Peds Test 4

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mel26704
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237576
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Peds Test 4
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2013-09-30 21:28:48
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Peds Test 4
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  1. The bladder capacity of a child can be determined by what formula?
    age in years + 2 = ounces of bladder volume or capacity
  2. Inflammation of the bladder:
    cystitis
  3. Bacteria in the urine:
    bacteriuria
  4. Infection of the kidney and the renal pelvis:
    pyelonephritis
  5. Infection of the ureters:
    ureteritis
  6. Infection of the urethra:
    urethritis
  7. Backward flow of urine into the ureters:
    What can result if not treated?
    • vesicoureteral reflux
    • pyelonephritis and scarring
  8. Normal urine specific gravity:
    It is __________ when dehydrated.
    It is __________ when overhydrated.
    • 1.030 - 1.005
    • high
    • low
  9. How is a child's urinary system different from an adult?
    • kidneys are immature
    • dehydrated quickly
    • higher risk of fluid overload
    • bladder capacity smaller
  10. What is the most reliable indicator of the GFR?
    creatinine clearance (24 hr urine)
  11. __________ is the most common organism that causes a UTI.
    E-coli
  12. UTI prevention:
    • wipe front to back
    • avoid bubble baths
    • wear white, cotton underwear
    • wear loose-fitting pants
    • increase fluid intake
    • have child urinate immediately after a bath
  13. Nephrosis is a chronic renal disease characterized by:
    • heavy proteinuria (protein gets through glomerulus)
    • hypoabuminemia
    • severe generalized edema - anasarca
    • hyperlipidemia (liver tries to bulk up blood)
  14. __________ or nephroblastoma is a common neoplasm of the kidney in children, develops from abnormal __________ tissue, and most often, affects the __________ kidney.
    • Wilm's tumor
    • embryonic
    • left
  15. Wilm's tumor is a highly __________ and fragile tumor.  The exact cause of this tumor is unknown, but it could be from a possible __________ abnormality.
    • malignant
    • chromosomal
  16. Wilm's tumor is __________, but there are no tests to identify carriers.
    genetically inherited
  17. S/s of a Wilm's tumor:
    • mass in flank area
    • abd distention
    • constipation
  18. If a child has Wilm's tumor, do not:
    palpate the abd
  19. __________ is an excessive amount of fluid in the scrotum that causes swelling.
    hydrocele
  20. A hydrocele is evident in a __________ or shortly thereafter as testicles descend through the inguinal ring into the scrotum.
    newborn
  21. A hydrocele is dx by:
    • transillumination
    • s/s
    • ultrasound
  22. __________ is also known as undescended testes and is the failure of testes to descend into the scrotal sac.  Descent occurs from __ to __ months intrauterine to __ weeks after birth.
    • cryptorchidism
    • 7-9 months
    • 6 weeks
  23. What are some causes of a cryptorchidism?
    • band of fibers at inguinal canal blocking descent
    • spermatic cord not long enough to reach
    • decreased testosterone level
  24. Which side does cryptorchidism usually occur in an infant?
    right
  25. There is an increased incidence of cryptorchidism in __________ infants.
    premature
  26. An infant with cryptorchidism may have spontaneous descent within the __ year, but other tx options include:
    • 1st
    • HCG
    • orchiopexy at age 1-2
    • suture undescended testicle into scrotal sac, repair hernia if present, close inguinal canal
  27. What should you teach the parents of an infant with cryptorchidism?
    • complications
    • increase risk of cancer and infertility
    • TSE when child is older
  28. What are some s/s of HYPOthyroidism in a newborn/infant?
    • dry, cool skin
    • dry, brittle hair
    • puffiness around eyes
    • large tongue and head
    • excessive sleepiness "good baby syndrome"
    • constipation and enlarged abd
    • umbilical hernia
    • hypotonia/floppiness (rag doll appearance)
    • feeding difficulties
    • growth problems/FTT
  29. What are some s/s of HYPERthyroidism?
    • excessive sweating
    • restlessness, nervousness, emotional lability
    • declining school performance
    • increased appetite with weight loss
    • fatigue
    • wide-eyed, staring expression (exophthalmos)
    • tremors of tongue, hand
    • heat intolerance
    • goiter
    • palpitations/tachycardia
  30. A complication of HYPERthyroidism is a thyroid __________.  It occurs when there is a sudden release of the thyroid hormone.  The s/s can include:
    What is the tx?
