Exam 2 Peds - Summary Set Flashcards
1
Q
children ages 6-12 should grow about ___ lbs per year
A
5
2
Q
children ages 6-12 should grow about ___ inches in height per year
A
2
3
Q
when do the lungs fully mature?
A
age 6-8
4
Q
____ injuries are common in children ages 6-12
A
overuse
5
Q
name at least 3 cognitive developments of children ages 6-12
A
(1) mastering skills
(2) language - rapid development
(3) logical thinking
(4) perspective (others)
(5) increased attention span
(6) understanding major concepts
6
Q
ages 6-12 is the age of ___
A
exploration
7
Q
brain size is complete by age ___
A
10
8
Q
learning rules of interactions, social rules, and self-esteem occurs at which age?
A
ages 6-12
9
Q
____ peaks in school-aged and up through teen years in the US
A
obesity
10
Q
obesity in children can lead to what 3 health issues?
A
(1) fatty liver
(2) high cholesterol
(3) high BP
11
Q
____ are strange teeth formations
A
malocclusions
12
Q
ages 6-12 should get ___ hours of sleep/night
A
9-10
13
Q
____ are changes to adrenal gland and release of androgen
A
adrenarche
14
Q
puberty can start as young as ___ in females
A
8
15
Q
___ is when secondary sex characteristics begin, tanner stage 2-3
A
thelarche
16
Q
____ onset is 16
A
menarche
17
Q
____ is tanner stage 3-4, 1.5-2 years after Thelarche, linear growth slows
A
Menarche
18
Q
growth is complete ____ years after menses for girls
A
1-1.5 years
19
Q
___ have a longer and slower process for sexual development
A
males
20
Q
___ is testicular enlargement that starts around age 14 (as early as age 9)
A
gonardarche
21
Q
tanner stage 2 is associated with ____
A
gonadarche
22
Q
pubic hair and penile growth are characteristic of Tanner stage ___
A
3
23
Q
peak height velocity, muscle over fat is what Tanner stage?
A
Tanner stage 4
24
Q
growth is complete by Tanner stage
A
5
25
Treat ____ as a normal part of growth and development
sex
26
name at least 3 considerations for working with school-aged kids
(1) consistent limits
(2) realistic expectations
(3) family responsibilities
(4) natural consequences
(5) communication with teachers
27
name at least 3 stressors in school-aged kids
(1) food insecurity
(2) anxiety
(3) bullying
(4) over-scheduling
28
name at least 3 traits of early adolescence (11-14)
(1) same-sex friends
(2) egocentric
(3) "imaginary audience"
(4) "invincibility"
29
name at least 3 traits of middle adolescence (15-17)
(1) platonic to romantic
(2) peer group conformity
(3) impulsive and impatient
(4) negotiate choices & limits
30
name at least 3 traits of late adolescence (18-21+)
(1) idealistic, modified by experience
(2) uniqueness prevails
(3) relationships less turbulent
(4) mature social relationships
(5) emancipation & career goals
31
higher reasoning, impulse control, and emotional lability will continue to develop until around ____ age
26 yo
32
name 3 cognitive developments of adolescents
(1) concrete to abstract
(2) focus on community / society
(3) decision-making
(4) consequences of alternatives
(5) prioritization
33
seeking autonomy, parental relationship shifts, and peer relationships as primary role are characteristic in what age group?
adolescents
34
nursing considerations when working with adolescents include:
(1) allow space for private conversation
(2) explain limits of confidentiality
(3) ask open-ended questions
35
Name at least 3 decisions that can impact adolescent health
(1) tattoos / piercings
(2) tanning
(3) substance use
(4) sexual activity
36
what should you screen for in a sexual risk assessment?
(1) consent
(2) number of partners
(3) pregnancy
(4) STIs
37
what does the daily discrimination tool tell us?
if you score higher on the scale, you are more likely to have health-related issues d/t discrimination
38
mental health routine screening is recommended at age ____
10 yo
39
____ is a suicide screening tool
ASQ
40
____ is characterized by uncontrolled growth and spread of abnormal cells, which, if not adequately treated, results in death
cancer
41
most childhood cancers arise from the ____
mesoderm
42
what two cancers make up the majority of pediatric cancer diagnoses?
(1) leukemia
(2) lymphoma
43
what is the #1 cause of death in children by disease?
cancer
44
how do we prevent cancer in childhood?
not yet possible
45
early detection in childhood vs. adulthood
childhood - usually accidental, no screening
adulthood - possible with screening
46
stage at diagnosis - childhood vs. adult
80% metastatic in childhood
local or regional in adulthood
47
the response to chemo in childhood is ___
very chemosensitive
48
what are the effects of chemo treatment in childhood?
