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Pediatrics N637 > Pediatrics - Quiz #2 > Flashcards

Pediatrics - Quiz #2 Flashcards

1
Q

Exocrine gland dysfunction affecting chloride channel regulation

A

Cystic fibrosis

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2
Q

Name the priority assessment and interventions in the acute phase for CF

A

Fluid and antibiotics, ongoing management plan

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3
Q

Name the clinical findings for CF

A

Meconium ileus (unusually thick, causes bowel obstruction), steatorrhea (fat in feces d/t fat malabsorption d/t pancreas obstruction -> cachexia), chronic cough, frequent respiratory infections, failure to thrive, sterility (males)

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4
Q

How is CF diagnosed?

A

Symptoms and positive sweat chloride test X2

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5
Q

Signs/Sx of this disease/exacerbation include cough, fever, lower PFTs, low appetite, nutrition deficit, CBC w/ elevated WBC, radiographic changes, new crackles/wheezes, decreased activity, and sputum

A

CF

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6
Q

What would you find on a CF assessment?

A

Adventitious breath sounds (crackles), nutritional deficit, vigorous pulmonary toilet to clear lungs, frequency, nature of stools, abdominal distention, weight loss, anorexia, decreased activity

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7
Q

How would you treat CF?

A

Pancreatic enzymes, ATB (inhaled, PO, IV), pulmozyme (reduces viscosity of mucous in lungs), vitamins A, D, E, K, antifungals (Candida), antihistamines, and anti-inflammatories

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8
Q

What is the purpose of the vest treatment, how often is it used and when?

A

Fill up then shake’s child to clear lung mucous, done BID, and before eating to decrease risk for aspiration

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9
Q

What is the ideal diet for a patient with CF?

A

High protein, high caloric/ HESI: moderate to low CHO

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10
Q

What are some endocrine issues to monitor for patients with CF?

A

Insulin resistance and deficiency, monitor blood glucose levels

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11
Q

Part of the routine health maintenance for patients with CF is:

A

flu immunization beginning at 6 months then yearly booster, prevent and treat pulmonary infections and nutritional deficiencies

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12
Q

An obstructive, inflammatory, reversible airway disease characterized by hyperresponsiveness of the trachea and bronchi is called

A

Asthma

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13
Q

What pathophysiological changes occur in asthma?

A

Edema of mucosa, increased secretions, and spasm of smooth muscle

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14
Q

Name the 3 classic symptoms of asthma.

A

Cough (mostly at night), dyspnea and wheeze

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15
Q

What are the triggers/precipitating factors of asthma?

A

Viral infection (infants), allergens, environmental/weather changes, GERD, emotional factors, meds, exercise

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16
Q

Which of the following drugs is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

A

Short acting Beta 2 antagonists such as Albuterol

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17
Q

Anti-inflammatories such as Flovent/Pulmicort can be used in treating asthma

A

TRUE

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18
Q

Inhaled corticosteroids can reduce the rate of growth.

A

TRUE

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19
Q

Acute bacterial infection of the lower respiratory tract characterized by a paroxysmal cough is known as

A

Pertussis/whooping cough

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20
Q

What kind of precaution is pertussis?

A

Droplet

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21
Q

The duration of this infection is 6-10 weeks, requires hospitalization d/t risk of sleep apnea, and vaccine recommendation is 6 weeks-6 years

A

Pertussis

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22
Q

Apnea monitor, IV hydration/feeding assistance, oxygen, nasal suctioning, ATB are nursing care needed for this infection

A

Pertussis

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23
Q

This is an acute VIRAL infection of the lower respiratory tract which in the first two years of life can be problematic and indicate an early manifestation of hyperactive airway disease

A

Bronchiolitis

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24
Q

Some of the symptoms of bronchiolitis includes

A

cough, rhinorrhea, congestion, fever, increased RR, wheezing, crackles, rhonchi, increased WOB, irritability, poor feeding, fatigue, abnormal pulse ox, and respiratory distress

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25
Q

What are some nursing care interventions for a patient with bronchiolitis?

A

Careful observation, O2 sat >92%, trial of bronchiodilators, cool mist, suctioning, hydration (to keep secretions moving), antipyretics, CONTACT precaution

26
Q

What population is is most at risk for RSV?

A

Preemies, <2 y/o w/ chronic lung disease, and hemodynamically significant congenital heart disease

27
Q

Monthly injections from November to April are given for what respiratory infection?

A

RSV

28
Q

Patients with RSV can be roomed with one another as long as not other significant organisms are present

A

TRUE

29
Q

This respiratory infection is characterized by parainfluenza, barky cough worsened at night, stridor, hoarseness, low grade fever

A

Croup and LBT (laryngeal, bronchitis, tracheal)

30
Q

What is epiglottitis?

