Peds 2 exam Flashcards
(45 cards)
Congenital Anomalies
What are the nine types of limb deficiencies
What are there definitions?
- Polydactyly- an excess of fingers or toes
- Syndactyly- webbing between the fingers or toes
- Bradydactyly- abnormal shortening of the digits
- Microdactyly & Macrodactyly- overgrowth or undergrowth of soft tissue or bone. Macro-large, Micro- small digits
- Amelia- complete absence of one or more limbs
- Phocomelia- fully or partially formed distal limbs with a lack of one or more segments of the proximal limb
- Paraxial deficiency- defect where part or all of the medial or lateral bone is missing
- Transverse hemimelia- failure to develop one or more limb segments across the central axis of the limb
Client factors or performance skills affected by congenital abnormalities
• Specific and global functions, emotional, experience of self and time, temperament and personality. Pain, proprioception and sensation/sensory. Function of the joint- joint mobility, stability, muscle power, muscle tone, muscle endurance, motor reflexes, gait patterns, control of voluntary movement
Performance Skills
• Motor and praxis skills, sensory-perceptual skills
Interventions and assesments used for congenital anomalies
Assessments
• ROM, alberta infant motor scales, toddler and infant motor evaluation, brunicks, fine motor task assessment
Interventions
• Education, devices, joint protection, sensory educations, mirror therapy, pain management, ADL training, scar management
Asthma
Definition and symptoms
definition
A chronic lung disease characterized by inflammation of airways breathlessness and wheezing
symptoms
wheezing, chest tightness, breathlessness, ccoughing
Client factors and performance skills affected by asthma
Client factors
• Energy drive, sleep, attention, perception, cardiovascular and respiratory system functions-pain
Performance areas
• motor skills-Endurance, paces process skills-attends, initiates, social interaction -produces speech asthma attack moves and walks
Asthma interventions and assesments
Assessments
• COPD, child occupational self assessment, pediatric interest profile, perceived efficacy and goal setting systems, short child of occupational profile, school setting interview, preferences of activities of children
Interventions
• Education, role exploration, interest exploration, environmental modifications, school accommodations
Respiratory disorder
definition and symptoms
Definition
• Respiratory distress due to lungs being underdeveloped, infants suffering from respiratory
Disorder
Symptoms
• Cynanosis, apnea, decreased urine output, grunting, nasal flaring, rapid breathing, shortness of breath and grunting while breathing
Respiratory disorder
performance skills and client factors affected
client factors
cardiovascular and respiratory functions,
global mental functions-energy drive and sleep muscle functions-endurance tone
movement functions-pain
performance skills-motor-endurance, paces, moves, lifts, walks, and transports
Respiratory disorder
assessments and interventions
Assessments
• Clinical observations, interviews, alberta infant motor scales and bayley scales of infant development
Interventions
• Infant positioning, environmental modifications, caregiver/staff education and coaching,
Neonatal cardiac problems
Five different types definitions and symptoms of each?
Definition
• Atrial Septal Defect- ASD is a major congenital malformation that causes increased pulmonary blood flow. Blood flows from LA to RA
• Ventricular Septal Defect- Major congenital malformation that causes increased pulmonary blood flow. Blood flows from LV to RV
• Tetralogy of fallot- Defect of DECREASED pulmonary blood flow. Diagnosis based on same as ASD and VSD and also the presence of cyanosis
• Transposition of great vessels- Mixed pulmonary blood flow. the pulmonary artery leaves the LV and the aorta exits the RV with no communication between pulmonary and systemic circulations
• Dysrhythmias- Irregular cardiac rhythms
Symptoms
• Septal defect- tachycardia, poor exercise tolerance, small frame size, feeding problems, frequent respiratory or lung infection, swelling of legs, feet or stomach and stroke
• TOF- central cyanosis, clubbing of fingers or toes, feeding difficulties, failure to thrive and
dyspnea
• TGV- cyanosis, congestive heart failure and respiratory distress
• Dysrhythmia- fever, anxiety, anemia, pain and irritable
neonatal cardiac problems
client factors and performance skills affected
client factors
global mental-energy drive and sleep cardiovascular and respiratory fuctions movement functions muscle functions-muscle endurance muscle power
performance skills pain vestibular auditory
motor skills-lifts, walks, transports, endurance pace move
social interaction
neonatal cardiac problems
assesments and interventions
assesments
alberta infant motor scales, infant motor evaluation, battele developmental inventory, test of playfulness, toddler/infant sensory profile
interventions
• Suck-swallow-breath sequence. Positioning, edema management, sensory stimulation, auditory stimulation, bedside feeding, parent education
Fetal alcohol
definitions and symptoms
Definition
a congenital syndrome caused by excessive consumption of alcohol by the mother during pregnancy, characterized by retardation of mental development and of physical growth, particularly of the skull and face of the infant.
symptoms
stunted growth(size height), distorted facial features,learning disabilities, flat midface, thin upper lip
Fetal alcohol
client factors and performance skills affectes
client factors
mental functions specific and global-higher level cognitive,thought, attention, memory etc. sensory functions-auditory body structures-brain cns
peformance skills-social interaction-speaks fluents,questions, replies, discloses and processing skills-initiates, heeds, attends etc.