(1) decreased acute toxicity
(2) increased long-term effects
49
name at least 4 childhood cancer warning signs
(1) pallor, bruising, bleeding
(2) general bone pain
(3) lumps or swelling
(4) unexplained weight loss
(5) fever
(6) sweating at night
(7) eye changes
(8) abdominal swelling
(9) headaches, dizziness
50
what is the goal of the children's oncology group (COG)?
share protocols freely to provide state-of-the-art care
51
low birthweight is associated with which cancer?
hepatoblastoma
52
there are possible correlations between certain ____ and leukemia
medications
53
chemotherapy typically lasts ___
3 months to 2.5 years
54
the function of chemo is
to target rapidly dividing cells to slow or stop growth
55
what are the 3 routes for chemo in children?
(1) oral
(2) IV
(3) intrathecal
56
children need ____ doses of chemo, compared to adults
higher
57
___ is critical in delivering chemotherapy
timing
58
what is combination chemotherapy?
(1) combines 2 or more agents
(2) together or in a planned sequence
(3) produces higher response rates
59
T/F: Children's organ systems can tolerate higher doses of chemo
T
60
the most common short-term effects of chemo are ___ and ___
bone marrow suppression; mucositis
61
___ is sores in the mouth and GI tract
mucositis
62
name the 5 short-term effects of chemo
(1) bone marrow suppression
(2) mucositis
(3) N/V
(4) neuropathy
(5) hair loss
63
name the 5 long-term / late effects of chemo on children:
(1) cognitive changes
(2) cardiac, pulmonary, GI, renal issues
(3) hearing issues
(4) fertility and other endocrine issues
(5) second malignancies
64
____ is a treatment option for solid tumors
surgery
65
name 4 common tumors in children
(1) brain tumors
(2) Wilms
(3) neuroblastoma
(4) osteosarcoma
66
what is the goal of radiation therapy?
deliver therapeutic dose while sparing healthy cells as much as possible
67
which type of radiation is more specific, delivers a low dose in front of tumor, and minimal exit radiation?
proton beam
68
____ are calculations to figure out the exact angle of the radiation
dosemetry
69
what therapy can be super painful?
biotherapy - immunotherapy
70
name 2 types of biotherapy / immunotherapy
(1) monoclonal antibodies
(2) adoptive cell transfer
71
____ are drugs designed to bind to specific targets in the body
monoclonal antibodies
72
____ boosts the natural ability of T cells to fight cancer
adoptive cell transfer
73
____ aims to more selectively attack the cancer cell or its immediate supportive environment
precision medicine
74
one of the most common treatments for leukemias and lymphomas that are resistant to other types of treatment is ____
stem cell transplant
75
name at least 3 nursing considerations for cancer treatment
(1) manage pain and symptoms
(2) monitor for signs of infection
(3) optimize nutrition, growth, and development
(4) provide education
(5) assess coping
(6) optimize strength and mobility
76
severe neutropenia is ____
absolute neutrophil count (ANC) < 500 mm^3
77
neutropenia +/- ____ creates high risk for infection
fever
78
name at least 3 priorities for someone with severe neutropenia
(1) HH
(2) avoid ill contact (no school)
(3) daily bath and oral cares
(4) nothing rectally
(5) awareness of implanted devices
(6) potential medical emergency
(7) cultures and abx within an hour
79
severe thrombocytopenia is ____
<25,000
80
what are two pieces of education for patients with thrombocytopenia?
(1) watch for bruising, bleeding, epistaxis, and heavy menses
(2) avoid NSAIDs and contact sports
81
when should someone with anemia receive a transfusion?
Hgb < 7-8 g/dL
82
dizziness, fatigue, and SOB are symptoms of ____
anemia
83
what is the routine lab / blood count for neutropenia?
CBC with diff and platelets
84
name at least 4 ways to manage N/V symptoms
(1) small, frequent meals
(2) high protein and caloric foods
(3) monitor fluids
(4) avoid strong odors
(5) administer antiemetics
(6) aromatherapy
(7) sea bands
(8) acupressure
85
name at least 3 ways to manage mucositis
(1) oral cares 2x daily
(2) manage pain
(3) special rinses
(4) keep up intake - can even switch to NGT if needed
86
3 ways to manage fatigue in children with cancer is
(1) yoga
(2) PT for rehab or structured activity
(3) nutrition
87
name at least 3 ways to manage neuropathies
(1) footboard in bed to prevent foot drop
(2) high-top shoes
(3) PT/OT
(4) encourage mobilization
(5) medications for neuropathic pain
88
3 ways to address diarrhea / constipation in cancer patients is:
(1) increase dietary fiber
(2) monitor fluids
(3) mush, then push
89
name at least 3 considerations related to mood / coping with cancer patients
(1) body image
(2) high symptom burden
(3) isolation
(4) provide socialization
(5) provide space
(6) involve psychosocial team
90
the 3 most common types of cancer are:
(1) leukemias
(2) lymphomas
(3) CNS tumors
91
high-grade gliomas and DIPG have ___ outcomes
poor
92
in the last 20 years, almost every diagnosis has seen an uptick in ____
survival rates
93
name at least 3 improvements based on COGS studies
(1) reduced radiation
(2) reduce dose and frequency of chemo
(3) targeted therapy
(4) earlier referrals to palliative care
94
____ is low RBC count that leads to decreased O2 supply to the cells
anemia
95
the 2 main causes of anemia are ___ and ___
iron deficiency; genetic syndromes
96
name at least 3 s/s of anemia
(1) pallor
(2) fatigue
(3) muscle weakness
(4) SOB
(5) dizziness
(6) tachycardia
97
which treatment for anemia is common but has low compliance?
