Peds exam 2

Question 1

Hypoxemia assessment findings

Answer 1

Cyanosis
Wheezing
Grunting
Rales
Inc accessory muscle use
Flaring nares
Cough
Tachypnea
Club fingers
Anxiety and restlessness
Stridor on inspiration

Question 2

Hypoxemia management

Answer 2

Pulse oximetry, oxygen therapy(lowest O2 needed to correct), chest physiotherapy(contraindicated dec cardiac reserves PE or inc ICP), suctioning

Question 3

Hypoxemia priorities of care

Answer 3

Priority problems= ineffective breathing pattern/impaired gas exchange/ineffective airway clearance

Question 4

Patho of hypoxemia

Question 5

Patho of cystic fibrosis

Answer 5

Autosomal recessive disorder CFTR gene with various mutations- disrupts chloride ion movement and sodium reabsorption=thick tenacious mucus in resp tract, pancreas, GI tract, and other exocrine tracts/ducts

Question 6

Cystic fibrosis effects on body

Answer 6

Pancreatic enzyme function=lost—>malabsorption of fats, proteins, and CHOs, dec growth and foul, fatty stools
Excess mucus production plugs smaller airways causing bronchiolitis-> secondary bacterial infections, chronic obstruction/inflammation, tissue damage, resp failure

Question 7

Cystic fibrosis physical findings

Answer 7

-Thick, tenacious sputum
Air
obstruction/trapping/chronic cough URI
-unable to clear secretions
-R sided HF (cor pulmonale)
-clubbing/barrel chest
-dehydration
-dec pancreatic enzymes=thick mucous
-abd distension/difficulty passing stool (bulky, fat, greasy stools=steatorrhea)
-poor weight gain despite appetite, delayed growth
Deficiency of fat soluble vitamins (A,D,E,K)

Question 8

Cystic fibrosis diagnostics

Answer 8

Sweat chloride test: Chloride >40mEq/L in infants (<3mo), >60mEq/L for all other ages.
Sodium >90mEq/L
KUB-detects meconium ileus
Stool analysis-presence of fat and enzymes
CXR-hyperinflation, bronchioles wall thickening , atelectasis, infiltrates
PFT-dec forced vital capacity/expiratory vol

Question 9

Cystic fibrosis nursing management priorities

Answer 9

-ACT therapy (airway clearance therapy): chest PT w/ postural drainage-clear secretions and prevent infection
-aerosol therapy
-O2 as prescribed
-Monitor for CO2 retention
-High protein high calorie diet
-supplement fat soluble vitamins (A,D,E,K)
-admin pancreatic ensures within 30 min of eating meal or snack

Question 10

Croup

Answer 10

Laryngotracheobronchitis; 3mo-3yrs most Connolly affected and rare after age 6

Question 11

Croup patho

Answer 11

Inflammation and edema of larynx, trachea, bronchi obstructing airway- viral(parainfluenza)
Sudden onset at night, gone in morning, self-limiting, lasts 3-5 days

Question 12

Croup physical findings

Answer 12

-low grade fever, restlessness
-“barking” cough
-inspiratory stridor,dyspnea, retractions
Infants: nasal flaring, intercostal retractions

Question 13

Croup nursing management priorities

Answer 13

Managed at home, educate about inc resp distress s/s
-hospitalization for significant stridor at rest/severe retractions
-cool mist humidifier/steamy BR
-O2 continuous oximetry
-hydration

Question 14

Asthma patho

Answer 14

Chronic inflammatory airway disease—> intermittent and reversible airflow obstruction of bronchioles

Question 15

Asthma medications

Question 16

Asthma medications-acute

Question 17

Asthma medications-chronic

Question 18

Asthma medication management

Question 19

Asthma medications-acute indications

Question 20

Asthma medications-chronic indications

Question 21

Asthma assessment findings

Answer 21

-Hacking cough, worse at night, non-productive
-dyspnea w/ exercise, SOB, chest tightness, CP
-wheeling, coarse crackles, may be diminished BS;SILENT CHEST=OMINOUS SIGN(no air movmt)
-difficulty talking
-restlessness, irritability
-sweating
-use of accessory muscles
-low O2 sats
-tripod positioning

Question 22

Asthma diagnostics

Answer 22

CBC(inc WBC, inc eosinophils)
ABG (inc CO2, dec O2)
Allergy/RAST testing
Dec SpO2
CXR(hyperinflation/infiltrates)
PFT(lung capacity and overall lung function)
PIFR-Peak inspiratory flow rates

