T3 - Blueprint 3 (Josh) Flashcards Preview

Peds (Josh) > T3 - Blueprint 3 (Josh) > Flashcards

Flashcards in T3 - Blueprint 3 (Josh) Deck (102):
1

--- is NOT associated w/ a neurological deficit b/c there are no nerves in the sac.

Meningocele

2

Leukemia is more common with who?

- whites
- boys
- family history
- Down's Syndrome

3

Normal HCT

Male: 38.8 - 50.0%

Female: 34.9 - 44.5%

4

How is Wilm's Tumor treated?

Surgery to remove kidney/tumor

Chemo (dactinomycin or vincristine)

Postop Radiation

5

Meds for ICP

Mannitol and steroids

Midazolam

Antibiotics

Antiepeleptics

Barbituates

Phenobarbital

6

Signs of ICP

headaches

irritability

HIGH PITCHED CRY (Cat Cry)

Vomiting

Visual Changes

Ataxia

Seizures

7

After amputation w/ Osteosarcoma, what drugs help treat phantom limb pain?

TCA Antidepressants

8

Unilateral dilated pupils indicate ---

Fixed dilated pupils indicate ---

Bilateral fixed and dilated pupils indicate ---

intracranial mass

brainstem herniation

brainstem herniation from ICP

9

--- is a very serious form of Lymphoma and is treated aggressively.

NHL

- radiation
- chemo

10

--- is a malignancy that occurs in the adrenal gland, sympathetic chain of the retroperitoneal area, head, neck, pelvis, or chest.

Neuroblastoma

11

What is Hemorrhage Cystitis and how is it treated?

S/E of Chemo where a sudden onset of hematuria combined with bladder pain and irritative bladder symptoms.

treat w/
- encourage fluids
- encourage frequent voiding
- mesna to protect bladder

12

Oftentimes, with osteosarcoma, there can be temporary relief of pain when ---

extremity is flexed

13

What is the purpose of chemo for Retinoblastoma?

to reduce tumor size so that other treatments can be used

14

Leukemia can lead to...

- Deficient RBCs = ----
- Deficient WBCs = ---
- Deficient Platelets = ---

Anemia

Neutropenia

Thrombocytopenia

15

Which stage of NHL?

single tumor w/ regional involvement on SAME SIDE of diaphragm

Stage 2

16

Which stage of NHL?

Any of stages 1-3 plus CNS or bone marrow involvement

Stage 4

17

The following are LATE SIGNS of which type of cancer?

- Pain

- Hematuria

- Ulcerations in mouth

- Enlarged kidneys and TESTICLES

- ICP

Leukemia

18

Positive signs for meningitis:

Brudinski Sign

flex the child's head while supine

if this makes knees or hips flex involuntarily, it is a positive sign

B for brain (lift head)

19

Which Stage of NHL?

single tumor at single site

Stage 1

20

--- seizures are drop attacks.

Atonic or Akinetic

- can cause injuries to face and head b/c they are unable to break their fall

21

We want our Hgb to be above ---

11 gm/dL

22

What is Intrathecal Chemotherapy?

chemo administerd via lumbar puncture to treat cancers that have reached the CNS

23

Positive signs for meningitis:

Kernig Sign

raise leg w/ knee flexed then extend leg at knee

if resistance or pain, it is positive sign

K for knee (flex the knee)

24

Foods rich in Folic Acid are ---

Foods rich in Vit C are ---

Folic Acid
- leafy green veggies
- beans
- citrus fruits
- breads
- cereals
- rice
- pastas

Vit C
- bell peppers
- dark leafy greens
- kiwi
- broccoli
- berries
- tomatoes
- peas
- papayas
- citrus fruits

25

Which type of Lymphoma is more diffuse through the body, Hodgkins or Non-Hodgkins?

Non-Hodgkins

- also cell type is undifferentiated

- dissemination is earlier and faster

- mediastinal involvement and invasion of meninges also is typical

26

-- is toxic encephalopathy that can be caused by ASA use in kids?

Reye's Syndrome

- also pepto bismol

27

What is reduced and elevated w/ VIRAL Meningitis?

Protein slightly elevated

WBC elevated (500 or more)

28

Treatment for Rhabodmyosarcoma?

surgical biopsy, local radiation and chemo, rather than radical surgical procedures

29

What will be reduced and elevated with BACTERIAL Meningitis?

