Pediatrics

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Author:
darcy11
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39760
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Pediatrics
Updated:
2010-10-04 21:50:19
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Pedi
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review for NCLEX/FINAL
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  1. What vaccine can be used to prevent epiglottitis in children?
    Hib vaccine
  2. What does "Silent Chest" indicate?
    Worsening of Acute Asthma (decreased wheezes)
  3. How is bronchiolitis diagnosed?
    RSV antigen detection by nasal secretions
  4. What are some contraindications for ribavirin (antiviral) when treating bronchiolitis?
    • teratogenic- no pregnant providers
    • No contact lenses
  5. What are some signs and symptoms of bronchitis?
    • dry, hacking cough
    • cough may become productive after 2-3 days
    • cough is worse at night
  6. What is used prophylactically in high risk infants to prevent RSV?
    RSV-IGIV (IV immunoglobulin)
  7. what immunization prevents Pertussis?
    dTap or Tdap
  8. what are major culprits of foreign body aspiration?
    grapes, hot dogs, and peanut butter
  9. What illness would you not just treat the child with it, but the whole family as well?
    Pertussis
  10. What children are at increased risk for aspiration pneumonia?
    • Children with feeding difficulties such as:
    • reflux
    • cleft palate
    • TEF
  11. what illness is characterized by recurrent episodes of wheezing, coughing, tightness of the chest, and SOB?
    Asthma
  12. what are some diagnostic tests performed with Asthma?
    • Pulmonary function tests (PFTs) upon initial assessment every 1-2 years
    • Personal best Peak Flow Test
  13. what are the "rescue" meds for Asthma?
    Bronchodilators: Albuterol, Zopenex
  14. What are the "prevention" meds given for Asthma?
    • inhaled corticosteroids
    • leukotriene inhibitors
  15. What are diagnostic tests performed with suspected Allergic Rhinitis?
    • Hisotry
    • RAST test: determines the IgE antibodies to specific allergen
    • Blood sample for eosinophils and total IgE
    • Skin testing
  16. What are the signs and symptoms associated with Allergic Rhinitis?
    • clear runny nose; sneezing
    • Itchy nose, itchy watery eyes
    • Allergic shiners; allergic salute
    • congestion; chronic nasal obstruction
    • Pallor of nose; cobblestoning
  17. Cerebral Palsy
    chronic disability characterized by impaired movement and posture resulting from an abnormality in the extrapyramidal or pyramidal motor system
  18. What should be at the bed side when a patient is in the hospital with Spina Bifida?
    a bottle of normal saline to keep sac covered with a moist, sterile dressing to prevent breakdown of skin and infection
  19. what is the earliest sign of Cystic Fibrosis?
    meconium ileus in a newborn
  20. What are some signs and symptoms of GER?
    emesis and heart burn
  21. What are some treatment goals associated with GER?
    • small, frequent feedings every 3 hours
    • thickened formula with rice cereal (1 oz of formula to 1 TBS of cereal)
    • Prone positioning after feeding but NOT when sleeping
    • Older child: left side position with head of bed elevated
  22. What medications help treat GER?
    • PPIs: lansoprazole (suppress acid)
    • H2 receptor agonists (cimetidine)- for esophagitis
    • Antacids
    • Cholinergics (bethanechol/metoclopramide)- increase gastric emptying
  23. What illness is the surgical procedure Nissen Fundoplication suggested for ?
    GER
  24. Encopresis
    constipation with soiling
  25. How is the diagnosis of Hirschsprung Disease confirmed?
    Lung biopsy
  26. What are some surgical procedures that help manage Hirschsprung Disease?
    • Temporary colostomy (relieves dilation)
    • Soave endorectal pull-through (infant must be 9 kg!)
  27. What are the nursing considerations associated with managing Hirschsprung disease?
    • monitor for progressive abdominal distention (girth at umbilicus, leave tap in place)
    • Preop Bowel emptying
    • Teach colostomy care
    • goal: return of normal bowel
  28. acute obstruction of lumen with hard feces
    Acute Appendicitis
  29. What is the most important sign of Acute Appendicitis?
    Focal Abdominal tenderness at McBurney's point in RLQ
  30. Rosving Sign
    RLQ pain with palpitation or precussion of other quadrants
  31. Ruptured apendix results in?
    Peritonitis
  32. what are the signs of a ruptured appendix?
    sudden, brief relief of pain & high fever
  33. what are the treatment methods for a ruptured appendix?
