Pediatric exam 3

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britsands
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187014
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Pediatric exam 3
Updated:
2012-12-04 13:33:52
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Peds 3
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  1. Hemophila superficial bleeding
    apply pressure for at least 15 min and ice to vasoconstrict
  2. Decreased rbc and h&h
    anemia
  3. Effects of anemia on circulatory system
    • hemodilution
    • decreased peripheral resistance
    • increased cardiac circulatio and turbulece ( may have murmer or lead to failure)
    • Cyanosis
    • growth retardation if prolonged
  4. when should iron be administered?
    • between meals for better absorption
    • green poop
  5. If milk introduced to soon
    • gi bleed
    • milk protein allergies
    • iron def anemai
  6. ages most common with iron def anemia
    • 10 months- not on formula as much
    • 2 years - milk babies
    • adolesents- growth spurt, poor nutrition
  7. Splenic sequestration
    • blood pools in the spleen
    • ruptures
    • may require emergenancy spleenectomy and will make patient immnocomprimised
  8. precipitating factors for sickle cell crisis
    • anything that increases body's need for oxygen or alters transport of oxygen:
    • trauma
    • infection and fear
    • physical and emaotional stress
    • dehydration
    • hypoxia- high altitiude, poorly pressurized planes, hypoventilation, hypothermia
  9. Life expectancy of sickle cell
    30 days
  10. signs fo splenic sequestrations
    profound anemia, hypovolemia, and shock
  11. Vaso-occlusive thrombotic
    • Sickle cell anemia
    • most common type of crisis
    • stasis of blood with clumping of cells in microcirculation
    • SIGNS: fever, pain, tissue engorgement
  12. Aplastic crisis
    • type of sicklecell crisis
    • trig by being sick or folic acid def
    • signs are profound anemia and pallor
    • watch Retic count- high good, low transfusion
  13. Sicke turbidity test
    Rapid test to sickle cell anemia at least 6 months old
  14. Hemophilia A
    • Classic
    • factor 8
    • only in males
    • x-linked recessive trait
  15. Peak onset for leukemia
    2-6 years of age
  16. Children at greater risk for ALL
    • Children with trisomy 21: 20 times more likely
    • Downs
  17. Most severly affected organs with leukemia
    liver and spleen
  18. lab values with leukemia
    • low plt
    • low hgb
    • high or low wbc
  19. clinical manifestations of leukemia
    bruising, anemic, tired, fever
  20. what shows makred infiltration and enlargements and fibrosis of leukemia
    spleen, liver, lymph glands
  21. Diagnositics of leukemia
    • Peripheral blood smears
    • -immature leukocytes
    • frequent low blood counts
    • LP to eval cns
    • bown mare aspiration and biopsy
  22. GVHD
    • graft vs host disease
    • body rejects the stem cell transplant (HSCT)
  23. epidural hemorrage
    blood beteween dura and skull arterial bleeding
  24. subdural hemorrahage
    bleeding between dura and cerebral- venous
  25. manifestations of nonbacterial meningits (aseptic)
    • headache, fever, malaise, abdominal pain, photo phobia
    • subside 3-10days
  26. Rifampin
    menectra
    • rifampin- prophalactic nonbacterial men
    • meactra - immunization has to be ll or older
  27. impaired absorption of csf within the subarachnoid space
    communicating hydrocephalus
  28. obstruction to flow of csf through ventricular system
    non- communicating hydropcephalus
  29. alpha fetaprotien at what time
    if high
    if low
    • 16-18 must be sure how far along
    • high- spina bifida
    • low- downs
  30. myelogmenigocele if defect 2nd lumbar vertebra
    • flaccid paralysis of lower extremities
    • sensory defect

    • early closure 12-72hours after birth
    • cath q4hrs
    • constipation
  31. muscular dystrophy
    diagnosis
    • emg, muscle biopsy, and serum enzyme measurement
    • serum cpk and ast levels high in the first 2 years of life before onset of weakness, then levels dimisish
  32. normal wbc
    5-10
  33. hbg normal
    12-15
  34. hct
    35-50
  35. platelets
    150-400
  36. retardation diagnosis criteria
    • <75 iq
    • before 18
    • 2 functional imparments: communication, home living, community use, leisure, health safety, self care, special skills, fuctional academics, work, self direction
  37. mental retardation cause
    • rubella intrautrein infection and intoxication
    • trama
    • metabolic and endocrine disorders
    • inadequate nutrition
    • postnattal brain disase
  38. S&S of downs
    • hypotonia
    • short fingers
    • small ears
    • depresed nose
    • protruding tongue
    • semion creases- on line on hand that goes form on side to other with no breaks
  39. Hip dysplaisa
    therapeutic management
    • newborn- 6 months- pavlik harnis for abduction of hip
    • 6-18 months- spica cast
    • older child- surg
  40. positive ortolani test
    • ddh
    • hip click
  41. scoliosis
    >20*
    MONITOR XRAY
  42. scoliosis
    20-40*
    bracing
  43. >40-50* scoliosis
    surgery

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