Peds Test 4

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Peds Test 4
2013-09-30 21:28:48
Peds Test

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:
  3. Bacteria in the urine:
  4. Infection of the kidney and the renal pelvis:
  5. Infection of the ureters:
  6. Infection of the urethra:
  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.
  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.
  20. A hydrocele is evident in a __________ or shortly thereafter as testicles descend through the inguinal ring into the scrotum.
  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?
  25. There is an increased incidence of cryptorchidism in __________ infants.
  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.
  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 _________.
  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.
  39. __________ is one of the most common deformities of the skeletal system, and characterized by a foot that has been twisted inward or outward.
  40. Talipes equinovarus is:
    feet are turned inward, child walks on toes/outer borders of feet
  41. Hip dysplasia is more common in __________.
  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.
  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.
  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.
  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 __________.
  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:
  57. Also known as "hunchback," and is an increased roundness in the thoracic curve commonly found in the elderly.
  58. An abnormal side to side curvature of the spine:
  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.
  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.
  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:
  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