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NUr1085 > Peds Final > Flashcards

Peds Final Flashcards

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1
Q

Biliary Atresia

A

Blockage in bile ducts

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2
Q

Biliary Atresia manifestations

A

persistent or recurring neonatal jaundice
colic
clay colored stool
hepatomegaly
splenomegaly
FTT

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3
Q

Biliary Atresia Outcomes

A

cirrhosis
liver damage
early diagnosis/intervention improves outcomes

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4
Q

GI infection Causes

A

Viral: rotavirus
Bacterial: Salmonella, shigella, E. coli
Parasitic: Giardia

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5
Q

GI Infection S/S

A

diarrhea
abdominal pain
abdominal distention
nausea
vomiting

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6
Q

GI infection Management

A

Dehydration: oral hydration therapy/ Pedialyte (mild to moderate), IVF (severe)
Antibiotics: Shigella, C. diff, Giardia
Antibiotics CI: E. Coli, Salmonella
Skin care: diaper area

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7
Q

Cleft Lip

A

incomplete fusion in oral cavity

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8
Q

Cleft Palate

A

incomplete fusion of palatal plates

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9
Q

Cleft Lip/ Cleft Palate Complications

A

difficulty feeding
ear infections
hearing loss
dental issues
speech difficulties

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10
Q

Cleft Lip/ Cleft Palate Care

A

surgical closure (lip before palate, tape lip before procedure)
orthodontics for teeth
speech therapy

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11
Q

Cleft Lip/ Cleft Palate Post op Care

A

Protect operative sites:
elbow immobilizers/ restraints
avoid suctioning
avoid putting objects in mouth like pacifier, straw or hard sippy cup Diet: NPO, liquid advanced to soft diet after 3-4 days

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12
Q

Esophageal Atresia

A

failure of esophagus to develop

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13
Q

Tracheoesophageal Fistula

A

trachea and esophagus fail to separate

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14
Q

EA/ TEF S/S

A

Respiratory compromise: coughing, choking, cyanosis, aspiration, frothy saliva, nasal return of fluid
gastric distension with air

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15
Q

EA/TEF Management

A

Respiratory: maintain airway, prevent pneumonia, supine with HOB elevated, suction secretions,
GI: gastric decompression, NPO
Surgery: usually staged repair

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16
Q

Umbilical Hernia

A

bulge of organs through umbilicus

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17
Q

Umbilical Hernia Manifestations

A

pronounced protrusion of umbilicus with crying
S/S of I: intense pain, budging, firm, red

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18
Q

Umbilical Hernia Management

A

close spontaneously by age 3 or 4
surgery of incarcerated/does not closed

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19
Q

Inguinal Hernia

A

inguinal canal fails to close and intestines/ ovaries move in to canal

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20
Q

Inguinal Hernia Manifestations

A

progressive, enlargement and weakening
possible incarceration
intestinal obstruction
S/S of I: painful, firm bulge, abdominal distension, vomiting

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21
Q

Inguinal Hernia Management

A

Emergency if incarcerated/cannot be reduced
Elective if it can be reduced
No major restrictions on activity

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22
Q

Hypertrophic Pyloric Stenosis

A

Thickening of pyloric sphincter

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23
Q

Hypertrophic Pyloric Stenosis S/S

A

colic
intermittent abdominal pain
drawing legs up
currant jelly like stools (blood and mucus)
fever

