Pediatrics Exam 2

What can cause iron deficiency anemia

prematurity, excessive cow milks intake, blood loss, and inadequate dietary intake

Nursing management regarding vesicoureteral reflux

prevent infection: empty bladder completly perineal hygiene education monitor BP antibiotic therapy: give at bedtime

What is the best management of diaper dermatitis

prevention

If a patient is struggling to breathe would it better to keep them elevated or lay flat

elevate HOB

What is a symptom bacterial pharyngitis?

fever

Croup can also be known as

laryngotracheobronchitis

RSV can cause____

secondary bacterial infection such as pneumonia

S/S of RSV

wheezing, trouble breathing, wet sounding cough, fever, runny nose, nasal congestion, irritability, rapid breathing, decreased appetite, difficulty feeding

What are controller meds for asthma

beta 2 agonists (long acting): salmetrol; methylxanthines, mast cell inhibitors

If RSV is progressing and becoming a lower respiratory tract infection what is it turning it

bronchiolilits

What type of tonsils is medical emergency

kissing tonsils

The nurse has assessed a 6-year-old child as having respiratory distress due to swelling of the epiglottis and surrounding structures. Which signs and symptoms would support this assessment?

sitting in the tripod position

When listening to a patient would it be better to hear wheezing or no air sound

wheezing

If a patient is diagnosed with influenza what kind of precautious should they be placed on

droplet

A patient comes in sitting in tripod position, agitated, and has respiratory arrest what would suspect this patient has

epiglottitis

If a patient is taking methylxanthines what would need to be monitored

need therapeutic levels for control so need frequent labs

When infants are born they are _____ breathers

nose

A group of nurses is reviewing the diagnosis of cystic fibrosis. With regard to the effect of this disease on the body, which parts of the body (besides the lungs) are most affected by this disease?

pancreas and liver

usually viral inflammation of the throat mucosa, may be accompanied by nasal congestion

pharyngitis

3 complications of cystic fibrosis

pneumothorax, hemoptysis, intussisecption

What is the major concern with a strep infection

secondary issues such as acute glomerulonephritis and rheumatic fever

S/S of GABHS

sore throat, tonsils: exudate, fever, sandpaper rash, abdominal pain, strawberry tongue

S/S brochiolitis

tachypnea, retractions, cyanosis, poor breath sounds, and wheezing

Usually if someone is going to be around a baby what vaccination would be needed to prevent pertussis

tdap booster

Hallmark symptom of asthma

wheezing

What is NEC

necrotizing enterocolitis

What test diagnosis cystic fibrosis

sweat chloride test, pulmonary function tests

The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child?

sweat sodium chloride test

What type of treatment should be provided for influenza

symptomatic treatment: tylenol, motrin, and stay hydrated

How can RSV be treated

symptomatic unless respiratory distress happens, so they may need O2 and suction

If a patient has nephrotic syndrome what would they be at risk for

increased risk of clotting because decrease in blood volume and increased risk of infection or renal failure

What is the prevention of diarrhea

hand hygiene and probiotics

What is the oxygen carrying capacity of the blood

hemoglobin

In sickle cell anemia hemoglobin A is replaced with

hemoglobin S

3 features of hemolytic uremic syndrome

hemolytic anemia thrombocytopenia acute renal failure

A patient has recently visited a petting zoo they are having watery diarrhea what would you diagnose this patient with

hemolytic uremic syndrome

Group of X linked recessive disorders that result in deficiency in one of the coagulation factors

hemophilia

Acute, self limiting infectious disease that is common among adolescents caused by Epstein Barr virus

infectious mononucleosis

What is epigolittitis

inflammation and swelling of the epiglottis

S/S of tonsillitis

inflammation of tonsils, difficulty swallowing or breathing

What is necrotizing enterocolitis?

inflammatory bowel disease that causes necrotic injury to the GI tract

s/s of acute glomerulonephritis

edema: starts perioribital, tea colored urine, mild proteinuria, elevated ESR, reduced urine volume, elevated BP, pale, irritable, anorexic, lethargic

