kids Flashcards
(429 cards)
1
Q
What is maltreatment?
A
Maltreatment can be real or threatened, including physical injury, mental injury, sexual abuse (including exploitation), exposure to family violence, and neglect.
2
Q
What are some risk factors for being a maltreat-er?
A
- Mental health issues in caregivers
- Parent abused as a child
- Low social supports
- Poverty
- Low education
- Low self-esteem
- Alcohol and substance abuse
- Adolescent parents
- Chronic stress
3
Q
What age group is most at risk for child maltreatment?
A
Children 1-3 years old.
4
Q
Which gender is at a higher risk for violence and sexual maltreatment?
A
Girls are at a higher risk than boys.
5
Q
What are some signs and symptoms of child maltreatment?
A
- Sleep disturbances
- Head or stomach aches
- Depression or anxiety
- Enuresis
- Aggressive behaviour
- Altered social behaviour
- Developmental regression
- Learning issues
6
Q
What is the role of a nurse in suspected child maltreatment cases?
A
To recognize signs and symptoms of abuse and report information to an officer or peace officer.
7
Q
How should suspected or confirmed child abuse be handled?
A
- Report to MRP, social work, administrators
- Avoid leading questions
- Do not contaminate evidence
- Maintain a non-judgmental approach
- Do not discuss with parents or guardians
8
Q
What are some typical injuries that should raise suspicion of child maltreatment?
A
- Hand/finger bruises
- Bruises in unexpected areas
- Long, narrow bruises from sticks or ropes
- Burns in stocking or glove fashion
- Bleeding, discharge, or bruising to genitals or anus
9
Q
What is Shaken Baby Syndrome?
A
A form of child maltreatment that involves shaking a baby, leading to severe brain injury.
10
Q
What is Münchausen Syndrome by Proxy?
A
A condition where a parent meets their psychological needs by making their child ill, leading to frequent healthcare presentations.
11
Q
Fill in the blank: Neglect refers to not providing the means for healthy _______.
A
Growth and Development.
12
Q
True or False: Sexual abuse is more common in males than females.
A
False.
13
Q
What are some long-term signs and symptoms of child maltreatment?
A
- Poor school performance
- Absenteeism
- Difficulty completing tasks
- Altered interaction with adults
- Negative/self-harming actions
- Drugs/etOH use
- Sexual activity
- Suicide attempts
- Pregnancy
14
Q
What should a nurse do if they suspect sexual abuse in a child?
A
If you suspect it, report it. Do not investigate yourself.
15
Q
What is a common behavior indicating possible sexual abuse?
A
Child complains of pain to suspect areas.
16
Q
What are some behaviors that may indicate abnormal sexual behavior in children?
A
- Puts mouth on sex parts
- Makes sexual sounds
- Asks to engage in sex acts
- Engages in kissing with the tongue
- Masturbates with objects
17
Q
What are examples of medical conditions that can mimic signs and symptoms of maltreatment?
A
- Hemophilia
- Osteogenesis imperfecta
- SIDS
- Cultural practices of coining or cupping
18
Q
What is a significant emotional sign of child maltreatment in caregivers?
A
Withdrawn emotional response.
19
Q
What should be documented in cases of suspected abuse?
A
CHART, CHART, CHART.
20
Q
A
21
Q
What is the Convention on the Rights of the Child?
A
A UN Declaration that Canada signed in 1990
22
Q
What is the primary focus of child- and family-centred care?
A
To respect and involve both the child and their family in care decisions
23
Q
What does evidence-informed practice involve?
A
Using the best available evidence to make healthcare decisions
24
Q
Fill in the blank: The process of nursing includes assess, diagnose, planning, ______, and evaluation.
A
implementation
25
What is trauma-informed care?
A framework that emphasizes safety, trustworthiness, transparency, and empowerment
26
What is a key principle of trauma-informed care?
Collaboration & mutuality
27
What is the significance of Jordan’s Principal?
A child-first approach for funding for First Nations children
28
True or False: Inuit infant mortality rate is lower than the overall Canadian infant mortality rate.
False
29
What are some risks for infant death?
* Low maternal education
* Housing instability
* Lack of access to health care
* Food insecurity
* Poverty
* Lack of employment
* Being First Nations
30
Fill in the blank: Herd immunity requires about ______% immunization.
95
31
What is the difference between vaccination and immunization?
Vaccination is the process of administering a vaccine; immunization is the process of becoming immune.
32
What major health disparities affect First Nations populations?
* Multigenerational trauma
* Forced relocation
* Loss of culture/traditions
33
What is the immunization coverage for 2-year-olds with one dose of MMR vaccine in 2023?
82.5%
34
What should a nurse consider when working with families in pediatric care?
The definition of family is fluid and dynamic
35
True or False: A nurse should avoid making judgments during family assessments.
False
36
What should be the approach when interacting with anxious and scared children?
Use distraction and allow them to feel in control
37
What is the importance of cultural care resources in pediatric nursing?
To address health inequalities and provide culturally competent care
38
How should health professionals communicate with older children and adolescents?
Allow them to speak and be heard, and avoid using youth slang
39
What is the recommended approach for caring for 2SLGBTQIA+ youth?
Use inclusive language and practice trauma-informed care
40
What aspects are included in a pediatric health assessment?
* History
* Physical Exam
* Pain Assessment
41
What vital signs should a nurse know for each age group?
* Temperature
* Heart Rate
* Respiratory Rate
* SpO2
* Blood Pressure
* Weight
* Height
* BMI
* Head circumference
42
What is the significance of the IWK (Halifax Children’s Hospital) resources?
To provide guidance on pediatric pain assessment
43
What does the term 'critical thinking' refer to in nursing?
A systematic thought process in making clinical decisions
44
What are the leading causes of death in children under 1 year of age?
To be determined based on current data
45
What is the significance of counting for 1 minute?
To assess vital signs accurately
## Footnote
This may include counting heart rate or respiratory rate to ensure proper measurement.
46
What are the key vital signs to measure?
* SpO2
* Blood pressure
* Weight
* Height
* BMI
* Head circumference
* Head to Toe assessment
47
What should you know regarding content 107, 203, and 204?
You should know your content thoroughly
48
What is the focus of pain assessment in children?
To assess pain in various age groups: infants, toddlers, preschool, school-aged, and older
49
What resources are available for pain assessment in children?
* IWK (Halifax Children’s Hospital): pediatric-pain.ca
* National Pain Centre: nationalpaincentre.mcmaster.ca
50
How can expressions of pain manifest in children?
Children may not eat, sleep, or perform well in school, and may exhibit emotional instability
51
What are some barriers to pain recognition and treatment?
* Poor English
* Reluctance to report pain
* Fear of what the pain means
* Adhering to a role/image
* Concerns over pain medications
* Poor adherence to pain medications/treatments
* Cultural differences
* Cognitive challenges
52
What are the two main categories for managing pain?
* Non-pharmacological
* Pharmacological
53
True or False: Pain expression is universal.
True
54
Fill in the blank: Pain is ______, but expression isn’t.
universal
55
What are hormones?
Chemicals created in the body that are released into bodily fluids to cause physiological changes in target tissues.
56
What is the main focus of endocrine assessment?
Growth and development, energy levels, sleep patterns, muscle strength, appetite, bowel and bladder patterns, hair distribution, skin color, condition, warmth, bruising/bleeding, and vital signs.
57
What is exophthalmos associated with?
Grave’s disease.
58
What is gigantism?
A condition characterized by excessive growth hormone (GH) production.
59
What is a goiter?
An enlargement of the thyroid gland.
60
What are striae and hirsutism associated with?
Cushing's disease.
61
What is acanthosis nigricans?
A skin condition characterized by dark, velvety patches in body folds and creases.
62
What is growth hormone deficiency?
A type of hypopituitarism where the anterior pituitary fails to produce growth hormone.
