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What could these signs indicate:
- Hypothermia
- Hypoglycemia
- Poor feeding
- Listlessness
- Irritability
Sepsis
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What is the common med tx of RDS and its basic cause?
Betamethasone: basic cause if lack of surfactant
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What is the tx for shock, pallor, or hemorrhage in LBP following delivery?
Volume expanders of 10 ml/kg
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This results in PDA and the foramen ovale to reopen in the preemie
Hypoxia leading to shunting of blood and persistent fetal circulation
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What is cephalocaudal?
Intensity and progression of jaundice
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What can these s/s indicate:
- hypoxia
- Low APGAR
- staining of skin
- rales/rhonci
MAS (meconium aspiration syndrome)
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What could a hematocrit of 68% indicate in a newborn?
RDS and a risk for jaundice
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Fill in:
Infants have __a__mL of CSF, while adults have 150mL
a. 50mL
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Fill in:
Average head circumference @ birth __a__ cm, __b__ @ 6 months, and __c__ cm @12months
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This a rare condition, in which a baby develops or is born with an abnormally shaped skull. It happens when one or more of the infant's cranial sutures fuses too early. What is the tx?
Craniosynostosis: tx if cranectomy, which opens the sutures that already opened to manage increased ICP.
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T or F: newborns can follow moving objects and recognize familiar objects
False: they can folow to midline only and fixate, and only focus on faces about 12 inches away
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State the ages f these visual acuity changes
1. 20/20-20/30
2. 20/40-20/70
3. 20/30-20/40
4. 20/50-20/80
- 1. 5 years
- 2. 1 year
- 3. 4 years
- 4. 4 months
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Fill in: Lacrimal ducts function by about __a__ months. They may not have tears til about __b__ months
A & B: 3 months
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Fill in:
Eye orbits double at _a_ year(s) and double again at __b__ years.
Eye growth will be complete by __c_ years
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Fill in:
Ears are developed by __a__ week(s), and hearing in the __b__ trimester.
- a. 3rd week
- b. 2nd trimester
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Infants will distinguish familiar sounds by __a__ days old.
3 days
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T or F: Babies will try to "talk back" with syllables by 3 - 5 months old.
- False: they imitate between 3-5 months old
- At 6-9 months, they "talk back" with syllables
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Parents of a 4 yo child are concerned of his stutter. Which of the following interventions are correct?
A. remind parents stuttering is normal if <10 yo
B. reinforce the fact that this common speech defect requires no tx
C. tell parents speech problems are most treatable during child's teen years
D. inform parents to have a speech eval performed if it continues >5yo
D. (this multiple choice question has been scrambled)
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This is the medical term used when the vision of one eye is reduced because it fails to work properly with the brain. The eye itself looks normal, but for various reasons the brain favors the other eye. This condition is also sometimes called lazy eye.
Amblyopia
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T or F: Ambylopia is a visual problem in which the eyes are not aligned properly and point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward, or downward.
False: that is Strabismus
Amblyopia is the medical term used when the vision of one eye is reduced because it fails to work properly with the brain. The eye itself looks normal, but for various reasons the brain favors the other eye. This condition is also sometimes called lazy eye.
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Match tx:
1. Amblyopia
2. Strabismus
a. Patching
b. Eye exercise, corrective lenses, sugery
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Match:
1. Unable to recognize person/place
2. Unable to think clearly/rapidly
3. awakens easily, limited response
4. sleeps unless aroused, limited interaction with environment
5. considerable stimulation to arouse
a. conused
b. stupor
c. obtunded
d. Disoriented
e. lethargic
- 1. d - disoriented
- 2. a - confused
- 3. e - lethargic
- 4. c - obtunded
- 5. b - stupor
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Spina Bifida is strongly linked to this
Folic acid deficiency
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Match name from left to right:
a. Meningocele
b. Myelomeningocele
c. Occulta
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T or F: an Occulta and Cystica(Spina Bifida) may have no sensory/motor deficits
False: level of involveent determines the deficits
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What deficits can occur in the location of the Cystica (Spina Bifida)
1. T12
2. L1-3
- 1. flaccid LE, incontinent
- 2. Hip adduction
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Which dz can have a HIGH risk for dveloping allergy to latex r/t exposure to catheterizations/surgeries
Spina Bifida
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Fill in:
For Spina Bifida Management, antenatal surgery can be performed at __a__ weeks to close the myelomeingocele
a. 19-25 weeks
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This is a condition that occurs when fluid (CSF) builds up in the skull and causes the brain to swell. The name means “water on the brain.” Brain damage can occur as a result of the fluid buildup.
