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Peds exam #2
| Question | Answer |
|---|---|
| Kawasaki acute phase | fever > 5 days, rash, strawberry tongue, swollen hands/feet, enlarged cervical l ymph nodes, bilateral conjuctival hyperemia (5/6 to dx) |
| Kawasaki subacute phase | desquamation, joint pain, cardiac dz, thrombocytosis |
| what triggers a sickle cell crisis? | Hypoxia, fever, stress, dehydration, infx |
| ITP desired response to tx | control bleeding & safety |
| What are the meds for laryngotracheobronchitis/LTB? | β-agonists & β-adrenegics; albuterol, racemic, & epinephrine aerosolized through a face mask those are rapid acting. Corticosteroids; Dexamethasone IM, PO, nebulized budesonide more LT used to ↓ edema. Also, humidified O2 to get rid of the boogies |
| Hemophilia interventions | ASA (no), ROM (no), provide ice packs, pressure, elevate area for 15 min to vasoconstrict--RICE |
| Most common s/s bone marrow involvement/ leukemia | infection--> RBC & plts are replaced which results in thrombocytopemia, anemia & immunosuppression. s/s; fever, pallor, lethargy, malaise, overt signs of bleeding, joint/bone pain, enlarged liver/spleen, lymph nodes, anorexia & wt loss. |
| cyanotic heart defect | low Hb |
| Premies w/bronchopulmonary (BPD) dysplasia | heart conditions, so give diuretics, preferably aldactone |
| s/s CHF | tachycardia, pulmonary/venous congestion, impaired c/o, ↑ metabolic rate, tires easily, diaphoresis (esp the head), wt ↑ (infants= ftt & ↓ wt), nasal flaring, grunting, retractions, cough, frothy secretions, JVD, ascites, hepato/cardiomegaly |
| osteosarcoma | pain that awakens the child during the night, swelling, limp, ↑ WBC & ↑ ESR |
| pyloric stenosis | begins as regurgitation, then projectile vomiting. There are visible peristaltic waves ↓ abdomen, & olive sized mass in RUQ. |
| hirshprung dz | unable to pass meconium in 24H, distended abdomen, chronic constipation alt w/ diarrhea, wt hx, nutritionally deficient ribbon-like stools in older child, enterocolitis may occur (emergency) |
| Transesophegile fistula & esophagile atresia | watch for aspiration |
| cast care | check skin integrity, pulses, cap refill, swelling, drainage |
| s/s hyperthyroidism | goiter & exopthalmos (not as common in children as in adults), eyelid lag, tachycardia, nervousness, irritability, tremors. ↑ appetite with wt loss, emotional labile, heat intolerance, perspiration, ms weakness, bruit on auscultation of thyroid, insomnia |
| cyclosporine | postop- renal transplant--> To reduce the activity of the patient's immune system & To reduce the risk of organ rejection |
| s/s acute renal failure | hyperkalemia (most life threatening), uremia (urine in blood) & fluid overload, gross hematuria, oliguria, HA, HTN, edema, gallop, crackles, lethargy, pallor, n/v, mass in flank area, tumor or obstructive lesion |
| s/s increased ICP early | HA (infant has dilated scalp veins), bulging fontanel, ↑ head circumference, irritability, cat cry, diplopia, N/V, dizzy, vertigo, ataxia, slight v/s changes, pupils not as reactive, sunsetting eyes, sz, slight change in LOC, confusion |
| s/s increased ICP late | Significant & deteriorating LOC, Fixed & dilated pupils, Cushing’s Triad (r/t v/s): 1) HTN, wide pulse pressure 2) Bradycardia 3) Irregular respirations keep in semi fowlers position |
| cerebral palsy s/s | hypotonia, hypertonia,(scissoring of legs), athetosis (involuntary writhing), ataxia, hemiplegia (1-sided & upper more dysfx), diplegia (spastic-all & lower more affected), quadriplegia (involves all extremities- arms in flexion, legs in extension) |
| Bacterial meningitis sign | rigid/ spastic |
| Slipped capital femoral epiphysis (SCFE) nursing assessment | boys, growth spurt, Femoral head displaced @ proximal epiphyseal plate, r/t obesity, endocrine- hypogonadism, hypothyroidism- s/s; inability bear wt lower extremity, out-toeing w/flexion of the lleg, limp-loss of hip motion. acute < 3 weeks maybe d/t tr |
| hip dysplasia popping in/out | girls, moe on left side,Limited ROM & abduction (away from midline) of affected hip, telescoping of thigh, asymmetry of gluteal & fat thigh folds, shortened leg, older kids limp. Femoral head & acetabulum improperly aligned/dislocated. Dislocation= compl |
Created by:
arsho
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