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69 Cards in this Set

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PATENT DUCTUS ARTERIOSUS is
-a defect resulting from the failure of the ductus (located between the aorta and the pulmonary artery) to close, causing shunting of blood to the pulmonary artery
PATENT DUCTUS ARTERIOSUS s/s are
mild cyanosis, machinelike heart murmur, respiratory distress, tachycardia, tachypnea
PATENT DUCTUS ARTERIOSUS maybe confirmed by
chest x-ray shows prominent pulmonary vasculature and enlargement of the L ventricle and aorta
PATENT DUCTUS ARTERIOSUS tx is, what should be noted about one of the treatments
ligation of the patent ductus arteriosus in closed-heart operation.

Digoxin (Lanoxin) *remember to take an apical pulse for 1 minute before giving digoxin. You are checking for bradycardia. (infants: rate below 100/min)

Diuretics
VENTRICULAR SEPTAL DISORDER is
defect occurring when the ventricular septum fails to complete its formation between the ventricles, resulting in a left-to-right shunt
VENTRICULAR SEPTAL DISORDER s/s are
respiratory distress, tachycardia, tachypnea, cyanosis
VENTRICULAR SEPTAL DISORDER maybe confirmed by ____, what would this test show
chest x-ray that may show cardiomegaly with a large L atrium and ventricle.
VENTRICULAR SEPTAL DISORDER tx options include:
pulmonary artery banding to prevent heart failure and permanent correction with a patch later when the heart is larger. Spontaneous closure is possible by age 3. Digoxin, and diuretics may be used.
Provide an overview of CYSTIC FIBROSIS excluding s/s, tx, dx
generalized dysfunction of the exocrine glands that affects multiple organ systems. It is transmitted as an autosomal recessive trait. It is one of the most common inherited disease in children. It is a common cause of childhood death and occurs equally in both sexes
CYSTIC FIBROSIS s/s are
salty taste on child’s skin, bulky, greasy foul-smelling stools that contains undigested food. Airway obstruction caused by the increased and constant production of mucus, little or no release of pancreatic enzymes (lipase, amylase, and trypsin), malabsorption
CYSTIC FIBROSIS maybe confirmed by
sweat chloride 2-5x normal, stool specimen analysis indicated the absence of trypsin
CYSTIC FIBROSIS tx is
chest physiotherapy, multivitamins especially fat-soluble, hig-protein diet, mucolytic, bronchodilator, antibiotic all by nebulizer, and oral pancreatic enzyme replacement with pancrelipase.
Provide an overview of TRACHEOESOPHAGEAL FISTULA
congenital anomaly in which the esophagus and trachea don’t separate normally. Most common is the esophagus ends in a blind pouch, with the trachea communicating by a fistula with the lower esophagus and stomach
TRACHEOESOPHAGEAL FISTULA is
congenital anomaly in which the esophagus and trachea don’t separate normally. Most common is the esophagus ends in a blind pouch, with the trachea communicating by a fistula with the lower esophagus and stomach
TRACHEOESOPHAGEAL FISTULA s/s are
difficulty feeding, such as choking or aspiration, cyanosis during feeding. Respiratory distress to include tachypnea, cyanosis, sternal and substernal retractions. Maternal polyhydramnios (because fetus can’t swallow amniotic fluid
TRACHEOESOPHAGEAL FISTULA may be confirmed by
abdominal x-ray shows the fistula and a gas-free abdomen.
TRACHEOESOPHAGEAL FISTULA tx includes
emergency surgical intervention to prevent pneumonia, dehydration, and fluid and electrolyte imbalances, maintenance of patent airway. Antibiotics as prophylaxis for aspiration pneumonia
ESOPHAGEAL ATRESIA is
the proximal end of the esophagus ends in a blind pouch. Food can not enter the stomach via the esophagus
ESOPHAGEAL ATRESIA s/s are
excessive salivation and drooling due to inability to pass food through the esophagus. Regurgitation, possible aspiration
what should be noted about newborns in realtion to ESOPHAGEAL ATRESIA
Newborns are fed first with a few sips of sterile water to detect these anomalies and to prevent the aspiration of formula or breast milk into the lungs
