Exam 2 Review

What are normal PT times?

11-13 seconds

5 cystic fibrosis interventions

1. Chest PT is priority (pat them in the back or give them the vest) 2. pancreatic enzymes with every meal 3. high calorie high protein diet 4. lung transplant down the line 5. respiratory meds

What vaccines would an 11 year old child get?

1. HPV 2. meningococcal (MCV) 3. Tdap (not Dtap)

2 forms of chelation therapy

1. Iron in Thalassemia patient: deforaxamine 2. Lead levels >44: edetate calcium disodium

3 interventions for DKA

1. Normal Saline first! 2. Insulin 3. monitor glucose every hour

7 S/S of hyperglycemia

1. Polydipsia 2. polyphasia 3. polyuria 4. dry skin 5. glucouria 6. N/V 7. weight loss

3 late signs of leukemia

1. bone pain 2. enlarged lymph nodes 3. hepatospleenomegaly

5 S/S of Scarlet Fever

1. bright red rash 2. sore throat 3. high fever 4. flushed face 5. strawberry tongue

5 S/S of Thalassemia

1. bronze skin 2. pallor 3. bony changes (maxillary/frontal bossing) 4. hepatospleenomegaly 5. jaundice

3 Treatment for Rheumatic Fever and Scarlet Fever

1. corticosteroids 2. NSAIDs 3. Penicillin

What can lead to a sickle cell crisis (6)

1. decrease in oxygen (high altitudes, so no airplanes) 2. illness/infection (given prophylactic penicillin at 2 months old) 3. continued stress 4. excessive blood loss (surgery/trauma) 5. dehydration is the biggest cause (low fluid intake, extreme exercise or very hot temperatures, don't take this kid to the beach) 6. extreme cold temperatures

5 S/S of DKA

1. fruity breath 2. ketonuria 3. kussmal respirations 4. dry flushed skin 5. dehydration

3 S/S of AGN?

1. hematuria (Coca Cola/tea colored urine) 2. hypoalbumia 3. proteinuria

5 S/S of Rheumatic Fever

1. high fever 2. arthralgia (muscle aches/joint pain) 3. subcutaneous nodules 4. joint pain 5. rash on chest

5 interventions for AGN?

1. high protein diet 2. antibiotics 3. diuretics 4. antihypertensive meds 5. keep patient in semi fowlers

7 S/S of hypoglycemia

1. hunger 2. confusion/slurred speech 3. pallor 4. jitteriness/shaking/dizziness 5. diaphoresis 6. tachycardia 7. rapid shallow respirations

3 treatments For Kawasaki

1. immunoglobulin 2. aspirin 3. serial echocardiograms

4 S/S of ADHD

1. inattention 2. hyperactivity 3. distractibility 4. impulsivity

Scabies symptom and treatment

1. linear wavy rash 2. permethrin cream applied everywhere in the body from the neck down for 10-12 hours

Interventions for a Sickle Cell Crisis

1. oxygen 2. IV fluids 3. pain meds (morphine or hydromorphone NEVER MEPERIDINE)

5 Early signs of leukemia

1. pain (genralized) 2. brusing 3. petechia 4. weight loss 5. fatigue

Labs for a Sickle Cell Child (5)

1. platelets- elevated 2. ESR- elevated (can be normal unless there is splenic sequestration ) 4. bilirubin- elevated (due to hyper hemolytic state, dying RBC are releasing it) 5. reticulocytes- very elevated

6 S/S of cystic fibrosis

1. salty skin 2. steatorrhea (fatty malodorous stools) 3. thin extremities 4. chronic respiratory infection/cough 5. thick secretions 6. chronic low oxygen (clubbing, barrel chest)

7 Side Effects of Isotretenoin

1. sun sensitivity 2. suicidal thoughts 3. tetragenic 4. elevated liver enzymes 5. dry skin 6. mood swings 7. elevated cholesterol

5 S/S of Kawasaki

1. unilateral cervical lymphadenopathy 2. bilateral conjunctivitis 3. desquamation of soles of the palms and feet 4. unrelenting fever 5. strawberry tongue

What type of catheter will an 11 month old need?

6 French

How is ADHD diagnosed?

6 symptoms in at least 2 different settings persistent beyond 6 months at least 2 of these symptoms must have occurred before the age of 12 and cannot be explained by any other mental health disorder

If a child with hemophilia is scheduled for a medical procedure what is given to them prophylactically?

Factor VIII (AMICAR) & DDVAP (synthetic desmopressin)

What is a child with hemophilia lacking?

Factor VIII is absent/decreased

True or False patients with cystic fibrosis can get antihistamines

False

If a child with thalassemia comes in and their skin is much bronzer what do you do?

Assess first by asking the mom if there has been any changes in their medications, then notify provider this would never be a normal finding

Developmental Theories for the Adolescent

Erickson: "Identity vs Role Confusion" Piaget: "Formal Operations"

Developmental Theories for the School Age Child

Erickson: "industry vs inferiority" Paiget: "Concrete Operational"

Should a child with leukemia that has been exposed to varicella receive the vaccine?

No, live vaccines cannot be administered to an immunocompromised child if they have been exposed to varicella the immunoglobulin can be given but not the vaccine

hemearthrosis

bleeding into a joint space

Sickle Cell Vaso-occlusive crisis pathology

RBCs stick to blood vessels preventing blood flow and causing tissue ischemia that results in severe pain

What 2 things are monitored in AGN?

Strict I & O (not restricted unless they have edema) and daily weights

How would pain be assessed in a 9 year old?

Wong Baker Scale aka "Faces"

Can hemophilia be managed at home?

Yes, factor 8 can be replaced at home if injury occurs parent can RICE, if swelling doesn't go down call doctor

hemosiderosis

abnormal increase of iron in blood patient will need chelation therapy with deferoxamine

Erickson's Developmental Theory of Identity vs Role Confusion (4)

apples to adolescents 1. bodily changes 2. mood swings 3. peer norms/acceptance 4. early emancipation phase

Piagets Developmental Theory of Formal Operations (4)

applies to adolescents 1. egocentric thinking 2. abstract thinking 3. invisibility 4. risky behavior

Piagets developmental theory of concrete operational (3)

applies to school age children (6-12 y/o) 1. collect things 2. understand time 3. can reverse thought process

Ericksons Developmental theory of industry vs inferiority

applies too school age children (6-12 y/o) children are trying things out for themselves and need support and reassurance even when they fail if not inferiority will develop

What type of play does the 9 year old engage in?

cooperative play basketball, girl scouts, etc.

Sweat Chloride Test

diagnostic for cystic fibrosis suss if >50 definitive if >60

Cystic Fibrosis

gene mutation on chromosome 7 that causes increased thick secretions

What type of play does the 5 year old engage in?

imaginative play

What should a Kawasaki caregiver be taught?

irritability can last up to 2 months after treatment has been initiated

How does a child acquire hemophilia?

it is X link recessive Boys get it from their mother Girls are carriers

3 Risk Factors Associated with increased incidence of hemearthrosis

joint destruction limited ROM limited function

What foods should be limited in a child with Acute Glomerular Nephritis? (6)

limit SALT potato chips, canned food, turkey sandwich, cottage cheese, French fries, hot dogs

What is the medicine for ADHD, when is it given, and what may it cause?

methylphenidate & dextroamphetamine given in the morning because it may cause insomnia may stump growth

What is administered before a child receives chemotherapy?

ondasetron for nausea/vomiting

What causes rheumatic fever?

post strep infection

What does an increase in PT time mean?

the child is not forming clots quick enough and is at risk for bleeding