63
What are common causes of precocious puberty?
* Tumor
* CNS infection
* Irradiation
* Congenital adrenal hyperplasia (CAH)
64
What is delayed puberty?
No pubertal development by age 13 for girls and age 14 for boys, or a halt in progression once it begins.
65
What is congenital hypothyroidism?
A condition where an infant is born with a defect in the thyroid, leading to low serum T3 and T4.
66
What is juvenile acquired hypothyroidism?
Hypothyroidism that develops after infancy, often due to problems with the pituitary or thyroid gland.
67
What causes Cushing's disease?
Excessive release of glucocorticoids (cortisol) due to pituitary over-production or cancers.
68
What is the main difference between Cushing's disease and Cushing's syndrome?
Cushing's disease is caused by pituitary overproduction of cortisol, while Cushing's syndrome results from prolonged intake of therapeutic systemic corticosteroids.
69
What is Type 1 diabetes mellitus?
Childhood onset diabetes that is always insulin-dependent due to damage to the pancreas.
70
What are the diabetes treatment goals?
* Achieve normal growth and development
* Promote optimum blood glucose levels
* Prevent DKA or HHS
* Prevent long-term disease
* Support patients and families
71
What is the dawn phenomenon in diabetes?
A surge of hormones around 4 to 5 am that leads to increased blood glucose levels.
72
What is the Somogyi effect?
An increase in blood glucose levels due to the body's release of cortisol and catecholamines after overnight hypoglycemia.
73
What percentage of children in Canada are considered obese?
About 13% of children between the ages of five and 17.
74
What are the two types of growth charts used to determine obesity?
* Weight and length for age
* BMI for age
75
What is considered obesity based on BMI percentiles?
BMI > 97th percentile.
76
What are some risk factors for childhood obesity?
* Overweight/obese family members
* Lack of exercise
* Unstructured meals
* Genetic issues
* Socioeconomic status
* Environmental factors
* Parental understanding or knowledge
77
What are health-related risks of obesity?
* Hypertension
* Type II diabetes mellitus
* High cholesterol
* Obstructive sleep apnea
* Depression
* Anxiety
* Orthopedic problems
* Eating disorders
* Bullying
78
What guidelines are recommended for screen time in children?
* No screen time for < 2 y/o, except for video-chatting
* Limit screen time to about 1 hour or less per day for ages 2-5
* No screens during family meals or book-sharing
* No screens at least 1 hour before bedtime
79
What strategies can help mitigate obesity risk in children?
* Advocacy for safe, accessible parks and paths
* Affordable nutrition
* Access to quick meals
* Public education
* Affordable sports equipment and teams
80
What is sepsis primarily associated with?
Sepsis is part of a continuum.
81
How can the continuum of sepsis potentially be stopped?
With prompt, goal-directed treatment.
82
What is the focus of the SHR Screener in relation to sepsis?
Recognition of sepsis.
83
What is the standard IV bolus of isotonic solution for sepsis treatment?
20 mL/kg.
84
What are examples of isotonic solutions used in sepsis treatment?
crystalloid solutions (NS, Ringers lactate and plasmalyte)
85
What supportive measures are emphasized in the management of sepsis?
* O2
* HR
* BP
* Ventilatory effort
86
What ventilatory supports may be used in the treatment of sepsis?
* CPAP
* BiPAP
* Intubation
87
What type of lab work is mentioned in the context of sepsis treatment?
A lot of lab work. CBC, Neutrophils, thrombocytopenia, blood cultures, PCT, CRP, Lactate, BMP, ABG, PT aptt INR, Urinalysis, Liver function chest xray
88
True or False: Sepsis is mainly covered in CNUR 302.
False
89
Fill in the blank: Sepsis is mainly covered in _______.
[CNUR 305]
90
What is recommended for filling knowledge gaps about sepsis?
A quick read of the sepsis section in chapter 47.
91
What is the condition of Sven, the 3-day-old male?
Born with a bluish color to his skin, tires easily, slow feeder, SpO2 86% on room air
## Footnote
Indicates potential cyanosis and possible congenital heart defect.
92
What is the pathophysiology of congenital heart defects (CHD)?
Variations in heart structure and function leading to impaired blood flow
## Footnote
Can result in conditions such as increased pulmonary flow or obstructive defects.
93
What are the two main classifications of congenital heart defects?
* Acyanotic
* Cyanotic
## Footnote
Acyanotic defects include those with increased pulmonary flow and obstructive defects.
94
What occurs in Acyanotic defects with increased pulmonary flow?
Blood from the high pressure left side flows into the low pressure right side, causing too much blood in the lungs
## Footnote
Results in left-sided heart failure, hypertrophy, and pulmonary congestion.
95
What is ASD and its significance?
Atrial Septal Defect; allows blood flow from left atrium to right atrium, can be asymptomatic or cause heart failure
## Footnote
May require surgical closure if severe.
96
What is the role of indomethacin in Patent Ductus Arteriosus (PDA)?
Inhibits prostaglandin to help close the ductus arteriosus within the first few weeks of life
## Footnote
Surgery is also an option if needed.
97
What is coarctation of the aorta?
A condition where blood flow is obstructed due to narrowing of the aorta
## Footnote
Results in increased pressure before the blockage and decreased pressure after it.
98
What are the signs of heart failure in coarctation of the aorta?
* Increased BP & bounding pulses in upper body
* Decreased BP, weak/absent pulses in lower body
## Footnote
Indicates significant obstruction and potential complications.
99
What happens to fetal circulation at birth?
Lungs expand, vascular resistance drops, right side becomes lower pressure system
## Footnote
Forces closure of the foramen ovale and ductus arteriosus.
100
What changes occur in the heart from infancy to adolescence?
* Heart rate decreases
* Blood pressure increases
* Blood volume increases
* Heart wall muscle thickens
* Innocent murmurs disappear
## Footnote
These changes are part of normal growth and development.
101
What are some risk factors for congenital heart defects?
* Prenatal factors (maternal rubella, poorly-controlled maternal diabetes)
* Environmental factors (drugs like thalidomide, warfarin)
* Genetic factors (family history of CHD)
* Chromosomal alterations (e.g., Trisomy 21)
## Footnote
Multifactorial causes contribute to the development of CHD.
102
What is pulmonary stenosis?
A condition where blood is prevented from flowing into the pulmonary artery
## Footnote
Can lead to right ventricular hypoplasia and increased right atrial pressure.
103
What may accompany right ventricular hypoplasia in pulmonary stenosis?
Increased right atrial pressure causing the foramen ovale to re-open
## Footnote
This can result in systemic cyanosis.
104
How does cyanosis change with the severity of pulmonary stenosis?
↑ cyanosis with ↑ narrowing
105
What compensatory mechanism can occur in pulmonary stenosis?
A patent PDA allows blood to move from the pulmonary arteries into the aorta
106
What is the role of IV prostaglandin in pulmonary stenosis?
Keeps the PDA open until surgery
107
Which treatment is more common for pulmonary stenosis?
Balloon angioplasty is more common than valvotomy
108
What is the survivability outlook for pulmonary stenosis?
Very good, but may have long-term valve issues
109
What are the two categories of congenital heart defect symptoms?
Cyanotic and Non-cyanotic
110
List some cyanotic heart defect symptoms.
* Cyanosis
* Failure to thrive
* Feeding intolerance/poor feeding
* Decreased SpO2 (60s to 80s)
* Tires easily
* Cardiorespiratory distress or shock
* Hepatosplenomegaly
* Respiratory distress
* Wheezing, crackles in lungs
* Mottling on skin
* Life-threatening events
* Death
111
List some non-cyanotic heart defect symptoms.
* Cyanosis with exertion (maybe)
* Failure to thrive
* Edema
* Chronic cough
* Tires easily
* Dizziness
* Chest pain
* Feeding intolerance/poor feeding
112
What is a common complication of congenital heart defects?
