Peds Test 3

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Peds Test 3
2013-09-24 21:19:09
Peds Test

Peds Test 3
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  1. A congenital defect of the lip that varies from simple notching of vermillion border on one side to bilateral fissure or opening is:
    cleft lip
  2. Problems that are associated with cleft lip are:
    • bonding
    • feeding
  3. Surgical repair of a cleft lip is __________.
  4. Cheiloplasty post-op:
    • IV fluids
    • I&O
    • avoid sucking for 1-2 weeks
    • feed with rubber tipped syringe
    • Breck feeder (bulb tipped syringe)
    • H2O first, then formula
    • upright for feeding, burp every 1/2 oz
    • no suctioning or tongue depressors
    • position inclined on back/upright in infant seat or on right side NEVER on abdomen
  5. Suture line care after a cheiloplasty:
    • do not allow to crust (scarring)
    • use saline/sterile water
    • antibiotic ointment
    • Logan Bar- prevents strain/stress
    • sutures usually removed 7-10 days
    • analgesics
    • cuddle (crying puts strain on suture line)
  6. __________ is a congenital defect resulting in failure of the hard palate to fuse, leaving passageway between nasopharynx and nose.
    cleft palate
  7. Problems associated with cleft palate:
    • increased resp/middle ear infections
    • can interfere with bonding
    • speech problems
    • dental problems
  8. Surgical repair of a cleft palate should be performed around __ to __ months of age and is called a __________.
    • 6-18
    • palatoplasty
  9. __________ is the abnormal narrowing of the pyloric sphincter caused by overgrowth of muscle at the pylorus.  Hypertrophy causes the stomach to become __________.
    • pyloric stenosis
    • distended
  10. S/s of pyloric stenosis appear when the infant is about __ to __ weeks old; includes occasional vomiting that becomes __________ with a very sour smell.  Other s/s:
    • 2-3 weeks old
    • projectile
    • sunken fontanels
    • dry and mucous membranes
    • no tears w/crying
    • inelastic skin turgor (tenting)
    • pallor, gray skin with dark circles
    • weight decrease
    • decreased UOP
    • urine specific gravity >1.030
    • VS changes (weak pulse)
  11. Pyloric stenosis is usually dx by __________.
  12. __________ is performed by splitting the hypertrophied pyloric muscle down to the submucosa.
  13. While awaiting surgery for pyloric stenosis, they might recommend a small amt of __________ to be added to the formula to thicken it and give extra nutrients.
  14. __________ is commonly given to infants with pyloric stenosis.
  15. How should you feed an infant after a pyloromyotomy?
    feed slowly and upright, burp frequ, position on right side after feedings
  16. Who gives the feeding schedule for an infant who had a pyloromyotomy?
  17. After a pyloromyotomy, the infant may vomit within the 1st 24 hrs and have a brief dumping syndrome; this is __________.
  18. __________ is a medical emergency and is described as the telescoping of the bowel into itself usually at the __________ valve.
    • intussesception
    • ileocecal valve
  19. Intussusception usually affects males under __ years of age.
  20. Intussesception may correct itself, and the prognosis is good if it is treated in the first __ hrs.
    24 hrs
  21. Fetal shunt:  from the umbilical vein to inferior vena cava
    ductus venosus
  22. Fetal shunt:  from the right atrium to the left atrium
    foramen ovale
  23. Fetal shunt:  from the pulmonary artery to the aorta
    ductus ateriosis
  24. CHF tx goals:
    • improve cardiac function:  Digoxin, ACE inhibitors
    • remove accumulated fluid:  diuretics, monitor K level (low K can lead to dig toxicity), fluid and Na restrictions, monitor I&O, daily wts
    • decrease cardiac demands:  bed rest, small freq feedings; soft nipple with enlarged hole; semi-fowler's
    • increase tissue oxygenation:  supplemental O2, inrease iron foods; supplements as needed