oral iron
98
if oral iron is not being taken, you can switch to ____
iron infusions
99
what do you treat anemia with if it is really severe?
transfusions (PRBCs)
100
4 nursing considerations for anemia are
(1) constipation / diarrhea
(2) N/V
(3) monitor labs
(4) provide rehab
101
___ is often triggered by illness, infection, fever, or dehydration
sickle cell
102
SOB, congestion, pain, jaundice, headache, and hematuria are all S/S of ____
sickle cell
103
name at least 3 long-term consequences of sickle cell
(1) osteomyelitis
(2) retinal detachment / blindness
(3) renal failure
(4) cirrhosis
(5) hepatomegaly
(6) skeletal deformities, avascular decrosis
104
delay in tx of sickle cell can result in:
(1) severe dehydration
(2) hypovolemic shock
(3) stroke
(4) CVA
(5) acute chest syndrome
105
what are the first two priorities in patients with sickle cell?
(1) fluids
(2) pain management
106
what is the primary medication for sickle cell?
hydroxyurea
107
how old does the child need to be to receive hydroxyurea?
at least 6-7 yo
108
name 6 treatments for sickle cell
(1) fluids
(2) pain management
(3) antibiotics
(4) O2
(5) RBCs
(6) stem cell transplant
109
name at least 3 nursing considerations for sickle cell
(1) pain management
(2) treat and prevent infection
(3) monitor F&E
(4) provide education
(5) mobilization
(6) monitor for CVA
110
____ is a deficiency in clotting factors
hemophilia
111
hemophilia is often identified in infants during ____
circumcision
112
the most common type of hemophilia is ____
hemophilia A
113
hemophilia A is a deficiency in ____
factor VIII
114
name at least 3 s/s of hemophilia
(1) nose bleeds (epistaxis)
(2) bruising
(3) excessive bleeding
(4) joint pain
(5) headache / changes in speech / LOC
115
2 long-term consequences of hemophilia are:
(1) joint deterioration
(2) stroke
116
the main priority for hemophilia is ___
administer exogenous factor and blood products
117
name at least 3 nursing considerations for hemophilia
(1) teach parents how to administer exogenous factor
(2) monitor for bleeding
(3) control bleeding and RICE
(4) provide pain mgmt
(5) provide education
(6) rehab for strengthening
(7) low contact activities
118
____ still includes curative care, while ____ is when we stop trying to cure the disease
palliative care; hospice
119
name the 5 goals of palliative care
(1) establish trust
(2) review and prioritize goals of care
(3) provide optimal pain and symptom management
(4) add layer of support
(5) provide anticipatory guidance
120
____ is the specialty of palliative care
ongoing pain and symptom management
121
T/F: Kids who receive palliative are earlier tend to live longer than those who delay palliative care
T
122
3 common conditions seen in palliative care are:
(1) neurodegenerative disorders
(2) CHD
(3) genetic disorders
123
name at least 3 nursing considerations for palliative and hospice care
(1) manage pain and symptoms
(2) provide support
(3) create space
(4) be present
(5) involve and update teammates
124
when the esophagus doesn't form a continuous tube
esophageal atresia (EA)
125
an abnormal connection between the esophagus and trachea
tracheoesophageal fistula (TEF)
126
3 s/s of EA with distal TEF are:
(1) feedings that cause regurgitation and coughing
(2) constant flow of saliva
(3) gastric distention
127
the treatment for EA with TEF is ____
surgical repair
128
what are the nursing considerations for someone with EA and TEF?
