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Pediatrics N637 > Pediatrics - Quiz #1 > Flashcards

Pediatrics - Quiz #1 Flashcards

1
Q

What are the 3 causes of death in children <1 y/o?

A

1) Congenital anomalies 2) Prematurity 3) SIDS

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2
Q

A congenital anomaly is AKA

A

birth defect

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3
Q

Erikson’s psychosocial stages relies on

A

Successful mastery of tasks during critical periods; progress to next stage by resolving conflict between favorable and unfavorable components

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4
Q

Trust vs Mistrust occurs

A

birth to 1 y/o. It is the 1st and most important attribute to develop a healthy personality. Results in faith and optimism

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5
Q

Autonomy vs shame and doubt

A

1 to 3 y/o. Symbolized by holding on and letting go of the sphincter muscles; centered on the toddler’s increasing ability to control their bodies, themselves and their environment (wants to do things for themselves, imitating behaviors and activities of others). Negative feelings of shame and doubt arise when children are made to feel small and self conscious. Favorable outcomes of self-control and willpower

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6
Q

Initiative vs guilt

A

3 to 6 y/o. Characterized by vigorous, intrusive behavior, strong imagination. Being made to feel that their activities or imaginings are bad produces a sense of guilt. Lasting outcomes are direction and purpose

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7
Q

Erikson’s stage during 6 to 12 y/o

A

Industry vs inferiority. Children are ready to be workers and producers; want to carry through to completion/achievement/learn the rules. If too much is expected of them, inadequacy/inferiority can develop.

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8
Q

Erikson’s stage during 12 to 18 y/o

A

Identity vs role confusion. Characterized by rapid and marked physical changes. Children become overly preoccupied with the way they appear in the eyes of others compared with their own self concept.

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9
Q

What is the first stage of intellectual/cognitive development by Piaget?

A

Sensorimotor (birth to 2 y/o). Progress from reflex activity, begin problem solving, learn objects have permanence, and at the end, begin to use language and representational thought

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10
Q

When does preoperational begin?

A

2 to 7 y/o

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11
Q

Children in this stage have the inability to put themself in the place of another; they are unable to see things from any perspective other than their own, egocentrism

A

Pre-operational

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12
Q

Concrete operations (7 to 11) becomes

A

increasingly logical and coherent. They can consider POV other than their own and thinking has become socialized

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13
Q

Piaget’s stage occurs at 11 to 15 y/o

A

formal operations. Adolescents can think in abstract terms, use abstract symbols and draw logical conclusions from a set of observations.

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14
Q

Height increases by how much in a year

A

50%

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15
Q

Weight doubles by 4 to 7 months and triples by

A

one year

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16
Q

This begins around 6 months w/ lower incisors. 6-8 teeth by 1st bday

A

Teething

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17
Q

The anterior fontanel closes first at the 6th - 8th week. T/F

A

False. The posterior closes first.

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18
Q

This closes by the 12th - 18th month

A

Anterior fontanel

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19
Q

During this kind of play, children play alone with toys different from those used by other children in the same area

A

Solitary play (0 to 1 year)

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20
Q

Parallel play occurs when children play independently but among other children. They play with toys similar to those the children around them are using; each plays beside but not with other children.

A

TRUE

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21
Q

What age does parallel play occur?

A

2-3 y/o

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22
Q

Associate play occurs at what age?

A

Preschoolers 3 - 7 y/o

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23
Q

What is associate play?

A

Children play together and are engaged in a similar or even identical activity but there is no organization

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24
Q

Describe cooperative play. What age does it occur?

A

It is play that is organized and children play in a group with other children. It occurs at ages 7-11

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25
Q

What is the single most importance influence on growth?

A

Nutrition

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26
Q

What is the FLACC scale?

A

Measures behavioral pain. (F) facial expression, (L) leg movement, (A) activity, (C) cry and (C) consolability

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27
Q

This type of developmental screening test provides a mean of recording objective measurements of developmental function

A

Denver II test

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28
Q

What is the maintenance fluid for a child less than 10kg?

