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MSC Peds Test
181 test #2 3/22/10
| Question | Answer |
|---|---|
| Pediatric care should be family centered, care should be a partnership with the parents | families have access to health record, chart, and are allowed to stay 24 hrs a day. |
| what is it important for a nurse to understand what to be able to recognize delays or abn development | normal/typical growth and development of a child |
| what is anticipatory guidance | preparing a child for a surgical procedure or stressful event by explaining what will happen |
| what is an infants concept of illness | perceive illness as a general discomfort and pain |
| what is a preschoolers concept of illness | illness is seen as a punishment for bad behavior and believe that the adults can magically cure the illness if they wanted to |
| what is a school age childs concept of illness | may perceive illness as a result in bad behavior, they start to understand the body functions and processes |
| what is the adolescents concept of illness | focus on discrete symptoms rather than overall impact of illness, may use the denial as a form of coping |
| what growth measurements are taken on a pediatric patient | height, head circumference, weight, skin fold thickness |
| Pediatric Physical assessment should be performed in appropriate, non-threatening area, provide time for play and to get acquainted, observe for behaviors that show child is ready to cooperate | Perform a Pediatric physical assessment by beginning in a non-threatening manner and involve child inexam process |
| what is the most reliable evaluation of growth | comparing measurments over a long period of time |
| how is length measured | child is supine with legs stretched out |
| how is height measured | child standing up |
| where is head circumference measured | above eyebrows and ears and around the back of the head |
| where is the preferable site for pulse in a child under 2 | apical |
| a child resp rate is irregular must take for 1 full minute | make sure you use the right size BP cuff (2/3 of arm) |
| why do peds pts have a demand for a high caloric intake | rapid increase in height and weight |
| what is weaning | the gradual replacement of bottle/breast with the cup adn table feeding |
| the rate of metablism if higher in newborns/infants that in the adult | infants triple weight by age 1 |
| the younger the child the faster they will heal due to faster metabolism | total sleep time decreases with aging |
| what is a childs first form of communication | crying |
| with infants use body lang, gesture, posture, intonation and pitch of voice when communicating, use gental phy. contact, tone of voice more important than words, keep upright and close to parents to ease anxiety | preschool/young school age child: avoid quick movements, let them make 1st move, smile, be at child's eye level, avoid direct eye contact until child is comfortable, substitute words that have threatening meaning |
| older school age children: give them the opportunity to express their feeling, avoid comments that convey disapproval or surprise, avoid asking embarrassing ? or lecturing when giving advice | adolescents: be prepared to deal w/ large range of emotions, give concrete explanations, ask for clarification when necessary, let them be in charge with goals and decisions, allow time to develp trust, ask broad ? before asking specific info. |
| what is the most important when preparing a child for being in the hospital | prepare the parents |
| when hospitalization is expects what opportunity should the child be given | the opportunity to explore the new surroundings |
| before surgery allow an infant to remain on caregiver's lap as long as possible | before surgery use dolls, puppets, and play hospital with toddlers |
| before surgery use books, videos, and assure a preschooler that the surgery is not their fault and is not a punishment | before surgery offer school age children a breif expalnation with supporting visuals |
| when an infant is undergoing surgery who should the surgery be explained to | the caregivers only |
| when should a toddler who is undergoing surgery have the procedure expalined to them | 3 days before if possible |
| when should a preschooler who is undergoing surgery have the procedure explained to them | prepare no more than 1 week in advance |
| what should be used to help school age children who are undergoing surgery | videos and tours |
| how much time should be given to an adolescent who is undergoing surgery | as much time as possible so they can prepare for time away from school and friends |
| what do you need to be taken care of postop for an infant | maintain body warmth, monitor I & O |
| what should you do for a toddler and preschooler postop | give a favorite toy an try to comfort |
| what should you do postop for school age children | ask about comfort level and preferred distraction activities |