(1) no oral feeding
(2) need IV access
(3) may be associated with a syndrome
(4) surgery as neonate
(5) at risk for infection (lung or pneumonia)
129
____ is a hole in the diaphragm in utero
congenital diaphragmatic hernia
130
congential diaphragmatic hernia results in ___ and ___
GI issues; respiratory impairment
131
congenital diaphragmatic hernia treatment
requires urgent surgical repair after birth or fetal surgery
132
name at least 3 nursing considerations for congenital diaphragmatic hernia
(1) requires mechanical ventilation
(2) underdeveloped lungs
(3) chronic issues
(4) parental support during fetal surgery
133
a potential long-term result of congenital diaphragmatic hernia is ____
restrictive lung disease
134
____ is a defect near the umbilicus where there is an opening and some of the abdominal contents is outside of the body
oomphalocele & gastroschesis
135
name at least 3 nursing considerations for oomphalocele and gastroschesis
(1) nutrition - parenteral and decompression
(2) infection risk
(3) fluids b/c of increased loss
(4) respiratory support
(5) watch for necrotizing entercolitis
136
____ requires primary or staged surgical intervention
oomphalocele & gastroschesis
137
___ may result in chronic GU issues
imperforate anus
138
name at least 3 nursing considerations for imperforate anus
(1) parenteral nutrition and decompression
(2) fluid losses
(3) constipation
(4) bowel and bladder function
(5) parental support
139
name 3 reasons why children have a higher risk of fluid loss
(1) higher body surface area
(2) higher respiratory rates
(3) higher metabolic rates
140
the 4 main causes of diarrhea in peds are:
(1) intestinal infection
(2) intestinal obstruction or intussusception
(3) malabsorption
(4) inflammatory bowel disease
141
what are 4 red flags in diarrhea?
(1) blood
(2) fever
(3) poor growth
(4) severe belly pain
142
4 main causes of GI pain in peds are
(1) appendicitis
(2) acute gastroenteritis
(3) UC
(4) Crohn's
143
RLQ is characteristic of ___
appendicitis
144
we will always see ____ in appendicitis
nausea and vomiting
145
the biggest differentiator between UC and Crohn's is...
UC - pus or blood in stools
Crohn's - constipation; sometimes rectal bleeding
146
diarrhea, N/V, fever, crampy, and poor intake are characteristic of ___
acute gastroenteritis
147
frequent urge to defecate is ___
tenesmus
148
pus or blood in stools, rectal bleeding, poor appetite, and tenesmus are s/s of ___
ulcerative colitis (UC)
149
key s/s of Crohn's are
(1) constipation
(2) night sweats
(3) loss of menstrual cycle
(4) tenesmus
150
____ is when the body is unable to absorb nutrients
Short Bowel Syndrome
151
SBS can occur in the neonatal period if they experience ___
necrotizing enterocolitis
152
3 s/s of SBS are
(1) loose, watery stool
(2) hard time gaining weight
(3) failure to thrive
153
___ is the treatment for SBS
long-term parenteral nutrition (TPN)
154
what is the risk of long-term TPN?
can lead to total liver failure or definite liver issues by around 5-6 yo
155
name at least 3 nursing considerations related to SBS
(1) risk for infection
(2) risk for altered fluid balance
(3) poor weight gain
(4) liver failure
(5) liver / bowel transplant
156
fungal overgrowth from candida is ___
oral thrush
157
the most common reason for thrush is ____
baby's falling asleep with a bottle in their mouths
158
oral thrush is common in...
(1) infants
(2) immune disorders
(3) DM
(4) antibiotic overuse
159
how do you treat thrush?
(1) antifungal lozenge
(2) swab
(3) rinse
160
___ is caused by coxsackie virus
hand foot and mouth
161
161
how is hand foot mouth spread?
contact
162
how do you treat hand foot mouth?
(1) supportive care - manage fever and pain
(2) no effective treatment!
162
3 s/s of hand foot mouth are
(1) fever
(2) sore throat
(3) blisters
162
viral illness - parvovirus is ___
fifths disease
163
how is fifths disease spread?
droplet infection
164
name at least 3 s/s of fifths disease
(1) headache
(2) runny nose
(3) low-grade fever
(4) lacy rash
165
___ is caused by herpes virus
roseola
166
high fever and flat rash on trunk and neck is characteristic of ____
roseola
167
how do you treat roseola?
(1) control fever
(2) monitor for seizures
(3) supportive care
168
____ is caused by untreated strep throat
strep rash / scarlet fever
169
what age group can get scarlet fever?
5-15 yo
170
name 3 s/s of strep rash / scarlet fever
(1) sore throat
(2) high fever
(3) diffuse bumpy rash
(4) red tongue / "strawberry"
171
we treat strep rash / scarlet fever with ____
antibiotics
172
____ conjunctivitis is VERY contagious
bacterial
173
we can see purulent drainage in ____ conjunctivitis
bacterial
174
redness, swelling, and sensitivity to light are s/s of ____
pink eye / conjunctivitis
175
how do you treat pink eye / conjunctivitis?