If a patient has a cleft palate what should be done pre/post operatively

elbow restraints, soft spout sippee cup, and watch for aspiration, pain meds PRN

If a patient presents with olive shaped mass in RUQ what surgery should be conducted

pyloromyotomy

S/S of dehydration

rapid breathing, increased heart rate, restlessness, irritability, lethargy/weakness, poor skin turgor, sunken fontanelle, sunken eyes, lack of tears, decreased urine output

How can RSV be identified

rapid test from direct aspiration of nasal secretion or NP wash

s/s of cellulitis

redness, pain, edema, warmth at site, may have fever

GERD is caused by

relaxed lower esophageal sphincter

Complications associated with sickle cell anemia

retinopathy, stroke, paralysis, abdominal pain, osteomyelitis, chronic ulcers, and splenomegaly

If a patient is believed to have appendicitis where would the nurse check

right lower quadrant

Tinea Corporis is also known as

ringworm

What vaccine can prevent diarrhea in children

rotovirus: 2,4,6

Describe ringworm

round or oval lesion where the outside is red and scaly while the inside is clear

What is the function of the GI system

ingestion, digestion, and absorption of fluids and nutrients, excretion of waste products

S/S of scabies

intense grayish brown threadlike with black dot at the end of burrow

How can you see if a patient has pinworms

intense perianal itching-> tape over rectum because they will come out at night attaching to the tape

A patient presents with perfuse/ forceful vomiting, his mother states that he turned blue last night what nursing intervention should be used following feedings

elevate HOB 3-40min, burp frequently

Where should a nurse look if a patient thinks they have scabies

in between fingers

What is Hirschsprung disease

inadequate peristalsis in the intestine caused by absence of ganglion cells

S/S of a infant having GERD

spitting up, fussiness, weight loss, they have turned blue, forceful vomitting, arched back

How is acute glomerulonephritis diagnosed?

+ antistreptolysin O (ASO) titer or chest X-ray

Side effects of chemotherapy

- neutropenia - thrombocytopenia - anemia - peripheral neuropathy

When providing iron supplementation what are some teaching points

-do not give with milk -place behind teeth -do not be alarmed by green or black stool

What are the goals of management with atopic dermatitis

-hydrate skin -relieve itching -reduce flare ups use a room humidifier

Acne treatment

-reduce bacteria -decrease sebum production -normalize skin shedding -avoid oil based facewash or hair products

Steps to use metered dose inhaler

-shake medicine -insert mouthpiece of inhaler into rubber sealed end -breathe all air out of your lungs and then put spacer into your mouth -press the MDI down once to release spray of medicine -hold breathe for 5-10 seconds and then breathe out slowly

What is nursing management for nephrotic syndrome

-strict I and O -daily weight -promote diuresis -prevent infection -encourage nutrition -monitor skin: prone to breakdown so turn q2hr

If a patient has surgery for vesicoureteral reflux how long should antibiotics be used

1-2 mo until no reflux is seen

Normal RR for adolescent

12-18

Normal RR for school age

14-22

When double diapering after putting stents in following hypospadias or epispadias surgery what are 2 diapers for

1st diaper is for stool 2nd diaper is for urine

If a patient presents with a cleft lip when would surgical correction be made

2-3 months

Normal RR for preschooler

20-25

What is the highest amount of oxygen given nasal cannula

4L

Caused by human parvovirus b19

5ths disease

Most cases of nephrotic syndrome occur before what age

6yo

How to treat UTI

7-14 days PO antibiotics, fever management, adequate fluid intake

If a patient is being treated for lice when should treatment be repeated

7-9 days

Causes of nephrotic syndrome

80% idiopathic, congenital (rare), and secondary to immune response or infection (diabetes, lupus)

Chronic inflammatory airway disorder characterized by airway hyperresponsiveness, airway edema, and mucus production

Asthma

Chronic disorder characterized by extreme itching and inflamed red and swollen skin

Atopic dermatitis: eczema

IX is what type of hemophilia

B

Medication used for acne that could bleach bed linens, towels, clothing, but not skin

