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peds test 3 Flashcards

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1
Q

The wrong reasons for not reporting 8

A 
Someone else will
Lack of training
discipline vs abuse
lack of knowledge
fear of legal consequences
fear of loss of therapeutic relationship
CPS wont help
Biases
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2
Q

Age range for school-aged child

A

6-12 yrs

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3
Q

Weight and height for school aged kid

A

7lbs a year and 2.5 in/yr

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4
Q

When is brain growth complete?

A

10 yrs

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5
Q

four cognitive developments of a school age kid

A

Can see things from another point of view
can think through an action anticipating consequences
can classify and divide things

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6
Q

3 motor skills of school age kid

A

Ride a two wheel bike
jump rope
sports participation

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7
Q

What is the nutrition rule for school aged kids?

A

5210- 5 fruits and veggies 2 hours screen time 1 hour of active play 0 sweet beverages

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8
Q

What is the best thing to do for a kid who has a fever?

A

Hydrate them

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9
Q

Fluids and kids 4

A

Kids have more fluid than adults
need more fluid per body weight than adults they excrete more
Extracellular fluid is more with higher Na+ Cl-
don’t concentrate urine very well

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10
Q

Three abnormal signs of vomit

A

bilious, bloody, projectile

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11
Q

Explain how a virus causes diarrhea

A

Injury to absorptive surface resulting in decreased fluid absorption

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12
Q

Explain how bacteria causes diarrhea

A

Intestinal injury by invasion of mucosa and release of toxins

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13
Q

Chronic diarrhea 5 causes

A

milk/soy intolerance, giardia, tumors, ulcerative colitis, celiac

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14
Q

What should an oral rehydration solution contain?

A

75mmol/L NaCl and 13.5 g/L

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15
Q

If someone is dehydrated, why do you not want them drinking tap water?

A

It will cause hypoNa+

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16
Q

how to give oral rehydration therapy
and
What if the child vomits?

A

50-100mL/kg over 4 hours-give 1mL/kg every five mins

resume after 30mins

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17
Q

What should normal urine output be for a child?

A

1-2ml/kg/hr

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18
Q

IV replacement bolus of and time

A

20ml/kg over 30-60mins

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19
Q

What is hyper trophic pyloric stenosis?

and is it rare?

A

Circular muscle of the the pylorus becomes hypertrophied causing thickening of the pyloric canal this causes gastric outlet obstruction
yes

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20
Q

s/s of hypertrophic pyloric stenosis 5

A

non-bilious vomiting, projectile vomiting, hunger right after vomit, olive in RUQ, possible visible peristalsis

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21
Q

What is the surgery for hypertrophic pyloric stenosis?

A

pyloromyotomy

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22
Q

What is Intussusception?

A

Process where the proximal segment of the bowel telescopes into the more distal segment

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23
Q

What will intussusception cause? 6

A

edema, vascular compromise, obstruction, bowl rupture, paratenitis, Jelly stool

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24
Q

What vaccine can cause intussusception?