A

100ml/kg

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29
Q

What is the maintenance fluid for a child 10-20kg?

A

1000ml+50ml/kg for every kg >10

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30
Q

What is the maintenance fluid for a child weighing more than 20kg?

A

1500ml+20ml/kg for every kg>20

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31
Q

What is the max amount of maintenance fluid?

A

2500ml/day

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32
Q

Where would you administer an IM med to a newborn/toddler?

A

Vastus lateralis

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33
Q

For any older child >3 y/o, inject an IM med here.

A

Deltoid

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34
Q

Absorption rate is slowest from

A

Oral>SQ>IM>Pulm>IV

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35
Q

What is HEADSS?

A

Home and environment, education and employment, activities, drugs, sexuality, suicide/depression

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36
Q

Symptoms that occur between early manifestations of the disease and its overt clinical syndrome, ie fever or rash

A

Prodrome

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37
Q

This disease has no or mild prodrome, superficial vesicles, pruritic, crops in different stages, concentrated on the trunk, fewest on extremities, exposed 2-3 weeks before, vaccine is 85% effective

A

Varicella zoster/chicken pox

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38
Q

What is the transmission of varicella/chicken pox?

A

Direct contact, droplet (airborne) spread, and contaminated products

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39
Q

What is the incubation period of varicella/chicken pox?

A

2 - 3 weeks, usually 14-16 days

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40
Q

1 day before eruption of lesions (prodromal period) to 6 days after first crop of vesicles when crusts have formed is when the period of communicability is for this disease

A

Varicella/chicken pox

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41
Q

Rubeola (measles) shows prodrome how many days before presentation?

A

3 - 5 days

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42
Q

“Three C’s”

A

Rubeola (measles)

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43
Q

Confluent maculopapular rash

A

Rubeola (measles)

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44
Q

Name the consequences/manifestations of rubeola (measles)

A

Fine desquamation, otitis media, pneumonia, and encephalitis

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45
Q

This type of disease is cause by the human herpesvirus type 6

A

Exanthum subitum (roseola infantum)

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46
Q

Rubeola (measles) has what kind of transmission?

A

Direct contact and droplet precaution

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47
Q

Exanthum subitum (roseola infantum) has what kind of transmission?

A

Year round; no reported contact with infected individual

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48
Q

Discrete rose pink macules or maculopapules appearing first on trunk and then spreading to neck, face and extremities; non pruritic, risk of febrile seizure, lasts 1-2 days

A

Exanthum subitum (roseola infantum)

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49
Q

Erythema infectiosum (Fifth disease) is caused by what specific kind of virus?

A

HPV B19

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50
Q

Rash appears in 3 stages

A

Erythema infectiosum

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51
Q

Birth weight quadruples by what age

A

2.5 years - toddler

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52
Q

Birth length triples by what age

A

13 years

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53
Q

What is the normal heart rate for a newborn?

A

Awake: 100-180, Sleeping: 80-160

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54
Q

What is the normal heart rate for a 1wk to 3 mo?

A

Awake: 100-220, Sleeping: 80-200

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55
Q

Birth length triples by what age

A

13 years

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56
Q

What is the normal heart rate for a newborn?

A

Awake: 100-180, Sleeping: 80-160

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57
Q

What is the normal heart rate for a 1wk to 3 mo?

A

Awake: 100-220, Sleeping: 80-200

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58
Q

The following heart rate is for what age group? Awake: 80-150, Sleeping 70-120

A

3mo - 2 yr

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59
Q

The following heart rate is for what age group? Awake: 70-110, Sleeping 60-90

A

2 - 10yr

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60
Q

What is social-affective play?

A

Infants take pleasure in relationships with people. As adults talk, nuzzle and elicit responses from an infant, the infant learns to provoke parental emotions and responses with smiling, cooing, or initiating games and activities.

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61
Q

This type of play is a nonsocial stimulating experience that originates from without ie handling raw materials, body motion and other uses of senses and abilities.

A

Sense-pleasure play

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62
Q

In this type of play, infants have developed the ability to grasp and manipulate; they persistently demonstrate and exercise their newly acquired abilities, repeating the action over and over.

