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