heart defect that causes a right to left shunt of blood squatting!! - an unconscious means of relieving hypoxia

Peds Final Blueprint 1 Flashcards by Josh Miller

What is PKU Test?

Phenylketonuria Test

measures if baby has enzyme to use phenylalanine in body. Phenylalanine is an amino acid that is needed for normal growth and development

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What surgery for Clubfoot?

percutaneous heel cord tenotomy

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Hypoglcyemia or Hyperglycemia?

deep, rapid kussmaul respirations

Hyperglycemia

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Decreased BP in lower limbs may be a sign of —

coarctation of the artery

check BP in all four extremeties

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Clubfoot:

Eversion of feet(bending outward)

Talipes Valgus

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When would a Halo Vest be used?

vertebral fracture w/out neurological deficit

permits earlier ambulation

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S/S of Tet Spells?

Peripheral dilation

Increased HR

Decerased diastolic filling time

Blood flows from RIGHT TO LEFT—TETRALOGY OF FALLOT (Path of least resistance)

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Hypoglycemia is glucose of —

Hyperglycemia is glucose of —

250

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Best exercise for JIA kids?

swimming

though they can do most activities

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What is the usual organism for UTI?

E coli

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— is the most common heart defect in children.

Ventricular Septal Defect

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Tetralogy of Fallot?

heart defect that causes a right to left shunt of blood

**squatting!!
- an unconscious means of relieving hypoxia

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Clubfoot:

Inversion of feet

Talipes varus

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What does HgA1c measure?

3-mth avg of plasma glucose concentration

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What are the screening tests for Scoliosis?

Cobb technique - degree of curvature

Risser Scale - skeletal maturity

Measure truncal rotation

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Heart defects w/ decreased pulmonary blood flow.

Tetralogy of Fallot

Tricuspid Atresia

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Which cardiac defects result in obstruction of blood flow?

Coarcation of artery

Aortic Stenosis

Pulmonic Stenosis

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When sick, how often should we monitor blood glucose and ketones in urine?

q 3 hrs

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Exopthalmos is a clinical manifestation of —

Graves Disease

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Poor appetite, FTT, and frequent urination are S/S of —

UTI

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Hypoglcyemia or Hyperglycemia?

Double Vision

Hypoglycemia

Hyper has blurred vision

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Hypoglcyemia or Hyperglycemia?

Rapid onset

Hypoglycemia is rapid

Hyper is slow

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In —, alterations in glomerular membrane allow proteins (albumin) to pass into urine.

Nephrotic Syndrome

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Clinical manifestations of Minimal Change Nephrotic Syndrome?

Weight gain / edema (facial, ankles, periorbital)

Ascites

Anorexia, diarrhea, lethargy

Decreased frothy urine

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What are normal HgA1c values for a child w/ diabetes?

6.5-8% but we won't to stay

Treat hypoglycemia with --- of simple carbs.

10-15 g - milk - soda - T of sugar

How is Juvenile Idiopathic Arthitis treated?

PT Splinting at night Warm baths / packs on joints NSAIDs, DMARDs, corticosteroids

Facial features for Down's Syndrome

Oblique palpebral fissures (upward, outward slant) of the eyes Iris speckled “Brushfield spots” Flat nasal bridge (Saddle nose) Large protruding tongue Low set ears Short broad neck

Which cardiac defects result in increased pulmonary blood flow?

Ventricular Septal Defect Atrial Septal Defect Patent Ductus Arteriosis

What is the significance of a blue hue to the sclera in the newborn assessment?

Osteogenesis Imperfecta The blue-gray color of the sclera is due to the underlying choroidal veins which show through. This is due to the sclera being thinner than normal because the defective Type I collagen is not forming correctly

--- is caused by disrupted blood flow in the femoral head, resulting in necrosis.

Legg Calve Perthes

Hypokalemia --- Digoxin toxicity.

potentiates ***serum potassium

--- is narrowing of aortic valve and causes which side of heart to enlarge?

Aortic Stenosis - causes left ventricular hypertrophy

Normal urine should be negative for ---

protein

What are the warning signs for Acute Compartment Syndrome?

Pain Pressure Paresthesia (numbness) Paralysis Pulselessness

What is the onset of Duchenne Muscular Dystrophy?