A

Skill play

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63
Q

What is unoccupied behavior?

A

Children are not playful but focusing their attention momentarily on anything that strikes their interest

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64
Q

What is dramatic/pretend play?

A

Begins in late infancy (11-13 mths) and is the predominant form of play in preschool children. By acting out events of daily life, children learn and practice the roles and identities modeled by their family and society

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65
Q

During this type of play, children watch what other children are doing but make no attempt to enter into the play activity

A

Onlooker play

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66
Q

What is solitary play?

A

Children play alone with toys different from those used by other children in the same area. They enjoy the presence of other children but make no effort to get close to or speak to them; interest is centered on their own activity

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67
Q

During this type of play, children play independently but among other children. They play with similar toys to children among them. Each plays beside, but not with, other children.

A

Parallel play

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68
Q

What is associative play?

A

Children play together and are engaged in similar or even identical activity, but there is no organization, division of labor, leadership assignment, or mutual goal.

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69
Q

What is cooperative play?

A

Play is organized, and children play in a group with other children. They discuss and plan activities for the purposes of accomplishing an end

70
Q

The sequence for examining patients follows what direction?

A

Head to toe

71
Q

In a physical examination of a patient, you will perform the traumatic procedure first.

A

FALSE

72
Q

Young children, especially preschoolers, fear intrusive procedures because of

A

their poorly defined body boundaries. Also, avoid using the word “take” when measuring vital signs because young children interpret words literally

73
Q

The child’s general appearance is based on what?

A

Cumulative, subjective impression of the child’s physical appearance, state of nutrition, behavior, personality, interaction with parents, siblings, and nurse.

74
Q

What does the Hirschberg test for?

A

Used to detect misalignment of the eyes. Shine a light of the opthalamoscope directly into the pt’s eyes from a distance and the light should fall symmetrically within each pupil.

75
Q

Which assessment is the broadest and most diverse part of the examination process?

A

Neurological assessment

76
Q

What is NPASS?

A

neonatal, pain, agitation, & sedation)-mostly used

with preemies. measures crying irritability, behavior state, facial expression, extremities tone & VS

77
Q

What is the FACES pain scale?

A

Consists of 6 cartoon faces ranging from smiling face for “no hurt” to tearful face for “hurts worst” Can be used in children as young as 3

78
Q

This pain scale uses a straight line with endpoints identified as “no pain” and “worst pain” and sometimes “medium pain” in the middle

A

Numerical scale

79
Q

At what age can you administer the numerical scale?

A

Children as young as 5 as long as they can count and have some concept of numbers

80
Q

During the physical exam of an infant, you will start with visual observations, obtain V.S then?

A

Elicit reflexes as body parts are examined, perform traumatic procedures last (eyes, ears, mouth while crying) and Moro reflex last

81
Q

Sequence of PE during toddler includes

A

Inspect body area through play: “count fingers, tickle toes”, use minimal physical contact initially, introduce equipment slowly, auscultate, percuss, palpate whenever quiet, and perform traumatic procedures last

82
Q

For preschool, school age children and adolescents, proceed in what sequence for PE?

A

Head to toe direction with the exception of examining genitalia last in school age and adolescents

83
Q

Toys appropriate for a newborn to 1 mo include:

A

hang bright, shiny objects close to baby, b&w mobiles, look at infant in close range

84
Q

Coos & grasping, cradle gym, rattles & chimes, providing bright objects are skills and toys for what age?

A

2 months

85
Q

Head control is seen at what age?

A

4 months

86
Q

What kind of toys would you give a 4 month old?

A

Brightly colored books

87
Q

Children in this age group are most likely to grasp rattles/chimes, bright toys, enjoy mirror play and soft squeeze toys

A

4 - 6 months

88
Q

In a 7 month old, you would expect to what skills and what kind of toys in 6-9 mo?

A

Transfers objects and large bright toys with moveable parts, peek-a-boo, ball of yarn to pull apart and play with various textures

89
Q

Sitting unsupported in seen in children

A

8 months old

90
Q

By what age would you expect to see a child crawl?