Benzoyl peroxide

Pertussis is caused by

Bordetella pertussis

Factor XI is what kind of hemophilia

C

If a patient presents with current jelly stools what would you suspect is happening

intussusception: proximal segment "telescopes" into more distal segment

How can pneumonia be diagnose

Chest X-ray see consolidated areas

If a patient is diagnosed with acute streptococcal pharngitis what is the most important education point

Complete all antibiotics

What is needed for hemoglobin production

iron

S/S of common cold

irritability, fever, aches, snotty nose, cough

What is the main goal of therapy with vesicoureteral reflux

prevent infection and renal scarring

Most common reason for HUS in 6mo-4yo

E.Coli

Main cause of UTI

E.Coli (intestinal bacteria)

How is vesicoureteral reflux graded

Graded scale I to V: grade 1 is minor dilation if urerter; Grade V: severe dilation of ureter and kidney

Surgery that is down for GERD

Nissen Fundoplication

A patient comes in with epiglottis can the HIB vaccine be given

No: HIB vaccine will not treat but can prevent, but once you already have epiglottitis the vaccine cannot treat it

If a mom states her son is pouring snot what would you assume

RSV

What are some anatomical differences between infants and adults

diameter of airway is smaller, trachea is smaller, bad at clearing their airway, and tongue is larger,

How is meckel diverticulum treated

Surgery

How can RSV be prevented

Synagis monthly IM but its very expensive and you must qualify

Inflammatory reaction of the skin that is bright red and extends gradually

diaper dermatitis

What medication can be used to treat cystic fibrosis

dornase alpha

Patches of scaling on the scalp with hair loss, can spread to neck or hairline

Tinea capitis

If a child has recurrent strep throat (3 infections in one year) what would be the treatment

Tonsillectomy/Adenoidectomy

How is vesicoureteral reflux diagnosed?

VCUG

If someone has 2 or more UTI with 1 being E.Coli what might need to be done

VCUG

What is the difference between cleft lip vs cleft palate

a cleft lip is affecting the lip while the palate is affecting the roof of the mouth being a little more invasive

What causes bronchiololitis

a virus usually RSV

Treatment of hypospadias and epispadias leads to

ability to control urine and good cosmetic outcome

This type of acne is a response to the maternal androgens in newborn

acne neonatorum

Endrogenous hormones increase sebum production causing

acne vulgaris

Bronchiolitis is...

acute inflammation process of the bronchioles and small bronchi

Grade III and V vesicoureteral reflux

associated with UTI, renal damage usually warrants surgical intervention

Cystic fibrosis is what kind of genetic disorder

autosomal recessive disorder

How should a food allergy be managed

avoid allergen, carry epi pen and know how to use in case of emergency, and have written emergency plan

To see if a patient has an intusseption what would need to be done

barium enema

Pinworms are caused by what bacteria

enterobius vermicularis

If a hemophilia patient has acute bleeding what should be given

factor

What is esophageal atresia

failure of esophagus to connect to the stomach

T/F: ice should be applied to burn

false

T/F: lice is caused by poor hygiene

false: lice like clean hair

s/s of iron deficiency anemia

fatigue, pallor, spooning, tachycardia, and murmur

What is some nursing management that can be done for a child that has a cleft palate who is struggling to feed

feed in upright position, burp frequently, special spoon, and special nipple

HSV II

genital

What is happening with acute glomerulonephritis

it is condition which immune processes injure glomeruli causing inflammation and edema due to leukocytes so the glomerular structure is altered causing excessive amounts of water and retention of sodium

How does urine leave the body?

kidney-> ureter-> bladder-> urethra

Another name for whopping cough

pertussis

What is the difference between primary reflux and secondary reflux

primary reflux is a congenital valve defect where bladder meets ureter; secondary occurs as result of another structural or functional problem

nephrotic syndrome can lead to

proteinuria, hypoalbuminemia, edema, ascites, hypovolemia, hyperlipidemia

The nurse is caring for a child who has been admitted with a diagnosis of asthma. What laboratory/diagnostic tool would likely have been used for this child?