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24
Q

Hypertrophic Pyloric Stenosis Management

A

NG for stomach decompression
IVF
antibiotics
enema
pain management

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25
Hirschsprung's Disease
Congenital absence of ganglion cells in intestine leading to inadequate motility and mechanical obstruction
26
Hirschsprung's Disease S/S
failure to pass meconium within 48 hours of birth distended abdomen feeding intolerance bilious vomiting
27
Hirschsprung's Disease Management
pull through procedure ostomy
28
Appendicitis
Obstruction of appendix leads to inflammation, compression of blood vessels (ischemia), ulceration of epithelial lining, bacterial invasion and necrosis with perforation
29
Appendicitis S/S
abdominal pain in RLQ anorexia vomiting nausea normal or elevated temp guarding of abdomen rebound tenderness increased WBC Rovsing’s Sign
30
Appendicitis Managment
appendectomy NPO pain control antibiotics fluids
31
Anorectal Malformation
Failure of rectum to form properly either displaced or connected to urinary/reproductive tract, or missing
32
Anorectal Malformation S/S
Lack of stool stool from vagina urine from anus constipation obstruction vomiting abdominal distension
33
Omphalocele
herniation of abdominal contents through umbilical ring *peritoneal sac containing bowel and other viscera*
34
Gastroschisis
herniation of abdominal contents through defect in abdominal wall *no membrane covering exposed bowel*
35
Treatment for Omphalocele/ Gastroschisis
surgical repair focus on nutrition to promote growth and development will use silo with staged repair
36
GER
Reflux of stomach contents into esophagus when lower esophageal sphincter fails
37
GER S/S
spitting vomiting severe weight loss FTT
38
GER Managment
Medical: small frequent feeds, upright after feeding, thicken formula Surgical: Nissen Fundoplication to support LES (Cannot vomit post op) Feeding assessment: discomfort with feeds, arching of back, irritability Growth and development assessment
39
Ulcerative Colitis
inflammation/ulceration of *mucosa and submucosa of colon and rectum*
40
UC S/S
rectal bleeding diarrhea abdominal pain anorexia weight loss fever anemia
41
Crohn's Disease
inflammation of *entire GI tract and all layers of bowel wall* skip lesions
42
IBD (UC/ CD) Managment
Focus on Nutrition high protein high calorie vitamin supplement
43
CD S/S
malabsorption diarrhea severe anorexia severe weight loss crampy abdominal pain growth retardations fistulas and strictures
44
Constipation
Difficulty or infrequent passage of hard stool with straining, abdominal pain, or withholding behaviors for over 2 weeks
45
Constipation S/S
hard stools soiling underwear abdominal pain and distention irritable loss of appetite pain with toileting
46
Encopresis
involuntary passage of stool after 4 years old associated with constipation and impaction
47
Constipation Management
bowel evacuation stool softener regular toileting change in diet no punishment is indicated child and parent needs counseling
48
Sickle Cell Anemia
Autosomal recessive inheritance resulting in abnormal Hgb formation common in African Americans
49
Sickle Cell Anemia Precipitating factors
factors that increase oxygen demand and alter oxygen transport: Trauma, fever, infection, physical and emotional stress, increased viscosity due to dehydration, hypoxia, vasoconstriction
50
Sickle Cell Anemia S/S
severe pain in hands and feet swelling
51
Sickle Cell Anemia Crisis Patho
abnormal formation of Hgb> rigid sickle shaped Hgb > obstruct blood flow > inflammation > tissue ischemia > cellular death
52
Sickle Cell Crisis Prevention
childhood vaccines (pneumococcal and meningococcal) prophylactic penicillin from 2 moths to 5 years hydroxyurea good hydration pain management
53
Aplastic Anemia
All cell lines are simultaneously depressed (pancytopenia), marrow is “empty”
54
S/S of Aplastic Anemia
pancytopenia: thrombocytopenia anemia neutropenia
55
Hemophilia Patho
X-linked recessive bleeding disorders to deficiency of clotting factors carried by females, affects males
56
Hemophilia A
deficiency of Factor VIII
57
Hemophilia B
deficiency of Factor IX
58
Classification of Hemophilia
Mild: 5-40% factor activity, bleeding with severe trauma or surgery Moderate: 2-4.9% factor activity, bleeding with trauma Severe: <2% factor activity, spontaneous bleeding without trauma
59
Hemophilia Managment
apply pressure transfusion for factor replacement with severe bleeding elevate and immobilize joint, ice analgesic ROM exercise atter bleeding stops to prevent contractures
60
Immune Thrombocytopenic Purpura
hemorrhagic disorder Acute: self limiting after a viral illness Chronic: > 12 months
61
ITP S/S
thrombocytopenia purpura (discoloration caused by petechiae under skin, with no other sings of bleeding) normal bone marrow
62
ALL
Acute: involving immature cells that mature rapidly Lymphoblastic: B and T cells Leukemia: Unrestricted proliferations of WBCS that infiltrate and replace normal tissues and depressed production of normal blood cells in the marrow
63
ALL S/S
reflect infiltration of bone barrow by nonfunctional leukemic cells: Decreased erythrocytes: anemia, fatigue, pale Neutropenia: infections, repeated, fever Decreased Platelets: increased bleeding Cell Infiltration: bone pain, organomegaly T-cell subtype: enlarged thymus, respiratory distress
64
ALL Diagnosis
bone marrow aspiration or biopsy
65
ALL management
Chemotherapy Remissive induction: achieve remission <5% blasts in bone marrow Consolidation: eradicate leukemic cells Maintenance: preserve remission
66
Wilms Tumor
primary malignant renal tumor
67
Wilms Tumor S/S
asymptomatic abdominal mass hematuria malaise hypertension
68
Wilms Tumor Management
Surgery to completely recent tumor Contraindication: palpation due to risk of capsule rupture Chemo Radiation for stage 3 and 4
68
Neuroblastoma
Peripheral nervous system tumor arising along sympathetic chain most commonly affecting the abdomen
69
Neuroblastoma S/S
Spine: stop crawling and waling, weakness, paralysis Chest: trouble breathing Abdomen: pain, distension, constipation, vomiting, diarrhea Metastasized: black eyes, bone pain, bruises, Fever, painless
70
Hodgkins and NH Lymphoma S/S
non-tender, painless, firm, movable, enlarged lymph nodes low grade fever anorexia weight loss night sweats pruritus
71
Hodgkins Lymphoma Diagnosis
biopsy for presence of Hodkin and Reed-Sternberg Cells
72
Lymphoma Treatment
radiation, chemo NHL: radiation only with chemo resistance
73
Non-Hodgkins Lymphoma Vs Hodgkins Lymphoma
NHL: metastasis in bone marrow and CNS HL: still only in lymph nodes
74
General care of patient with cancer/on chemo
Dose calculation and verification and administration Monitor for acute and delayed onset toxicities Call treatment team at first sign of fever
75
Mylosupression
Decreased bone marrow activity S/S: neutropenia, anemia, thrombocytopenia
76
Prevention of Infection with neutropenia
hand washing, mouth care, private room, precaution based on neutrophil count, colony stimulating factors *initiate broad spectrum antibiotic for fever during period of neutropenia*
77
Thrombocytopenia Management
platelet transfusion avoid skin puncture mouth care with soft toothbrush Tylenol for pain (not aspirin)
78
Anemia Managment
PRBC transfusion regulate activity to manage fatigue
79
N/V managment
Prevention is goal: administer antiemetics 24 hours before, during and after chemo

NUr1085 (3 decks)

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