A

9 months old

91
Q

Play ball by rolling it to child, build 2 block tower, read books & imitate sounds of animals, you point & name body parts are toys of a

A

9-12 month old

92
Q

A 12 month old should be able to

A

walk with assistance

93
Q

What is the plantar reflex?

A

The normal response to stroking the lateral aspect of the plantar surface of the foot is extension of the great toe and fanning of the other toes. The “babinski sign” is normal in an infant and may be present for the first year of life because of the incomplete myelination of the corticospinal tracts. i would note that primitive reflexes like babinski may be present with people with CP.

94
Q

This reflex is obtained by gently stroking the cheek towards the lips. The baby should open the mouth towards the stimulus and turn the head to latch on to the object.

A

Suck/root

95
Q

What is the moro reflex?

A

is obtained by holding the baby’s head and shoulders off of the mat with the arms held in flexion on the chest. The examiner suddenly lets the head and shoulders drop back a few inches while releasing the arms. The arms should fully abduct and extend, then return towards the midline with the hand open and the thumb and the index finger forming a “C” shape.

96
Q

This reflex is obtained by holding the baby upright over the mat with the sole of the foot touching the mat. This initiates a reciprocal flexion and extension of the legs and it looks like the baby is walking.

A

The stepping or walking reflex

97
Q

This type of seizure is brief (usually less than 20 seconds), generalized epileptic seizures of sudden onset and termination. When someone experiences this type of seizure they are often unaware of their episode. Brief loss of consciousness, minimum or no alteration in muscle tone, amnesia, no incontinence, often mistaken for daydreaming or inattentiveness Onset usually between 4-12 years of age. Will usually cease at puberty

A

Absence formally known as petit mal or lapses

98
Q

What is a simple partial seizure?

A

has a local onset and involves a relatively small location in the brain; characterized by localized motor symptoms, somatosensory, psychic, and autonomic symptoms, no impairment of consciousness

99
Q

This type of seizure is observed more often in children from three years through adolescence; characterized by period of altered behavior,amnesia of event, inability to respond to the environment, impaired consciousness during event, drowsiness or sleep usually following the seizure

A

Complex partial seizure

100
Q

What are the two types of generalized seizure?

A

Tonic and clonic

101
Q

This type of seizure lasts about 10-20 seconds; manifestations include: eyes roll upward, immediate loss of consciousness, if standing, falls to the floor or ground, stiffens in generalized symmetric tonic contraction of entire body musculature, apneic and may become cyanotic, increases salivation and loss of swallowing reflex

A

Tonic

102
Q

What is a clonic phase seizure?

A

last approx. 30 seconds;manifestations include: violent jerking movements as the trunk and extremities undergo rhythmic contraction and relaxations, may foam at the mouth, may be incontinent of urine and feces; as event ends the intensity of the movements will decrease and eventually cease

103
Q

This is a continuous seizure that lasts more than 30 minutes or a series of seizures from which the child does not regain a premorbid LOC

A

Status epilepticus

104
Q

What is the initial treatment for status epilepticus?

A

Support and maintenance of vital signs, ABCs of life support, oxygen, gaining IV access, and IV administration of antiepileptic agents

105
Q

This type of seizure appears to relax, may remain semi-conscious and difficult to arouse, may awaken in a few minutes, may remain confused for several hours, poor coordination, may have visual and speech difficulties, may vomit or complain of H/A,when left alone, usually sleeps for hours, no recollection of the event, tired and sore muscles

A

Postictal state

106
Q

What is the initial management of seizures?

A

Assess immediate environment and protect from harm, assess airway, oxygen if needed, medicate, placing the child on their side, suction oral cavity and posterior oropharynx if necessary, take vital signs

107
Q

What is the longterm management of seizures?