pulmonary function tests

If a patient vomits their trach out, but you do not have another one what should you do

put the dirty trach back in until you can get another-> do something to hold opening open

What can help with bleeding in hemophilia patients

apply pressure if active bleeding, elevate injury, and apply ice

Insensible water losses in children

fevers increased body surface area basal metabolic rate immature kidneys: can dump

What is the function of tonsils

filter the respiratory tract

S/S of vesicoureteral reflux

frequency, urgency, dysuria, pain, fever, hematuria

If a child presents with diarrhea should they be prescribed anti-diarrhea

no because it can cause further problems by inhibiting the diarrhea from leaving

How do you treat acute glomerulonephritis

no treatment: supportive measures

Clinical manifestations of sickle cell anemia are

obstruction caused by sickled RBC, vascular inflammation, and increased RBC destruction

What is meckel diverticulum

occurs when there is incomplete fusion of inflators mesentery duct during embryonic development-> a piece of the intestines attaches to umbilicus

S/S of pyloric stenosis

olive shaped mass, projectile, non-bilious vomitting, weight loss and dehydration

If a patient test positive with throat swab or throat culture for acute streptococcal pharngitis how will it be treated

oral penicillin for 10 days or IM pen G

A mom is asking a nurse what drink is best to give with iron what would be your reply

orange juice

A partial thickness burn has what kind appearance

painful, wet, edematous

What is the treatment of scabies

permethrin: should be applied on the entire body below the head and leave cream for 8-14 hours and rinse

How should a stoma present

pink, red, moist

s/s of pyelonephritis

high fever, chills, flank pain, vomitting, and dehydration

Prevention for hemolytic uremic syndrome

hnadwashing, use of swim diapers, throughly cooked meats, wash all fruits and veggies, avoid unpasteurized dairy products and juices

s/s of necrotizing enterocolitis

huge distended abdomen, darker abdomen spots, metabolic acidosis, cardiopulmonary changes

Dilation of renal pelvis from distention

hydronephrosis

A olive shaped mass in the upper right quadrant

hypertrophic pyloric stenosis

pylorus is hypertrophied causing

hypertrophic pyloric stenosis

Common cause of NEC

idiopathic: common in formula

What would need to be given before eating and in between meals to help with digestion in cystic fibrosis patient

pancreatic enzymes to help with digestion and absorption

_____ is the most common cause of croup

parainfluenza

injury to epidermis and portions of dermis

partial thickness

How to diagnose epiglottitis

paternal neck x-ray: carefully so airway isn't occluded

Topical chemical that is used to kill lice

pediculicides

What vaccines can help with sickle cell

pneumococcal, mengiococcal, and flu

inflammation of the lung parenchyma

pneumonia

What is a complication of cystic fibrosis?

pneumothorax

urethral defect in where the opening is located on dorsal side of penis above glans penis

Epispadias

A patient has a slapped appearance with circumoral pallor that can spread to the truck

Erythema Infectious (5th disease)

T/F: clothes have to be removed prior to giving epi pen

False

VII is what kind of hemophilia

Hemophilia A

How would perioribital cellulitis be treated

IV antibiotics: cephalosporins

What type of response is a food allergy

IgE

What is the difference between intussusception and pyloric stenosis

Intussusception: bile stain vomit, sausage shaped mass, and currant jelly stools Pyloric stenosis: non-bile stain vomit, olive shaped has, projectile vomiting

A patient presents with tinea capitis and asks how long it will take for their hair to grow back. How would the nurse answer

It will take 3-12 months

s/s of acute laryngotracheobronchitis

Low fever Restless Hoarse Barky cough Stridor suprasternal Retractions

This medication does not cure the flu, but can decrease symptoms -must be started within 24-48hrs of symptoms

Oseltamivir: Tamiflu

What medications can be given for a child with GERD

PPI, zantac, or pepsin

Apply within 20-30 min of washing face, avoid sun exposure, and use sunscreen

Tretinoin

T/F: Epiglottitis is a medical emergency

True

How is UTI diagnosed

U/A and culture: determine type of bacteria and appropriate antibiotics

Lab and DX for HUS

UA: blood, protein, pus, BUN/Cr, anemia, increased relic count, electrolyte imbalance, thrombocytopenia