A

Rotavirus

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25
S/s of intussusception | and one thing about it
Sudden cramping pain of abdomen Severe pain with legs drawn up vomiting/diarrhea If the vomiting is bilious- it has perforated and is an emergency
26
What fixes intussusception?
Barium enema
27
A cause of appendicitis
obstruction of fecal matter impacted on the appendix
28
3 s/s of a appendicitis and one if it perfs
N/V, sm frequent lose stools, fever | pain goes away
29
what is the point for appendisitis?
Mcburneys point
30
2 things that would turn up on labs for appendicitis
Increased WBC and C-reactive protein
31
PUD 3 things
Erosion of GI mucosa from HCL and Pepsin. any point in GI tract, chronic
32
Manifestations of peritonitis 8
rebound tenderness, ab distention, rigidity, decrease bowel sounds, fever, increased pulse, bp, increase WBC
33
Functional constipation criteria one rule and 5
``` Must meet 2 less than 3 bowel movements a week at least 1 episode of fecal incontinence a week stool withholding behavior hard or painful BM Large poop ```
34
What is Encopresis?
Leak of lose stool around mass
35
What is Hirschsprung disease? and what is the other name for it?
Congenital aganglionic megacolon | movement disorder of intestinal tract that results in obstruction.
36
What is a sign of hirschsprung disease in a newborn?
They don't pass meconium in the first 24hours of life.
37
2 things to remember about Hirschsprung disease
due to lack of ganglion cells, it is rare
38
s/s of celiac 1
steatorrhea
39
How do we diagnose celiac
auto tissue transglumtimate IgG, intestional biopsy, genetic testing
40
diabetes 1 connects to what disease?
Celiac
41
What is Biliary atresia? leads to 3 is it rare?
no excretion of bile from liver into the duodenum leads to cholestasis, fibrosis, and cirrhosis no
42
How to treat biliary atresia | Time
Kasai procedure | w/i 45 days
43
When do kids get hep A shot?
12 months and 6-12 month later
44
When do kids get hep b shot?
at Birth and 1-2months and 6-18month
45
What is associated with cleft lip and palate?5
Heart defects, ear malformations, skeletal deformities, genitourinary malformations, midline defects
46
one complication of cleft lip
otitis media
47
When do we start repairs of cleft lip
2-3 months
48
What to remember about breastfeeding an cleft lip?
It is better for growth and better than a plastic nipple because it provides a better seal .
49
Esophageal atresia and tracheoesophageal fistula is what
The esophagus and trachea do not separate normally during embryonic development
50
What is esophageal atreasia?
Distal and proximal ends of esophagus don't connect
51
What is the first sign of esophageal atresia? | What are the signs after birth? 3
polydramnios | frothy mucus and drooling, ab distention
52
TE fistula manifestations 6
Rattling respirations, excessive salivation and droolong and 3 c-couching choking, cyanosis.
53
Esophageal atresia and TE fistula management 6
``` Immediate surg HOB 30-45 NPO IV fluids 02 Prevent respiratory distress ```
54
What causes omphalocele and gastroschisis | and how are they detected? 2
Malformation of abdominal wall | During prenatal ultrasound or increased alpha-fetoprotein
55
Management of omphalocele and gastroschisis?4
Prevent hypotherm, fluid loss, keep covered, sterile
56
Infant and child urine capacity
30ml | 270ml
57
What is bladder extropy?
Bladder is outside of the body at birth
58
How to tx bladder extropy
Cover with sterile gauze, antibiotics, surgery w/I 48 hours
59
what is Hypospadias?
Urinary meatus on the underside of the penis
60
One thing to remember about hypospadias and epispadias
don't circumcise until after fixed
61
Epispadias
Urinary meatus on upper surface of penis
62
what is Chordee and what is associated with it?
Penial ventral curvature due to fibrous tether | hypospadias
63
What is cryptorchid? what is the surgery called?
Undescended testicles | Orchiopexy
64
What is hydrocele?
Excessive fluid in the scrotal sac
65
What is an inguinal hernia?
Happens when in inguinal canal does not close and intestines protrude into the canal and can become incarcerated
66
Epididymitis cause can cause 3
Bacterial usually STD | Scrotal abscess, testicular infarction, infertility
67
s/s for epididymitis 6
