Final

Question 1

precocious puberty is characterized as

Answer 1

onset of breast development before age 7 in girls (6 for AA) and enlargement of testes before age 9 in boys
More common in girls

Question 2

malformation/malfunction of the thyroid gland during fetal development

Answer 2

congenital hypothyroidism

Question 3

congenital hypothyroidism diagnosed by:

Answer 3

low concentrations of T3 and T4

Question 4

symptoms of congenital hypothyroidism:

typical NCLEX question

Answer 4

dull expression, puffy face, hoarse cry, tongue sticks out

along with all s/s adults have

Question 5

energy and blood sugar regulating hormone

Answer 5

cortisol

Question 6

salt and water-regulating hormone

Answer 6

aldosterone

Question 7

SOB, swollen belly, and multiple metastasis sites are associated with:

Answer 7

non-hodgkins

Question 8

s/s in assessment of pyloric stenosis

Answer 8

projectile vomiting 30-60 minutes after feeding
immediately hungry after vomiting
weight loss/can’t gain weight
dehydration
constipation
olive-shaped mass on palpation
visible reverse peristalsis (left to right shift)

Question 9

chronic constipation mgmt

Answer 9

diet (increase fiber)
increase fluids
restore stool pattern (scheduled time, go as often as they can/need to, make pleasant experience, same time of day)
bowel cleanser
maintenance therapy (miralax, milk of magnesia)
Avoid enemas when possible

Question 10

Hirschsprung’s disease

Answer 10

lack of ganglion cells (which allow for motility) in distal colon – so inadequate motility in part of intestine causing bowel to dilate

Question 11

how is Hirschsprung’s disease diagnosed

Answer 11

rectal bx

Question 12

physical findings of Hirschsprung’s disease

Answer 12

vomiting, abd. obstruction, explosive bowel movements, constipation, diarrhea
older kids – chronic constipation, ribbon or pellet-shaped and foul smelling BMs

Question 13

with Hirschsprung’s disease, important to look out for _____ which may indicated it has turned in to enterocolitis

Answer 13

abrupt onset of foul smelling diarrhea, abdominal distension, and fever

Question 14

tx for Hirschsprung’s disease

Answer 14

surgical resection

Question 15

inflammation and infection of intestines

Answer 15

enterocolitis

Question 16

appendicitis s/s

Answer 16

periumbilical pain initially (may also have RLQ rebound tenderness @ McBurneys point)
younger kid -- generalized pain
older kid -- localized pain
low-grade fever, nausea, anorexia
knees flexed -- position of comfort

Question 17

with appendicitis, must make sure there is no abdominal distention with perforation as this indicates ____

Answer 17

peritonitis

Question 18

Tx for appendicitis

Answer 18

antiobiotics first (if ruptured because of potential for petionitis)
surgical emergency

Question 19

what is Meckel diverticulitum

Answer 19

painless rectal bleeding
–caused by vitelline duct in intestine that typically goes away after birth. With this, it doesn’t go away and it can rupture and cause bleeding.

usually located within 2 feet of ileocecal valve.

Question 20

s/s crohn’s disease

Answer 20

acute, insidious onset
depends on area of intestine:
—limited to colon: similar to ulcerative colitis
—upper GI tract: vomiting, epigastric pain
—small bowel: cramping in RLQ

common s/s: abdominal pain, mod to severe diarrhea, bleeding, anorexia, weight loss, growth retardation (FTT), abdominal infections from holes created in intestine, joint pain, rashes
*inspect skin of skin tags or fissures

Question 21

s/s intussusception

Answer 21

paroxysmal, episodic abdominal pain with vomiting every 5-30 minutes
screaming and drawing up legs with periods of calm, sleeping or lethargy between episodes
stool, possibly diarrhea in nature, with blood (looks like currant jelly)
high fever, dehydration, abdominal distension
*sausage shaped mass in URQ (Dance’s sign)