Fetal alcohol
intervention and assesments
assesments
peabody, test of sensory function in infants, sensory integration and praxis test.
interventions
family and parent education, fine motor skills pre-writing, k’nex, cutting shapes, building blocks
Identify areas of intervention in early intervention
- Play
- Motor performance- muscle tone, fine motor skills, bilateral manipulation, in-hand manipulation
- Sensory processing- Low registration, sensation seeking, sensation avoiding and sensory sensitivity
- Self-care/adaptive
- Adapted equipment and positioning
Identify the basic properties of the law and how it affects OT practice
Therapist bills from the time spent in direct, face-face contact with the child, family or other caregiver. Billing for time spent in team meetings, on the phone with team members or family and other indirect activities may or may not be reimbursed. Subject to annual budget shortfalls. Paid through Medicaid or private insurance. Travel is not reimbursed. Therapy sessions in community settings are considered indirect service and may not be reimbursable.
Explain the eligibility criteria
- Infants and toddlers who have established risk because of diagnosis are automatically eligible. Diagnoses associated with developmental delay such as CP, Down syndrome or spina bifida. Infants without a specific diagnosis who are suspected of having developmental delay are entitled to an evaluation
- Developmental areas that the team evaluated to determine eligibility are cognition, communication, motor, social-emotional and adaptive.
Explain individualized family service plan
A map of the family’s services and informs anyone who will be working with the child and family which services will be provided, where they will be provided, who will provide them and outcomes. Reviewed every 6 months or more. Family meets with other team members at least once a year
Define the Public Laws relevant to early intervention
- Part C of the individuals with disabilities education act (IDEA) (early intervention)- All children from birth through 2 years of age who have developmental delays are entitled to services. An entitlement program. 16 primary services, individualized family service plan, family-centered and occurs in natural settings
- Part B of IDEA (special education)- defines school programs for eligible students between 3-21 years of age, it is a mandated service. Discipline specific assessment, individualized education program, child-focused in practice, family focused in theory, service coordination recommended but not mandated and occurs in the home, center or school based
chap 23 key terms: Definitions
Early Intervention Part C IDEA Family-Centered intervention Coaching models Natural environments
- Early Intervention- Services for children from birth to 3 years of age, who have an established risk, have a developmental delay or considered to be environmentally or biologically at risk. The goal is prevent or minimize the physical, cognitive, emotional and resource limitations of young children disadvantaged by biologic or environmental risk factors
- Part C of the individuals with disabilities education act (IDEA)- All children from birth through 2 years of age who have developmental delays are entitled to services
- Family-centered intervention- Family have control and make choices regarding the care their child receives; family and providers work together to ensure provision of optimal early intervention services
- Service coordination-
- Coaching models- supports the learner and the child to achieve outcomes through a process
- Natural environments- home or community-based settings (childcare center, playground, library, grocery stores or fast-food restaurants)
What is Case Cody?
Cody is a 39 week post-conceptional age (GA) at 25 weeks by date (WBD), 24 weeks by examination (WBE) by spontaneous vaginal delivery (SVD) to a 19 year old now second pregnancy, 1 birth and 1 abortion (G2P1Ab1), venereal disease research laboratory (VDRL) mom with history of intravenous drug abuse (IVDA), smoked 1 packs per day (PPD), pregnancy-induce hypertension (PIH), preterm labor (PTL), prolonged premature rupture of membranes (PPROM), Appropriate for gestational age (AGA) at 545gm. Significant complications have included respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), pulmonary interstitial emphysema (PIE), apnea of prematurity (AOP), patient ductus arteriosus (PDA), hyperbilirubinemia, anemia, methicillin-resistant (MRSE) and CONS sepsis, medical necrotizing entercolitis (NEC), bilateral inguinal hernia (BIH), periventricular leukomalacia (PVL), retinopathy of prematurity (ROP) stage III oral-duodenal (OD)
HFOV- high-frequency oscillating ventilation
iNO-
SIMV for 8 days-
BiPAP for 14 days
NCPAP for 9 days- nasal continuous positive airway pressure
HFNC-
Fi02- fraction of inspired oxygen
Identify general considerations for feeding in the NICU unit?
10 characteristics
- Coordination of suck and swallows with breathing- interventions include slow-flow nipples and pacing to force breaks for breathing
- Sucking pattern
- Movements of the jaw and tongue- dysfunctional feeding may occur due to abnormal movements
- Sucking bursts are initially continuous for 10 to 30 sucks with a smooth 1:1:1 suck-swallow-breath rhythm in which respiration appears continuous and uninterrupted
- Adequate postural control
- Calm environment
- Burping
- Endurance
- Jaw support
- Thickened formula for easier oral bolus control
- Risk of aspiration if the infant is not actively participating in the feed
Distinguish between neonatal assessments
5 assesments
- Assessment of preterm infant behavior- Als- used for stable preterm infants and term infants
- Naturalistic observations of newborn behavior- for very fragile preterm and term infants
- Neonatal behavioral assessment scale- for term healthy infants
- Neurological assessment of the preterm and full term newborn- dubowitz—for infants who tolerate handling
- Neonatal neurobehavioral evaluations (NNE)-Morgan- has predictive indicator for muscle tone and motor responses