Peds Exam 2 - Acute Res. Flashcards

Question

strep clinical manifestations

Answer 1

sudden onset, sore throat, headache, fever, vomiting, lymphadenopathy, abdominal pain, bad breath & a beefy red tongue

Answer 2

antibiotics for 10 days

Answer 3

-seek care & get meds -pt teaching **finish meds** -comfort: ice pack on neck, Tylenol -go back to school 24 hours after antibiotic start -very communicable (get new toothbrush & clean/sanitize dental equipment)

Answer 4

**wait until older & be cautious, can lead to death** indicated only if documented recurrent, frequent "strep", perotonsillar abscess, or sleep apnea

Answer 5

-cleft palate -acute infections -uncontrolled systemic disease or blood dyscrasias -age <4 y/o

Answer 6

**observe for S/s of excessive bleeding -> lots of swallowing** -position on side until awake -avoid suctioning, drooling is ok **Blood tinged sputum is fine** -discourage straws, coughing, laughing, or crying -diet: soft diet & no red foods & no milk products -swelling & airway compromise (stridor) -ice collar and/or cool mist -pain mgt

Answer 7

-around days 8-10 all the white patches on surgical site will peel off and pt is at increased risk for bleeding -watch for excessive swallowing and clearing the throat

Answer 8

inflammation/infection of outer ear (auricle or canal) -> water gets trapped by ear wax which mediates growth

Answer 9

-very painful (increases w/ movement) -drainage (serosangeuineous or purulent)

Answer 10

antibiotic drops or steroid drop + Tylenol **no oral antibiotics**

Answer 11

infection of middle ear (behind the tympanic membrane) associated w/ collection of fluid or pus **true ear infection**

Answer 12

-**exposure to cigarette smoke and/or many people** -**bottles in bed** -**non immunized** -**winter** -non BF infant -pacifier use beyond infancy -fam hx -immun def -allergic rhinitis

Answer 13

-irritable (infants) -holds or pulls at ear -may roll head from side to side -ruptured tympanic membrane **hearing loss if chronic**

Answer 14

**80% of ear infections will go away on its own but causes too much pain & complications to daily life so we treat** -antibiotics -tylenol/ibuprofen -warm compress

Answer 15

get tubes in ear **once in, no diving, jumping or submerging head in water(can use ear plugs), no lakes or rivers avoid pressure postoperatively**

Answer 16

swelling or obstruction in region of larynx, can be viral or bacterial which creates a horse, barky cough, stridor & respiratory distress **croup in very important to know (& so brochiolitis)**

Answer 17

**viral croup** -inflammation of the mucosal lining of the larynx, trachea & bronchi causing narrowing of the airways -children <5 -slowly progressive (may develop w/ influenza or bronchiolitis) ** sound a lot worse then they look**

Answer 18

-usually can be managed at home as long as they are not hypoxic or in distress -harsh, metallic "barky" cough, stridor, hoarseness

Answer 19

-high humidity (steam shower) -cool mist -adequate fluids -comfort measures -avoid cough syrups or cold meds -racemic epinephrine **watch for rebound** -corticosteroids **bronchodilators & antibiotics are not helpful**

Answer 20

-continuous, vigilant observation & accurate assessment of respiratory status -bed rest to conserve energy -decrease anxiety -assess and prevent dehydration -support the family

Answer 21

-increase RR, infants >60, **keep child NPO** -increased agitation, restlessness, anxiety, decreased LOC -cyanosis

Answer 22

**bacterial croup** serious, life threatening obstructive inflammatory process -> lose airway -usually occurs between 2-5 yrs -H. influenza B or strep. pneumoniae **vaccine for it so rare now** **sounds better than they are**

Answer 23

-abrupt onset, starts w/ sore throat -high fever -open mouth, tongue out, drooling, agitated -looks very sicks & wants to be upright -sore red inflamed throat, difficulty swallowing -muffled voice, stridor, no spon. cough

Answer 24

**maintain the airway** -no tongue blades, do not look in throat -avoid xray & transport (portal if needed) -let parents be w/ child & keep everyone calm -**prepare for sedation & intubation -> antibiotic -> extubate**

Answer 25

acute airway infection resulting in inflammation (edema d/t mucus) of the smaller bronchioles, characterized by thick mucus -children < 2 yr, peak @ 2-5 mo **RSV is the communicable causative agent in more than half the cases**

Answer 26

no -> go based on symptoms, all treatment is the same

Answer 27

-rhinorrhea -pharyngitis -couhg & sneezing -eye & ear infection -intermittent fever

Answer 28

-increased coughing & wheezing -tachypnea and retractions -fever -feeding problems -increased secretions

Answer 29

-increased tachypnea -apneic spells -reduced breath sounds -listlessness -poor air control -cyanosis

Answer 30

-maintain airway -symptomatic treatment (suction, oxygen, pain meds) -med (for severe cases): ribavirin, bronchodilators (albuterol), ~cort steroids -contact isolation & hand wahsing -hydration

Answer 31

pregnant women

Answer 32

**suction** on the exam do not over think, suction first -> could keep baby off of O2

Answer 33

only for high risk infants (<29wk), very expensive

Answer 34

inflammation of the alveoli, can be viral or bacterial

Answer 35

-fever -chest pain **child might say abdomen pain** -dullness to percussion -non pro cough -rhonchi or fine rales, decreased breath sounds -res distress

Answer 36

-empyema -pyopneumothorax -tension pneumothorax -pleural effusion

Answer 37

-humidified oxygen -antibiotics & may dilators -possible chest tube for purulent drainage -CPT -rest & hydration -elevate HOB -close observation

Answer 38

**Tdap vaccine so dont see very much** -cough so much that they cannot catch breath -infants <6mo might need to be vented -decreased intake, maintain hydration -humidified oxygen -treatment: erythromycin

Answer 39

-rare but presents exactly like adults (lung infection) & is treated like adults -only do skin TBs if not high risk or traveling from different country **if you have had TB, you will always test positive so chest xray**

Answer 40

-rarely need hospitalization -**adherence to medication** -isolation: can attend school once on therapy & S/s reduced -**adequate nutrition is as necessary as adherence to meds**

Answer 41

**when an infant will just stop breathing or turn blue** -come to ER and they recover on own, usualyl w/o CPR -hook up to monitor and observe + try to figure out cause

Answer 42

-lots of tests and monitoring -assessments -explore possible underlying conditions -give methylxanthine (caffeine)

Answer 43

-CPR -monitor if they go home with it -> interference w/ TV, radio, phones, police scanners -no extension cords -emergency # on phones

Answer 44

the sudden death of an infant under 1 yr old that occurs during sleep & remains unexplained after a complete postmortem examination, including investigation of the death scene and a review of the case hx **leading cause of death in infants 1-12mo**

Answer 45

-**overheating** -**unsafe sleeping arrangements** -**maternal age** -**prenatal or postnatal smoking parents** -**substance abuse parent** -**poor prenatal care** -premature -multiple births (youngest) -low apgar score -bottle feed (breast milk is protective)

Answer 46

-safe sleep / back to sleep -compassionate approach -ask only factual questions -allow family time to say goodbye -provide a keep sake -arrange home visit

Answer 47

if an event occurs in a premature infant we do not consider it an ALTE bc so common

Peds Exam 2 - Acute Res. Flashcards

(71 cards)