Heart failure (secondary to the CHD)
113
What is cardiomyopathy?
Insufficient cardiac output relative to demand
114
What are the two types of cardiomyopathy?
Dilated cardiomyopathy and hypertrophic cardiomyopathy
115
What are some heart failure assessment indicators?
* FTT/low weight gain/slow development
* Fatigue/poor eating/cyanosis with feeding
* Dizziness, fatigue
* Exercise intolerance
* Shortness of breath
* Decreased urine output
* Tachycardia & tachypnea
116
What supportive care measures are used in heart failure management?
* Ensure rest
* Supplement nutrition
* Diuretics
* Digitalis (inotrope & antiarrhythmic)
117
What is myocarditis?
Inflammation of the heart muscle
118
What are common symptoms of myocarditis?
* Flu-like symptoms
* Low-grade fever
* Weight loss
* Anorexia
* Night sweats
* Chest pain
119
What is acute rheumatic fever (ARF)?
An autoimmune condition that develops post group A strep infections
120
What are the original infections that can lead to ARF?
* Strep throat
* Scarlet fever
* Impetigo
121
What are some symptoms of ARF?
* Carditis
* Arthritis
* Chorea
122
What is Kawasaki Disease?
A condition characterized by widespread mid-sized arteries and mucocutaneous inflammation
123
What are the symptoms of Kawasaki Disease?
* Conjunctivitis
* Erythema to the lips/mouth
* Cervical lymphadenopathy
* Skin rash
* Peeling palms
* Prolonged fever (> 3 days)
124
What is tetralogy of Fallot?
A cyanotic defect consisting of four structural heart defects
125
What are the four defects in tetralogy of Fallot?
* Ventricular septal defect (VSD)
* Pulmonary stenosis
* Overriding aorta
* Right ventricular hypertrophy
126
What are tet spells?
Sudden onset of anoxia during crying or feeding
127
How is tricuspid atresia classified?
A cyanotic defect where blood cannot enter the lungs
128
What keeps a child with tricuspid atresia alive?
The presence of ASD/patent foramen ovale (FO) and VSD
129
What is transposition of the great arteries?
A condition where the aorta is connected to the right ventricle and pulmonary arteries to the left ventricle
130
What is hypoplastic left heart syndrome?
A cyanotic defect with no left ventricle and a narrowed aorta
131
What must be kept patent in hypoplastic left heart syndrome?
The ductus arteriosus
132
What is the usual cause of epiglottitis?
H. influenza type B (HiB vaccine)
## Footnote
With immunizations, epiglottitis has become rare but could resurface due to antivaxxing.
133
What are the key symptoms of epiglottitis?
* Rapid onset of sore throat
* Fever
* Difficulty swallowing
* Stridor
* Drooling
* Tripoding with the tongue out
* Toxic appearance
134
What is the definitive treatment for epiglottitis?
* Securing the airway
* Antibiotics
* O2
* Fluids
* Epi nebs
* Steroids
135
What is the normal respiratory rate (RR) for pediatric patients?
30 - 60/min
136
What are typical breathing characteristics in infants?
* Primarily nose breathers
* Abdominal breathers
* Large tongue
* Smaller lung capacity
* Underdeveloped muscles
* Funnel-shaped larynx
* Barrel-shaped chest
* Rib cage very compliant
* Short and straight Eustachian tubes
137
What is pharyngitis?
Inflammation of the throat
138
What can untreated strep throat lead to?
* Rheumatic fever
* Carditis
* Glomerulonephritis
139
What is tonsillitis?
Inflammation of the tonsils
140
When might tonsils be removed in children?
* Numerous infections
* Trouble breathing
* Obstructive sleep apnea (OSA)
141
What is croup?
A virus that causes swelling/obstruction to the larynx
142
What areas can croup syndromes affect?
* Supraglottitis
* Epiglottitis
* Laryngitis
* Tracheitis
* Laryngotracheobronchitis
143
What are signs of increased work of breathing (WOB) in infants?
* Seesaw breathing
* Retractions
* Nasal flaring
* Intercostal in-drawing
* Suprasternal in-drawing
* Substernal in-drawing
* Tracheal tug
144
What should be assessed in a pediatric respiratory examination?
* Respiratory rate
* Retractions
* Breath sounds
* Oxygen saturation
* Work of breathing
145
Fill in the blank: Epiglottitis could make a comeback with ______.
antivaxxing
146
True or False: Croup is typically caused by a bacterial infection.
False
| viral infections
147
What is the role of the U of R’s Centre for Student Accessibility?
To confirm accommodations for students
148
What is the primary focus of the Pediatric Med Math/Med Theory/Pain Assessment?
To evaluate understanding of pediatric medication math and theory
149
What is the primary muscle used by infants for breathing?
Abdominal muscles
## Footnote
Infants typically utilize their abdominal muscles, leading to characteristic breathing patterns.
150
What does seesaw breathing indicate?
Increased work of breathing (WOB)
## Footnote
Seesaw breathing occurs when there is an increased effort required to breathe.
151
Describe the abdominal movement during inspiration.
Abdomen contracts (goes down), chest expands (goes up)
## Footnote
This movement reflects the mechanics of breathing in infants.
152
Describe the abdominal movement during expiration.
Abdomen relaxes (goes up), chest contracts (goes down)
## Footnote
This is part of the normal respiratory cycle in infants.
153
What are signs of respiratory distress in infants?
* Suprasternal in-drawing
* Substernal in-drawing
* Nasal flaring
* Intercostal in-drawing
* Tracheal tug
## Footnote
These physical signs indicate difficulty in breathing.
154
List some differential diagnoses for bronchiolitis.
* Bacterial pneumonia
* Tuberculosis
* Fungal pneumonia
* Upper airway tract infection
* Asthma
* Pertussis
## Footnote
Understanding these conditions is crucial for accurate diagnosis and treatment.
155
What are typical symptoms of bacterial pneumonia in children?
* High-grade fever
* Sicker child
* Tachypnea
* Chest/upper abdominal pain
* CXR findings
* Usually in older children (ages 5+)
## Footnote
These symptoms help differentiate bacterial pneumonia from bronchiolitis.
156
What are the three phases of pertussis?
* Catarrhal
* Paroxysmal
* Convalescent
Catarrhal stage
Similar to a cold, with a runny nose, sneezing, low-grade fever, and a mild cough
Lasts 1 to 2 weeks
The most infectious stage of the disease
Paroxysmal stage
Characterized by bursts of rapid coughing, ending with an inspiratory whoop
Can last from 2 to 8 weeks
Episodes may be triggered by cold or noise and are more common at night
Convalescent stage
Recovery is gradual and may take weeks to months
A residual cough persists for weeks to months, usually triggered by exposure to another upper respiratory infection or irritant
## Footnote
Pertussis is characterized by these distinct phases, with the paroxysmal phase featuring the classic 'whoop' cough.
157
True or False: Most deaths from pertussis occur in children over 12 months of age.
False
## Footnote
Most deaths occur in children under 12 months of age.
158
What is a common cause of airway obstruction in children aged 1-3?
Foreign body airway obstruction
## Footnote
This can occur from items like popcorn, nuts, and round candies.
159
What is Cystic Fibrosis?
An autosomal recessive disorder affecting chloride movement in cells
## Footnote
This leads to thick secretions that can cause various organ complications.
160
What complications can arise from Cystic Fibrosis?
* Chronic lung damage
* Delayed growth and bone development
* Malabsorption
* Cirrhosis
* Infertility
## Footnote
These complications illustrate the systemic impact of Cystic Fibrosis.
161
What are some common treatments for Cystic Fibrosis?
* Mucolytic medications
* PO pancreatic enzymes
* Growth hormone injections
* Prophylactic antibiotics
* Double lung transplant
## Footnote
These treatments aim to manage symptoms and improve quality of life.
162
What is the peak age for bronchiolitis?
