PEDS FINAL
Acute Glomerulonephritis (AGN) is often caused by what?
Group A Beta-hemolytic Strep infection
What is lost in nephrotic syndrome?
Massive amount of protein (majority: albumin)
folic acid daily requirement for prevention of cleft palate and other deformities
400mcg
Distribution of body water for a child:
50% total body water
moderate dehydration
6-9% weight loss
Distribution of body water for an infant:
65% total body water
Distribution of body water for newborn
75% total body water
how to hydrate a pediatric patient
Oral fluids first! Ex: pedialyte
malignant tumor of the long bone near the growth plate involving rapidly growing bone tissue
Osteosarcoma
How is scabies treated?
Permethrin 5% cream for 3 days
2, 4, 6, 12 months
Pneumococcal (PCV), HiB Schedule
2, 4, 6 months, & 4-6 years
Polio IPV Schedule
True or false: Injury of epiphyseal plate can impact future growth
True
What is the most common cause of cerebral palsy?
complications during labor and delivery, prematurity
coarctation of the aorta
congenital cardiac condition characterized by a narrowing of the aorta
What foods can patients with Celiac Disease eat?
corn, rice, millet, quinoa
indicative sign of intussusception
currant, jelly stool
what is a key sign of a congenital heart defect in an infant?
cyanosis and heart murmurs
Two arteries return __________ blood to the placenta
deoxygenated
Consideration for Wilms' tumor
do not palpate abdomen
Which is the biggest shunt that is connected to the aorta to help get blood to the rest of the body?
ductus arterious
Dizziness or vertigo
early sign of ICP
Headache
early sign of ICP
Nausea and Vomitting
early sign of ICP
Pupils not reactive or equal
early sign of ICP
Slight change in vital signs
early sign of ICP
Slight changes in LOC
early sign of ICP
Sunsetting eyes
early sign of ICP
Visual disturbances, diplopia
early sign of ICP
bulging fontanelle
early sign of ICP
dilated scalp veins
early sign of ICP
high-pitched, catlike cry
early sign of ICP
irritability
early sign of ICP
restlessness
early sign of ICP
wide sutures, increased head circumference
early sign of ICP
production of red blood cells
erythropoiesis
What are three categories assessed in the GCS?
eye opening, motor response, verbal response
patent ductus arteriosus (PDA)
failure of ductus arteriosus to close s/s: respiratory distress, machinery-like murmur, tachypnea, growth failure, tachycardia
What meds are given for tumor lysis syndrome as a result of chemotherapy?
kayexalate, allopurinol
Cushing's Triad: -increased systolic BP and widened pulse pressure -bradycardia -irregular respirations
late sign of ICP
Fixed and dilated pupils, papilledema
late sign of ICP
seizures
late sign of ICP
significant decrease in LOC
late sign of ICP
Cyanotic Heart Defects
life threatening
Roseola
maculopapular rash that starts on the trunk and spreads to the face, neck and extremities
Important note about spina bifida-meningocele?
no nerve involvement
Which cancer can be secondary to radiation?
osteosarcoma
umbillical vein bring _________ blood to the fetus
oxygenated
What are the s/s of nephrotic syndrome?
periorbital edema, proteinuria (urine looks frothy), hypoproteinemia, hyperlipidemia
atrial septal defect (ASD)
permits left to right shunting of blood in the heart mild: no symptoms large: CHF, tired, poor growth treatment: surgery if no spontaneous closure
Clinical manifestations of Leukemia
petechia, fever, fatigue
indicative sign of pyloric stenosis
projectile vomitting visible gastric peristalsis
What medication should be given for pulmonic and tricuspid atresia?
prostaglandin E to keep ductus arteriosus open until surgery can be done. Incompatible with life
What is an important intervention when taking care of a patient with JIA?
provide toys and activities that help with fine and gross motor skills
How is Ewings sarcoma treated?
radiation & chemotherapy. Amputation as last resort
Signs and symptoms of PDA
respiratory distress, machinery murmur, growth failure, tachypnea, tachycardia
Indicative sign of hirschsprung disease
ribbon like stools
what can pulmonic stenosis lead to?