Glucose reduced

Protein elevated

WBC elevated (1000 or more)

30

Why is Intrathecal Chemo necessary?

typically, BBB prevents chemo drugs from crossing into brain to treat cancer there

so it must be administered into the spinal column

31

Surgery for spina bifida is usually done when?

24-48 hrs after birth

32

Setting sun eyes are a sign of ---

hydrocephalus

33

Ways to manage seizures w/out meds?

Ketogenic Diet

VNS

34

Which vaccine helps prevent Viral Meningitis?

H flu

35

--- clients always end up in ICU

Encephalitis

36

The Tonic phase lasts ---

The Clonic phase lasts ---

10-20 secs (stiffening)

30 secs (clonic muscle activity)

37

Which posture is associated w/ an injury above the brainstem?

Decorticate

- corting is a HIGHER FORM of dating

38

What is Cushing's Triad?

Bradycardia

Bradypnea

High BP

- all LATE signs of ICP

39

Normal Leukocyte values?

4,500 - 11,000

40

Which positiion is associated w/ meningitis?

opisthotinic position

- head and neck hyperextened to relieve discomfort

41

--- seizures last 5-10 seconds and is more common in girls.

Absence (petit mal)

42

--- is the use of freezing to destroy bloodflow to teh tumor w/ Retinoblastoma.

Cryotherapy

43

--- is a cancer that originates in the lymphoid system.

Hodgkins

44

Management of Meningitis?

ELEVATE HEAD

reduce stimulation (dark room, limit visits)

45

--- is the most common cause of childhood cancer.

Leukemia

46

What is the third most common cancer in Peds?

Non-Hodgkins Lymphoma

47

LOC levels

Lethargy

Obtunded

Stupor

Coma

Persistent Vegetative State

48

Meds for Seizures

Diazepam

Phenytoin

Carbamazepine

Valproic Acid

Fosphenytoin Sodium

Ethosuximide

49

The following are S/S of which type of cancer?

- Pallor, eays bruising, lethargy, malaise

- Enlarged liver, lymph nodes, joints

- Abdominal, leg, and joint pain

- Constipation, headache, vomiting/anorexia, unsteady gait

Leukemia

50

Spina Bifida is closely associated w/ ---

hydrocephalus

51

Which seizure if often mistaken for daydreaming in class?

Petit Mal (Absence)

52

Why should bed be flat postop for shunt placement?

to avoid overdrainage

53

Glasgow Coma Scale measures...

Eye opening

Verbal Response

Motor Response

54

Normal Platelet values?

150-450 billion

55

How effective is chemo with advanced Retinoblastoma?

not effective

no evidence it increases survival rates

56

The following are s/s of which type of cancer?

- leukocoria
- strabismus
- blindness

Retinoblastoma

57

Which stage of NHL?

tumor on both sides of abdomen; also, all primary thoracic, intraabdominal and paraspinal or erpidural tumors.

Stage 3

58

What is the most common finding w/ Hodgkins Lymphoma?

firm, nontender, enlarged movable nodes in supraclavicular or cervical area

59

When we typically think of seizures, we think of which kind?

Tonic Clonic (Grand Mal)

60

What are the four phases of Tonic Clonic (Grand Mal)?

Aura phase

Tonic Phase

Clonic Phase

Postlictal Phase (altered LOC after seizure is over)

61

-- is premature closure of the sutures (or absence of sutures) leading to cone-head type appearance.

Craniosynostosis

62

How will CSF appear w/ Meningitis?

cloudy (should be clear)

63

The following are s/s of which type of childhood cancer?

- Firm, nontender, abdominal swelling/mass
- Fatigue, malaise, weight loss
- Fever
- Hematuria
- HTN

Wilm's Tumor (Nephroblastoma)

64

Which chemo is good for Wilm's Tumor?

Dactinomycin

Vincristine

65

Inflammation of brain usually caused by viral infection like meningitis.

Encephalitis

66

What is Polycythemia and what are the complications?

increased concentration of Hgb in blood

This can be associated with higher risk of thrombus or clot formation leading to strokes, heart attacks, pulmonary embolism, and possibly death.

Another complication of polycythemia vera is the potential transformation into a blood cancer (leukemia), excessive bleeding (hemorrhage), or clotting problems.

