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z Here you go, Alexis! > peds > Flashcards

peds Flashcards

1
Q

anterior fontanel closes

A

12 - 18 months

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2
Q

posterior fontanel closes

A

2 - 3 months

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3
Q

earlobe positioned to view auditory canal in child

A

down and back

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4
Q

cups of milk 15 mo toddler should consume daily

A

2 - 3

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5
Q

best friend stage occurs at what stage

A

9 - 10

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6
Q

major causes of accidents in children up to 1 year x3

A

falls
poisoning
burn

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7
Q

major cause of accidents 6 - 12 years

A

motor vehicle accident (more active)

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8
Q

school age child requires how many calories per day on average

A

2400

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9
Q

how much earlier do girls experience onset of adolescence

A

1 - 2 years

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10
Q

obtaining vitals (peds)

A

least invasive first, observe before touching/talking

RR *
HR *
BP
T

  • count for 1 full minute (irregularities)
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11
Q

temperature routes (peds) x4

A

rectal ( under 2 )
axillary ( alt to oral )
oral ( start 5 - 6 )
tympanic ( all )

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12
Q

observable signs of respiratory dysfunction (peds)

A
  • accessory muscle use
  • nasal flaring
  • circumoral pallor (around mouth)
  • sternal retraction
  • cap refill greater than 3 seconds
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13
Q

if child is grunting do what?

A

assist into position of comfort (tripoding)

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14
Q

laryngotracheobronchitis

A

most common type of croup experienced by peds admitted to hospital

primary affects kids under 5; viral

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15
Q

causative viruses of laryngotracheobronchitis

A

parainfluenza
adenovirus
RSV

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16
Q

laryngotracheobronchitis s/s

A

slight to severe dyspnea
barking / brassy cough
increased temperature

amount of distress depends on degree of airway obstruction

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17
Q

laryngotracheobronchitis treatment (mild)

A

at home

  • steam (hot showers)
  • night car rides, windows down
  • cool-temp therapy (constricts edematous blood vessels)
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18
Q

laryngotracheobronchitis treatment (severe)

A

hospitalization

nebulized epinephrine (racemic epi) = vasoconstrict edematous blood vessels

corticosteroids (decrease airway inflammation)

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19
Q

epiglottitis

A

serious obstructive inflammatory process in 2 - 5 yo

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20
Q

epiglottitis key s/s

A

absence of cough
dysphagia
rapid progression to severe resp distress

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21
Q

epiglottitis vs laryngotracheobronchitis kids

A

epiglottitis kids look worse than they sound

laryngotracheobronchitis kids sounds worse than they look

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22
Q

nebulized epinephrine

A

aka racemic epinephrine; vasoconstriction of edematous blood vessels in kids with severe laryngotracheobronchitis

rapid onset
improvement in 10 - 15 minutes
(observe for relapse; ~2 hours)

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23
Q

respiratory syncytial virus

A

acute viral infection affecting bronchioles

RSV bronchiolitis or RSV pneumonia

more serious in very young (leading cause lower resp tract illness in under 2)

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24
Q

RSV is more serious in who?

