conditions, and/ or limited ability to participate in fxn’l activities for those who are admitted for non rehab needs
  • a potential for weekly/ monthly progress towards fxn’lly based goals
  • risk for loss of skills due to prolonged hospitalization if not followed/ progressed by skilled PT
  • d/c status not dependent on PT
  • currently receiving or most likely be recommended for EI or OP services in the community upon d/c from hospital
A

Occasional

1-2 visits per weeks

21
Q

Frequency and duration of PT services? Patient who presents with:

  • new or chronic impairments, medical conditions, and/ or fxn’l limitations
  • a potential for daily/ weekly progress towards fxn’l goals
  • risk for complications associated with immobility and decr PA due to hospitalization, requiring a skilled PT to achieve fxn’l goals
  • d/c status not dependent on PT
  • currently receiving or most likely will be recommended for OP services
A

Regular

3-4 visits per week

22
Q

Frequency and duration of PT services? Patient who presents with:

  • acute loss of fxn’l skills due to new illness/ injury and are making signif gains in fxn’l status
  • good to excellent potential for daily progress toward fxn’l goals and risk losing skills if seen at lower frequency
  • a high risk for reconditioning and loss of mobility without direct, skilled Pt intervention
  • a need for extensive family education on newly acquired loss of fxn’l skills
  • d/c status not dependent on PT
  • potential to be recommended for inpatient rehab, day hospital, or high-frequency services upon d/c from hospital
A

Frequent

5 visits per week

23
Q

Frequency and duration of PT services? Patient who presents with:

  • acute loss of fxn’l skills due to new illness/ injury and are making signif gains in fxn’l status
  • excellent potential for daily progress toward fxn’l goals, recovery of fxn’l mobility skills, and/ or risk losing skills if seen at lower frequency
  • a high risk for reconditioning and loss of mobility without direct, skilled Pt intervention
  • a need for extensive family education on newly acquired loss of fxn’l skills
  • d/c status dependent on PT
  • potential to be recommended for inpatient rehab, day hospital, or high-frequency services upon d/c from hospital
A

Intense

greater or equal to 6 visits per week

Pediatrics (19 decks)

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