Hydrocephalus
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T or F: Post-op car for VP shunt includes pt. needs to stay supine or flat for the first 24 hours
True
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What do these s/s indicate
- Chronic, nonprogressive disorder of posture and movement
- diffulcty controlling muscles
Cerebral Palsy
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What do these neural s/s indicate:
photophobia, HA, irritability, nuchal rigidity, N/V
Meningitis
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Match these types of Cerebral Palsy:
1. slow, writhing involuntary movement of all extremities
2. Increased DTR, hypertonia, contractures
3. appearing clumsy
4. tremors at rest and with movement
a. Ataxic
b. Spastic
c. Rigid
d. Dyskinetic
Which one is the most common and which one is rare?
- Common: Spastic
- Rare: Rigid
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This is a condition that occurs when fluid builds up in the skull and causes the brain to swell. The name means “water on the brain.” Brain damage can occur as a result of the fluid buildup.
Hydrocephalus
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95% of meningitis are from 3 bacterial pathogens that start at these localized infection sites.
- 1. Otitis media
- 2. Sinusitis
- 3. PNA
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What are the 2neonatal cause of meningitis?
Group B strep. and E. Coli
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T or F: Meningitis requires contact precautions
How long will they be on these precautions for?
False: Droplet
24 hours after abx
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This term is food poisoning caused by clostridium toxin which is rare, but is still considered a medical emergency. What are its s/s?
What is the food source that infants must avoid to prevent it?
Botulism: 12-36 hours after ingestion = weakness, vomiting, resp. weakness, decreased gag, paralysis.
- Infants: honey is the primary one
- For children and adults: home-canned foods with low acid content
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What is craniosynotosis? tx?
- Early fusing of the fontanels
- Tx: craniectomy to reopen the suture to prevent inhibition of brain growth
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Fill in the months:
_a_ months to follow moving objects
_b_ months for binocularity (eye crossing after this many months may be strabismus)
_c_ months recognize familiar objects
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What is OME and the tx?
- Otitis Media with Effusion. It often follows an episode of AOM (Acute Otitis Media) and should resolve within 1-3 month.
- *Difference between OME and AOM is that there are no signs of acute infection with OME*
It can cause mild temporary conductive hearing loss because of decreased mobility of the ossicles.
Minor surgery to put tubes in and drain discharge and equalize pressure in the ears if it won't resolve within 3 months.
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T or F: when patching an eye for amblyopia tx, do you want to patch the weak eye or the strong eye?
Strong eye
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What is pepilledema and what is it a sign for?
Eyes are bugging out and a late sign for ICP in children
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What position will you keep a baby in until they can get into surgery with spina bifida?
prone
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What is Hydrocephalus and what is it almost always involved with which spinal defect?
Spina bifida
Hydrocephalus: Hydrocephalus is the buildup of fluid in the cavities (ventricles) deep within the brain. The excess fluid increases the size of the ventricles and puts pressure on the brain. Cerebrospinal fluid normally flows through the ventricles and bathes the brain and spinal column.
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How is hydrocephalus treated?
Postop management?
What are parents taught
bypass blockage, drain fluid in ventricles, and insert possible VP shunt
- Keep baby flat at first, then eventually higher to HOB 45 degrees
- keep baby hydrated
- pain management
Education: teach about s/s of ICP to assess functionality of shunt (lethargy, LOC changes, irritability)
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What symptom can a child show around >2 years old who had hydrocephalus?
n/v
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Abrnomal motor development can be suspected for which disorder of posture and movement?
cerebral palsy or static encephalopathy
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List the different types of CP (5)
Which one is the most common? Which one is rare?
- Dyskinetic: slow, writhing involuntary movement of all extremities
- Spastic: (most common) increased DTR's, hypertonia, contractures
- Rigid: (rare) tremors at rest and with movement
- Mixed: 50% have degree of cognitive impairment, other disabilities (hearing/visual loss, epilepsy, learning problems, GERD)
- Ataxic: child appears clumsy
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What is the leading causes of death in children beyond infancy?
Unintentional trauma: MVA, bicycle falls, sports, beatings, GSW
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Fill in: 50% of infants with seizures develop ____
Epilepsy: a neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain.
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List management of seizures
- SAFETY
- do not insert something into mouth
- loosen clothing around neck
- turn on side
- watch clock to time seizure, where and when began/end, progression of seizure throughout body
- Imp to record precip factors, LOC, behavior dur sz
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Status epilepticus is defined as a seizure greater than _____.
Med given?
30 minutes: given Ativan
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What are neonatal causes of meningitis?
Flora of mom: GBS or E. Coli
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When will IV abx be stopped for tx of Meningitis?
If cx are negative after 72 hours: it is then considered viral and only supportive care is given.
IV abx won't help at this point.
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State if this ICP s/s will be for infant or child:
a. Papilledema >48 hours
b. Setting sun sign
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What is the cardinal sign of meningitis?
- Can't touch chin to chest
- Light sensitivity
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