Around 6 months
## Footnote
This is when bronchiolitis most commonly affects infants and toddlers.
163
What virus is most commonly associated with bronchiolitis?
Respiratory syncytial virus (RSV)
## Footnote
Other viruses may also contribute, but RSV is the primary cause.
164
What is the recommended management for bronchiolitis in the hospital?
* Supportive care
* Assisted feeding
* Minimal handling
* Gentle nasal suctioning
* Oxygen therapy
## Footnote
Evidence does not support the use of certain medications in routine management.
165
What is the role of Palivizumab in bronchiolitis prevention?
Monoclonal antibody for RSV prevention
## Footnote
It is particularly beneficial for at-risk infants.
166
Fill in the blank: Bronchiolitis is a clinical diagnosis based on _______.
[history and physical examination]
## Footnote
Diagnostic studies are often unhelpful and can lead to unnecessary interventions.
167
What percentage of 15-19 year-olds smoke tobacco in Canada as of 2017?
3%
## Footnote
This percentage increased to 5% in 2019.
168
What percentage of 15-19 year-olds in Canada had vaped in their lifetime as of 2017?
35%
## Footnote
14% vaped in the last 30 days, with 75% of these individuals never having smoked tobacco.
169
What is the past-year cannabis use percentage among 15-19 year-olds in Canada?
22%
## Footnote
This was a slight increase from 19% in 2017.
170
What percentage of 15-19 year-olds reported past-year use of psychoactive medications in Canada?
15%
## Footnote
This was a decrease from 17% in 2017.
171
What percentage of 15-19 year-olds in Canada reported past-year use of illegal drugs?
3%
## Footnote
There was no change from the data in 2017.
172
What is the past-year alcohol use percentage among youth aged 15-19 in Canada?
46%
## Footnote
This reflects a decrease from just under 60% in 2017.
173
What are some factors related to substance abuse in youth?
Home life, past exposures, attitudes to substances at home
## Footnote
Certain populations, such as Indigenous youth, are at higher risk.
174
What are some signs that may indicate a youth is abusing substances?
Altered school performance/attendance, changes in physical appearance, mood swings, onset of criminal activity
## Footnote
Other signs include insomnia, pupil changes, dry mouth, odd behaviors, resistance to care, and drug-seeking.
175
What is the definition of bullying?
Willful repetitive aggressive behaviour to exert power over another person.
176
What are some short-term effects of bullying on children?
Isolation, loneliness, feeling unsafe, absenteeism, poor school performance.
177
What are some long-term effects of bullying?
Anxiety, depression, self-esteem issues, physical illness, suicide.
178
What approach can be taken to prevent bullying in schools?
Whole-school approach: policies, practices, and initiatives
## Footnote
This includes creating a positive school culture and encouraging bystander action.
179
What are the complex reasons behind youth suicide?
Up to 90% of youth who died by suicide met the diagnostic criteria for at least one psychiatric condition, with depression being the most common.
180
What should individuals do when they have concerns about a youth's suicidal thoughts?
Report concerns to the appropriate authorities
## Footnote
There is an ethical obligation to ask questions.
181
What demographic groups are at higher risk for suicide?
Indigenous, gay, bisexual, and transgender youth.
182
What are the suicide rates for First Nations youth in Saskatchewan?
First Nations male: 6x higher; First Nations female: 26x higher.
183
What community-based strategies can help reduce bullying and substance abuse?
Decrease bullying, control drugs and alcohol, provide activities, support programs, ensure safety.
184
What governmental support is needed for youth mental health?
Crisis support, suicide awareness education, health-education-community integration.
185
What is the purpose of reviewing mental health emergencies on the ward?
To prepare for potential mental health emergencies encountered on the ward
## Footnote
This was covered in CNUR 304 and is briefly reviewed here.
186
What resource is recommended for further information on mental health issues?
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, text-revision (2022; DSM-V-TR)
## Footnote
Available through the U of R library.
187
What are the subtypes of ADHD?
* Inattentive
* Hyperactive-impulsive
* Combined
188
What are common causes of ADHD?
* Prenatal etOH exposure
* Tobacco exposure
* Hypoxia
* Lead exposure
* Traumatic brain injury (TBI)
189
What psychiatric comorbidities are common with ADHD?
* Conduct disorder (CD)
* Oppositional defiant disorder (ODD)
* Depression
* Anxiety
190
What is a primary treatment method for ADHD?
Stimulants
191
What defines anxiety disorders?
Worrying and fixation on concerns that impact the ability to live a productive life
192
What are some symptoms of anxiety disorders?
* Avoidance of situations
* Trouble concentrating
* Irritability
* Poor sleeping
* Nausea/vomiting
* Diarrhea
* Nervous habits (e.g., biting fingernails)
193
What characterizes depression?
Loss of interest in life and lack of motivation affecting school, work, and social life
194
What are some risk factors for depression?
* Comorbid psychiatric diagnoses (ADHD, anxiety, substance abuse)
* Learning disabilities
* First Nations status
* LGBTQ+
* Transgender status
* Isolation
* Family history
* Loss/separation
195
What is the third leading cause of death for ages 10-14?
Suicide
196
What is the first-line treatment for depression in children?
SSRIs
197
What does SSRI stand for?
Selective serotonin reuptake inhibitor
198
What is the first-line treatment for anxiety?
Cognitive behavioural therapy (CBT)
199
What are the symptoms of PTSD?
* Intrusive symptoms (memories, dreams, distress, flashbacks)
* Avoidance of triggers
* Depressive-like symptoms
* Social detachment
* Exaggerated startle response
* Hypervigilance
200
What is a common treatment approach for PTSD?
* SSRIs/SNRIs
* CBT
* Stress management therapy
* Eye movement desensitization and reprocessing (EMDR)
201
What is Anorexia Nervosa characterized by?
Dramatic weight loss from extreme dieting and excessive physical activity
202
What are common signs and symptoms of Anorexia Nervosa?
* Distorted body image
* Obsession with appearance
* Rigid control over eating
* BMI less than 17
203
What is Bulimia Nervosa characterized by?
Cyclic binge-eating followed by purging
204
What are some effects of Bulimia Nervosa?
* Electrolyte imbalances
* Tooth decay
* Esophagitis
* Damage to hands
205
What distinguishes Anorexia Nervosa from Anorexia?
Anorexia means lack of appetite; Anorexia Nervosa is a clinical condition
206
What is refeeding syndrome?
Complications from nutrition and electrolytes leading to cardiovascular, hematological, and neurological issues
207
What are some approaches to treat Anorexia and Bulimia Nervosa?
* Support groups
* Food journals
* Anxiolytics
* Addressing underlying stressors
208
What is a common complication associated with fractures?
Infection
## Footnote
Commonly includes osteomyelitis and septic arthritis.
209
What is avascular necrosis?
A condition where bone tissue dies due to a lack of blood supply.
210
What can result from bone shortening due to epiphyseal arrest?
Bone shortening.
211
What are potential nerve injuries associated with fractures?
Nerve injuries.
212
What is fat embolism?
A rare but serious complication where fat globules enter the bloodstream.
213
What is compartment syndrome?
A condition where increased pressure within a muscle compartment leads to muscle and nerve damage.
214
What is Developmental Dysplasia of the Hip?
A spectrum of developmental abnormalities of the hip.
215
What are potential consequences of Developmental Dysplasia of the Hip?
* Hip instability
* Possible dislocation
* Abnormal leg growth
* Gait and posture issues
216
What tests should be performed with care in suspected hip dysplasia?
Ortolani and Barlow tests.
217
What is scoliosis?
A lateral curvature of the spine.
218
What are the types of scoliosis?
* Congenital
* Neuromuscular
* Idiopathic
219
When can scoliosis onset occur?
In infancy, childhood, or adolescents/teens.
220
What is the primary goal of bracing in scoliosis treatment?
