Exam 4 - Customized

Question 1

When the circulations of blood vessels is obstructed by abnormally shaped RBCs causing ischemia & infarction

Answer 1

Sickle Cell Disease

Question 2

Physical Cues of Sickle Cell Disease

Answer 2

Extreme fatigue or irritability
Pain in abdomen, thorax, joints, and digits
Dactylitis
Cough, increased WOB, fever, tachypnea, hypoxia (Acute Chest Syndrome s/s)
Splenomegaly
Jaundice (from hemolysis) or pale conjunctiva, palms, soles, and skin

Question 3

Sickle Cells Labs

Answer 3

Decrease H&H and reticulocyte count
Increase Platelets (SC increase plt activation)

Question 4

Sickle Cell Vaso-Occlusive Episodes

Answer 4

Pain Control (Distraction, NSAIDS, acetaminophen, warm compression - PCA or regular schedule)

Hydration (double maintenance fluid requirement (150 ml/Kg/day)

Hypoxia (O2 via NC if SpO2 <92, incentive spirometry)

Question 5

Radiation Skin Integrity Care

Answer 5

Wash skin with mild soap and water
Avoid lotion/powder/ointments
Avoid sun and heat exposure
Diphenhydramine or hydrocortisone cream for itching
Antimicrobial cream for desquamation
Moisturize with aloe vera

Question 6

BM aspirate Medication

Answer 6

Fentanyl and Versed (anesthetic and sedation meds)

Question 7

BM Aspirate Post-procedure

Answer 7

Hold pressure and monitor for bleeding and infection

Question 8

Neutropenia Precation

Answer 8

Assess for infection Q8H and PRN
No raw fruits, vegetables, fresh flowers, or live plants

Other precautions: Private room, avoid invasive procedures, soft toothbrush, and wear mask when child is outside.

Question 9

Lab test for Skin

Answer 9

Blood test (CBC, ESR, IgE)
Culture and sensitivity
KOH prep (positive fungal hyphal indicates ringworm)
Allergy testing
Woods Lamp (light exposure)

Question 10

KOH can make me shine
I prefer hanging out on arms and legs and a contagious personality
My nickname is ring worm

Answer 10

Tinea Corporis

Question 11

Topical antifungal

Answer 11

Clotrimazole - use for at least 4 weeks, and used clothing, etc have to be washed to reduce spread

Question 12

Tinea pedis Education

Answer 12

Do not walk barefoot

Question 13

Tinea Versicolor

Answer 13

Resolve by itself in several months

Question 14

Medication for Tinea Capitus

Answer 14

Oral Griseofulvin (4-6 wks) cannot use topical

Question 15

Verruca Cues

Answer 15

warts - Elevated, rough, gray-brown firm papules, single or in groups

Viral

Question 16

Molloscum Contagiosum

Answer 16

Flesh-colored papules on stalk (extremities, face, and trunk) - Resolves spontaneously in 18 months
Complicated cases can use chemical or curettage, cryotherapy, or electro-dissection to remove

Viral

Question 17

Daiper Dematitis Non-candida Care

Answer 17

Skin Barriers - Zinc Oxide, A,D, and E ointment, petroleum)

Question 18

Daiper Dematitis Candida Medication

Answer 18

Nystatin (antifungal)

Question 19

Temperature Change and sweating makes me come out to play
I can make you wiggle and scratch all day and night
Sometimes I bring my friend Wheeze
I amke IgE levels Rise

Answer 19

Eczema - Atopic Dermatitis

Question 20

Atopic Dermatitis Physical cues

Answer 20

Extreme itching, erythema, and inflammation
Lesions/rash (plaques, papules, scaling, vesicles) can affect everywhere but abd, chest, hands, and feet.

Question 21

Atopic Dermatitis Management

Answer 21

Topical Corticosteroids and Immune modulations tacrolimus
Avoid hot water but shower 2 times a day in warm water
Do not use soaps containing perfumes, dyes or fragrances but you can use moisturizers
Use 100% cotton product

Question 22

When Staph aures or MRSA come to town that’s when I come around
My favorite hang outs are around the nose and mouth
My spots fill up with fluid then erupt
Some say I look liekt he color of honey

Answer 22

Impetigo

Question 23

Impetigo Cues

Answer 23

Honey color skin lesions; itchy and painful

Question 24

Impetigo Treatment

Answer 24

Soak impetigo with appropriate solution and apply topical or oral antibiotics

Question 25

Staph Aurues is my name and producing toxin is my game I can make babies' skin weep and peel I sometime look like a bad sunburn

Answer 25

SSSS - Burn-like appearance

Question 26

SSSS Treatment and Education

Answer 26

Mild: Oral antibiotics Sever: IV antibiotics, fluid management, and burn treatment

Question 27

Localized infection

Answer 27

Cellulitis

Question 28

Cellulitis treatme

Answer 28

Oral or parental antibiotics Rest and immobilize affected areas

Question 29

What are the bacterial skin infection

Answer 29

Cellulitis Impetigo SSSS

Question 30

I come in many different shapes and sizes Mom says this, Dad says that of how I came to be Poverty, prematurity, and chronic illness can lead to me The buttocks, back and thighs are hiding places of these Pattern marking can be key

Answer 30

Intentional Skin Injuries (posterior location are the most suspecious)

Question 31

Risk factor of injuries

Answer 31

Poverty, prematurity, chronic illness, intellectual disability, parent with abuse history, and extreme stressor

Question 32

15 year-old male presents with areas of comodones on forehead and cheeks and scattered pustules on back with hypertrophic scaring

Answer 32

Acne

Question 33

Hx and Physical Cues of Acne

Answer 33

Family Hx,endocine disoreder,comodones, oily skin and hair

Question 34

Management of Acne

Answer 34

Avoid oil-based product cosmetics Avoid picking comodone Medication Tretinoin, benzoyl peroxide, antibacterial, isotretinoin (severe cases), and oral contraceptives Can lead to infections and cellulitis

Question 35

Sensorineural hearing loss Causes

Answer 35

Aging Noise damage Drug side effect Auditory tumors Explosion/blast Meningitis CMV

Question 36

Conductive Hearing Loss Causes

Answer 36

Fluid, foreign object, allergies, rupture eardrum, impacted earwax, and OM

Question 37

Mixed Hearing Loss Causes

Answer 37

Genetic, infection, Head trauma

Question 38

Glaucoma

Answer 38

Grey/Gray red reflex Enlarged eyeball Excessive tearing or conjunctivitis After Surgery No rough-housing or contact sport for 2 wks

Question 39

Neuroblastoma Diagnosis and cues

Answer 39

24 Hr urine test - elevated HVA and VMA Unilateral Proptosis Often Metastasize to other organs

Question 40

Lymphoma Cues

Answer 40

Night sweats (>10% wt loss)

Question 41

ALL cUE

Answer 41

eNLARGED lIVER AND lYMPH NODES