| what do all children need postop | the presence of parents |
| how should nose drops be given to infant | 1 naris at a time |
| how should rectal meds be given | push past sphincter and hold buttocks together for a short time |
| how are ear medications given to infants | pull ear back and down (back and down make them frown) |
| how are ear medications given to children (and adults) | pull eat back and up (back and up make them smile) |
| how is O2 given to infants | nasal canula, hood and incubator, mist tents |
| what pain scale is used with children | the wong-baker FACES pain scale |
| what are the ages for infancy | birth -1 |
| what are the ages for a toddler | 1-3 |
| what are the ages for a preschooler | 3-5 |
| what are the ages for a school age child | 6-12 |
| what are the ages for an adolescence | 13-19 |
| what are the ages for early adulthood | 20-40 |
| what are the ages for middle adulthood | 30-65 |
| what are the ages for late adulthood | 65 + |
| what is growth | increase in size of the whole or its parts |
| what is development | gradual process of change and differention from simple to complex |
| what is cephalocaudal | head to tail |
| what is the Erickson's stage for infancy | trust vs mistrust |
| what is the Erikson's stage for a toddler (1-3 yrs) | autonomy vs shame |
| What is the Erikson's stage for a preschooler (ages 4-6) | initiative vs guilt |
| what is the Erikson's stage for school age (7-11) | industry vs inferiority |
| what is the erickson's stage for adolescence (12-19) | identity vs role confusion |
| What is the piaget stage of development for birth- 2 | sensorimotor |
| what is the piget stage of development for 2-6 year olds | preoperational thought |
| what is the piget stage of development for 7-11 year olds | concrete operational thought |
| what is the piget stage of development for 12 and older | formal operational thought |
| what is anticipatory guidance | psychologiaccly preparing somone for what is going to happen, both parent and child |
| what is the proper car seat and position for a child birth to 20 lbs. | rear facing in rear seat |
| what is the proper car seat postions for a child 20-40 ilb | front facing on rear seat |
| what is the proer car seat and position for a child over 40 lbs | boster seat |
| what is an atrial septal defect (ASD) | a hole in the wall between the atria |
| with an ASD which direction is blood shunted | left to right due to greater pressure on leftside |
| how might a small ASD manifest | child may be asymptomatic |
| how might a large ASD manifest | murmur, heart failure |
| what is treatment for ASD | surgery, either closed by purse string sutures or a dacron patch. |
| what is ventricular septal defect (VSD) | hole in septum between the ventricles |
| how does blood flow with VSD | blood with O2 from left ventricle flows to right ventricle (no O2) an then back to heart, oxygenated bllod travesl back to lungs |
| how might VSD be manifested | may be asymptomatic at first but will eventually develop a murmur and heart failure. |
| what % of VSD close by themselves | 50 % |
| who are VSD fixed surgically | pulmonary artery banding for palliative or surgiacl repair |
| what caused decreased pulmonary blood flow defects | some type of obstruction of blood flow to lungs or no conection between right side of heart and lungs |
| what type of defects have decreased pulmmonary blood flow defects | pulmonary stenosis, pulmonary atresia, tetralogy of fallot (most common) |
| what is tetrolgy of fallot | it is a combo of 4 defects: pulmonary stenosis, VSD,right venticular hypertrophy, and overriding aorta |
| how is tetraolgy of fallot manifested | profound cyanosis, hypoxia, murmur, clubbing nails, dyspnea, squatting, poor growth, mental slowness, , fainting, stroke |
| how is tetraolgy of fallot treated | blalock-taussig shunt connetion between PA an aorta or complete surgical closure |
| what is a tet spell | when children with tetraolgy or fallot cries or feeds skin may turn blue |
| what is a mixed defect | does not fit into a category, often include mixing of oxyenated blook adn non-oxygenated bool in heart, great vessels (ex: transposition of great vessels or truncus arterious |
| what is transpostion of the great vessels | PA arises from left ventricle and aorta from right ventricle, venous blood leaves right side of heart and returns with no oxygen, oxygenated blood goes through heart and right back to lungs |
| how does transpoition of the great vessels manifest | profound cyanosis, if child has PDA, ASD, or VSD there will be less cyanosis |
| how is tranposition of the great vessels treated | palliative : create an ASDcorrection: surgery |
| what are defects with obstruction to systemic flow | blood is unable to reach the body from the heart, there is a lack of O2 and decreased peripheral flow, heart failure |