(1) depends on cause
(2) bacterial - ABX
(3) clogged duct or viral - no abx
176
how is head lice spread?
direct contact
177
itching, sores on head, neck and shoulders are characteristic of
head lice
178
____ is difficulty to treat
head lice
179
spinosad, malathion, and ivermectin are all meds to treat ____
head lice
180
____ is the least developed system at birth
endocrine
181
when does the endocrine system reach full functioning?
12-18 months of age
182
what hormones does the anterior pituitary secrete?
(1) adrenocorticotropin
(2) TSH
(3) FSH
(4) LH
(5) prolactin
(6) GH
183
what hormones does the posterior pituitary secrete?
(1) vasopressin
(2) oxytocin
184
____ is an aplastic, underdeveloped thyroid gland or poor TSH secretion
congenital hypothyroidism
185
name at least 3 s/s of congenital hypothyroidism
(1) low T4, high TSH
(2) large tongue
(3) hypotonia
(4) distended abdomen
(5) slow reflexes
(6) large anterior fontanelle
(7) skin mottling
186
congenital hypothyroidism treatment
lifelong levothyroxine
187
congenital hypothyroidism can lead to irreversible ____
cognitive impairment
188
congenital hypothyroidism nursing considerations
(1) newborn screen
(2) monitor levels
(3) education
189
___ is an autosomal recessive disorder
congenital adrenal hyperplasia
190
name at least 3 s/s of congenital adrenal hyperplasia
(1) dehydration
(2) failure to thrive
(3) hyponatremia
(4) hyperkalemia
191
congenital adrenal hyperplasia treatment
lifelong glucocorticoid treatment
192
congenital adrenal hyperplasia effect
(1) ambiguous genitalia in females
(2) salt wasting
193
congenital adrenal hyperplasia nursing considerations
(1) newborn screen
(2) monitor electrolytes
(3) dose adjustments when ill
(4) education
194
the 2 acquired endocrine disorders of the thyroid are __ and __
hypothyroidism; hyperthyroidism
195
acquired hypothyroidism causes
(1) autoimmune
(2) enlarged thyroid (goiter)
196
acquired hypothyroidism s/s
(1) dry, thick skin
(2) coarse, dull hair
(3) fatigue
(4) constipation
(5) weight gain, edema
197
acquired hypothyroidism treatment
thyroid hormone replacement
198
acquired hypothyroidism nursing considerations
(1) monitor weight
(2) monitor bowel function
(3) monitor cognitive function
(4) growth & development
199
causes of acquired hyperthyroidism are ___ and ___
autoimmune; graves disease
200
acquired hyperthyroidism s/s
(1) diarrhea
(2) weight loss
(3) prominent eyes
(4) hyperactivity / nervousness
(5) increased HR and BP
(6) muscle weakness
201
acquired hyperthyroidism treatment
(1) antithyroid medication (PTU)
(2) ablation
202
acquired hyperthyroidism nursing considerations
(1) optimize mobility
(2) growth & development
203
____ is 10x more likely in girls than in boys
precocious puberty
204
the biggest problem with precocious puberty is ____
it can cause growth limitations
205
onset of precocious puberty in girls starts at about age ___ and the cause is ____
8; idiopathic
206
onset of precocious puberty in boys starts at age ____ and the cause is ____
9; usually associated with a genetic syndrome
207
what is the main goal of treatment for precocious puberty?
stop / reverse development of secondary sexual characteristics
208
what is the treatment for precocious puberty?
hormone agonists
209
name s/s of growth hormone deficiency
(1) hypoglycemia
(2) height < 5th percentile
(3) cherubic face
(4) increased body fat to muscle
210
___ may be associated with Turner's or Prader-Willi syndromes
growth hormone deficiency
211
how do you treat GH deficiency?
(1) daily SQ injections of GH
(2) manage self-esteem
212
T1DM diagnosis peak age is
12 yo
213
name 4 genetic and environmental factors at play with T1DM
(1) infections
(2) dietary toxins
(3) obesity
(4) chemical exposure
214
name at least 4 s/s of T1DM
(1) polyuria
(2) polydipsia
(3) polyphagia
(4) fatigue
(5) blurred vision
215
the 3 treatments for T1DM are ___, ___, and ___
SQ insulin, diet, and exercise
216
SQ insulin is fastest absorbed in the ___
abdomen
217
SQ insulin is slowest-absorbed in the
thighs
218
s/s of hypoglycemia
(1) clammy
(2) sweaty
(3) pale
(4) tachycardia
(5) slurred speech
(6) decreased LOC
(7) seizure
219
hypoglycemia, glucose is ___
<60 mg/dL
220
causes of hypoglycemia
(1) too much insulin
(2) excessive activity
(3) poor intake
221
hypoglycemia treatment
(1) 15 g of carbs
(2) glucagon if LOC / seizures
222
hyperglycemia s/s
(1) fatigue
(2) thirst
(3) blurred vision / headaches
(4) weight loss
(5) headache
(6) emotionally labile
223
hyperglycemia blood glucose levels
>160 mg/dL
224
hyperglycemia causes
(1) excessive intake
(2) poor activity
(3) insufficient insulin
225
hyperglycemia treatment
(1) insulin
(2) increased activity
226
DKA s/s
(1) acetone / fruity breath
(2) kussmaul breathing
(3) sunken eyes
(4) n/v
(5) increased HR and RR
(6) decreased UO
(7) dry mouth and lips
(8) lethargy
(9) coma
227
DKA blood glucose levels
>200 mg/dL
228
DKA causes
(1) excessive stress
(2) insufficient insulin
229
DKA treatment
(1) IV Fluids
(2) IV Insulin
230
insulin should be ____ not ____ to mix
rolled; not shaken
231
regular insulin peaks in ____
2-3 hours
232
example of rapid-acting insulin
Humalog, Novolog
233
rapid-acting insulin peak is
30-60 minutes
234
when mixing insulin in a syringe, which should come first?