A

Anti-epileptic medications-diazepam drug of choice (book answer), ketogenic diet- high fat, low carb and adequate protein diet, vagus nerve stimulation- an implantable device (subcutaneously in the chest) to reduce seizures is tunneled underneath the skin and delivers electrical impulses to the left vagus nerve (CN 10)
surgical therapy- when seizures are determined to be caused by a hematoma, tumor or other cerebral lesion, surgical removal is treatment
seizure precautions- side rails raised while resting or sleeping, side rails padded, waterproof mattress or bad on bed or crib; precautions while swimming, bathing, bicycle riding, skating, and skateboarding

108
Q

What is meningitis?

A

Bacterial or viral organisms spread to CNS causing an inflammatory response

109
Q

Name the three most common bacteria that cause meningitis?

A

Haemophilus influenzae, streptococcus pneumoniae, and neisseria meningitidis

110
Q

Viral meningitis is more common in younger children.

A

TRUE

111
Q

What are the presenting symptoms of meningitis?

A

Headache, fever, photophobia, nuchal rigidity, and “sunset eyes”

112
Q

What are some of the viruses which cause meningitis (aseptic)?

A

Arbovirus, HSV, cytomegalovirus, adenovirus, and HIV

113
Q

Name some of the consequences of meningitis

A

Death, DIC, increased ICP, shock, hearing loss, seizures, developmental delay

114
Q

Name the points of entry for meningitis

A

Direct vascular dissemination from a focus of infection elsewhere Nasalpharynx to underlying blood vessels and enter the cerebral blood supply and organism gain entry by direct implantation after penetrating wounds, skull fractures that provide an opening into the skin or sinuses., LP

115
Q

Describe management for spinal cord injury

A

Initial management: use a rigid cervical collar on immobilization board. Do not take infant out of carseat. Methylprednisolone/SoluMedrol is given in high doses to decrease inflammation and spinal cord edema. Respiratory care: in a high level cervical injury, patient may need ventilation or tracheostomy. Altered temperature regulation, so body temp must be monitored closely for fluctuations.Other care issues include skin breakdown, tissue perfusion and decreased physical mobility

116
Q

This type of injury can result in loss of motor function, sensation, reflexes or bowel/bladder control depending on site of injury

A

spinal cord injury

117
Q

As the nurse caring for a SCI patient, what must you monitor closely?

A

Altered temperature regulation

118
Q

What is otitis media?

A

middle ear swelling/inflammation/irritation of ear bones

119
Q

Why is otitis media the common cause of URI?

A

During a URI, the swelling of mucous membranes in the nasopharynx blocks the eustachian tubes. This then traps air in the middle ear, creating a vacuum that sucks fluid into the middle ear. This fluid can then become infected, causing AOM.

120
Q

What puts a baby at risk for developing OM?

A

letting baby fall asleep with bottle, smoking and cleft lip/palate put baby at risk for OM. Cleft palate/lip-it’s because tubes poorly formed and fluid gets trapped. Children below the age of seven years are much more prone to otitis media since the Eustachian tube is shorter and at more of a horizontal angle than in the adult ear.

121
Q

Not all vaccines are given IM. MMR and varicella zoster are given subq.

A

TRUE

122
Q

A 1 in size needle is used for what age group?

A

1-12 months

123
Q

Toddlers (1-3 y/o) are given injections using what size needle?

A

1 1/4 needle

124
Q

A 1 1/2 in size needle is used for what age group?

A

> 3 y/o

125
Q

What is a prevention treatment for sleep apnea in premature infants?

A

Keep isolet, instruments, room warm

126
Q

What is the cause for sleep apnea and bradycardia in preemies?

A

An immature CNS

127
Q

When asphyxiated, the infant responds with an increased respiratory rate. If the episode continues, the infant becomes apnic, followed by a drop in heart rate and a slight increase in blood pressure. The infant will respond to stimulation and 02 therapy with spontaneous respirations. essentially, baby “forgets” to breathe and nurse can intervene by stroking foot, waking baby.

A

Primary apnea

128
Q

What is secondary apnea?

A

When asphyxia is allowed to continue after primary apnea, the infant responds with a period a gasping respirations, falling heart rate, and
falling blood pressure. The infant takes a last breath and then enters the secondary apnea period. The infant will not respond to stimulation and death will occur unless resuscitation begins immediately. nurse can only intervene with resuscitation via bag & mask. apnea→bradycardia→O2 desat

129
Q

What is a teratogen?

