Peds Final Diseases Flashcards
(91 cards)
1
Q
Infant type of play
A
solitary play
2
Q
Infant Age
A
birth to 12 months
3
Q
toddler type of play
A
parallel play
4
Q
Toddler Age
A
1-3 years
5
Q
preschooler type of play
A
associative play
6
Q
Preschooler Age
A
3-6 years
7
Q
school-age type of play
A
cooperative play
8
Q
School-age Age
A
6-12 years
9
Q
Infant Atraumatic Care
A
playing soothing music, therapeutic hugging, speak in calm tones
10
Q
Infant Appropriate Activites
A
mobiles, noise-making, soft toys, large blocks
11
Q
Toddler Atraumatic Care
A
approach carefully, use toys/books to distract
12
Q
Toddler Appropriate Activities
A
play with them, push-oull toys, large puzzle pieces, balls
13
Q
Preschooler Atraumatic Care
A
use play, allow to touch equipment, allow choices, use simple terms, count out loud, pretend play (give bear a shot)
14
Q
Toddler Appropriate Activities
A
arts & crafts, playing pretend, books
15
Q
School age Atraumatic Care
A
encourage questions, use diagrams, illustrations
16
Q
School age Appropriate Activities
A
board games, action figures, models, video games
17
Q
Adolescent Atraumatic Care
A
respect privacy, do not force to talk, use appropriate medical terms, allow to be part of decisions
18
Q
Adolescent Appropriate Activities
A
reading, listening to music, peer time
19
Q
Preschooler Cognitive Development
A
magical thinking
imaginary friend
animism
time
20
Q
Preschooler Social Development
A
fears
imaginative play
dramatic
21
Q
School Age Social Development
A
body image
model themselves after peers, parents, or other personalities
peer pressure begins
clubs and BFFs are popular
22
Q
Asthma Preventative Medications
A
Long-acting bronchodilator/B2-Adrenergic Antagonist (Formoterol)
Inhalation corticosteroid (Fluticasone)
Mast-cell stabilizer (Cromolyn)
Leukotriene Receptor Antagonist (Montelukast)
23
Q
Asthma Acute Exacerbation Medications
A
Short-acting bronchodilator (Albuterol)
Anticholinergic (Ipratropium)
Corticosteroid (Prednisone, IV/PO)
24
Q
What is a Pulmonary Function Test (PFT)
A
measures lung volume capacity and overall lung function (not useful during acute exacerbation)
25
What is Peak Inspiratory Flow Rate (PIFR)
use a flow meter to measure the amount of air that can be forcefully exhaled in 1 second, used daily to monitor management and signs of acute symptoms
26
Cystic Fibrosis Medication Management
Airway Clearance Therapy (ACT)
Aerosol Therapy (pulmonary enzyme dornase alfa)
Fat Soluble vitamins ADEK
Pancreatic Enzymes
27
Cystic Fibrosis Diagnostics
Sweat Chloride Test: Chloride>40 in infants less than 3 months; Chloride>60 for all other ages; Sodium>90
KUB: detects meconium ileus
Stool analysis: presence of fat and enzymes
CXR: hyperinflation, bronchial wall thickening, atelectasis, or infiltrates
PFT: decrease force vital capacity/expiratory volume
28
Coup Assessment Findings
"barking cough", inspiratory stridor, tachypnea, respiratory distress
infants: nasal flaring, intercoastal retractions
sudden onset at night, gone in the morning, lasts 3-5 days
29
Croup Management
Cool mist humidifier or steamy bathroom
30
HF Medications
Metoprolol, Lasix, Captopril/Enalapril, Digoxin
31
Digoxin Antidote
Digoxin Immune Fab
32
What makes up the Tetralogy of Fallot
Overriding Aorta, Right Ventricular Hypertrophy, Ventricular Septic Defect, Pulmonary Stenosis
33
What are TET spells
blue baby, trouble breathing
mostly seen in AM
cyanosis, hypoxia, dyspnea, agitation
34
How do you treat TET spells
knee to chest positioning or squatting
35
What is Kawasaki Disease