short-acting, then long-acting (cloudy)
235
NPH insulin peak
4-10 hours
236
Lantus is an example of ____
long-acting insulin
237
Apidra is ____ insulin
rapid-acting
238
add ____ g of carbs for each 45-60 minutes of exercise
15-30
239
glucose levels in infants
90-130 mg/dL
240
glucose in toddlers should be
100-180 mg/dL
241
3 key s/s of T2DM are
(1) fatigue
(2) blurred vision
(3) frequent urination
242
the biggest long-term risks of T2DM are
HTN and HLD
243
front-line therapy for T2DM is
diet, exercise, and oral agents
244
long-term consequences of T2DM are:
(1) retinopathy
(2) cardiovascular disease
(3) peripheral neuropathy
(4) nephropathy
245
___ youth are more likely to be referred to juvenile system than mental health provider
BIPOC youth
246
what are the 4 types of externalizing disorders?
(1) oppositional defiant disorder (ODD)
(2) conduct disorder (CD)
(3) ADD/ADHD
(4) autism spectrum disorder (ASD)
247
what are the 4 categories of internalizing disorders?
(1) depression and mood disorders
(2) anxiety disorders
(3) feeding and eating disorders
(4) trauma and stressor-related disorders
248
name the 6 risk factors for externalizing disorders
(1) genetics
(2) child abuse history
(3) environmental adversity
(4) poor family functioning
(5) parents with disorders
(6) SES
249
name at least 3 temperamental traits of someone with an externalizing disorder
(1) high anxiety
(2) distractibility
(3) high intensity
(4) poor reaction to new stimuli
(5) poor adaptability
(6) strong-willed
(7) low sensory threshold
(8) negative mood
250
persistent pattern or resistance to authority, angry outbursts, and blaming others
oppositional defiant disorder (ODD)
251
breaks the law, antisocial behavior, aggressive towards people and animals, steals, and destroy property
conduct disorder (CD)
252
name 3 ways to support someone with ODD or CD
(1) cue for transitions
(2) low stimulus environment
(3) graceful exit
(4) realistic choices to give some control
253
name at least 3 complications associated with ADD
(1) accidents
(2) school or job failure
(3) substance abuse
(4) depression
(5) anxiety
(6) relationship / family stress
(7) delinquency
254
the 3 sub-types of ADD are...
(1) inattentive
(2) hyperactive / impulsive
(3) combined
255
what is the criteria for ADD diagnosis?
(1) inattention
(2) hyperactivity
(3) impulsivity
256
name at least 3 potential risk factors for ADD
(1) exposure to lead or pesticides
(2) low birth weight
(3) premature birth
(4) brain injury
257
what may worsen but does NOT cause ADD?