Diagnosis or nephrotic syndrome

UA: marked proteinuria, serum albumin is low, elevated triglycerides and cholesterol, elevated BUN and creatinine

RSV begins as ____ with ___ and ____

URI with rhinorrhea and low grade fever

S/S of pertussis

URI, cough at night: short, rapid, high pitched crowning sound on inspiration, vomitting

What kind of infection is a flu

Viral infection

What is the difference between acute and chronic diarrhea

acute is usually caused by virus, bacteria, and parasites; chronic usually lasts for longer than 2 weeks: celiac disease, lactase deficiency

What type of leukemia is less responsive to treatment

acute myelogenous leukemia

What is pertussis

acute respiratory infection in children younger than 3yo who may not have been immunized

What can help with pain crisis in sickle cell anemia

adequate hydration, pRBC transfusions, and hydroxyurea

If a patient has acute streptococcal pharngitis when would they be able to go back to school

after 24 hours on antibiotics: also after 24hrs get rid of the things that have been in mouth (Toothbrush, pacifiers)

3 main complications with burns

airway compromise, shock, infection

S/S of epiglottis

airway inflammation: obstruction increased pulse restlessness retractions anxiety increased inspiratory stridor drooling Tripod position

What is the primary treatment for asthma attack

albuterol: use before inhaled steroid

What causes contact dermatitis

allergen response; not contagious, plants, jewelry, dyes, soaps

How is an allergy diagnosed

allergy testing oral challenge trial elimination diet

___ is the first indicator of RSV in infants

apnea

a facial malformations that form during embryonic development

cleft lip and cleft palate

If a patient has both cleft lip and cleft palate which one would need to be fixed first

cleft lip and then fix the cleft palate

HSV I

cold sore

what is anemia

condition in which levels of RBC and hgb are lower than normal levels of age

What is vesicoureteral reflux?

condition in which urine from bladder flows back up the ureters

All GU disorders are

congenital

If a patient has RSV what should isolation status should they have

contact

If a patient presents with dehydration what type of isolation should they be placed on

contact

if a patient has community acquired MRSA what type of precautions

contact

What type of precautions would a patient with hemolytic uremic syndrome be placed on

contact precautions

What is the treatment for hypospadias and epispadias

corrective surgical placement or urethral meatus: corrected after 1 yo of age

1st line of therapy with nephrotic syndrome

corticosteroids: prednisone for 21 days then taper off

What needs to be taught in patients for parents whose children have acne neonatorum

not to pick or squeeze the pimples-> risk for bacterial infections or scares

How is diaper candidiasis treated?

nystatin cream with each diaper change for several days

Which of the following would be best for celiac patient -bran muffin -potatoes -vegetables -corn -fruits -meat/fish -milk -toast

potatoes, vegetables, corn, fruits, meat/fish

What is the major concern when a patient is using isotretinoin

pregnancy because it is teratogenic

Select all that apply: symptoms of celiac disease -steatorrhea -abdominal distention -vomitting -anemia -delayed puberty -diarrhea

steatorrhea, abd distention, anemia, delayed puberty

What should be avoided post op T and A

straws and no red or brown liquids

What is common cause of cellulitis

strep or staph

burn that involves epidermis

superficial

A mild sunburn is considered what type of burn

superficial burn

If a patient has just had a cleft lip surgery what position should the patient be placed in

supine with no tummy time and elbow restraints

what are the 4 different places to see retractions

suprasternal, intercoastal, substernal, subcostal

How can Hirschsprung disease be treated

surgical resection of ganglionic bowels: 1st they create ostomy then the 2nd surgery they pull through and close stony

How does a child get pinworms

the eggs are ingested or inhaled

Known as inflammation of tonsils

tonsillitis

T/F: should a patient have a BRATS diet

False

T/F: a hair dryer should be used to dry out diaper dermatitis

False: burn

T/F: infants should be given cough suppression

False: infants coughing could be the only way they are able to get rid of secretions