acute febrile, systemic vasculitis occurring in the blood vessels due to inflammation and edema, especially in the coronary arteries
36
Kawasaki Assessment Findings
chills, HA, malaise, extreme irritability, V/D, abdominal pain or joint pain, high fever> 5 days, bilateral conjunctivitis w/out exudate, dry mouth and throat, fissured lips, strawberry tongue, pharyngeal/oral mucosal edema, desquamation of fingers toes and perineal areas
37
Kawasaki Treatment
Immunoglobulin (IVIG)
high-dose aspirin followed by a low-dose aspirin after fever breaks
acetaminophen for fever and cool cloths if tolerated
daily weight
rest and quiet
lip lubricants and mouth care
clear liquids and soft foods
38
What is Pyloric Stenosis
Pylorus muscle hypertrophies and thickens on the luminal side of the pyloric canal causing gastric outlet obstruction
39
Pyloric Stenosis Assessment Findings
forceful projectile vomiting
hunger soon after vomiting
weight loss
dehydration w/ subsequent lethargy
olive-shaped moveable mass in RUQ
40
Pyloric Stenosis Nurses Priorities
IV fluids to correct electrolyte imbalances and dehydration
Post0op care would care (4 tiny incisions)
NGT for decompression, NPO, Strict I&O
Resume PO feedings 1-2 days
41
Hirschsprung's Assessment Findings
current or past Hx of Down Syndrome or family Hx or Down syndrome/Hirschsprung
newborn: failure to pass meconium 24-48 hrs after birth, episodes of vomiting, refusal to eat, abdominal distention
infant/child: constipation, V/D, abdominal distention, visible peristalsis, palpable fecal mass, foul-smelling ribbon like stool
42
Hirschsprung's Treatment
Resection or re-anastomosis surgery
ostomy care
monitor signs of enterocolitis (fever, abdominal distention, chronic diarrhea or explosive stool, rectal bleeding, or straining)
43
Acute Glomerulonephritis Assessment Findings
recent pharyngitis/strep-throat
fever, lethargy, irritability, HA, decrease UOP, abdominal pain, vomiting, diarrhea, edema
44
Acute Glomerulonephritis Management
monitor fluid status/volume & manage HTN
Abx for strep infection
Monitor I&Os, BP, Neuro, and Renal changes
45
Hemolytic Uremic Syndrome (HUS) Assessment Findings
Past Hx of indigestion of ground beef, visits to public pool or water park or petting zoo
watery diarrhea w/ cramping that can become bloody, possible vomiting, pallor and toxic appearance, edema, oliguria or anuria, irritability, altered LOC, seizures
46
Hemolytic Uremic Syndrome (HUS) Management
POC: maintaining fluid balance, managing HTN, acidosis, and electrolyte abnormalities
contact precautions
stict I&O
monitor for bleeding, fatigue, pallor
blood transfusion (PRBC and Platelets)
47
Growth Hormone Deficiency Assessment Findings
disruption of vertical growth (retarded bone growth)
large/prominent forehead
underdeveloped jaw
high-pitch voice
delayed sexual maturation
delayed dentition/skeletal maturation
decrease muscle mass
48
Growth Hormone Deficiency Treatmetn
Biosynthetic GH (given Sub-Q, daily until growth plates close)
measure height Q3-6 months
growth stops when epiphyseal plates close
GH continue until growth rate less than 1 in/yr
49
Congenital Hypothyroidism Assessment Findings
poor sucking reflex
hypothermia
constipation
lethargy/hypotonia
periorbital puffiness
cool dry scaly skin
bradycardia, RR distress
large fontanelles (delayed closure)
50
What medication is given for Congenital Hypothyroidism
Thyroid hormone replacement (L-Thyroxine) administered daily for life
51
Hydrocephalus Assessment Findings
lethargy, irritability, poor feeding, vomiting (projectile), complaint of HA or vision changed (older child), altered or diminished or change in LOC, wide open budging fontanels, large head or recent change in HC, think shinny scalp with prominent scalp veins, sunset eyes