| what is coarctation of the aorta | narrowing of lumen of the aorta. causes increased pressure in head and upper exremeties, decreased pressure in body and lower extrememties, has to be fixed with surgery |
| name a acquired heart disorder | rheumatic fever, damage is done to heart valves. |
| how rheumatic fever treated | aspirin or corticosteroid, abx |
| what are the 2 holes in a newborns heart that close | foramen ovale and ductus artteriosus |
| what kinds of damage can rheumatic fever cause | damage to heart valves, endocarditis, pericarditis, sydenham's chorea |
| what is endocarditis | infection of the lining of hte heart caused by bacteria entering the heart and settling on any roughened areas caused by ds or surgery |
| what children are at risk for endocarditis | kids with mitral valve prolapse, hx of endocarditis, PDA, VSD, coarctation of the aorta, rheumatic heart ds leading to heart valve dysfunction, hypertrphic cardiomyopathy |
| how to prevent endocarditis | good oral hygiene, reg dental visits, prophylactic abx for high risk pts. |
| what causes iron deficiency anemia | inadequate dietary intake of iron, blood loss, inability ro absorb iron (diarrhea, or malabsorbtion. |
| what is anemia | reduced O2 carrying capacity of the blood from a decrease in RBCs and/or hemoglobin |
| when does anemia become apparent in infants | full term baby: 6 mos oldpremie baby: 3 mos old |
| what are the s/s of anemia | irritability, weakness, fatigue, anorexia, pallor, pale mucous membranes, chronic anemia can cause retardation and developmental delays |
| what test are done for anemia | hx of diet and rate of growth, recent blood loss, CBC |
| how is anemia managed | iron supplement |
| what is hemolytic anemia | condition of inadequate # of circulating RBCs caused by premature destruction of RBCs. Occurs when the bone marrow is unable to compensate for premature destruction of RBCs by increasing their production |
| what causes hemolytic anemia | infection, some meds, autoimmume disorder, genetic (inherited) disorder |
| what are the types of hemolytic anemia | sickle cell anemiathalassemiaidiopathic autoimmune anemianon-immune hemolytic anemia caused by chemical or physical |
| what are the symptoms of hemolytic anemia | chills, fatigue, pale skin, SOB, rapid heart rate, jaundice, dark urine, enlarged spleen |
| what is thalassemia | genetic blood ds involving decreased and defective production of hemoglobin, RBCs can be smaller than normal or the amount of hemoglobin can be below normal levels, can range from mild to very serious |
| Thalassemia is a recessive genetic disorder | Both parents have to be carriers for it to occur in a child |
| what are the s/s of thalassemia | fatigue, SOB, heart palpitations, mild jaundice, enlarged liver or spleen, growth delay, problems with bone growth, gallstones |
| how is thalassemia treated | spleen removal, blood transfusion (freq), chelation therapy, bone marrow transplants, stem cells |
| what is sickle cell anemia | genetic, abn form of hemoglobin within RBC, most common if africe an americans |
| after qxygenation hemoglobin changes to a sickle shape | the sickle cells clump, slowing circulation, hypoxia |
| what caused the sickling | infection, fever, hypoxemia, dehydration, high altitudes, cold, stress |
| how is sickle cell anemia manifested in a child | pallor, irritability, fatigue, jaundice, below average wt/ht, enlarged heart, heart failure in response to hypoxia, decreased cardiac output, joint swelling, stroke, priapism-persistent penile erection due to occluded veins |
| Diagnostic tests for sickle cell anemia: sickle turbidity test followed by hemoflobin exam | treatment of sickle cell anemia is mostly palliative: pain meds, hydration, oxygen, transfusions, splenectomy |
| what are coagulation disorders | disorder characterized by abn bleeding either into the skin or from internal organs related to platelet dysfunction, clotting factor defects, vascular compromise |
| what is hemophilia | a serious lifeling inherited (x linked) recessive gene, transmitted by female carrier but only affects males |
| what are the manifestations of hemophilia | usually dx in infancy, toddlers have more oral bleeding and bruising, freq bleeding into joints (hemarthrosis), intracranial hemorrhage |
| what are the tests for hemophilia | PT, INR, PTT |
| how is hemophilia managed | pressure, cold packs, factor VIII, pain meds, hep B vaccine |
| what is Von Willebrand's ds | a hereditary bleeding disorder caused by a deficiency of Von Willebrand's factor, affects both sexes |
| Von Willebrand's ds worsens with the use of ASA and NSAID | Von Willebrand's facotr helps platelets sitck to the blood vessel wall and to each other for normal blood clotting. |
| what are the Ps/s Von Willebrand's ds | nose bleeds, bleeding gums, abn menstrual bleeding, bruising, skin rash, prolonged bleeding time, reduced platelet aggregation |
| what tests are done for Von Willebrans's ds | platelet count (normal), PT,PTT, INR, abn factor VII level |