If a patient has bilateral pits in their ears what would you suspect

Genitourinary disorder

What is the main cause of acute glomerulonephritis

Group A B-hemolytic streptococcus

What causes strep throat

Group A beta-hemolytic streptococcus

What causes epiglottitis

H. influenza type B

If a patient presents with vomitting what should be given what medications

antiemetics: zofran, promethazine, and minocloprimide

How is ringworm treated

antifungal cream for at least 4 weeks

What are some S/S of respiratory distress

anxiety, restlessness, tachycardia, bradycardia, nasal flaring, cyanosis, retractions, floppy

Common cause of abdominal surgery

appendicitis

How should impetigo be treated

antibiotic topical for 5-7days

What is the treatment for molluscum

beetlejuice

How can epiglottitis be prevented

beginning at 2 mo all children should receive the HIB vaccine

S/S of meckel diverticulum

bleeding, anemia, abdominal pain, palpate for abdominal masses

S/S of hemophilia

bleeding, hemorrhage, bruising, swelling in joints, blood in urine, tarry stools

How would epi pen be administered

blue to the sky orange to the thigh

2 types of chemotherapy

cell cycle specific and cell cycle non-specific

What is daily trach care

change trach ties daily, provide trach care, weekly trach change, and always use 2 people for trach change

What should be avoided when a patient has UTI

chocolate caffeine coke bubble bath

What is seborrhea

chronic inflammatory dermatitis that may occur on skin or scalp

A general term for inflammation, edema, and excess mucous production that obstructs airway in region of larynx

croup

What is the best indictor of acute glomerulonephritis fluid balance

daily weight

injury to epidermis and all dermis

deep partial thickness

What key sign would you associate with Hirschsprung disease

delayed meconium passage

What medication can be given for spasms following hypospadias or epispadias surgery

dentropan

What is diaper dermatitis caused by

detergents, wipes, prolonged exposure to feces, soaps

Clinical manifestations of nephrotic syndrome

edema, massive proteinuria, hyperlipidemia, and weight gain

Risk factors for UTI

females: short urethra, close to vagina and rectum, sexually active females, urinary stasis, alkaline urine, decreased fluid intake

What oral medication is used to treat tinea capitis

griseofulvin

What is a major complication associated with T and A?

hemorrhage: increased HR, constantly clearing throat, pale, restless

uretheral defect in where the opening is located on the ventral side of the penis below glans penis

hypospadias

Where does intussusception usually occur?

ileosequeal valve

What is celiac disease

immunologic to gluten causing damage to small intestine

Adverse affects of chemotherapy

immunosuppression, infection, myelosuppression

characterized as honey colored crust

impetigo

reddish macule that is characterized by Staphylococcus and group A B-hemolytic strep

impetigo

Explain what is happening with nephrotic syndrome

increased glomerular permeability so plasma proteins are able to pass through glomerular basement membrane which can result in excess loss of protein (albumin) in urine (proteinuria) so there's decreased protein in blood, edema, and hypovolemia

What is nephrotic syndrome

increased permeability of the glomerular membrane causing abnormal loss or protein in urine

4 phases of acute lymphoblastic leukemia treatment

induction, intensification therapy (consolidation), maintenance, prophylactic treatment

If a patient presents with currant jelly stools, sausage shaped mass, abdominal pain, lethargy what would you suspect

intussusception

When suctioning how should it been done

least invasive to most invasive

What needs to be taught when using selenium sulfide for tinea versicolor

leave it on for 12hrs once weekly for 4 weeks

What needs to be checked before prescribing griseofulvin

liver and renal enzymes

What 3 organs are affected by cystic fibrosis

liver, pancreas, and lungs

Deletion occurring on the ________

long arm of chromosome 7

What type of diet would a patient with nephrotic syndrome be on

low salt diet and possibly fluid retention

Main nursing management for patient with HUS

maintain fluid volume balance: strict I and O, IVF, diuretics, assess BP

Who is more prone to Hirschsprung disease

male, down syndrome patients

How should treatment of pinworms be conducted

mebendazole or pyrandtell (pinrid) once now and then once again in 2 weeks; everyone in household should be treated, keep nails short, once outfit is best, showers are better