3-7 yrs old

Safe Digoxin Range

0.8-2.0

Scoliosis affects the spine. What else does it affect?

ribs

Best position to increase oxygenation during Tet Spell?

knee to chest

S/S of Nephrotic Syndrome

elvated protein in urine decreased serum protein (6.1-7.9) elevated serum lipid level normal potassium level

What is Gower's Sign?

unsteady gait w/ a waddle ***it is a sign of MD

Clubfoot: Toes are facing inward lower than heel

Talipes Equinovarus

What affect does exercise have on child w/ diabetes?

decreases need for insulin ***snack 30 mins before to prevent hypoglycemia

What is the Pavlik Harness?

treatment for DDH - keeps hips in place - adjust q 1-2 weeks - wear for 12 wks

What are the 4 types of clubfoot?

Talipes Varus Talipes Valgus Talipes Calcaneus Talipes Equniovarus

What is the most accurate lab for diabetes?

HgA1c - glycated Hgb - can't be 'faked' last minute for a good reading

Failure to smile and poor head control at 3 months are a warning sign for ---

Cerebral Palsy

What is MCNS?

Minimal Change Nephrotic Syndrome - most common form of Nephrotic Syndrome

Blue sclera and Hearing Loss are S/S of --

Osteogenesis Imperfecta

Graves Disease leads to ---

Hyperthyroidism

What will you listen for w/ Ventricular Septal Defect?

loud, harsh murmur on left sternal border

How long does somatropin treatment last?

until epiphyseal closure

Brain abscesses are more common in --- than any other Congenital Heart Disease.

Tetrology of Fallot

Long term problems w/ Cerebral Palsy?

``` Seizures Drooling Difficulty feeding / speech Risk for aspiration Orthopedic complications –hip dislocation/scoliosis Constipation Dental caries ``` ``` Gingivitis Nystagmus Hearing Loss Latex allergy has also been reported in children with CP Intellectual Impairment (70% normal) ADHD ```

Types of DDH?

Acetabular Dysplasia (delay in acetabular development) Subluxation (incomplete dislocation of hip) Dislocation (femoral head does not have contact w/ acetabulum)

Clubfoot: Dorsiflexion (toes higher than heels)

Talipes Calcaneus

S/S of Fractured Femur

Crepitus Edema/Swelling Pain Ecchymosis

Maternal chorioamnionitis increases risk for ---

Cerebral Palsy

What is DDH?

Developmental Dysplasia of the Hip

What is one of the first things we do with DKA?

obtain venous access to give all the fluids

S/S of MD

fatigue/muscle weakness (lower extremities first) Unsteady gait, with a waddle Lordosis Frequent falling Learning difficulties/cognitive delays Atrophy of muscles--possible loss of ability to walk by age 12

What is the pre-op treatment for Clubfoot?

serial casting shortly after birth

Treatment for a sprain?

RICE Rest Ice Compression Elevation

S/S of Compartment Syndrome

Increased pain that is unrelieved with analgesics or elevation Numbness Pulselessness Inability to move digits Warm digits with skin that is tight and shiny pallor

Which type of traction? skin traction on lower leg and padded sling under the knee

Russell Traction

What do we do w/ bony prominences when casting?

pad them

Nursing responsibilities w/ Legg Calve Perthes?

Maintain rest and no weight bearing Administer NSAIDs

Urinalysis for Nephrotic Syndrome?

Proteinuria (2+ on dipstick)

Nursing responsibilities w/ a fracture

Assess 5 P's Cover open wound w/ sterile dressing Immobilize limb Neurvascular checks often Elevate if possible Ice for 20 mins Pain meds Keep client warm

What is a Denis Browne Splint?

shoes w/ a bar holding them apart used as postop treatment for clubfoot

What are Tet Spells?

acute episodes of cyanosis and hypoxia

What is Torticollis?

wry neck (head tilt)

Kernicterus, caused by | Billirubin, is a risk factor for ---

Cerebral Palsy

What is the cause of Aortic Stenosis?

bicuspid, instead of tricuspid, aortic valve

Pathology of Cerebral Palsy

Cerebral anoxia --> Brain damage --> Loss of normal function

Why are NSAIDs good for JIA?

control pain and inflammation long term use w/ few S/E ***take w/ food for gastric irritation

Bryant Traction is which type of traction?

Skin Traction - hips are at 90 degree angle - butt off bed

Can MD be treated?

no, just manage symptoms - encourage ROM and ADL as long as possible - keep lungs functioning

What is Lordosis?

sway back

When is permanent closure of the ductus areriosis?

10-21 days after birth

What is the growth hormone?

Somatropin - subQ

MD affects which extremities first?

lower

Why are fluids necessary w/ DKA?

because they are so dehydrated