67

Half of children w/ --- have few symptoms.

neuroblatoma

68

With encephalitis, --- impairment is common.

neurological

69

Reflex:

Infant swings to the side that is stroked

galant reflex

70

What is Agranulocytosis and what are the complications?

deficiency in granulocyts in blood

increased vulnerability to infection

71

Nephroblastoma is another term for which type of cancer?

Wilm's Tumor

72

What is SVC Syndrome?

obstruction of Superior Vena Cava which leads to swelling of upper arm, face and neck

happens w/ NHL

73

Some general S/E of Chemo include:

Mucosal Alteration

Skin breakdown

Neuropathy

Loss of appetite

Hemorrhage Cystitis

Alopecia

74

Which Stage of Hodgkins?

lesions in one lymph node area or only one extralymphatic site

Stage 1

75

---- is seizure that lasts more than 30 mins, or a series of seizures which are so rapid that they don't allow child to regain consciousness before next one.

Status Epilepticus

76

When is Rhabodmyosarcoma painful?

when tumor starts pressing against vital structures

sometimes there is no pain with Rhabdomyosarcoma

77

Leukemia causes an increase in what?

immature WBCs (bands) which then infiltrate into organs and tissues

78

Diagnosis of Encephalitis.

History
- recent immunizations
- recent travel (to areas w/ vectors)
- recent insect bites

79

How should we approach hydration w/ ICP client?

2/3 maintenance

we don't want to increase ICP even more w/ too much fluid

80

Which Stage of Hodgkins?

lymph node regions on both sides of diaphragm, or one extralymphatic site, spleen, or both are involved

Stage 3

81

Which odd allergy is associated w/ spina bifida?

latex allergy

82

Is Cushing's Triad an early sign or late sign of Brain injury?

LATE

83

Treatment for Bacterial Meningitis

IV antibiotics

Isolatoin for 24 hrs

Hydration

Antiseizure Meds

Mannitol

84

Glasgow coma scale scoring?

15 best

8 or less is bad

3 is worst

85

Which Stage of Hodgkins?

two or more node regions on same side of diaphragm or one additional extralymphatic site or organ on same side as diaphragm

Stage 2

86

What type of foods to prevent spina bifida?

Folic Acid and Vit C

87

Reflex:

Infant extends arm when head is turned toward that side

Tonic Neck

88

Which Stage of Hodgkins?

ancer has metastasized diffusely throughout body to one or more extralymphatic sites

Stage 4

89

Leukemia is classified how?

type of WBCs that are effected

- Acute Lymphoid Lukemia (ALL)
- Acute Myelogenous or Nonlymphoid Leukemia (AML/ANLL)

90

Where are we most likely to first see enlarged lymph nodes in Hodgkins Lymphoma?

Painful?

supraclaviular or cervical area

Not painful

91

--- is a cancer that effects the ends of long bones.

Osteosarcoma

- distal femur
- proximal tibia
- proximal humerus

92

Which syndrome is a primary cause of Hydrocephalus?

Arnold Chiari Syndrome

93

-- is the use of laserbeams to destroy retinal blood flow to the tumor w/ Retinoblastoma.

Photocoagulation

94

Seizure manifestation can be caused by ---

Hyponatremia

Hypernatremia

Late: hypoglycemia

95

-- is a type of cancer that effects skeletal muscle.

Rhabdomyosarcoma

- typically in head/neck and orbit of eye

96

Meds for Infantile Spasms

ACTH (gel form)

97

What concerns might the nurse have about sedation in the acute head injury patient?

interferes w/ the need to perform periodic LOC exams

98

Complications from Meningitis

DIC

Subdural Effusion

Sepsis

Septic Arthritis

Seizures

Hearing Loss (w/ gentamycin)

99

What is a Ketogenic Diet?

What?
- high fat
- low carb
- adequate protein

why?
- body can shift from using glucose as fuel, allowing brain to use it

100

An --- hemorrhage is between skull and Dura Mater

A --- hemorrhage is between Dura and Arachnoid.

Epidural

Subdural

101

What are Leukemic (Blasts)?

immature WBCs

affects the normal production or mature WBCs

102

Implantable device that reduces seizures?

Vagus Nerve Stimulation (VNS)