| how is Von Willebrand;s treated | cryoprecitate, fresh plasma |
| what is idiopathic thrombocytopenia Prupura (ITP) | decrease is the amount of circulating platelets, bleeding under skin, most freq in 2-5 yo, can be acute or chronic |
| how is ITP (idopathic thrombocytopenia prupura) manifested | bruising, petechiae, bleeding gums/lips, nose bleeds, serious complication - intracranial bleed, hematuria, melena, hematemesis, menorrhagia |
| how is ITP Iidiopathic thrombocytopenia prupur) managed | corticosteriods, transfusion, gamma globulin, spleenectomy |
| what is leukemia | group of malignant ds of the bone marrow/lymphatic sys, most common malignancy of childhood, more common in males than females |
| what is acute lymphoid leukemia (ALL) | ucontrollabel proliferation of blast cells (immature WBCs), accumulated in marrow and crowds, depresses mature cells, invades lymph nodes and liver causing them to enlarge |
| how does acute lymphoid leukemia (ALL) manifest | pallor, fatigue, decreased WBCs, fever, infection, decreased platelets, bleeding, petechiae, enlarged liver, spleen, bone pain, limping, joint pain, increased risk of bone fx, CNS involvement causeing increased intracranial pressure |
| what dx test are done for acute lymphoid leukemia | CBC, bone marrow aspiration show immature blast cells, lumbar puncture to check for CNS involvement |
| how is acute lymphoid leukemia managed | chemo, drugs injected into CSF |
| what is neutropenia | a hematological disorder characterized by anb low # of neutrophils |
| what are the types of neutropenia | congential, cyclic, idipathic, autoimmune, drug-induced |
| what are the caused of neutropenia | decreased production of neutrophils in bone marrow, hereditary disporder, cancer, certain meds, radiation, vit B-12 or folate deficiency, aplastic anemia, autoimmune neutopenia, chemo, hemodialysis |
| what are the s/s of neutropenia | absent pus formation, fever, freq infection, mouth ulcers, diarrhea, durning w/ urination, sore throat, SOB, shaking chills, unusual redness, pain, swelling around a wound |
| how is neutropenia dx | CBCbone marrow biopsy |
| how is neutropenia treated | granulocyte colony-stimulating factos (CSFs), neupogen, leukine or prokine |
| what is mononucleosis | epstein barr viral syndrome (kissing ds) |
| what causes mononucleosis | transmitted by salivia, occurs mostly in 15-17 yo |
| what are the s/s of mono | fever, sore throat, enlarged lymph nodes in neck and armpit, generla discomfort, uneasiness, or ill feeling, drowsiness, loss of appetite, muscle aches or stiffness, enlarged spleen, rash |
| what labs/test are done for mono | WBC (elevated), exam of lymphocytes (abn), liver function test (abn), monospot test, epstein-barr virus antigen, epstein-barr virus titers |
| how is mono treated | usually recover in weeks w/o meds, no specific tx, fatigue up to 6 wks with older kids |
| what is hodgkin's ds | painless, pregressice enlargement of lymphoid tissue, exact cause unknown, more common in males |
| what is juvenile rheumatoid arthritis | chronic inflammatory ds of connective tissue, chronic inflammation of synovium and joint effusion -erosion of joint. |
| how is juvenile rheumatoid arthritis manifested | stiffness, edema and loss of motion in the affected joints, temp spikes, macular rash on trunk and extremeties, pericarditis, lymphadenopathy, hepatosplenomegaly, iridocyclitis, anemia |
| how is juvenile rheumatoid arthritis dx | elevated sedimentation rate, x-ray, changes in joints |
| how is juvenile rheumatoid arthritis managed | prevent joint damage, releve discomfort: NSAIDs, enbrel, cytoxan, corticosteroids, plaquenil |
| what is respiratory distress syndrome (RDS) | hyaline membrane ds, deficiency of surfacant, most common in premature infants |
| what is bronchoplumonary dysplasia | chronic pulmonary ds of premature infants, is associated with meconium aspiration, high O2 concentrations, + pressure ventilation |
| what is pneumonia | acute inflammation of pulmonary tissue, small aitways, alveoli. Usually caused by virus, bacteria, or foreign body, freq assoc with URI |
| when is resp season | nov-march |
| what is SIDS (sudden infant death syndrome) | sudden unexpalained death of a health baby under the age of 1. |
| what are the possible causes of SIDS | sleep apnea, decreased response to CO2, sleep in prone position, soft mattress/pilllow |
| what is an upper respiratory infection (URI) | sore throat, phayngitis, tonsillitis |
| what is acute pharyngitis | sore throat, usually viral, make sure it is not strep, if it is it is treated with abx |
| what is tonsillits | inflammation of tonsils due to pharyngitis (viral or bacterial) |
| what is rhinitis (alergic) | a collection of symptoms mostly in the nose and eyes caused by airborne particles of dust, dander, ro palnt pollens in people who are allergic to these susbtances. |