If a patient presents with pain in McBurneys point what should be done

medical emergency: surgery

mite that is spread by direct contact with an infected person

mite

flesh-colored, raised area caused by a viral infection

molluscum

How is infectious mononucleosis diagnosed

monospot test or Epstein Barr virus titers

Why is the mouth usually the optimal entry point for infection

mucus membrane very vascular-> kids putting hands in mouth

RSV causes

necrosis of respiratory epithelium causing increased mucous production and plugging of the lumens making it difficult to get air out

3 ways to help if apnea is occurring

rub chest, blower nd rub foot

When a patient has a trach what needs to be kept at bedside

same size trach, smaller size trach, and obstructor

____ burns are most common in children

scald

A patient has exudate on tonsils, thick coating and strawberry tongue what would you suspect

scarlet fever

infection that can occur from group A beta hemolytic strep: bacteria produce a toxin that causes a rash

scarlet fever

____ gland produces sebum and is connected by a duct to the follicular canal that opens on the skins surface

sebaceous

What is the first line of defense

skin

Causes of cleft lip and cleft palate

smoking or alcohol, prenatal infection, medications, and advanced maternal age

If a patient reports with hypoactive bowel sounds, distended abdomen, guarding, rebound tenderness what needs to be done

this needs to be reported to the physician immediately

Superficial tan or hyperpigemented oval scaly lesions, especially on upper back and chest and proximal arms

tinea versicolor

Full thickness burn has what kind of appearance

tough, leathery, pale white, black, tan: does not blanch on pressure

How is oxygen given through trach

trach coller or vent

How is pediculosis capitis spread

transmitted through direct contact with hair of infested person: place on contact precautions

What is the treatment for acute larynogotracheobronchitis

typically outpatient: maintain airway and high humidity with cool mist, cool air vaporizer

Interventions for fluid and electrolyte imbalance

use a crystalloid during first 24 hours then use colloids

What is radiation

uses high energy to damage or kill cancer cells: affects rapidly growing cells in the body

How can asthma be tested

usually caused by allergen so allergy testing or peak expiratory flow

What can HSV be treated with

valtrex and acyclovir

crops of vesicles that follow along affected nerve

varicella zoster

Pathophysiology of burns

vasoconstriction immediately after the burn then coagulation and vasoconstriction causing tissue ischemia and increases depth of burn

What type of pneumonia is more common in children

viral

Grey, brown, elevated firm papules that will disappear spontaneously

warts

S/S of Hemolytic uremic syndrome

watery diarrhea that progresses to bloody diarrhea, vomitting, edema, elevated BP, and tenderness, oliguria, pale, toxic appearance

grade I-II of vesicoureteral reflux

will resolve

Normal RR for toddler

20-30

Annual influenza vaccinations should be given _____ for what age group

annually; 6months-> first dose they will need 2 doses 4 wks apart

Normal RR for infant

22-55

When should a infant/child be given pertussis vaccinations

2mo, 4mo, 6mo, 15-18mo, and then booster at 4-6yo

How is pertussis treated

antimicrobials: erythromycin or azithromycin or antipyretics

Rescue drugs for asthma

beta 2 agonist, corticosteroids, anticholinergics

If an infant has a lot of secretions that will need to be suctioning when should the mother call

call before feeding to suction to decrease risk of aspiration

What type of people are more likely to get flu

chronic heart or lung disease, diabetics, chronic renal disease, or immunocompromised

A patient's mother states that when she is going to bed she has stridor and is barking like a seal what would you suspect this patient to have

croup

A child presents with salt taste to skin, foul frothy stool, difficult passage of stool, chronic cough what would you suspect

cystic fibrosis

most common debilitating disease of childhood among those with european decent

cystic fibrosis

Tx for epiglottis

decrease anxiety, do not examine throat, position for comfort, tract tray/endotracheal tube available, cool mist, oxygen, IV fluids