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Pediatrics > Week 5, Class 1 (9/27) > Flashcards

Week 5, Class 1 (9/27) Flashcards

1
Q

Types of cleft lip and palate

A
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2
Q

Cleft lip/palate pre op considerations

A

Assess ability to suck and feed
Obtain baseline weight
Inspect lip and palate with gloved finger
Instruct proper feeding care

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3
Q

Isolate cleft lip pre op considerations

A

Encourage breastfeeding
Use wide based nipple for bottle feeding
Squeeze infants cheeks together to decrease gap during feeding

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4
Q

Cleft lip and palate post op considerations

A

Keep infant pain free to decrease crying and stress on repair
Avoid infant sucking on nipple or pacifier
Daily weights
Observe family interaction with infant

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5
Q

Cleft lip post op considerations *(in red)

A

Position infant on back and upright or on side
Apply elbow restraints
- should be removed per protocol to assess the skin, allow limb movmt, and provide comfort
Use water or diluter hydrogen peroxide to clean incision site
Apply Abx ointment prn
Gently aspirate secretions of mouth and nasopharynx to prevent respiratory complications

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6
Q

Cleft palate post op considerations *(in red)

A

Change positions frequently to facilitate drainage and breathing
Place infant side lying position immediately
IVF until able to eat or drink
AVOID straw, tongue depressor, hard pacifier, rigid utensils, hard tipped sippy cups, or suction catheters in mouth
Elbow restraints
Close observations of airway obstruction, hemorrhage, and laryngeal spasm
Face mask to deliver O2 if needed.

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7
Q

Cleft lip/palate complications

A

Ear infections and hearing loss
Speech and language impairment
Dental problems

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8
Q

Important points for cleft lip/palate *(in red)

A

Protect surgical site
-minimize crying to prevent strains on lip suture line
-maintain Logan Bow to lip if applied
-cleansing surgical site (may have antibiotic ointment x3 days)
-elbow restraints ( assess limb movmt periodically)

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9
Q

Infant GERD signs and symptoms

A

Spitting up or forceful vomiting
Irritability , Excessive crying
Blood in vomitus
Arching of the back
Stiffening
Respiratory problems, apnea
FTT

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10
Q

Child GERD signs and symptoms

A

Heartburn
Abdominal pain
Difficulty swallowing
Chronic cough
Non-cardiac chest pain

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11
Q

Complication of GERD

A

Aspiration pneumonia ( stomach contents)

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12
Q

GER considerations

A

Small frequent meals
Thickened formula with 1tsp-1tbsp. Rice cereal per 1oz formula
AVOID foods that cause reflux
-caffeine, citrus, peppermint, spicy, fried
Position child with HOB elevated after meals

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13
Q

Surgical intervention for GERD

A

Nissen fundoplication. Gastric fundus is wrapped around lower 2-3cm of esophagus

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14
Q

Pyloric stenosis assessment findings

A

Projectile vomiting occurs within minutes after eating (3rd-6th week)
Palpable olive shaped mass in RUQ of the abdomen
Usually occurs in male infants
Metabolic alkalosis

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15
Q

What is a pyloromyotomy ?

A

Laparoscopic surgery for pyloric stenosis
Allows for proper drainage from the stomach into the intestines

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16
Q

Intussusception

A

Telescoping of one part of the intestine into the other
Partial to complete obstruction of the bowel

17
Q

Intussusception assessment findings

A

Currant jelly stool (mixed blood and mucus)
-important to ask what stools look like
Acute, intermittent abdominal pain
Movable sausage shaped mass in RUQ

18
Q

Hirschsprung disease/ signs and symptoms

A

Absence of ganglion cells in colon
S/s: vomiting bile, failure to pass meconium in first 24-48 hours of life, abdominal distention, palpable fecal mass, foul smelling ribbon like stool

19
Q

What can cause metabolic alkalosis?

A

Projectile vomiting
NG tube suctioning

20
Q

Lab value that indicates UTI

A

Nitrites

21
Q

What is responsible for 80% of GI disorders or defects

A

E coli

22
Q

What is the most common organism associated with the development of a UTI

A

E. Coli

23
Q

What increases the risk for febrile UTI?

A

Vesicoureteral reflux

24
Q

What is Phimosis?

A

Narrowing of opening of foreskin
Can lead to dribbling urine pattern

25
Q

Phimosis management

A

** Urologic emergency**
Compromises arterial circulation
Do not forcefully retract foreskin

26
Q

What is Anorchism?

A

Total absence of testis

27
Q

What do you need to avoid with Epispaidas?

A

Circumcision

28
Q

What is Epispadias ?

A

Exposed or open dorsal urethra

29
Q

What do you need to avoid with Hypospadias?

A

Circumcision

30
Q

What do you test for with disorders of sex development?

A

Laboratory testing for karyotype

31
Q

Nephrotic syndrome clinical manifestations

A

Normal to low BP
Decreased albumin in the urine
Serum albumin decreased
Fluid shifts from plasma to interstitial spaces
Facial and periorbital edema that improves throughout the day

32
Q

Lab test for for Nephrotic syndrome

A

Proteinuria up to 15 grams in 24 hour period
Increased specific gravity
Hypoalbuminemia
Low total serum protein, low albumin
Low serum sodium (hyponatremia)

33
Q

Therapeutic management for nephrotic syndrome

A

Corticosteroids- Prednisone
Diuretics- Furosemide

34
Q

Interventions for nephrotic syndrome

A

Daily weights
Strict I&O
Salt and fluid restriction
Abdominal girth measurement
Avoid large crowds
Adhere to medication regimen

35
Q

Acute glomerulonephritis assessment findings

A

Hypertension (mild to severe)
Smoky, cloudy, tea colored urine
Proteinuria (increased amount of proteins reflects increased severity of renal disease)

36
Q

Renal failure lab findings

A

Elevated serum phosphorus level
- phosphorus cannot be excreted
Decreased serum calcium levels
-not enough vit D absorb calcium
Anemia
- lack of erythropoietin made by kidneys

37
Q

Acute kidney injury treatment

A

Treat the underlying cause

38
Q

What is the preferred method of dialysis for children?

A

Peritoneal dialysis

39
Q

What does hemodialysis achieve?

A

Rapid correction of fluid and electrolyte abnormalities

Pediatrics (20 decks)

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