| what is vasomotor rhinitis | a non-allergic condition that causes a constant runny, sneezing, and nasal congestion, unknown cause. |
| what is croup | acute viral ds with a barking cough, suffocative adn difficult breathing, laryngeal spasm. |
| what is laryngotracheobronchitis | usually a viral infection that starts in the upper resp and moves to lower resp, usually in kids 3 mos-3 yrs |
| what is epiglottis | severe life threatening bacterial infection that causes an inflammed epiglottis that can lead to total airway obstruction |
| what is laryngitis | ann inflammation of the larynx generally assoc with hoarseness or loss of voice, caused by swelling of vocal cords |
| what is a lower respiratory infection | inflammation of the large airways, trachea, and bronchi, usually viral, mainly in winter |
| what is bronchiolitis | inflammation of smaller airways of the bronchioles, inflamed with edema, usually caused by RSV, usually under 2 yo |
| what is RSV | respiratory syncytial virsu, most common cause of bronchiolitis and pneumonia in infants and children under 1 |
| what is cystic fibrosis | inheritied, genetic ds of the exocrine glands (mucus producing) causing abn thick mucus to collect in the lung airways and organ ducts. |
| what can be obstructed in CF | bronchi and pancreatic ducts causing a decrease in digestive enzymes |
| what is bronchial asthma | chronic imflammatory disorder of the airways, freq caused by allergic hypersensitivity |
| what happens during bronchial asthma | bronchospasm, mucosal edema, mucus plugs |
| cleft lip and palate is more common together that alone | cleft lip can be unilateral or bilateral |
| cleft palate can be of soft or hard palate | feedings may leak into nasal cavity causing gagging and choking,poor sucking |
| may be speech problems with cleft lip/palate even after repair | no feeding problems with only a cleft lip |
| cleft lip/palate may have delayed speech or nasal speech and recurrent otitis media | cleft lip is usually repaired by 1-2 mos of fage (z plasty) |
| cleft palate is usually repaired before age 1 | protect suture line, watch nutrition, no straw, pacifiers, or eating utensils. |
| what is bronchoplumonary dysplasia | chronic pulmonary ds of premature infants, is associated with meconium aspiration, high O2 concentrations, + pressure ventilation |
| what is pneumonia | acute inflammation of pulmonary tissue, small aitways, alveoli. Usually caused by virus, bacteria, or foreign body, freq assoc with URI |
| when is resp season | nov-march |
| what is SIDS (sudden infant death syndrome) | sudden unexpalained death of a health baby under the age of 1. |
| what are the possible causes of SIDS | sleep apnea, decreased response to CO2, sleep in prone position, soft mattress/pilllow |
| what is an upper respiratory infection (URI) | sore throat, phayngitis, tonsillitis |
| what is acute pharyngitis | sore throat, usually viral, make sure it is not strep, if it is it is treated with abx |
| what is tonsillits | inflammation of tonsils due to pharyngitis (viral or bacterial) |
| what is rhinitis (alergic) | a collection of symptoms mostly in the nose and eyes caused by airborne particles of dust, dander, ro palnt pollens in people who are allergic to these susbtances. |
| what is vasomotor rhinitis | a non-allergic condition that causes a constant runny, sneezing, and nasal congestion, unknown cause. |
| what is croup | acute viral ds with a barking cough, suffocative adn difficult breathing, laryngeal spasm. |
| what is laryngotracheobronchitis | usually a viral infection that starts in the upper resp and moves to lower resp, usually in kids 3 mos-3 yrs |
| what is epiglottis | severe life threatening bacterial infection that causes an inflammed epiglottis that can lead to total airway obstruction |
| what is laryngitis | ann inflammation of the larynx generally assoc with hoarseness or loss of voice, caused by swelling of vocal cords |
| what is a lower respiratory infection | inflammation of the large airways, trachea, and bronchi, usually viral, mainly in winter |
| what is bronchiolitis | inflammation of smaller airways of the bronchioles, inflamed with edema, usually caused by RSV, usually under 2 yo |
| what is RSV | respiratory syncytial virsu, most common cause of bronchiolitis and pneumonia in infants and children under 1 |
| what is cystic fibrosis | inheritied, genetic ds of the exocrine glands (mucus producing) causing abn thick mucus to collect in the lung airways and organ ducts. |
| what can be obstructed in CF | bronchi and pancreatic ducts causing a decrease in digestive enzymes |
| what is bronchial asthma | chronic imflammatory disorder of the airways, freq caused by allergic hypersensitivity |
| what happens during bronchial asthma | bronchospasm, mucosal edema, mucus plugs |
| cleft lip and palate is more common together that alone | cleft lip can be unilateral or bilateral |