Painful, edema, erythema, dysuria, fever, enlarged inguinal lymph
68
Tx for epididymitis 4
Elevation of scrotum, cold packs, NSAIDS, antibiotics
69
What is testicular torsion? | And it is....one
Twisting of the spermatic cord that can cut off the blood supply to the testicle EMERGENCY
70
s/s of testicular torsion 1
Sudden and severe pain
71
How do they treat testicular Torsion | time?
manual detorsion but probably need surgery | 6 hours-can spare testi but can't after 12
72
Phimosis | how to treat it?
Foreskin of penis cannot be retracted | Steroid cream
73
Phimosis s/s 4
foul smell, smegma irritation, pruritus
74
What is Paraphimosis
Foreskin is retracted past the glands and is immobile it becomes a tourniquet
75
What can cause ambiguous genitalia?
Increased androgen production in new born girls
76
How long does a circumcision take to heal?
7-10 days
77
What is a labial adhesion? when is it most common?
Partial or complete adherence of the labia minora | 3months to 4 yrs old
78
What can a labial adhesion tx 2
Topical estrogen cream and vaseline gel for one month
79
What is Vulvovaginitis? | usually caused by 2
inflammation of the vagina and vulva | Bacteria or yeast overgrowth
80
5 s/s of UTI that you don't know
Jaundice, FTT, Respiratory distress, constipation, HTN
81
What in enuresis?
Involuntary urination
82
Nocturnal enuresis common in 2
Family history and boys
83
tx of nocturnal enuresis 2 you don't know
diet change, constipation prevention
84
What are the meds used for Nocturnal enuresis 4
Desmopessin/ADH | ditropan drugs that decrease bladder spasms
85
What is vesicoureteral reflux?
Retrograde flow of urine from the bladder up into ureters
86
VUR testing 4
Culture, ultrasound, voiding cystrourethrogram , nuclear scan
87
How is VUR graded?
1-5 5 severe
88
Nephrotic synrome what is it called? | What is it?
Nephritis | Increased glomerular basement membrane permeability which causes abnormal loss of protein in urine.
89
What to remember about congenital Nephrotic syndrome?
It has poor prognosis unless they get a transplant
90
What would cause secondary Nephrotic syndrome? 3
Henoch-schnlein syndrome, Purpura, diabetes.
91
Two things to remember about idiopathic nephrotic syndrome | hint-One is another name for it.
Most common | also called change nephrotic syndrome
92
What are the complications of nephrotic syndrome 6
Anemia, infection, poor growth, peritonitis, thrombosis, renal failure.
93
What are the manifestations of Nephrotic syndrome 5
EDEMA!, LUOP, Hyperlipidemia, FTT, HTN
94
What is the best treatment for Nephrotic syndrome? What about vaccines with this disease?
Corticosteroids | No live until 2 weeks
95
Acute Glomerulonephritis caused by 2
POST strep group a beta hemolytic strep from an antibody antigen reaction. Staph or other infections
96
Acute Glomerulonephritis can cause 2
Uremia and kidney failure (Both a acute and chronic)
97
Acute Glomerulonephritis manifestations 7
hematuria, high fever, HA, CVA tenderness, HTN, perorbital edema, Elevated BUN/Creatinine
98
Acute Glomerulonephritis tx 4
manage HTN, sodium restriction, antibiotics, No NSAIDS
99
Nursing care for Acute Glomerulonephritis 6
Daily weights, UO, Edema care, hypertension care, neuro stat, activity restrictions.
100
Hemolytic-uremic syndrome is defined as three features, what are they? What happens before this disease? When is this most common ages?
1. Hemolytic anemia 2. Thrombocytopenia 3. Acute renal failure Usually diarrhea 6months to 4yrs
101
Bacteria causes HUS but give 3 examples
E coli, strep pneuminiae, shigella
102
HUS progression 3 things
Diarrhea-Hemorrhagic colitis-triad
103
What causes the triad symptoms in HUS
Microthrombi and ischemic changes in the organs.
104
Manifestations of HUS 10
fever, pallor, prupura/petechia, signs of kidney failure, edema, low UO, hypervolemia, increased BP, change in LOC, Seizures.
105
how long does ecoli spred?
up to 17 days
106
How can you tell when meat is cooked
155 degrees, Juices are clear, meat is no longer pink
107
Avoid HUS one thing
Avoid unpasterurized apple cider
108
Acute kidney failure in kids is mostly caused from? | 2
Hypovolemic shock or sepsis
109
Tx for acute renal failure 2
Fluids, and treatment of underlying cause

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