A

Any agent that can harm an embryo or fetus

130
Q

Most serious when structure is forming, susceptibility to harm is influenced by genetic makeup of mother and embryo, longer exposure/higher dose causes more harm, father’s exposure may affect embryo, some effects not apparent until later in life

A

Effect of teratogens

131
Q

One teratogen can cause different defects

A

TRUE

132
Q

Name common problems of preemies

A

Poor thermal regulation, immature CNS, immature immunity, IVH, immature cardiopulmonary system, immature GI system, and glucose instability

133
Q

Name the risk factors for IVH?

A

Extreme prematurity, presence of labor, birth asphyxia, vigorous resuscitation, mechanical ventilation, sudden change in BP as a result of rapid hypertonic volume expansion

134
Q

What is the most common GI disorder in preemies?

A

Necrotizing enterocolitis (NEC), most common surgical emergency in neonatal period

135
Q

Abdominal distention, visible bowel loops, bloody stool, feeding intolerance, increased residual, bilious vomiting, lethargy, apnea, bradycardia, desaturation, BG and temp instability are clinical presentations of

A

NEC

136
Q

What is the management of NEC

A

Stop all feedings and place IV for fluids, aggressive electrolyte/fluid replacement, ventilation by ETT, NG decompression, early TPN, broad spectrum antibiotics, pain control (minimal handling), serial exams, abd xrays, labs, and surgical emergency

137
Q

Cleft lip is most common in girls.

A

FALSE. It is most common in boys

138
Q

What are the feeding challenges of cleft lip as opposed to cleft palate?

A

Baby has a hard time creating a seal for suction

139
Q

Cleft babies are at high risk for

A

Aspiration

140
Q

Name some nursing considerations for a baby with cleft lip/palate

A

Always try bottle feeding first (according to HESI, you can also test baby with breastfeeding (via device like a nipple shield) and use pulse ox to measure stress (lowered O2 between feedings) to determine most tolerated option. Bottlefeed: use squeezable bottle with nipple that is longer, softer NG tube= inpatient option if poor PO intake
Gtube=long term option if poor PO intake

141
Q

What are the surgical timelines for cleft lip/palate?

A

lip→ 2wks-3 mo

palate→ 6-18 mo in stages

142
Q

Protecting the airway, suture line, feeding, pain management, elbow restraints are all nursing interventions for

A

post op cleft lip/palate surgery

143
Q

Why is hearing loss common in patients with cleft lip/palate?

A

likely to get many URIs (d/t poorly developed eustachian tubes & often on antibiotics to treat which may be OTOTOXIC. Most evaluate using AABR

144
Q

What are the psychological challenges of cleft lip/palate?

A

parent guilt, sibling reaction

145
Q

This neural tube defect is a hernial protrusion of a saclike cyst of meninges filled with spinal fluid

A

Meningocele

146
Q

What is myelomeningocele?

A

Hernial protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord with its nerves

147
Q

due to a neural tube defect associated with lack of folic acid. Most commonly found in lumbar-sacral area, but if defect is higher on spine, then the paralysis affects a greater part of the body

A

Spina bifida

148
Q

What are the immediate interventions of spina bifida?

A

Cover sac with moist clean dressing to prevent rupturing of defect/infection, no pressure over affected area, ATB, IV fluids to prevent dehydration, latex precautions, foley/intermittent cath in order to monitor for urinary retention, daily head circumference and weekly head ultrasounds to monitor for hydrocephalus. One should also monitor the fontanelle size.

149
Q

Orthopedic, such as monitoring and preventing spasticity, deformity or paralysis, skin breakdown, TEAM APPROACH, splints, ROM, physical therapy, straight cath, bowel program, sensation & motor function, mobility, Chiari Malformation II: brain tissue extends into spinal canal (congenital) are

A

therapeutic management for spina bifida

150
Q

What is hydrocephalus?

A

a condition caused by an imbalance in the production and absorption of CSF in the ventricular system. production>absorption. The CSF accumulates in the ventricular system and under increased pressure; producing passive dilation of the ventricles.