Prevents further curvature and allows musculoskeletal maturation.
221
What is involved in surgical fixation for scoliosis?
Placement of long rods along the spine with possible vertebral fusion.
222
What should be monitored during long-term recovery from scoliosis treatment?
* Body dysmorphia
* Bullying
* Self-harm behaviors
223
What is osteomyelitis?
An infection of the periosteum and/or bone.
224
How can bacteria cause osteomyelitis?
Bacteria can be carried through the blood from a distant wound or from an open fracture.
225
What is septic arthritis?
An infection of a joint space, usually the hip.
226
What are the nursing assessments for fracture management?
* History
* Physical examination
* Laboratory and imaging
227
What does P-R-I-C-E stand for in nursing management?
* Protect
* Rest
* Immobilize
* Cold
* Elevation
228
What are common medical treatments for fractures?
* Casts
* External fixation
* Traction
229
What are the complications of casting?
* Neurovascular compromise
* Skin integrity impairment
* Soft tissue injury
* Compartment syndrome
* Pin site infection
* Osteomyelitis
230
What is external fixation used for?
Complicated fractures, especially open fractures.
231
What is the purpose of traction in fracture treatment?
To straighten a limb, realign a fractured bone, and decrease pain.
232
Fill in the blank: Traction may be needed to straighten a limb, realign a fractured bone, and decrease _______.
[pain]
233
True or False: Traction can separate bone ends slightly to promote proper healing.
True
234
What do tendons connect?
Muscle to bone
235
What do ligaments connect?
Bone to bone
236
What is the growth plate also known as?
Epiphyseal plate
237
What is the common documentation symbol for fractures?
#
238
What type of fracture is most common in children?
Distal radius or ulna fracture
239
What characterizes a greenstick fracture in young children?
The bone bends and buckles instead of fracturing
240
What are the two main categories of musculoskeletal (MSK) issues?
Developmental vs trauma
241
What is the difference between a sprain and a strain?
Sprain is damage to a ligament; strain is damage to a tendon
242
Why are there fewer sprains and strains in young children?
Their soft tissue is more flexible
243
What increases the risk of MSK injuries in school-aged children?
Immobility affecting development and motor skills
244
When is myelination complete?
By age 2
245
What develops until the early teens?
Cerebellum
246
What is present and functional at birth?
All muscles, tendons, ligaments, and cartilage
247
What happens to muscles during adolescence?
They grow rapidly, causing clumsiness
248
When does ossification mainly occur?
Over the first few years of life
249
What is the growth plate's role?
Where growth of bones occurs
250
How does bone healing differ in children?
Children have a thick, strong periosteum with abundant blood supply
251
What is genu varum?
A postural alteration characterized by bow legs
252
What is genu valgum?
A postural alteration characterized by knock knees
253
What is metatarsal adduction?
A postural alteration where the metatarsals angle inward
254
What is a sprain?
Damage (stretched, torn, or microtear) to a ligament
255
What is a strain?
Damage (microscopic tear) to a tendon
256
In what situations can strains occur?
Over-use syndromes
257
What can a contusion occur to?
The periosteum
258
What is a dislocation?
When trauma causes bone ends to misalign
259
What can occur alongside a fracture?
Dislocation
260
What happens immediately after a fracture?
Muscles contract
## Footnote
This contraction attempts to splint and protect the site of injury.
261
What can account for any deformity after a fracture?
Muscle response
## Footnote
The contraction of muscles can lead to deformities in the fractured area.
262
What must be overcome to realign the distal bone fragment to the proximal bone fragment?
Muscle response
## Footnote
Traction or complete muscle relaxation is necessary to achieve realignment.
263
What are the two methods to realign bone fragments after a fracture?
* Traction
* Complete muscle relaxation
## Footnote
Both methods aim to counteract muscle contraction.
264
265
What is intellectual disability?
Impairment of reasoning, learning, problem solving, social skills, and/or adaptive skills
## Footnote
Often associated with developmental delay, genetic abnormalities, or hypoxic events
266
What is global developmental delay (GDD)?
Delay in all 5 developmental domains; it is permanent and there is no curative treatment
## Footnote
Focus on working with the child's abilities
267
What are common characteristics of intellectual disability?
Will not meet milestones; speech and fine motor deficits most common
## Footnote
Early diagnosis is best through routine developmental screening
268
What are chromosomal abnormalities?
Genetic diseases affecting chromosomal DNA; can involve missing, extra, or damaged/irregular DNA
## Footnote
Includes conditions like trisomy 21
269
What is trisomy 21?
Most common chromosomal disorder; affects all races, genders, and socioeconomic statuses
## Footnote
Risk increases with maternal age
270
What are some health issues associated with trisomy 21?
* Cardiac abnormalities
* Visual and hearing impairment
* GI issues
* OSA
* Thyroid disease
* Hypotonia
* Single palmar crease
* Increased risk of leukemia
## Footnote
10-20x more likely to get leukemia (AML > ALL)
271
What is Fragile X Syndrome?
Most common cause of GDD, intellectual delay, and autism spectrum disorders; mutation on X-chromosome
## Footnote
Symptoms vary between males and females
272
What are common behaviors associated with autism spectrum disorder (ASD)?
* Repetitive behaviors
* Resistance to interaction
* Altered emotional behavior
* Self-harming behaviors
## Footnote
Common issues include GI issues and psychiatric co-morbidities
273
What is the significance of early intervention therapy for children with trisomy 21?
It is multi-disciplinary and team-focused to speed development and prevent delays
## Footnote
Frequent check-ups and healthcare interaction are essential
274
What three primary areas are affected in autism spectrum disorder?
* Social skills
* Behavior
* Language/communication
## Footnote
Diagnosis often occurs around 12-36 months
275
What percentage of Canadians are reported to have learning disabilities?
3.2% (as of 2006)
## Footnote
Learning disabilities are the most common disability in Canada
276
Fill in the blank: The most common learning disabilities include _______.
[dyslexia, dysgraphia, dyscalculia]
## Footnote
Problems with speaking, reading, writing, and mathematics
277
What is the relationship between autism spectrum disorder and vaccines?
NOT linked to MMR or any other vaccine
## Footnote
This is a common misconception
278
How does a person with ASD typically respond to medical emergencies?
They may not understand the situation; structure and routine are crucial
## Footnote
Involve and consult the family for care
279
What are effective communication techniques for patients with ASD?
Using pictures rather than words to show what is going to happen
## Footnote
Determine the patient's developmental level and past interventions
280
What is the impact of maternal age on the risk of trisomy 21?
Risk increases with maternal age (1:350 at age 35; 1:30 at age 45)
## Footnote
This highlights the importance of prenatal screening
281
True or False: Asperger's syndrome is still a commonly used term in modern medicine.
False
## Footnote
It is now encompassed in the term autism spectrum disorder
282
What are the most common pediatric EENT disorders?
Conjunctivitis (Pink Eye)
## Footnote
Includes allergic, bacterial, and viral types.
283
What are the symptoms of allergic conjunctivitis?
Itching, excessive tearing, mucoid discharge, swelling of conjunctiva or eyelids
## Footnote
Common triggers include seasonal allergens, dust mites, animals, pollen, and food.
284
What is the recommended treatment for allergic conjunctivitis?
Avoid allergen; antihistamines (oral & eye gtts)
## Footnote
Gtts refers to eye drops.
285
What are the symptoms of bacterial conjunctivitis?
Usually starts unilaterally, pus, yellow-green discharge, encrusted eyes, foreign body-like sensation, photophobia
## Footnote
Often self-limiting; lubricating eye drops are recommended.
286
What are the symptoms of viral conjunctivitis?
Clear, watery discharge, bilateral involvement, URTI symptoms, photophobia, itchy eyes, swollen eyelids
## Footnote
Very contagious and self-limiting; lubricating eye drops are used.