| cleft palate can be of soft or hard palate | feedings may leak into nasal cavity causing gagging and choking,poor sucking |
| may be speech problems with cleft lip/palate even after repair | no feeding problems with only a cleft lip |
| cleft lip/palate may have delayed speech or nasal speech and recurrent otitis media | cleft lip is usually repaired by 1-2 mos of fage (z plasty) |
| cleft palate is usually repaired before age 1 | protect suture line, watch nutrition, no straw, pacifiers, or eating utensils. |
| what is dehydration | loss of more fluid than intake in, can be caused by diarrhea, vomiting. |
| what is mild dehydration | 5% loss |
| what is moderate dehydration | 10% loss |
| what is severe dehydration | 15% loss |
| what are the causes of dehydration | abn skin losses, respiratory, renal, GI |
| what is gasrtoenteritis | diarrhea caused by inflammatory process as infection, most commonly caused by virus or bacteria |
| what is constipation | passage of hardened stools |
| what is intestinal artesia | closure of intestine |
| what is intestinal stenosis | narrowing of the intestine |
| what is hirschsprungs ds | no peristalsis |
| what is a meconium ileus | obstruction of bowel meconium |
| what is an esophageal artesia | disorder of the digestive sys in which the esophagus does not develop properly, is a congenital defect, usually in upper esophagus, ends in a blind pouch and does not connect w/ lower esophagus and stomach, lower esophagus may be connected with trachea |
| what is tracheoesophageal fistula | connection between lower esophagus and the trachea is abn |
| what is gastroesopheageal reflux (GER) | effortless retuen of gastric contents into the esophagus and possibly the pharynx, caused by incompetent lover esophageal sphincter |
| what is pyloric stenosis | obstructive disorder of the gastric outlet, muscle between stomach and duodemum is enlarges making if dif for the stomach to empty. projectile vomitig is the hallmark of this ds. |
| what is intussusception | one portion on the intestine telescopes into another, most common obstruction in kids 3 mos-6 yrs, unknown cause. Hallmark is currant jelly-stool |
| what is hirschprung's ds | megacolon, no peristaltic waves in affected portion, lack of innervation of portion of bowel, affected part usually needs removed |
| what is a mecomium ileus | condition where the meconium in a newborn is very thick and is not expelled after birth (common with CF), causes a bowel obstruction |
| what is a UTI | urinary tract infection, infection of any protion of the urinary sys, usually caused by e coli, can be caused by urinary stasis which is a cngentital anomaly |
| what is nephrotic syndrome (nephrosis) | glomerular damage that causes teh glomerulus to become permeable to protein. characterized by proteinura, periorbital edema, hyperlididemia, hypoproteinemia |
| what does nephrosis (nephrotic syndrome) cause | low level of protein in bloodm decreased colloidal osmotic pressure in teh capillaries, leads to fluid leaking into intersitital spaces, causes decease in blood blood volume (hypovolemia) |
| what are the 3 types of nephrotic syndrome (nephrosis) | idiopathic or primary (most common), secondary (glomerular damage), congenitally acquired |
| what is acute glomerulonephritis | infallmation of the glomeruli of hte kidney, occurs from bacterial or viral infection, frequent follows a strep infection |
| what is poststreptococcal glomerulonephritis | most common type of glomerulonenephritis caused by strep infection. |
| what is Wilm;s Tumor (nephroblastoma) | most common type of malignant tumor in children, most common in left kidney, child must avoid contact sports |
| what is polycystic kidney ds (PKD) | usually inherited and caused by gene abnormalities, characterized by growth of cysts in the kidneys, both kidneys affected, cysts grow until the compress healthy tissue and keep kidneys from working correctly,no cure |
| what are the 3 kinds of polycystic kidney ds | autosomal dominant (50/50 chance of inheriting)autosomal recessive PKD (infantile PKD, rare)acquired cyctic kidney ds (ACKD): develops with long term kidnery problems esp people who are on long term dialysis |
| PKD cannot be cured and there is no restoration of kidney function | PKD required dialysis and transplant |
| what is phimosis | narrowing/stenosis of the opening of the foreskin |
| what is hypospadius | urethral opening on the underside of the penis, surgical correction usually done at 6-9 mos |
| what is epispadias | urethal opeing on upper portion of penis, surgical correction involve penial and ureheral lengthening and possibley bladder neck reconstruction |
| what is hydrocele | fluid in the testicles (perineal fluid), not painful, usually resolves self. |
| what is undescended testicle cryptochidism | failure of one or both testicles to descend, more common in premies, 65% descend by 9 mos, if not down by 1 then surgery is done. |