A

very young

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25
leading cause of lower respiratory tract illness in children less than 2 years
RSV
26
RSV s/s
important to know onset bc will become worse on days 2 - 3 ``` progressively worse: URI snot mild fever dyspnea non-prod cough tachypnea (flaring nares) retraction, possible wheezing ```
27
RSV will become worse...
on days 2 - 3
28
pneumonia
disease marked by inflammation of lungs
29
viral pneumonia (peds)
RSV, adenovirus, parainfluenza
30
bacterial pneumonia (peds)
usually strep pneumo | children under 4 = greatest % attacks
31
mycotic pneumonia (peds)
"walking pneumo" - mostly adolescents | mycoplasma pneumonia
32
aspiration pneumonia
something other than air has gotten into lungs
33
pneumonia s/s (peds)
fine crackles/rhonchi + cough that is prod or not decreased or absent breath sounds abd distension back pain fever (usually very high) chest pain
34
pneumonia tx (peds)
depends on type 1. ABCs always priority 2. oxygen 3. fluids - hydrate to move secretions 4. abx for bacterial 5. supportive care: hydration, antipyretics, nebulizers (appropriate for viral)
35
asthma
inflammation and constriction of airways resulting in obstruction
36
asthma s/s
``` cough sob audible wheeze prolonged expiratory wheeze restless and cyanosis ```
37
what is prolonged in asthma
expiratory wheeze
38
most important thing in proactive care for asthma patient
education, especially id-ing triggers
39
cystic fibrosis
respiratory and gi impacted give pancreatic enzymes to improve digestion diet: well-balanced, low fat, high calorie, high protein
40
pancreatic enzymes for + how
cystic fibrosis | take within 30 minutes of eating, do not crush or chew
41
vitamins for CF patient
ADEK are fat soluble but need to make them water soluble since CF kids can't process fat
42
diagnostic test for CF
sweat chloride
43
electrolyte imbalance child with CF at risk for
hyponatremia
44
earliest sign of CF (newborn)
meconium ileus (can't pass; thick and sticky)
45
CF inheritance
autosomal recessive
46
CF stools
steatorrhea
47
down syndrome kids prone to infection where?
respiratory - poor immune system
48
most common type of defect associated with down syndrome
heart
49
in peds, HF usually due to
congenital heart defects
50
s/s early heart failure (peds)
increased HR at rest + with slight exertion increased RR scalp sweating (infants @ feeding) fatigue sudden weight gain (greater than 1lb/day) FLUID RETENTION THINK HEART PROBLEMS FIRST
51
main signs of digoxin toxicity
bradycardia, vomiting (earliest sign)
52
digoxin: hold for ? in infants, children
infants: HR less than 110 kids: HR less than 70
53
normal digoxin level
0.8 - 2.0
54
infants rarely get more than ? of digoxin
1.0 mL per dose
55
give digoxin to infants when?
1 hour before or 2 hours after feeding
56
nursing considerations for digoxin admin to peds x2
ALWAYS check with another nurse | if 2 doses in a row missed, call provider
57
good feeding schedule for a heart baby
q 3 hours, do not prolong feedings past 30 minutes
58
blue spells aka tet spells
hypercyanotic spells often seen in infants with Tetralogy of Fallot
59
ace-i in kids, watch for
decreased BP kidney problems cough (dry) -- d/c ASAP
60
treatment for tet spell
``` infant: knee-chest position 100% O2 morphine (sedate) loose clothes, diapers quiet play no stress respond to crying quickly treat infections promptly (can't handle fever) ```
61
why knee-chest position for infants with tet spell?
decrease venous return from LE | increase systemic resistance to divert blood to pulmonary artery (increases O2 in blood)
62
polycythemia
increased red blood cells in response to chronic hypoxia; body senses hypoxia, increases RBC production, no more O2 to carry, blood gets thick so many RBCs no room for platelets
63
polycythemia treatment
hydration - keep blood thinned out
64
s/s chronic hypoxia
clubbing (late sign) poor growth, development squatting
65
congenital heart defects (peds)
structural or functional defect of heart or great vessels present at birth classified by blood flow patterns - increased or decreased pulmonary blood flow - obstructive defects
66
tetralogy of fallot
``` Ventricular Septal Defect Stenosis of Pulmonary Artery Overriding Aorta -- directly over VSD instead of LV Right Ventricular Hypertrophy ```
67
post cleft lip repair (peds)
on back or side-lying - protect suture line (NOT PRONE) clean suture with saline elbow no nos
68
best time for cleft palate repair to be done
before speech develops, between 1 - 2
69
GER vs GERD
GER = passage of gastric contents into esophagus GERD = tissue damage to respiratory structures, which can lead to pneumonia and bronchospasms
70
pyloric stenosis s/s x3
projectile vomiting, usually after feeding - pressure behind vomitus olive shaped mass in epigastric region near umbilicus (enlarged pylorus) pressure build up in stomach = pyloric ultrasound
71
intussusception key s/s (peds)
sudden onset cramping, intermittent abd pain, inconsolable drawing up of knees currant jelly stools!
72
intussusception poo
currant jelly stools
73
celiac disease
celiac sprue is a genetic malabsorption disorder where there is permanent intestinal intolerance to gluten
74
celiac patients can't have (mnemonic)
b arley r ye o ats w heat
75
hirschsprung's disease
congenital anomaly known as aganglionic megacolon - results in mechanical obstruction; usually affects sigmoid colon no nerves, no peristalsis = constipation + abdominal distention remove disease bowel - give intestines time to heal (maybe 2 sx)
76
hirschprung's poo
foul smelling and ribbon-like
77
sickle cell disease
hereditary disorder in which hemoglobin is partly or complete replaced with sick-shaped hgb - reduced O2 carrying cap as result of shape
78
#1 tx to stop sickling process
HYDRATION!!
79
FLACC
``` face legs activity crying consolability ```
80
numerical pain scale starting at age
5
81
hydrocephalus
disturbance of ventricular circulation of cerebral spinal fluid in brain; increased icp often associated with myelomeningocele
82
myelomeningocele
type of spina bifida, sac on the back - prone - moist sterile normal saline dressing - surgery ASAP
83
spina bifida
any birth defect involving incomplete closure of the spine
84
pinworms: transmission, test, treatment
hand to mouth tape test (rectal itching) whole family treatment; mebendazole
85
infectious mononucleosis: causative agent
epstein barr virus
86
positioning post tonsillectomy
side + elevated hob or prone
87
tonsillectomy post-op risk for hemorrhage up to
10 days (scabs slough 7 - 10)
88
otitis media
eustachian tubes (middle ear) blocked usually follows upper respiratory infection bulging and bright red tympanic membrane lie on affected side to promote drainage
89
cleft lip/palate epi
American Indians, Asians | boys

z Here you go, Alexis! (23 decks)

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