287
What is the typical visual acuity at birth?
Approximately 20/100 to 20/400
## Footnote
20/20 vision is usually achieved by 6 to 7 years of age.
288
What developmental considerations should be noted regarding infant eyes?
Infant’s eyes are more susceptible to injury, poor color discrimination, and very near sighted (up to 25 cm)
## Footnote
Premature infants are at risk for retinal damage due to oxygen toxicity.
289
What developmental consideration is significant about the tongue in small children?
The tongue is larger in relation to the oropharynx
## Footnote
This can impact airway management and swallowing.
290
What changes occur in the tonsils and adenoids as children grow?
School-age children have larger tonsils and adenoid
## Footnote
This growth can impact respiratory function and susceptibility to infections.
291
What are the symptoms presented by Josephina, the 10-year-old female?
Sudden onset of bilateral bloodshot eyes, itchy, copious clear stringy discharge
## Footnote
No other symptoms were reported.
292
How can one differentiate between bacterial, viral, and allergic conjunctivitis?
Consider symptoms and possible diagnostic testing
## Footnote
Diagnostic testing may include cultures or allergy testing.
293
What is Acute Otitis Media (AOM)?
Presence of fluid in the middle ear
## Footnote
AOM is commonly seen in children and can lead to complications if untreated.
294
Why are children's eustachian tubes significant in AOM?
They are at a flatter angle
## Footnote
This anatomical feature contributes to the risk of fluid accumulation.
295
What are common symptoms of AOM?
Pain and hearing loss
## Footnote
These symptoms occur due to the tympanic membrane being pushed outward.
296
What is the most common cause of AOM in children less than 2 years old?
Usually viral
## Footnote
Viral infections are more prevalent in younger children compared to bacterial infections.
297
List some increased risk factors for AOM.
* Tobacco smoke exposure
* Prematurity
* Orofacial structural issues
* Supine bottle feeding
* Immune issues
## Footnote
These factors can exacerbate the likelihood of developing AOM.
298
Which population is at higher risk for AOM?
First Nations children
## Footnote
This demographic shows a higher incidence of AOM compared to others.
299
What serious complication can AOM lead to if untreated?
Meningitis
## Footnote
This is a severe and potentially life-threatening condition related to brain infection.
300
How does the pneumococcal vaccine relate to AOM?
Helps prevent AOM
## Footnote
Vaccination can reduce the incidence of infections that lead to AOM.
301
What is middle ear effusion?
Fluid remains in inner ear for up to 3 months, but no infection
## Footnote
This condition can occur after AOM and does not necessarily indicate an active infection.
302
What is often over-prescribed for AOM?
Antibiotics
## Footnote
Guidelines exist to help determine when antibiotics are necessary.
303
What procedure may be needed for persistent AOM?
Tympanostomy (myringotomy) tubes
## Footnote
This procedure helps to drain fluid and relieve pressure in the middle ear.
304
What is the classification of hearing loss related to middle ear issues?
Conductive
## Footnote
Conductive hearing loss pertains to mechanical issues in the middle ear.
305
What type of hearing loss is caused by issues with hair cells or nerves?
Sensorineural
## Footnote
This form of hearing loss is typically more severe and often permanent.
306
What are the two types of hearing loss?
* Congenital
* Acquired
## Footnote
Congenital hearing loss is present at birth, while acquired hearing loss develops later.
307
List some causes of congenital hearing loss.
* Genetics
* Maternal infections
## Footnote
Congenital factors often play a significant role in hearing impairment from birth.
308
What are some causes of acquired hearing loss?
* Infections
* Toxins (medications)
* Hyperbilirubinemia
* Exposure to excessive noise
## Footnote
These factors can lead to hearing impairment at any stage of life.
309
Name infections that can cause hearing loss.
* Toxoplasmosis
* Rubella
* Cytomegalovirus (CMV)
* Herpes
## Footnote
These infections can be congenital or acquired and affect hearing.
310
What anatomical features do children have that are larger than adults?
* Tongues
* Tonsils
* Adenoids
## Footnote
These features can lead to obstructive issues, especially during illness.
311
What could larger tonsils and adenoids in children lead to?
Obstructive issues
## Footnote
Enlarged tonsils and adenoids can contribute to breathing difficulties and sleep apnea.
312
What is the significance of the uvula in children?
Part of the throat anatomy
## Footnote
The uvula plays a role in speech and swallowing.
313
What area of the throat is referred to as the nasopharynx?
The upper part of the throat behind the nose
## Footnote
It serves as a passage for air and connects to the nasal cavity.
314
What is a hordeolum commonly known as?
Stye
315
What are the symptoms of a hordeolum?
Swollen, red pustule to eyelid
316
What is the typical treatment for a hordeolum?
Warm compress and over-the-counter antibiotic ointment
317
How long may it take for a hordeolum to heal?
Weeks; may require incision and drainage (I&D)
318
What are the symptoms of a blocked tear duct?
Swollen, red lower eyelid with tearing
319
What is the treatment for a blocked tear duct?
Warm compress and massage
320
True or False: A blocked tear duct is associated with conjunctivitis.
False
321
What is periorbital cellulitis?
An infection of the integument around the eyeball (orbit), but the eye is not affected
322
What happens if periorbital cellulitis is untreated?
It can spread into the eye
323
What are the symptoms of periorbital cellulitis?
No pain with eye movements or vision
324
What is orbital cellulitis?
An infection of the outer layers of the eye
325
What symptoms indicate the need for emergent treatment in orbital cellulitis?
Pain with vision and eye movements
326
What are the symptoms of Gladys, the 8-month-old infant?
Pain (crying, fussy, pulling on right ear) and fever
327
What is a possible differential diagnosis (DDx) for Gladys?
Ear infection or other related conditions
328
What is the pathophysiology of Iron Deficiency Anemia (IDA)?
↓Fe = ↓RBC oxygen-carrying capacity = fatigue
## Footnote
Chronic or severe anemia can lead to cognitive dysfunction, behavioral changes, delayed growth and development in infants, and poor school performance.
329
What can be related to malabsorption conditions contributing to IDA?
Pica
## Footnote
Pica involves the eating of non-nutritive substances and is common with IDA.
330
What are common substances ingested in pica?
* Soil
* Sand
* Chalk
* Drywall
* Paint flakes
* Hair
* Erasers
* Cigarette butts
## Footnote
Pica can be a symptom of developmental delay or low iron.
331
What foods are high in iron?
* Any meat, especially liver
* Octopus
* Fortified cereal
* Oatmeal
* Spinach
* Tomatoes
* Asparagus
* Beans and lentils
* Blackstrap molasses
* Seeds and nuts
## Footnote
These foods can help increase iron intake.
332
What are risk factors for IDA?
* Rapid growth + low iron intake
* Low socioeconomic status
* Prematurity and low birth weight
* Excessive milk intake
* Early introduction of cow’s milk
* Prolonged bottle feeding with inadequate intake of solids
* Prolonged exclusive breastfeeding
* Overweight/obese
## Footnote
These factors can increase the likelihood of developing IDA.
333
What nursing assessments should be conducted for IDA?
* Fatigue & lethargy
* Inspect skin, conjunctivae, oral mucosa, palms, and soles for pallor
* Assess for spooning of the nails
* Evaluate SpO2
* Assess for tachycardia
* Auscultate for a flow murmur
## Footnote
These assessments help identify signs of IDA.
334
What would a child's labs look like for IDA?
Infants of 12 months and older: normal Hb level < 110, microcytic, hypochromic anemia, low ferritin
## Footnote
Serum iron is considered unreliable for diagnosing IDA.
335
What is ferritin and what does it indicate?
Serum ferritin of less than 10ug/L - 12ug/L indicates depletion of the body’s iron stores
## Footnote
Ferritin levels reflect the amount of stored iron in the body.
336
What is the therapeutic management for IDA in infants?