    • storm
    • delirium, seizure, stroke, coma; possible death
    • same as hyperthyroidism, but with higher doses of meds
  31. Some s/s of type __ diabetes include increased infections such as UTI/vaginal infections and slow healing.
    1
  32. What are the 3 goals of tx for type 1 diabetes mellitus?
    • ensure normal growth and development through metabolic control
    • enable child to cope with chronic illness, have happy and active childhood, and be well integrated into family
    • prevent complications
  33. When a child is in diabetic ketoacidosis (a form of metabolic acidosis) their ABG levels are all _________.
    low
  34. Insulin administration:
    (my version)
    • types, action/onset/peak/duration
    • equipment
    • drawing up- NRRN
    • site selection/rotation
    • insulin pump if needed
  35. What should you teach a parent/child with diabetes about nutritional management?
    • importance of spacing meals throughout day
    • importance of snacks/carrying snacks
    • myplate, glycemic index
    • high fiber foods
  36. What is Cushing syndrome caused by?
    excessive circulating free cortisol; cortisol overproduced by adrenal cortex
  37. The bones of kids are:
    soft and flexible
  38. Kids have __________ joints that allow for increased range of motion.
    flexible
  39. __________ is one of the most common deformities of the skeletal system, and characterized by a foot that has been twisted inward or outward.
    clubfoot
  40. Talipes equinovarus is:
    feet are turned inward, child walks on toes/outer borders of feet
  41. Hip dysplasia is more common in __________.
    females
  42. __________ test is performed to detect an unstable hip in the newborn.  The physician extends the hips while stabilizing the pelvis.
    barlow's test
  43. __________ sign is when the physician can actually feel and hear the femoral head slip back into the acetabulum under gentle pressure.
    Ortolani's sign/click
  44. __________ dislocation of the hip is more common.
    unilateral
  45. In infants more than 2 months of age, soft tissue contractures prevent stabilization of the hip, and longer-term immobilization with a __________ may be required.
    Pavlik harness
  46. The body __________ cast encircles the waist and extends to the ankles or toes.
    spica cast
  47. What are some early signs of dislocation of the hip?
    • limitation of abduction
    • asymmetry of skin folds
    • shortening of femur
  48. A spica cast maintains the legs in a __________ position and is used to treat developmental hip dysplasia.  The infant is able to move toes freely.
    frog-like
  49. __________ skin traction is a type of skin traction used in fractures of the femur and in hip and knee contractures.
    Bucks traction (Buck's extension)
  50. __________ traction uses a sling that is positioned under the knee, which suspends the distal thigh above the bed.
    Russell traction
  51. Skin traction is applied to the __________ extremity.
    lower
  52. Checklist for a traction apparatus:
    • weights hanging freely
    • body in alignment
    • HOB no higher than 20 degrees
    • heels elevated off of bed
    • monitor skin
    • pain/relief recorded
    • measures to prevent constipation
    • trapeze for change of position
    • neuro checks regularly
  53. __________ is an infection of the bone that generally occurs in children younger than 1 year of age and between 5-14 years of age and is more common in __________.
    osteomyelitis
  54. Characteristics of a child with muscular dystrophy:
    • onset usually between 2-6
    • calf muscles hypertrophy/pseudohypertrophic
    • weakness- falling, clumsiness, contractures of ankles/hips,
    • Gowers' maneuver
  55. Juvenile arthritis care:
    • moist heat/exercise are advised
    • whirpool baths
    • hot packs
  56. Commonly called "sway back," often seen during pregnancy:
    lordosis
  57. Also known as "hunchback," and is an increased roundness in the thoracic curve commonly found in the elderly.
    kyphosis
  58. An abnormal side to side curvature of the spine:
    scoliosis
  59. S/s of scoliosis develop __________ and are not painful so that detection is usually via an incidental screening at school.  The __________ are different heights.  Dx is made by __________ photography that highlights the asymmetry and a spinal x-ray study.
    • slowly
    • shoulders
    • moire photography
  60. Tx for scoliosis is aimed at correcting the __________ and preventing more severe scoliosis.
    curvature
  61. A __________ brace exerts pressure on the chin, pelvis, and convex side of the spine. It is worn __ hrs a day and is worn over a t-shirt.
    Milwaukee brace
  62. The __________  brace is proving effective for pts with ______ curvatures, and is more acceptable to the self-conscious young person.
    • boston brace
    • low curvatures
  63. Severe scoliosis necessitates ___________ to fuse the bones.
    surgery
  64. Neuro checks:
    • vital signs
    • LOC
    • pupil response
    • motor function/reflexes/posturing
  65. S/s of IICP:
    • T- increased
    • P- decreased
    • R- decreased
    • BP- increased
    • h/a
    • change in LOC/orientation
    • lethargy
    • irritability/high-pitched cry
    • sunset eyes
    • bulging fontanels 
    • change in pupils (PERRLA)
    • seizure activity
  66. Most common head injury:
    concussion
  67. Nonprogressive d/o of motion and posture resulting from brain injury or insult during pd of early brain growth:
    It is considered the most common permanent disability disease in children.
    cerebral palsy

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