151
Q

Impaired absorption in the subarachnoid space, obliteration of the subarachnoid cisterns, obstruction of the arachnoid villi is known as

A

non-obstructive or communicating hydrocephalus

152
Q

What is obstructive or non-communicating hydrocephalus

A

obstruction of flow of csf through the ventricular system

153
Q

Name the causes of hydrocephalus?

A

Infection, intraventricular hemorrhage, tumor, structural abnormality, prematurity; impaired absorption of CSF within the subarachnoid space

154
Q

How would you manage a VP shunt?

A
  1. keep child flat post-op to avoid rapid fluid reduction (subdermal hematoma)
  2. replace VP shunt as child grows
  3. Assess for signs of infection- vitals, poor feeding, vomiting, seizure, inflammation
  4. Test any leakage for glucose (indicates CSF)
  5. observe for abdominal distention- CSF may cause peritonitis or post-op ileus
  6. post-op evaluate pupillary dilation- pressure causes compression of the ocular nerve

Nursing care: measure head circumference, asses fontanels; smaller feedings at more frequent intervals

155
Q

removal of obstruction (ie tumor), placement of a shunt, endoscopic third ventriculostomy - endoscope is used to make a small opening in the floor of the 3rd ventricle that allows CSF to flow through the previously blocked ventricle are treatments for

A

Hydrocephalus

156
Q

This disorder is a non-progressive disorder of the developing brain. May present at birth or become evident in infancy/early childhood

A

Cerebral palsy

157
Q

What are the clinical manifestations of CP?

A

mental retardation, epilepsy, visual/hearing disturbances

158
Q

This type of gait is primarily associated with spastic cerebral palsy. That condition and others like it are associated with an upper motor neuron lesion

A

Scissoring

159
Q

What are the risk factors for CP?

A

birth asphyxia, intrauterine infection, preterm infant, and very low birth weight (most important risk factor).

160
Q

How would you manage CP?

A

Team approach, maximize function and prevent handicaps, maximize motor function, ADLs, AFOs (Ankle Foot Orthosis), enhance communication, bracing, casting, surgery, Meds (decrease spasticity), Nutritional assistance, Family support

161
Q

neuro exam, history, posture/tone, persistence of primitive reflexes–either the asymmetric tonic neck reflex or persistent Moro reflex (beyond 4 months) or crossed extensor reflex

A

Diagnosing CP

162
Q

Name the 3 factors in developing NEC

A

Intestinal ischemia, colonization by pathogenic bacteria, subbstrate (formula feeding) in intestinal lumen (seems to occur in infants that have a GI tract with vascular compromise)

163
Q

What is the most common location for spina bifida?

A

Lumbosacral 85%

164
Q

What is congenital hypothyroidism?

A

Represents a deficiency in the secretion of TH

165
Q

Quiet and good baby, prolonged jaundice, lethargy, poor appetite, brady macroglossia, dry skin, puffiness around eyes, sparse hair, constipation, sleepiness and mental decline are all clinical manifestations of

A

congenital hypothyroidism

166
Q

What are the treatment options for CH?

A

Levothyroxine sodium (Synthroid)

167
Q

What is Guillain Barre syndrome?

A

Acquired neuromuscular disorder via infectious polyneuritis, inflammation and demyelination of the myelin sheath causing impaired nerve conduction, the nerves are no longer protected, causes ascending flaccid paralysis

168
Q

Monitor respiratory status, tracheostomy, intubation, ventilation, positioning and skin care, ROM, PT, urinary catherization, bowel obstruction, UTI, constipation, IVIG (infusing immunoglobulins), steroids, and plasmapheresis are all management options for

A

GBS

169
Q

What is the 2nd most common solid tumor in children?

A

Brain tumors

170
Q

60% are infratentorial (below the tentorium cerebelli(

A

TRUE

171
Q

What are the s/sx of a brain tumor?

A

headache upon awakening, vomiting without nausea, loss of concentration, change in behavior, and vision problems

Pediatrics N637 (2 decks)

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