* Support breastfeeding or formula with iron
* Introduce iron-fortified infant cereal at 6 months
* Limit whole milk until 12 months
* Preterm infants should receive iron supplementation
## Footnote
Low iron formula should never be used unless prescribed.
337
What are the risks associated with a pRBC transfusion?
Teeth staining from oral iron
## Footnote
pRBC transfusions are reserved for the most severe cases.
338
What is sickle cell anemia?
An autosomal recessive trait where people make hemoglobin S (HbS)
## Footnote
About 5% of the world carries genes for sickle cell disease and thalassemia.
339
What are the genotypes associated with sickle cell disease?
* AS (trait)
* AA (unaffected)
* SS (sickle cell disease)
## Footnote
Individuals with sickle cell trait are typically asymptomatic.
340
What is the normal composition of adult hemoglobin?
Normal adult hemoglobin is made of 2 alpha-globin and 2 beta-globin chains (α2β2)
## Footnote
This is referred to as hemoglobin A.
341
What are the causes of anemia?
* Iron deficiency anemia (IDA)
* Lead poisoning
* Medication induced
## Footnote
For this context, only IDA is emphasized.
342
What are the key RBC cell indexes to know?
* Mean corpuscular volume (MCV)
* Mean corpuscular hemoglobin concentration (MCHC)
## Footnote
High MCV indicates macrocytic anemia, while low MCV indicates microcytic anemia.
343
What is the highest incidence age group for Iron Deficiency Anemia (IDA)?
1-3 years of age
## Footnote
Prevalence in specific populations, like First Nations children, can be significantly higher.
344
What are some of the negative aspects of sickle cells?
Sickled cells can cause blockage in blood flow, leading to vaso-occlusive crises and organ dysfunction.
345
Which tissues or organs are more affected by sickled cells?
Spleen, liver, bones, and brain.
346
What is the difference between sickled and normal red blood cells?
Sickled RBCs are deformed and cause blockage in blood flow, while normal RBCs are flexible and disc-shaped.
347
What is the increased risk associated with a non-functional spleen in sickle cell patients?
↑ risk of bacterial infections and sepsis.
348
What preventive measures are recommended for children with sickle cell disease?
* Extra immunizations
* Prophylactic antibiotics until 10-12 years old.
349
What percentage of children with sickle cell disease experience silent strokes?
5% to 10%.
350
What are some psychosocial needs of patients with chronic disease?
* Coping mechanisms
* Support with genetic counselling
* Financial needs
* Caregiver role strain
* Transitioning from pediatric to adult care.
351
At what age are infants typically asymptomatic for sickle cell anemia?
3 to 4 months of age.
352
What is the role of hemoglobin F (HbF) in infants with sickle cell anemia?
HbF does not sickle and is replaced by HbA around 4-6 months of life.
353
What triggers sickling in red blood cells?
* Infection
* Fever
* Acidosis
* Dehydration
* Heavy physical exertion
* Excessive cold exposure
* Hypoxia.
354
How long does sickle hemoglobin (HbS) last in circulation?
Approximately 10-20 days.
355
Where in the body are red blood cells destroyed?
In the spleen.
356
What is a vaso-occlusive crisis (VOC)?
Pain from ischemia in bone or soft tissue due to sickled RBC blockage.
357
What complications can arise from vaso-occlusive crises?
* Lung necrosis
* Stroke
* Splenic sequestration
* Acute chest syndrome.
358
What happens to the spleen as a result of repeated sickling?
Initially causes splenomegaly, leading to splenic necrosis and eventual disappearance by age 5.
359
What are some effects of sickle cell disease on growth and development?
* Delayed growth and development
* Poor school performance
* Delayed puberty.
360
What is the only potential cure for sickle cell anemia?
Bone marrow transplant.
361
What medication can stimulate the bone marrow to produce HbF instead of HbS?
Hydroxyurea.
362
Fill in the blank: Adequate hydration is important to _______ in sickle cell anemia.
prevent sickling episodes.
363
True or False: Sickle cell anemia can be cured with medications.
False.
364
What are common concerns associated with Cleft Lip and Palate?
Feeding issues, teeth development, speech difficulties, increased likelihood of otitis media
## Footnote
Cleft lip and palate often require management by a specialized team and surgical repair.
365
At what ages are surgical repairs typically performed for cleft palate and cleft lip?
Cleft palate: 2-3 months of age; Cleft lip: 9-18 months
## Footnote
Surgical timing can vary based on individual cases and team recommendations.
366
What are the variations in clefts of lip and palate at birth?
* Notch in vermilion border
* Unilateral cleft lip and cleft palate
* Bilateral cleft lip and cleft palate
* Cleft palate
## Footnote
These variations represent differing severities and presentations of the conditions.
367
What is a significant feeding challenge for infants with cleft lip?
Forming a lip seal
## Footnote
This challenge can impact the ability to breastfeed effectively.
368
What is a significant feeding challenge for infants with cleft palate?
Generating a force for a suck
## Footnote
Specialized feeding methods are often required for these infants.
369
What are the two conditions associated with abdominal organs maturing outside of the abdominal cavity?
* Omphalocele
* Gastroschisis
## Footnote
Both occur at the umbilicus, but differ in peritoneal covering.
370
What defines Omphalocele?
Organs covered by peritoneum
## Footnote
This condition is distinct from gastroschisis in terms of protective covering.
371
What defines Gastroschisis?
No peritoneal covering
## Footnote
This condition can lead to complications due to exposure of the organs.
372
What is Pyloric Stenosis?
Hypertrophied pylorus muscle and narrowed stomach outlet
## Footnote
This condition prevents stomach contents from moving into the intestines.
373
What age group is most affected by Pyloric Stenosis?
Infants between 1-2 weeks or 3-4 months
## Footnote
Early diagnosis is crucial for effective treatment.
374
What are the symptoms of Pyloric Stenosis?
* Projectile vomiting (no bile)
* Immediate hunger after vomiting
* Constipation
* Irritability
* Possible visible gastric peristalsis through skin
* Olive-shaped mass in RUQ
## Footnote
These symptoms can help in diagnosing the condition.
375
What is the primary treatment for Pyloric Stenosis?
Surgical pyloromyotomy
## Footnote
This procedure relieves the obstruction caused by the hypertrophied pylorus.
376
What is Gastroenteritis?
Inflammation of the mucosa of the GI tract
## Footnote
It can be caused by viral or bacterial infections.
377
What are common viral causes of Gastroenteritis?
* Rota virus
* Norovirus
## Footnote
These viruses often lead to non-bloody diarrhea.
378
What are common bacterial causes of Gastroenteritis?
* Salmonella
* E. coli
* Campylobacter
* Shigella
* C. diff
## Footnote
Bacterial infections can lead to bloody diarrhea and more severe symptoms.
379
How is Chronic Diarrhea defined?
Diarrhea ongoing for more than 2 weeks
## Footnote
This can indicate underlying health issues.
380
What are potential causes of Chronic Diarrhea?
* Food intolerances/allergies
* Tumors
* Inflammatory bowel disease
* Malabsorption
## Footnote
Identifying the cause is essential for appropriate treatment.
381
What management strategies are recommended for Diarrhea?
* Fluid and electrolytes
* Antibiotics or anti-parasitic agents
* Education on food safety and hygiene
## Footnote
Adequate hydration is crucial to prevent dehydration.
382
What is a common cause of Constipation in younger children?
Diet: increased dairy, decreased water, and decreased fiber
## Footnote
Dietary adjustments are often the first line of treatment.
383
What are some gentle laxatives recommended for treating Constipation?
* Prunes
* All-bran
* Metamucil
## Footnote
These options can help relieve constipation in children.
384
What is Meconium?
Fetal poop produced from digested amniotic fluid
## Footnote
It is a critical indicator of newborn health.
385
What does it indicate if a newborn does not pass Meconium within 48 hours?