Question 23

Status asthmaticus

Question 24

Status asthmaticus nursing actions

Question 25

Status asthmaticus medication management

Question 26

Epiglottitis

Question 27

Epiglottitis patho

Question 28

Epiglottitis assessment findings

Question 29

Epiglottitis management

Question 30

Epiglottitis priorities of care

Question 31

Foreign body aspiration assessment findings

Question 32

Foreign body aspiration risk factors

Question 33

Foreign body aspiration parent education

Question 34

Heart failure-right sided patho

Question 35

Heart failure left sided Patho

Question 36

Heart failure-right sided physical cues

Question 37

Heart failure-left sided physical cues

Question 38

Coarctation of aorta patho

Question 39

Coarctation of aorta

Question 40

Coarctation of aorta assessment findings

Question 41

Coarctation of aorta diagnostics

Question 42

VSD

Question 43

VSD patho

Question 44

VSD assessment findings

Question 45

PDA

Question 46

PDA patho

Question 47

PDA assessment findings

Question 48

PDA management

Question 49

Tetralogy of Fallot

Question 50

Tetralogy of Fallot patho

Question 51

Tetralogy of Fallot fatal four

Question 52

What is the fatal four-cardiac?

Question 53

Clinical features of Tetralogy of Fallot

Question 54

Nursing management for tetralogy of Fallot

Question 55

Treatment for Tetralogy of Fallot

Question 56

Kawasaki Disease

Question 57

Kawasaki disease patho

Question 58

Kawasaki disease assessment findings

Question 59

Kawasaki disease nursing management

Question 60

Kawasaki disease meds

Question 61

Medications management for HF

Question 62

HF medications indications

Question 63

HF medications nursing implications

Question 64

Priorities of care for child with HF/CHD

Question 65

Assessment triangle- child with HF/CHD

Question 66

Oxygenation- priorities of care for child with HF/CHD

Question 67

Nutrition-priorities of care for child with HF/CHD

Question 68

Acute rheumatic fever

Question 69

Acute rheumatic fever patho

Question 70

Clinical manifestations of acute rheumatic fever

Question 71

Diagnostic criteria for acute rheumatic fever

Question 72

Cardiac arrhythmias

Question 73

Sinus tachycardia characteristics

Question 74

SVT

Question 75

Sinus tachycardia vs SVT

Question 76

Management for sinus tachycardia

Question 77

Management for SVT

Question 78

SVT characteristics

Question 79

Dehydration

Question 81

Dehydration assessment findings

Question 82

Dehydration management

Question 83

Oral rehydration therapy

Question 84

Fluid maintenance formula

Question 85

GERD

Question 86

GERD patho

Question 87

GERD management

Question 88

GERD tx

Question 89

Pt education-GERD

Question 90

Hypertrophic pyloric stenosis

Question 91

Hypertrophic pyloric stenosis patho

Question 92

Hypertrophic pyloric stenosis assessment findings

Question 93

Hypertrophic pyloric stenosis management

Question 94

Hirschsprung’s

Question 95

Hirschsprung’s patho

Question 96

Hirschsprung’s expected findings

Question 97

Hirschsprung’s treatment

Question 98

Hirschsprung’s nursing management

Question 99

Intussusception

Question 100

Intussusception clinical manifestation

Question 101

Intussusception management

Question 102

Cleft lip and palate nursing management

Question 103

Cleft lip pre-op nursing management

Question 104

Cleft palate pre-op nursing management

Question 105

Cleft lip post-op nursing management

Question 106

Cleft palate post-op nursing management

Question 107

Poststeptococcal glomerulonephritis

Question 108

Poststreptococcal glomerulonephritis patho

Question 109

Poststretptococcal glomerulonephritis history findings

Question 110

Poststreptococcal glomerulonephritis physical findings

Question 111

Poststreptococcal glomerulonephritis nursing plan of care

Question 112

Hemolytic uremic syndrome (HUS) patho

Question 113

HUS

Question 114

HUS assessment findings

Question 115

Hemolytic uremic syndrome history

Question 116

Hydrocele patho

Question 117

Hydrocele physical findings

Question 118

Hydrocele management

Question 119

Varicocele patho

Question 120

Varicocele physical findings

Question 121

Varicocele management

Question 122

Nephrotic syndrome Patho

Question 123

Nephrotic syndrome assessment findings

Question 124

Nephrotic syndrome treatment

Question 125

Nephrotic syndrome nursing management

Question 126

Enuresis Patho

Question 127

Enuresis nursing assessment

Question 128

Enuresis interventions

Question 129

Enuresis parent education

Question 130

Phimosis patho

Question 131

Paraphimosis patho

Question 132

Phimosis vs paraphimosis

Question 133

Phimosis physical findings

Question 134

Paraphimosis physical findings

Question 135

Phimosis management

Question 136

Paraphimosis management

Question 137

Hypospadias patho

Question 138

Hypospadias physical findings

Question 139

Hypospadias treatment