right ventricular hypertrophy
thirst delayed cap refill mucous membranes are dry reduce skin turgor and tears slight tachypnea
signs and symptoms of moderate dehydration
lethargic to comatose low BP rapid, weak pulse poor skin turgor parched membranes absent urine output cool, mottled skin sunken fontanel
signs and symptoms of severe dehydration
Treatment for Hirschprung Disease
surgery
How is osteocarcoma treated?
surgical amputation, chemotherapy
eczema differentiation for 2months - 2yrs
tends to be on the face
Leukemia
the unrestricted proliferation of immature white blood cells and is the most common type of childhood cancer
mild dehydration
up to 5% weight loss
Acyanotic Heart Defects
usually not life threatening
What foods should patients with Celiac Disease avoid?
wheat, barely, rye, and oats
Sign of Retinoblastoma
white pupil "leukocoria" and absent red reflex
How to identify coarctation of the aorta?
BP and pulses will be low in the lower extremities
What are diagnostic tests of developmental dysplasia of the hip?
Barlow and Ortolani Test
When does JIA start?
Before age of 16, with a peak age of 1-3 years old
What is lost in acute glomerulonephritis?
Blood, and mild amounts of protein
Three shunts in fetal circulation
1. Ductus venosus 2. Foramen ovale 3. Ductus arteriosus
severe dehydration
10% or more body weight loss
What is the universal manifestation of cerebral palsy?
Delayed gross motor development
Which drug is given to reduce brain swelling for hydrocephalus?
Dexamethasone
tetralogy of fallot can lead to CHF. What meds would be given?
Digoxin, furosemide
2, 4, 6, 12 months, 4-6 years
Dtap Schedule
how to test for muscular dystrophy
Gower's sign
How is a Tinea fungal infection treated?
Griseofulvin for up to 6 weeks, Topical cream: ketoconazole
malignant tumor occuring in the bone marrow of diaphyseal seal
Ewings Sarcoma
Begins at 6 months, yearly from there
Flu Vaccine Schedule
How may urine present in a child with nephrotic syndrome?
Frothy and foamy urine
nursing interventions for a child with leukemia
Give iron supplement, PRBC transfusion, IV fluids, neutropenic isolation, platelet transfusions, vitamin K, soft-bristled tooth brush, humidified air
Signs and symptoms of a concussion
Headache, dizziness, difficulty concentrating, confusion
Signs individual to AGN
Hematuria, Hypertension, Pain
0, 2, 6 months old
Hep B Schedule
Hallmark characteristic of Impetigo?
Honey-colored crust
meds for kawasaki disease
IVIG high dose aspirin
What medication is used for PDA?
Indomethacin to stimulate closure
2 tests that determine increased ICP possibly related to meningitis
Kernig & Brudzinski Signs
1, 4 years
MMR, Varicella Schedule
what vaccines cannot be given before 12 months of age
MMR, varicella (live viruses)
Which viral infection may lead to orchitis and sterility in males?
Mumps
Which defects are included in Tetralogy of Fallot?
Pulmonic stenosis, ventricular septal defect, hypertrophy of right ventricle, overriding aorta
Why is the maintenance of fluid and electrolyte balance more critical in infants than in adults?
Renal function is immature in infants
2, 4, 6 months
Rotavirus schedule
Which viral infection presents with forschheimer spots?
Rubella (German measles)
high fever, coryza (inflammation of nasal mucosa), cough, Koplik's spots on buccal mucosa, red, blotchy maculopapular rash that begins on the face
Rubeola (Measles)
intervention for Tet spell/Blue baby syndrome?
Squat position to help breath better
What causes Impetigo? How is it treated?
Staph infection, treated with bacitracin ointment or systemic antibiotics if severe
Where does Measles rash usually start?
Starts on the face, then goes down
Nursing Management for Omphalocele and Gastroschisis?
Sterile gauze with normal saline Protect intestines!
Which meds are given to patients with Rheumatic Fever?
antibiotics, aspirin *d/t inflammation of mitral valve
ventricular septal defect (VSD)
a hole in the ventricular septum that causes blood to mix between the RV and LV
What is another common manifestation of CP?
abnormal motor performance
how to measure that a child with AGN is getting better
increased U/O and weight loss (resolving edema)
Important note about myelomeningocele?
involves meninges, spinal fluid, and nerves