Peds 28-32

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Author:
tiffanydawnn
ID:
25173
Filename:
Peds 28-32
Updated:
2010-06-28 22:07:05
Tags:
pediatrics
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Description:
Peds 28-32
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  1. Phimosis
    • —Narrowing of the distal end of the foreskin (prepuce) covering the head of the penis
    • —Normal from birth until the age of 3
    • May interfere with urination
    • Circumcision to cure
  2. Hypospadias / Epispadias
    • Hypospadias: Urinary meatus is on the undersurface of the penis
    • Epispadias: Urinary meatus is on the upper surface of the penis
    • Do not circumcise
    • Surgery between 6 - 18 months
    • Catheter 7-14 days post, pain mgmt, family teaching
  3. Exstrophy of the Bladder
    • —Bladder is opened & exposed
    • —Urine leaks & excoriates surrounding skin

    • Surgery, antibiotics
    • Position on back or side
  4. Acute Urinary Tract Infection
    • Urethritis: Infection of the urethra
    • Cystitis: Infection of the bladder
    • Pyelonephlitis: Infection of the kidney & renal pelvis


    • Caused by alkaline urine, vesicoureteral reflux (urine backs up into ureters)
    • Frequent UTI - suspect sexual abuse
  5. UTI S/S
    • Abrupt & severe
    • High fever
    • Febrile seizures
    • Pallor
    • Anorexia
    • Vomiting
    • Diarrhea
    • Frequent urination
    • Foul smelling urine
    • Flank pain
    • Abdominal tenderness
  6. UTI Treatments
    • Sulfonamides
    • Amipcillin/Rocefin
    • Increase fluids
    • I&O
    • Skin care
    • Cranberry juice
    • No tubs
  7. Nephrosis
    • Unknown cause - lasts 18 months
    • albuminuria, hypoalbuminemia, edema, anasarca, high blood cholesterol, hematuria
    • Boys 2-7
    • Slow onset
    • Edema, resp distress, irritable, anorexia, diarrhea, acites, low resistance to infection
    • Steroids, I&O, daily weight, skin care, semi-fowlers, measure abdomen, no salt, increase protein
  8. Acute Glomerulonephritis
    • Allergic reaction to group A beta-hemolytic streptococcus (1-3 weeks post strep infection)
    • glomerulus inflamed/blocked
    • Boys 3-7
    • Hematuria, edema, fever, HA, malaise, HTN, smoke colored urine. oliguria (restrict potassium)
    • Anti-infectives
  9. Wilm’s Tumor
    • Grows within the renal capsule
    • constipation, vomiting, abdominal distention, dyspnea, weight loss, pallor, anemia
    • Do not palpate abdomen
    • Nephrectomy, chemo/radiation
  10. Cryptorchidism
    • Undescended Testes
    • Increased incidence of testicular cancer, testicular torsion & decreased fertility or sterility
    • HCG or surgery
  11. Hydrocele
    —Water/edema accumulates in the membrane that surrounds the testes (swells)

    —Treatment involves aspirating fluid out of the sac & part of the sac is removed
  12. Enuresis
    • —Involuntary urination beyond when control of urination is acquired
    • psychological or physical
    • physical work up to rule out physical cause
  13. Macule
    • žA discolored spot that is even with the skins surface
    • Example: Freckles
  14. Papule
    • žA circumscribed, solid elevation of the skin
    • Examples: Elevated mole, warts
  15. žVesicle
    • A small circumscribed elevation of the skin containing fluid
    • Example: Cold sore
  16. žPustule
    • A small, circumscribed elevation of the skin containing purulent matter
    • Example: Infected pimple
  17. žCrust
    • Blood, pus or serum that has dried on the surface of the skin after the injury
    • Examples: Scab,eczema
  18. žWheal
    • A circumscribed, slightly reddened papule or irregular plaque of edema of the skin, usually accompanied by intense itching
    • Examples: Insect bites, hives
  19. žEcchymosis
    Purplish patch caused by extravasation (leaking) of blood into the skin; like petechiae but >3 mm diameter
  20. Erythema
    Redness
  21. Telangiectasia
    Stork bite

    • Small reddened vascular lesions common in newborns on the eyelids, forehead & back of neck
    • Will fade & disappear
  22. Port Wine Stain
    • Nevus Flammeus
    • dilated dermal capillaries
    • deep purple to pink flat & clearly demarcated lesions
    • darkens with age
    • laser therapy to treat
  23. Hemangioma
    Strawberry Mark

    Caused by an overgrowth of capillaries
  24. Prickly Heat
    Miliaria

    Caused by excess body heat & moisture

    • Pruritis, irritable
    • hot weather, hot room, overdressed
    • Parent teaching, expose to air
  25. Cradle Cap
    • Seborrheic Dermatitis
    • Accumulation of secretions from oil glands & cellular debris

    • Thick, yellow, oily, adherent & crustlike scales form on the scalp & forehead
    • Caused by insufficient hygiene
    • Shampoo, baby oil
  26. Diaper Rash
    • Caused by prolonged exposure to urine, feces, detergents, chemicals, food changes
    • Red skin, scales, blisters, ulcerations
    • Change diapers often, no fabric softeners, loose diapers, air out
  27. Infantile Eczema
    • žInflammation of the skin
    • Common up until the age of 2 years
    • Heredity, allergic reactions
    • Cheecks --> arms, legs, trunk
    • red papules, vesicles
    • pruritis
    • Can become infected
    • ID allergen, oatmeal baths, no vaccines, steroids, antihistimines
  28. Staph Infections
    • umbilicus & circumcision site
    • pustules
    • Contact isolation, antibiotics, handwashing
  29. Impetigo
    • žSuperficial skin infection, usually caused by staphylococci in the newborn & by group A beta-hemolytic streptococci in the older child
    • Easily spread

    • Red papules, vesicles, pustules surrounded by a reddened area (nose/mouth)
    • Vesicles break & area weeps



    Contact isolation, antibiotics, cleanse lesions 4 times a day, topical antibiotics, prevent scratching
  30. Tinea
    • Ringworm
    • capitus: scalp
    • corpitus: body
    • pedis: feet
    • cruris: groin
    • antifungals, avoid sun
  31. Pediculosis
    • Lice
    • capitus: head
    • corporis: body
    • pubis: pubic
    • pruritis, nits
    • RID, NIX, Kwell, fine tooth comb, treat family
  32. Scabies
    Dark lines, pruritis
  33. Burns
    • žThermal: Fire, scalding
    • žChemical: Corrosive substance
    • žElectrical: Electricity
    • žRadiation: Exposure to radiation, the most common type being sunburn
    • Airway, hypovolemic shock
    • IV fluids

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