52
Hydrocephalus Management
Ventriculoperitoneal (VP) shunt
monitor for increase ICP
53
Signs of VP shunt infection (increase ICP)
fever>101
HA, stiff neck, budging fontanelle
poor feeding/vomiting
increase HC
dilated pupil (sunset eye)
high-pitched cry
change in behavior or sleep patterns
54
What are Early Signs if increase ICP
HA, vomiting, blurred vision/double vision, dizziness
55
What are Late signs of increase ICP
lowered LOC
decreased motor and sensory responses
bradycardia
irregular respirations
Cheyne-stokes respirations
fixes and dilated pupils
Cushing's Triad
56
What is Cushing's Triad
hypertension, bradycardia, irregular breathing
57
Increase ICP Management
Position head midline, 30 degrees
calm quiet room, limit stimulation and visitors
minimal oral suctioning, no nasal suctioning
avoid coughing, blowing nose
stool softener
seizure precautions
monitor I&O
58
Bacterial Meningitis Management
ICU admission droplet precautions
IV broad-spectrum antibiotics, ventilator support, decrease ICP, seizure precautions, manage hyperthermia (NSAIDs, cooling blankets, cool compress, tepid baths)
59
Bacterial Meningitis Lab Findings
CBC: increase WBC
Blood/Urine/NP CX: ID source of infection, rule out sepsis, blood CX+ if sepsis
LP: CSF results in increase WBC, decrease glucose, increase protein, cloudy in color
60
What is Reye Syndrome
Results in encephalopathy that causes cerebral edema and liver failure
61
Reye Syndrome Assessment Findings
Severe and continual vomiting
lethargy, irritability, and confusion
hyperreflexia
red, macular rash
signs of increased ICP
signs of liver failure (jaundice, ascites, poor appetite)
62
Spina Bifida Cystica Management
Prevent rupture of Sac (prone/side positioning), monitor HC, signs of IICP, frequent NS moistened dressings, report any leakage, keep sac clean and dry
63
What is Cerebral Palsy primary goal
promote mobility, maintain cardiopulmonary function, prevent complications, and maximize quality of life
64
Cerebral Palsy medications
Baclofen: skeletal muscle relaxant
Botulinum toxin A: reduces spasticity (Botox)
Carbidopa: dopaminergic promotes relaxation of muscles
65
Cerebral Palsy Management
suction, IS, aspiration precautions, oral and enteral, monitor ht & wt, electronic devices, picture boards, touch screen computers, repositioning, monitor under splints/braces, promote independence and positive self-imagery, support family, monitor for developmental milestones, interact based on developmental level
66
What is Amblyopia
Asymmetry of corneal light reflex, lazy eye
67
Amblyopia Management
patching of stronger eye for several hours of the day
atropine drops in the stronger eye
vision therapy
eye muscle surgery
68
Acute Otitis Media Assessment Findings
rubbing/pulling on ear
crying/irritability/fussiness/ reports ear pain/poor feeding/difficulty sleeping
fever
TM dull, red, budging or opaque
purulent drainage if rupture
decrease or no tympanic membrane
69
Acute Otitis Media Management
acetaminophen/ibuprofen mild to moderate pain
opioid for severe pain
benzocaine (Auragen) drops
warm heat or cold compress
Antibiotic Therapy (10-14 days)
70
Fever Management
Assess temp every 4-6 hours, 30-60 minutes after antipyretic
use same site and device for temp
Tylenol and ibuprofen (>6 mo)
assess fluid intake
keep clothes dry
71
Pertussis Assessment Findings
cold symptoms 7-10 days, followed by cough up to 4 wks
Immunization status (Dtap after 11-Tdap)
paroxysmal cough ("whooping cough")
red face, cyanosis, protruding tongue