| what is bladder exstrophy | congenital birth defect causing malformation of the bladder and urethra, bladder is flattened, inside of bladder is exposed to abd |
| the thyroid is a sm gland in front to the neck, has 2 lobes, one on each side of trachea joined by sm area of tissue (isthmus) | function of the thyroid is to take iodine and convert it to thyroid hormones (thyroxine T3 and trilodothyronine T4) |
| every cell depends of T3 and T4 to regulate metabolism | thyroid is under control of the pituitary gland at the base of the brain |
| when the level of thyroid hormones drop too low in the blood teh pituitary produces thyroid stimulating hormone which stimulated the thyroid to produce more hormones | when the pituitary senses too high a level of thyroid hormone in the blood the pituitary gland decreases level of TSH |
| what is hypothyroidism | deficient production of thyroid hormone. Can be primary (congenital), acquired (insufficient stimulation of thyroid gland or resistance to thyroid hormone) |
| graves ds is the most common form of hypothyroid ds. | hypothyroidism is rare in young children, more common in young adolescents. Screening done at birth because it can be treated so that normal physical growth can happen) |
| what is thyroid storm. | severe hyperthermia, vomiting, diarrhea, severe tachycardia, coma, death |
| what is diabetes mellitus | deficiency of insulin resulting in alteratin in carbohydrate, protein, and fat metabolism |
| what is insulin dependent diabetes | IDDM, most common, must have compliance with meds, may use insulin pump |
| what is hypoglycemia | low blood sugar, s/s= HA, cold sweats, faitness, blurred vision, hunger, grouchiness, shallow breathing, personality changes |
| whay is hyperglycemia | high blood sugar, s/s= 3 P's (polydipsia, polyuria, polyphagia), fatigue, dry mouth, dry itchy skin, recurrent infections (ex: yeast), weakness, poor would healing, weight loss. |
| what is DDH or developmental dysplasia of hip | developmental abn of the femoral head, acetabulum or both |
| what is subluxation | partial dislocation, incorrect position of head in acetabulum |
| what is dislocation | femoral head has no contact with the acetabulum |
| what is scoliosis | skeletal deformity, lateral curvature of spine that causes changes in spine, chest, hips. Can affect cardiopulmonary and neurologic function, neg self image |
| what are the 3 classifications of neurologic disorders | increased intracranial pressurehypoxiaseixure activity |
| what is meningitis | infection of the meninges that cover the brain, usually affects kids under 5, can be casued by bacteria, viral, fungus, bacterial most common |
| what is the kernig sign | clinical hallmark of meningitis: leg flexed at knee then brought straigt - leg cannot be extended due to pain |
| what is the brudzinki's sign | severe neck stiffness causing pts hips and knees to flex when neck is flexed |
| what is encephalitis | inflammation of the central nervous sys (brain tissue, spinal cord), caused by bacteria, fungi, protozoa, and viruses (most common) |
| hydocephalus | increased production of CSF, obstruction w/in the ventricular system, or defective reabsorption of the CSF. Can be casued by tumor, congenital astresia, hemorrhage, infection |
| what is cerebral palsy | most common type of permanent physical disability of childhood, non-progressice disorder of neuron impairment-motor dysfunction. Primary dysfunction is abn muscle tome and poor coordination |
| what are seizures | sudden, excessive, disorderly discharge of abn electrical impulses by the brain's neurons, causes temporary alteration in CNS function |
| what is spina bifida | neural tube defect, tube fail to close during embryonic developent. Can be a tuft of hair, cleft, sm fatty mass, or sac w/ contents from spinal cord in it. |
| what is encephalocele | infant is born witha gap in the skull, membrane that covers brain and tissue protrude through gap, usually have physical and mental handicaps |
| what is microcephaly | term for head size that is signigicantly below noral for person's age and sex, failure of brain to grow at a normal rate during PG and infancy, can be casued by infection, genetic disorder, severe malnutrition that affects brain growth |
| what is anencephaly | the absence of a lare part of the brain and skull, is a neural tube defect. Caused by envrionmental toxins, low intake of folic acid during PG |
| what is neonatla abstinence syndrom | when opiated cross placental barrier giving the infant passive addiction (cocaine, heroine, methadone). Baby has symptoms of withdrawal, they can last for 3-4 mos, dx by urine screening/meconium drug screening |
| what is lead poisoning | blood lead level greater than 10, causes long term cognitive, behaior problems |
| what is pediculosis | head lice |
| what are communicable ds | ds that can be spread: rubeola, rubella, varicell, roseola infantum, fifth';s ds, scarlet fever, mumps, diphtheria, pertusis. |