(1) watching too much TV
(2) eating sugar
(3) family stress
(4) trauma
258
considerations for preschoolers with ADHD
(1) childcare issues
(2) family relationships
(3) social skills
259
considerations for school-aged children with ADHD
(1) childcare issues / summer camp
(2) family relationships
(3) social skills
260
persistent deficits in social communication and social interaction
autism spectrum disorder (ASD)
261
____ is characterized by restricted, repetitive patterns of behavior, interests, or activities
ASD
262
3 potential risk factors for ASD are
(1) older parents
(2) genetics
(3) environmental exposure
263
name at least 3 ways externalizing disorders may affect executive functioning
(1) organization and planning
(2) problem solving
(3) working memory
(4) considering previous experience
(5) separate feelings from problem
264
name at least 3 ways externalizing disorders may affect social functioning
(1) paying to attention to social cues
(2) connecting cues to past experiences
(4) planning and responding to outcomes
265
name at least 3 nursing considerations for children with ADD and ASD
(1) short, clear instructions
(2) daily routine
(3) break tasks into smaller portions
(4) get child's attention
(5) cue transitions
(6) manage stimulation
266
name at least 3 nursing considerations for ODD/CD
(1) teach collaborative problem-solving
(2) set clear rules and consequences
(3) be nonjudgmental
(4) work on talking vs. acting out
267
____ is the best form of de-escalation
prevention
268
patients with ____ need consistent limits to help them feel safe and contained
reactive attachment disorder (RAD)
269
RAD has a higher prevalence in ___
kids in multiple settings in a short amount of time
270
name at least 3 risk factors for RAD
(1) early trauma
(2) removed from caregivers
(3) multiple parent figures
(4) neglect
(5) institutional care
271
name at least 3 s/s of RAD
(1) lack of positive emotions
(2) avoidant of eye contact / touch
(3) tantrums / anger
(4) limited social interactions
(5) withdrawn
272
s/s of disinhibited social engagement disorder (DSED)
(1) breaks rules
(2) attention-seeking
(3) overly affectionate
(4) poor boundaries
(5) inappropriate social behavior
273
children with RAD are at risk for...
(1) developmental delays
(2) mood disorders
(3) school issues
(4) relationship issues
(5) risk-taking
274
____ is the most common mental health condition
anxiety
275
only about ___% of children with anxiety receive treatment
36.9
276
about ____% of children 13-18 have anxiety
25%
277
MDD, persistent depressive disorder, BPAD, SAD, and PMDD are examples of ____
mood disorders
278
_____ and ____ disorders can affect the ability to learn, thrive, and grow
anxiety; mood
279
3 biological nursing considerations for anxiety and mood disorders
(1) improve sleep
(2) reduce stimulants
(3) maintain adequate diet and eating patterns
280
4 behavioral nursing considerations for anxiety & mood disorders
(1) muscle relaxation and breathing
(2) imagery / meditation
(3) behavioral modification
(4) behavioral activation
281
cognitive interventions for anxiety & mood disorders
(1) distraction
(2) positive self-talk
(3) CBT
(4) psychoeducation
282
social interventions for anxiety & mood disorders
(1) stress and time management
(2) family psychoeducation and/or therapy
(3) increased social contact
(4) group therapy
283
we screen for suicide as young as ____
10 yo
284
higher social media use is associated with _____
higher anxiety incidence and symptoms
285
name at least 3 types of child maltreatment
(1) physical abuse
(2) sexual abuse
(3) mental injury
(4) threatened injury
(5) neglect
(6) substantial child endangerment
286
T/F: Failure to report is a misdemeanor
T
287
how do you make a report as a mandated reporter?
verbal - within 24 hours;
written - within 72 hours
288
call ____ when immediate safety is not a concern but maltreatment is suspected
CPS
289
call ____ when immediate safety is an issue
law enforcement (LE)
290
what are the only two services in MN that can put a hold on a child to keep them for 48 to 72 hours?
CPS and LE
291
___ determines if an investigation is warranted
CPS
292
if investigations are positive, it goes to ___
criminal or civil court
293
T/F: Corporal punishment is legal in MN
T
294
___ is NOT a primary prevention option for child maltreatment and abuse
CPS
295
while a child is on a protective hold, who is the legal decision-maker?
the parent
296
name at least 3 signs of abuse in children
(1) histories are inconsistent with injury
(2) delay in seeking medical care
(3) changing story
(4) physical signs
297
name at least 3 physical signs of abuse
(1) bruises on infants
(2) bruises on face, trunk, hands, ears, genitalia, or butt
(3) patterned bruises or burns
(4) fracture of ribs, sternum, and scapula
(5) shaken baby
298
___ is a leading cause of serious injury in small children
abusive head trauma
299
premature infants, twins, children with moms < 18, and children in military families are at higher risk for ____
incidence of head trauma
300
___ is failure of a caregiver to provide needed food, clothing, shelter, medical or mental healthcare, education, or appropriate supervision
neglect
301
evidence collection window for SANE pre-pubertal
up to 24 hours
302
evidence collection window for SANE post-pubertal
up to 72 hours
303
2 emotional signs of secondary traumatic stress
(1) feeling numb
(2) feeling overwhelmed or hopeless
304
___ is a physical sign of secondary traumatic stress
low energy / fatigue
305
changing routine and self-destructive behavior may be signs of ___
secondary traumatic stress
306
___ is the most common congenital condition
congenital heart disease
307
what is the order of cardiac physical assessment?
inspection
auscultation
palpation
308
____ is a sign of advanced CHD
nail clubbing
309
why do we monitor HR and BP?
we want to track over time to look at trends
310
___ is the #1 acquired heart disease in children in the US
Kawasaki Disease
311
what is the diagnosis for Kawasaki disease?
history of fever for 5 days AND 4 or more of the following:
(1) conjunctivitis w/o exudate
(2) nonspecific skin rash
(3) fissured lips and erythema of the buccal mucosa
(4) cervical lymphadenopathy
(5) palmar erythema and swelling of hands or feet
312
Kawasaki disease etiology
unknown
313
___ is an acute, febrile, systemic vasculitis
Kawasaki Disease
314
what is the treatment for Kawasaki Disease?
