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