ESOPHAGEAL ATRESIA tx is
surgical correction by anastomosing the esophageal ends. Repair is done in stages.
CLEFT LIP is ____, It places the patient at increase risk for
partial or complete defect of the lip that results in failure of the upper lip to fuse. Can range from a simple notch on the upper lip to complete cleft from the lip edge to the floor of the nostril, on either side of the midline, rarely along the midline itself. Increased risk for aspiration because of the increased open space in the mouth
CLEFT LIP may be determined by ______
may be determined by prenatal US
CLEFT LIP tx includes
Cheiloplasty performed between birth and age 3 months to unite the lip and gum edges in anticipation of teeth eruption.
CLEFT PALATE
mouth examination after birth if cleft palate is present without cleft lip
CLEFT PALATE tx may include
cleft palate repair surgery (staphylorrhaphy) scheduled for about 18 months to allow for growth of the palate and to be done before the infant develops speech patterns.
HYPOSPADIAS is
congenital anomaly of the penis. The urethral opening may be anywhere along the ventral side of the penis. This conditions provides a shorter distance to the bladder, providing easier access for bacteria
HYPOSPADIAS is caused by
Most likely caused by genetic factors
HYPOSPADIAS is confirmed by
observation confirms aberrant placement of the opening
HYPOSPADIAS tx is
avoid circumsion (the foreskin may be needed later during surgical repair), no treatment, mild disorder. Meatotomy
What is Meatotomy
procedure in which the urethra is extended into a normal position) to restore normal urinary function. At age 12-18 months surgery to release the adherent chordee (fibrous band that causes the penis to curve downward
Meatotomy tx is
analgesics for postoperative pain relief and antispasmodic agents (propantheline) for postoperative bladder spasms.
HYDROCEPHALUS is
increase in the amount of CSF in the ventricles and subarachnoid spaces of the brain. An imbalance in the rate of production and the rate of absorption of CSF. Congenital hydrocephalus is non-communicating, blocked by tumors, hemorrhage or structural abnormalities that causes fluid to accumulate in the ventricle
HYDROCEPHALUS s/s are
“cracked pot” sound when the skull is percussed, distended scalp veins, high-pitched cry, rapid increase in head circumference and full, tense, bulging fontanels. Skull x-ray shows thinning of the skull with separation of the sutures and widening of fontanels
HYDROCEPHALUS tx includes
shunt insertion to allow CSF to drain from the lateral ventricle in the brain. Anticonvulsants for seizures (pheobarbital, diazepam and phenytoin
Provide an overview of DOWN SYNDROME excluding tx, dx, and s/s
tri-somy 21 chromosomal aberration characterized by mental retardation, dysmorphic facial features. Most also have congenital heart defects, are predisposed to respiratory infections, chronic myelogenous, leukemia and have a weak immune response to infection
DOWN SYNDROME s/s are
brushfield’s spots, flat nose and low-set ears, mild to moderate retardation, protruding tongue, short stature with pudgy hands, simian crease, small head with slow brain growth, upward slanting eyes
DOWN SYNDROME tx is treated by what means
treatment for coexisting conditions (congenital heart problems, visual defects, or hypothyroidism).
brushfield’s spots is
marbling and speckling of the iris
HIP DYSPLASIA results from
results from an abnormal development of the hip socket. It occurs when the head of the femur is still cartilaginous and the acetabulum (socket) is shallow; as a result, the head of the femur comes out of the hip socket
HIP DYSPLASIA causes include
breech delivery, fetal position in utero, genetic predisposition, and laxity of the ligaments
HIP DYSPLASIA dx include
Increased number of folds on the posterior thigh of he affected side when the child is supine with knees bent

Appearance of a shortened limb on the affected side, restricted abduction of the hips.