(1) administer anti-inflammatory medication - aspirin
(2) administer IVIG within 10 days of symptom onset
315
describe the steps of normal blood flow
SVC & IVC ->
R atrium ->
Tricuspid valve ->
R ventricle ->
Pulmonary valve / artery ->
Lungs
Pulmonary vein ->
L atrium ->
Mitral valve ->
L ventricle
Aortic valve
aorta
body
316
is the pulse oximetry reading an arterial saturation or venous saturation?
arterial
317
R atrium normal pressure
5 mmHg
318
R ventricle normal pressure
25-30 mmHg
319
L atrium normal pressure
10 mmHg
320
L ventricle normal pressure
100 mmHg
321
which side of the heart will have lower pressures?
Right (compared to left)
322
if blood is fully saturated as it leaves the left ventricle, you can assume it's ____% saturated
75%
323
at what phase of the cardiac cycle are the coronary arteries perfused?
diastole
324
name the parts of the cardiac conduction system
(1) SA node
(2) AV node
(3) bundle of His
(4) Purkinje fibers
325
____ is the pacemaker of the heart
SA node
326
list the defects of acyanotic w/ increased pulmonary blood flow
(1) patent ductus arteriosus (PDA)
(2) atrial septal defect (ASD)
(3) ventricular septal defect (VSD)
(4) AVSD
327
define patent ductus arteriosus (PDA)
ductus arteriosus shunt does not close after birth
328
In PDA, the ductus arteriosus does not close because of...
(1) prematurity
(2) hypoxia
329
how do we treat premature infants with PDA?
(1) fluid restriction
(2) diuretics
(3) digoxin
(4) indomethacin
330
how do we treat larger kids with PDA?
coil occlusion / surgical correction
331
___ is a major risk factor for stroke
PDA closure
332
define atrial septal defect (ASD)
hole between the atria
333
ASD results in ____ in the right heart
increased workload
334
define ventricular septal defect (VSD)
hole between the ventricles
335
VSD results in ____ in the right heart
increased workload
336
what determines the magnitude of symptoms in VSD?
(1) size of defect
(2) pressures in the lungs (lower is worse)
337
the most common acyanotic defect that obstructs blood flow is ___
coarctation of the aorta (COA)
338
define coarctation of the aorta (COA)
narrowing of the aorta that hinders blood flow
339
what is the result of COA?
increased resistance to blood flow to the body
340
COA presentation
(1) cardiac collapse at birth
(2) extremely high BP in teens
341
what is the overall goal with COA?
prevent end organ damage
342
before the narrowing in COA, pressures ____; after the narrowing, pressures are ____
high; low
343
the 3 Ts and H represent what category of heart diseases?
cyanotic defects with increased pulmonary vascularity
344
in ____, the aorta rises from the right ventricle and has no opportunity to be oxygenated
D-Transposition of the Great Arteries (D-TGV/A)
345
what does the child require with D-Transposition of the Great Arteries?
intracardiac mixing to survive
346
___ is when the pulmonary veins have no connection to the left side of the heart
Total Anomalous Pulmonary Venous Return (TAPVR)
347
what are the characteristics of blood flow pathway in TAPVR?
(1) overcirculation on the R side
(2) inadequate blood flow to the body
348
____ results from inadequate division of the common great vessel during fetal development
Truncus Arteriosus
349
what is the key result of truncus arteriosus?
not enough blood flow to the body
350
Tetralogy of Fallot (TOF) is what type of defect?
cyanotic defect with decreased pulmonary vascularity
351
what are the 4 defects that make up the tetralogy of fallot?
(1) pulmonary valve stenosis / atresia / RVOT obstruction
(2) right ventricular hypertrophy
(3) overriding aorta
(4) ventricular septal defect
352
the main thing to monitor with TOF is ____
hypercyanotic or "tet" spells
353
causes of tet spells with increased R ventricular outflow tet resistance
(1) crying
(2) stooling
(3) feeding
(4) noxious stimuli
(5) any stressors
354
causes of tet spells with decreased systemic vascular resistance
(1) fever
(2) dehydration
355
if a patient has multiple Tet spells, what happens next?
this can bump up their surgery date
356
what are 3 things to know about acyanotic defects with normal blood flow?
(1) increase in LV work
(2) no intracardiac connections
(3) no shunting