| what is a cognitive impairment | significantly sub average general intellectual functioning existing concurrently with deficits in adaptive behavior, manifests during the developmental period (formerly called mental retardation). |
| what are cognitive impairments based on | IQ |
| a mild cognitive impairment can be educated and has an IQ of 50-55 | a moderate cognitive impairement is trainable and has an IQ of 35-40 or 55 |
| a severe cognitive impairment has a IQ of 20-40 | a profound congitive impairment has an IQ below 20 |
| what causes cogintive impairments | biochemical exposure, ifectious ds, genetics, endocrine problem, idiopathic, prematurity |
| cognitive impairment manifestations vary with age and degree of impairment | children fail to achieve developmental milestones at appropriate ages |
| what areas may have delays with cognitive imapirments | motor skills, social skills, cognitive ability, language skills. |
| cognitive impairments are dx by | neuro exam, CT scan, serum metabolic screening, developmental screen (Denver II), IQ tests, chromosome and genetic studies |
| interventions are based on promoting optimal development and supporting the family by providing education and referrals | early intervention programs are important. Love, social interaction and play are importatn no matter the cognitive ability |
| what is down syndrome | caused by an extra chromosome on the 21st pair (trisomy 21), risk of having child with downs increases with maternal ages especially over 35 |
| what are down syndrome characteristics | small rounded skull with flat occiput, upward slanting eyes, broad flat nose, protruding tongue, short, thick neck, hypptonic extrememties, mottled skin, low set ears, simian crease on palmar side of hand |
| all downs children have an intellectual impairment to some degree | other poss physical prob: URI, congenital heart defects, leikemia, immune sys dysfunction, thyroid dysfunction |
| what is autism | disorder of brain function accompanied by a broad range and severity of intellectual and behavioral deficits |
| when are autism behaviors usually seen | between age 24 mos and 48 mos |
| what is the cause of autism | cause unknown, may be genetic, not caused by MMR |
| what are the clinical manifestations of sutism | inability to maintain eye contact, avoid body contact, unusual interasction with toys, GI prob, 50-705 have some form of mental retardation, speech and lang delays, intense early interventions inmprove outcome |
| what is child maltreatment | physical and emotional neglect and physical, emotional, and sexual abuse of children |
| what is physical neglect | failure of a parent or caretaker to supply a child with adewuate food, clothing, shelter, education, or health care even though financially able to do so or offered the means to do so. |
| what is emotional neglect | failure by a parent or caregiver to meet a chold's needs for emotional nuturance, affection, and attention |
| what is physical abuse | intentional infliction of physical injury upon a child by a parent or guardian |
| what is emotional abuse | intentional attempt by a parent or caregiver to impair or destroy the mental or emotional state of a child |
| what is sexual abuse | commission of a sexual offense by an older person against a child who is dependent or developmentally immature for the purpose of the perpetrator's own sexual stimulation or greatification |
| what is school avoidance (school phobia, school refusal) | when a physically healthy child repeatedly stays home from school or is sent home from shcool for physical symptoms of an emotional orgin |
| what may school avoidance be related to | anxiety, academic progress, peer conflicts, marital discord, overprotective parents, 2ndary gains form not going to school, lenient or indifferent parents |
| how might school avoidance manifest itself | HA, abd pain, V/D, insomnia, pallor, palpitations, hyperventilation |
| Learning disabilities affect about 10% of all school choldren | LD impair child ability to understand, assimilate, recall, or produce information |
| LD are usually in math, reading, and/or writing | LD are usually present before school entry but manifest itself w/ academic demands |
| what are the dx tests for LD | H&P, lead level, EEG, chromosomal studies, hearing and vision screening, IQ tests, neuropsychological testing |
| what is ADHD | attention deficit hyperactivity disorder, has the follwing behaviors: hyperactivity, insttentiveness, and impulsivity. ADHD appears early in life, |
| what is depression | mood disturbance with overall feelings of sadness, despair, worthlessness, or hopelessness, more common in girls |
| what is suicide | deliberate act of self-injury with the intent that the injury will result in death, |
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shellyrbrooks
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