A

Severe, rapidly progressive infection of the epiglottis and surrounding tissues; it is an EMERGENT situation

31
Q

Do you examine the throat of a child with epiglottitis? Why or why not.

A

No because of the risk of obstructing the airway completely

32
Q

What is the etiology of epiglottitis?

A

Haemophilus influenzae type B

33
Q

What are some of the clinical manifestations of epiglottitis?

A

Sore throat, hoarseness, muffled voice, abrupt high fever, drooling, retractions, choking sensation, restlessness, hyperextension of the neck (tripoding-stretch out neck), seems like strep throat

34
Q

How would you diagnose epiglottitis?

A

Clinical presentation and lateral neck film

35
Q

Name the nursing management/care/precaution for epiglottitis.

A

Intubation and ATB/decrease crying, fluids, cool mist/oxygen/droplet

36
Q

Who is most at risk for foreign body aspiration and what is the most common aspirated material?

A

1-3/>50; FOOD

37
Q

Name the clinical findings for aspiration

A

Cough, wheezing (lower and only on one side), retractions, stridor (inspiratory), no symptoms

38
Q

If there is a foreign body in the trachea, would would happen.

A

General anesthesia and removal. If in esophagus/stomach, leave. Bronchoscopy, endoscopy, CXR

39
Q

This type of CHD lesion will result in increased blood flow causing CHF

A

Acyanotic

40
Q

What are the flow defects associated with acyanosis?

A

PDA, ASD, VSD

41
Q

Corarctation of the aorta, aortic stenosis are obstructive defects associated with

A

Acyanosis

42
Q

How would you manage acyanotic lesions?

A

Control CHF and maximize feeding

43
Q

This type of CHD lesion will results in decreased pulmonary blood flow causing

A

Cyanosis

44
Q

What are the conditions association with decreased pulmonary blood flow and how would you manage the sx?

A

Tetralogy of Fallot, transposition/monitoring, knee chest

45
Q

Long term acyanosis can lead to this

A

Pulmonary HTN and end up in cyanosis

46
Q

Which flow defect closes within the first few weeks of life? If it remains open, how can it be treated pharmalogically?

A

PDA/Indomethacin (IV chemical to close the ductus and act on ductal tissue)

47
Q

How else can PDA be treated?

A

Surgery and coil occlusion at age 2, cath lab, open the coil to close the ductus

48
Q

Pink tet when born is a sign of

A

Tetralogy of fallot

49
Q

Explain the pathophys of tetralogy of fallot

A

VSD &infundibular stenosis–>tissue under the pulmonic valve constrict blood of the pulmonary artery

50
Q

How does the knee-chest position help alleviate cyanotic spells?

A

It decreases systemic venous return which in turn decreases R to L sided blood flow; less work on the heart

51
Q

What are the treatment options for cyanotic spells?

A

Oxygen, morphine, Propranolol (Inderal) -> decreases the thickness of the valve tissue (infundibular therefore opening the valve up)

52
Q

This is an obstructive defect of the heart, the artery is narrow at the top of the descending aorta

A

Coarctation of the Aorta

53
Q

Upon nursing assessment of a patient with coarctation of the aorta, you would expect to see

A

increased bounding upper body pulses and decreased lower body pulses d/t increased pressure proximal to the defect

54
Q

What is the only other disease that causes pediatric HTN other than coarctation of the aorta?

A

Glomerulonephritis

55
Q

Name the nursing care management for atopic dermatitis and diaper dermatitis

A

Warm, water baths (NO SOAP) oatmeal OK, hydrating creams and low dose steroids, avoid precipitants, socks on hands, short nails, no stuffed animals (carry germs), consider diet, no immunizations during severe acute exacerbations

56
Q

This is the most common form of eczema

A

Atopic dermatitis

57
Q

Pruritis may lead to secondary infection

A

TRUE

58
Q

Most common pediatric rash

A

Diaper dermatitis

59
Q

There is a higher incidence of diaper dermatitis in bottle/formula fed infants

A

TRUE

60
Q

What is the nursing management for diaper dermatitis?

A

Change diapers Q2H/PRN, superabsorbent diapers, sitz bath for 10-15 min QID at home to lose the dead skin, advise against wipes, powders, hair dryers, use zinc oxide, KEEP EXPOSED TO AIR

61
Q

This is the medication administered to close the ductus and act on ductal tissue

A

Indomethacin

Pediatrics N637 (2 decks)

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