There is a problem
## Footnote
This could signal serious underlying health issues.
386
What does the acronym S.H.I.T. represent concerning No Meconium?
* Salt (cystic fibrosis)
* Hirschsprung’s disease
* Imperforate anus
* Twist (volvus)
## Footnote
This acronym helps remember critical conditions associated with failure to pass meconium.
387
What is Hirschsprung's disease?
Congenital lack of innervation to the distal colon and rectum, Hirschsprung's disease is a rare birth defect that occurs when nerve cells in the large intestine are missing. This prevents the intestine from moving stool properly, which can lead to constipation and blockages
## Footnote
This condition can lead to severe constipation and requires surgical intervention.
388
What condition is characterized by the intestinal tract twisting around itself?
Volvus
## Footnote
This can lead to intestinal obstruction and compromised blood flow.
389
What is avascular necrosis?
A condition where bone tissue dies due to a lack of blood supply.
## Footnote
Avascular necrosis can lead to the collapse of bone structures.
390
What are some complications of fractures?
* Infection
* Avascular necrosis
* Bone shortening from epiphyseal arrest
* Nerve injuries
* Fat embolism
* Compartment syndrome
## Footnote
These complications can arise from improper healing or treatment of fractures.
391
True or False: Compartment syndrome can occur in the hand.
True
## Footnote
Compartment syndrome can occur in various areas of the body, including the hand.
392
Fill in the blank: Bone shortening from _______ arrest is a complication of fractures.
epiphyseal
## Footnote
Epiphyseal arrest can lead to improper growth and shortening of the bone.
393
What is fat embolism?
A condition where fat globules enter the bloodstream and can cause blockages.
## Footnote
Fat embolism is often associated with fractures, particularly of long bones.
394
What is compartment syndrome?
A condition that occurs when pressure within the muscles builds to dangerous levels.
## Footnote
This pressure can decrease blood flow, leading to muscle and nerve damage.
395
What are nerve injuries in relation to fractures?
Damage to nerves that can occur due to trauma or swelling associated with fractures.
## Footnote
Nerve injuries can lead to loss of sensation or function in the affected area.
396
397
What is intussusception?
Intestine 'telescopes' (invaginates) backwards, usually at the ileocecal junction.
## Footnote
It can cause severe abdominal pain and requires urgent medical attention.
398
What are common symptoms of intussusception?
Vomiting, diarrhea ('currant-jelly stool'), lethargy, sudden onset of severe pain, pain in waves.
## Footnote
Children often draw their knees up to their chest and scream due to pain.
399
What is the most common serious bacterial infection in children?
Urinary Tract Infections (UTIs).
## Footnote
E. coli accounts for 70-90% of UTIs due to intestinal flora.
400
What factors contribute to UTIs in children?
Poor hygiene (wiping back to front), more common in uncircumcised males in the first year, and then more common in girls.
## Footnote
UTIs can involve the urethra, bladder, ureters, or kidneys.
401
What are the most common symptoms of UTIs in non-verbal children?
Poor feeding, vomiting, failure to gain weight, screaming on urination, poor urine stream, foul-smelling urine/diapers, fever, irritability/fussiness, frequent urination, urgency.
## Footnote
Symptoms can vary widely; some may not show typical signs.
402
What is the diagnostic method for UTIs?
Urinalysis: positive for blood, nitrites, leukocyte esterase, WBCs or bacteria; renal ultrasound.
## Footnote
Often, diagnosis can be made based on presenting signs and symptoms.
403
What is the treatment for UTIs?
Oral or IV antibiotics for 7–14 days, adequate fluid intake, fever management, and education to prevent future infections.
## Footnote
Treatment duration differs from adults, who may require only 1-3 days.
404
What is Chlamydia?
A bacterial infection of genitals that can lead to inflammatory disease (PID) in women and infertility in both genders.
## Footnote
Symptoms in women may include pain with sexual intercourse, lower abdominal pain, and changes in bleeding pattern.
405
What are common symptoms of Gonorrhea?
Discharge from the penis or anus, pain in testicles, pain on urinating in men; women may have pain with sex and vaginal discharge.
## Footnote
Many individuals remain asymptomatic.
406
What is Syphilis?
A bacterial infection that enters through breaks in skin or linings of the genital area and can damage internal organs over time.
## Footnote
Initial symptom includes a painless ulcer (chancre) on genitals.
407
What is the main concern regarding STIs in newborns?
Vertical transmission from mother to baby.
## Footnote
Prenatal screening includes STI checks and education on prevention and recognition.
408
What is the treatment for Jaundice caused by physiological hyperbilirubinemia?
Promote feeding, may need IV hydration, phototherapy, and possibly exchange transfusion if severe.
## Footnote
Physiologic jaundice normally resolves by day 10 to 12.
409
What is the difference between physiologic and pathologic hyperbilirubinemia?
Physiologic has a later onset and resolves by day 10-12; pathologic onset is early (<24 hours) and lasts >8 days.
## Footnote
Pathologic hyperbilirubinemia can be caused by ABO incompatibility or biliary atresia.
410
What are the common symptoms of internal parasites like pinworms?
Perianal itching, insomnia, irritability, hyperactivity.
## Footnote
Pinworms can be visualized after sleep using adhesive tape.
411
What is the normal urine output for infants and young children?
1.5 to 2 mL/kg per hour.
## Footnote
Output less than 1 mL/kg/hour raises concerns for kidney issues, dehydration, or decreased cardiac output.
412
What is the treatment for Giardia?
Medications and IV fluids; it is particularly concerning for the immunocompromised.
## Footnote
Giardia can cause abdominal pain, watery diarrhea, and foul-smelling gas.
413
What is the weakest point of long bones?
The cartilage growth plate (epiphysis)
## Footnote
This is crucial for bone growth and development.
414
What can happen if a growth plate injury is not treated?
The bone may stop growing or grow abnormally
## Footnote
This can lead to long-term complications in bone development.
415
What type of surgery is often required for a growth plate injury?
Surgery with internal fixation
## Footnote
This method is used to stabilize the bone during recovery.
416
What are the potential downsides of surgery for growth plate injuries?
Prolonged recovery and possible follow-up surgeries
## Footnote
Recovery can be lengthy, and complications may arise.
417
How are growth plate injuries graded?
By the Salter Harris classification
## Footnote
This classification system helps in assessing the severity and treatment approach.
418
Fill in the blank: The growth plate is also referred to as the _______.
epiphysis
## Footnote
The epiphysis is the end part of a long bone, initially growing separately from the shaft.
419
What is a Toddler's Fracture?
An oblique fracture of the tibia caused by a fall from standing while the child twists.
## Footnote
This type of fracture typically occurs in young children due to their activity level and physical development.
420
What are the symptoms of a Toddler's Fracture?
Child will limp or refuse to weight bear on that limb; may regress to crawling, but don't appear to be in pain.
## Footnote
Symptoms can be subtle and may not indicate severe injury.
421
How painful is a Toddler's Fracture?
It's not overly painful.
## Footnote
Children often show minimal signs of distress despite the injury.
422
When might a Toddler's Fracture be visible on an X-ray?
The fracture may not show on X-ray until 5-7 days later.
## Footnote
Delayed visibility on imaging can complicate diagnosis.
423
What causes a Toddler's Fracture?
A fall from standing while the child twists.
## Footnote
This injury is common during play or activity where a child may lose balance.
424
Fill in the blank: A Toddler's Fracture is caused by a _______.
fall from standing while the child twists.
425
What does FOOSH stand for?
Fall on out-stretched arm
426
What bones are often involved in a FOOSH injury?
Both radius and ulna
427
What are the potential outcomes of a FOOSH injury?
Can cause a major deformity in the arm or mild swelling
428
True or False: A FOOSH injury only causes major deformities.
False
429
Fill in the blank: FOOSH injuries can involve both the _______ and ulna.
radius