    • 5-7 days of antibiotics and IV fluids
    • NG suction for decompression
    • drain or surgery for abscess formation
  34. What illness causes Gastric outlet obstruction?
    Hypertrophic Pyloric Stenosis
  35. Which acid base imbalance would have to be corrected before surgery of Hypertrophic Pyloric Stenosis?
    metabolic alkalosis
  36. Pyloromyotomy
    • used for HPS
    • Incise circular muscle & open pylorus (RUQ incision)
  37. What should the postoperative care be following a pyloromyotomy?
    gradually progress oral feedings
  38. What is the most frequent cause of bowel obstruction in children 1 months-3 years old?
    Intussusception (more common in cystic fibrosis)
  39. What is intussusception?
    Telescoping or invagination of one portion of intestine into another (ileocecal valve)
  40. currant jelly stools; sudden, crampy pain; and a sausage shaped mass on palpation is indicative of what?
    intussusception
  41. What is the non-surgical treatment modality of intussusception?
    Hydrostatic reduction with air or contrast enema
  42. What teaching is most important regarding intussusception?
    Educating parents and child on the risk of recurrence
  43. What is it called when the bowel is not fixed in position in-utero?
    Malrotation
  44. What does volvulus result in?
    volvulus (intestines become twisted) -- decreased blood supply -- necrosis, peritonitis, perforation & death
  45. Abnormal rotation of the intestines around the superior mesenteric artery?
    Malrotation which leads to bowel obstruction
  46. gluten-induced enteropathy
    Celiac disease (genetic intolerance of gluten-protein in wheat)
  47. What are the four characteristics of Celiac disease?
    • steatorrhea
    • abdominal distention
    • general malnutrition
    • vitamin deficiencies
  48. What dietary management is associated with Celiac Disease?
    • life-long dietary management
    • Substitutes for wheat products
  49. What are the treatment goals of Short Bowel Syndrome?
    • preserve bowel strength
    • stimulate bowel adaptation
    • optimal nutritional and growth as bowel adapts
  50. What are the phases of nutritional therapy associated with Short Bowel Syndrome?
    • 1st phase- TPN
    • 2nd phase- introduce enteral feeding
    • final phase- enteral feedings alone sustain growth
  51. in SBS, what is taught to children in regards to developing oral muscles (speech)?
    Nonnutritive sucking
  52. what is the main symptom of Pinworm ingestion?
    Intense anal itching
  53. what is the diagnostic tool for Pinworms?
    Tape Test-collect eggs in morning after child awakens using clear tape over the anus
  54. What medication is given to all family members (>2) when one member has pinworms?
    One dose of Oral Mebendazole
  55. How can Pinworms be prevented?
    • Handwashing after toileting and before meals
    • Careful diapering
    • Short nails
    • Stop scratching
  56. the failure of the esophagus to develop a continuous passage is called?
    Esophageal atresia
  57. the VACTERL mnemonic associated with Esophageal Atresia stands for?
    • V- vertebral anomalies
    • A- imperforate anus or anal atresia
    • C- cardiac anomalies
    • TE- tracheoesophageal fistula
    • R- renal anomalies
    • L- limb anomalies
  58. What is the diagnosis based on in Esophageal Atresia?
    if an infant has at least three or more of the VACTERL anomalies
  59. an infant presenting with frothy saliva, drooling, choking, coughing, along with cyanosis and apnea r/t aspiration is indicative of
    Esophageal atresia
  60. What are the nursing considerations of an infant with Esophageal Atresia?
    • NPO
    • Maintain Patent Airway
    • Prevent Aspiration
    • Monitor surgical repiar/anastomosis postoperatively
  61. Persistent cloaca
    an anorectal malformation in females where the rectum, vagina, and urethra drain into perineum via one channel
  62. Imperforate anus
    an anorectal malformation in males and females where there is no obvious opening (with or without a fistual)
  63. What are the surgeries associated with anorectal malformations and their indications?
    • Short-term : temporary colostomy for fecal elimination
    • Long-Term: anorectoplasty and colostomy take down
    • wait for 24 hours after birth to perform surgery if the anorectal malformation is not life-threatening
  64. what nursing action can be done to identify anomalies in a newborn?
    Watch for the first stool
  65. Kasai drainage
    use in Biliary atresia to drain bile
  66. What is the definitive life-saving treatment of Biliary Atresia?
    Liver Transplantation
  67. Biliary Atresia can lead to?
    • Cirrhosis and death by age 2 if not treated
    • Jaundice that persists after age 2 weeks
    • Elevated conjugated bilirubin
  68. What is the most serious complication associated with Kawasaki Disease ?
    Cardiac involvement; aneurysms can develop
  69. chorea, carditis, erythema marginatum, polyarthritis, fever with history of sore throat, abdominal pain, and subcutaneous nodules are associated with what illness?
    Rheumatic Fever
  70. the child showing signs of exercise intolerance, chest pain, and dizziness when standing for long periods of time is associated with what specific cardiovascular disorder?
    Aortic stenosis
  71. Jones Criteria
    • Major: Carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules
    • Minor: Fever, arthralgia elevated ESR or positive CRP level, prolonged P-R interval
  72. What are the two objective of treating CHF?
    • reducing workload
    • increasing cardiac output
  73. What is the prophylaxis for recurrence of Rheumatic Fever?
    Penicillin G (Bicillin)
  74. What is a major risk factor for the cause of Cerebral Palsy?
    Low birth weight
  75. A dimple with or without hair tuft at base of spine?
    Spina Bifida Occulta
  76. Spina bifida is associated with what major problem?
    Hydrocephalus
  77. the signs of increased ICP are? (opposite of shock)
    • Increased ICP- decreased pulse and increased BP
    • Shock- increased pulse and decreased BP

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