tearing eyes, drooling, copious secretions (nose/mouth)
72
Pertussis Medications
Macrolides (-mycin)
Azithromycin <1 month
Pertussis vaccine <7
73
Pertussis Management
high humidity environment
observe for airway obstruction
push fluids
antibiotic compliance
droplet/standard precautions
74
Lyme Disease Assessment Findings
onset rash 7-10 days after bite
erythema migrais at site
fever, malaise, HA, mild neck stiffness, joint/muscle pain
late: pain in larger joints develops weeks to months after bite
75
Lyme Disease Management
ABX as ordered
Doxycycline >8 yrs
Amoxicillin< 8 yrs
14-28 days tx
76
Atopic Dermatitis Assessment Findings
inflammation, rash, itching, skin for redness, dry lesions or weepy papules or vesicles
possible wheezing
known as Eczema
77
Atopic dermatitis Management
topical corticosteroids and immune modulators (Tacrolimus)
avoid hot baths, bathe X2/day in warm water
avoid soaps with perfumes, dyes, or fragrances
pat skin dry, leave moist and apply moisturizers
100% cotton and bed liners, avoid synthetics and wool
keep fingernails short
Antihistamines at HS
78
Severe Combined Immunodeficiency (SCID)
absent T and B cell function
79
Severe Combined Immunodeficiency (SCID) Management
IVIG
bone marrow transplant
Infection prevention (good hand washing)
80
Juvenile Idiopathic Arthritis Assessment Findings
Hx of irritability or fussiness (first sign)
withdrawal from play
difficulty getting out of bed
joint stiffness and pain after inactivity/sleep
fever
pale red nonpruritic macular rash
limping gait or guarding of joint
joint with edema warmth erythema and tenderness
eye inflammation
81
Juvenile Idiopathic Arthritis Lab Findings
CBC: mild to moderate anemia, elevated WBC
Elevated ESR and CRP
ANA
RF
82
Hemophilia A Assessment Findings
swollen or stiff joints
multiple bruises
hematuria
bleeding gums
bloody sputum or emesis
black tarry stools
chest or abdominal pain (internal bleeding)
83
Hemophilia A Lab cues
PTT increased
hypercoagulation
PT/INR and Platelets normal
84
Hemophillia A Management
First line: Factor VII
Prophylaxis for mild cases (Desmopressin DDVAP)
apply direct pressure to eternal bleeding
ice or cold compress
85
Iron Deficiency Anemia Assessment Findings
irritability, HA, unsteady gait, weakness, fatigue, dizziness, SOB
pallor skin/MM/conjunctiva
assess for difficulty feeding (pica)
spooning of nails
86
Iron Deficiency Anemia Management
formula fortified with Fe+
Fe+ supplement breastfeeding by 4-5 months
breastfeeding mom increase Fe intake
limit cow's milk >1 yr 240z/day
encourage Fe foods
87
Sickle Cell Assessment Findings
extreme fatigue or irritability
pain (abdomen, thorax, joints, digits dactylitis)
cough, increase WOB, fever, tachypnea, hypoxia
splenomegaly
jaundice
pale conjunctiva/palms/soles/skin
88
Sickel Cell Management
Opioids for moderate to severe pain regular schedule
NSAIDs or acetaminophen for less severe pain combines with distraction, relaxation
warm compression to inflamed joints
double maintenace fluid replacement
IS
O2< 92%
89
Acute Lymphoblastic Leukemia Assessment Findings
low-grade fever
signs of infection
pallor
bruising/petechiae
enlarged liver
enlarged lymph nodes
90
Acute Lymphoblastic Leukemia Lab Cues
CBC: low H&H, low RBC, low/normal/high WBC, low platelets
LP: leukemic cells in CSF
LFT: BUN/Creatinine (help guide chemo)
CXR: detect PNA or mediastinal mass
BMA: determine of lymphoid or myeloid and cell type
91
Acute Lymphoblastic Leukemia Management
Chemo or bone marrow transplant
prevent infection
treating pain
anemia
prevent bleeding
blood transfusions for severe anemia
narcotics for acute pain
atraumatic care