Barlow’s sign

Ortolani’s click is present. Trendelenburg’s test is positive.

When the child stands on the affected leg, the opposite pelvis dips to maintain erect posture
Barlow’s sign is
a click is felt when the infant is placed supine with hips flexed 90 degrees, knees fully flexed, and the hip brought into midabduction
explain: Ortolani’s click
It can be felt by the fingers at the hip area as the femur head snaps out of and back into the acetabulum
HIP DYSPLASIAT tx includes
hip-spica cast or corrective surgery for older children, Bryant’s traction and triple-cloth diapering, casting or a Pavlik harness to keep the hips and knees flexed and the hips abducted for at least 3 months.
SPINA BIFIDA is
incomplete closure of one or more vertebrae without protrusion of the spinal cord or meninges
SPINA BIFIDA s/s are
Dimple (found on the skin over the spinal defect), no neurologic dysfunction except occasional foot weakness or bowel and bladder disturbances. Port wine nevi, soft fatty deposits, ulcerations, tuft of hair all commonly found on the skin over the spinal defect.
SPINA BIFIDA has two classifications what are they?
Meninogocele which usually has no neurologic dysfunction and a saclike structure protruding over the spine

Myelomeningocele has an external sac that contains meninges, CSF, and a portion of the spinal cord or nerve roots
SPINA BIFIDA s/s are
hydrocephalus, permanent neurologic dysfunction (paralysis, bowel and bladder incontinence), possible mental retardation, clubfoot, curvature of the spine and Arnold-Chiari syndrome.
SPINA BIFIDA may be dx or confirmed by
amniocentesis reveals neural tube defect. Elevated alpha-fetoprotein levels in the mother’s blood. Acetylcholinesterase measurement can be used to confirm the diagnosis.
SPINA BIFIDA interventions include
include handling the infant with care and not applying pressure to the defect. Measure head circumference daily to watch for signs of hydrocephalus. Detect signs of meningitis such as fever and nuchal rigidity.
WheSCOLIOSIS
lateral curvature of the spine, common among females.
SCOLIOSIS is dx when ?
Identified at puberty and throughout adolescence.
Provide an overview of CEREBRAL PALSY including tx, dx, and interventions
neuromuscular disorder resulting from damage to or defect in the part of the brain that controls motor function. Common in children born prematurely. CP can not be cured, treatment includes interventions that encourage optimum development
What are the five types of CEREBRAL PALSY
Ataxia
Athetoid
Rigidity type
Mixed
Spastic
How many types of are there CEREBRAL PALSY?
Five
CEREBRAL PALSY
uncommon, disturbances in movement and balance
Explain "Athetoid"
A type of CEREBRAL PALSY

involuntary, incoordinate motion with varying degrees of muscle tension. Facial grimacing, poor swallowing and tongue movements cause drooling and poor speech articulation. These children commonly have average or better intelligence.
Explain "Spastic"
A type of CEREBRAL PALSY


most common, hyperactive deep tendon reflexes, rapid involuntary muscle contraction and relaxation. Child’s legs are crossed and the toes are pointed down, so the child stands on his toes.
Explain "Rigidity type"
A type of CEREBRAL PALSY

rigid postures and lace of active movement.
Explain "Mixed"
A type of CEREBRAL PALSY

severe disability involving more than one type of CP. Causes for CP include anoxia before, during or after birth, infection and trauma
CEREBRAL PALSY s/s are
abnormal muscle tone and coordination, dental anomalies, mental retardation, seizures, speech, vision or hearing disturbances , mental retardation, seizures, speech, vision or hearing disturbances
CEREBRAL PALSY is dx by
neuroimaging studies determine the site of brain impairment. Cytogenic studies and metabolic studies rule out other causes
CEREBRAL PALSY tx is
braces or splints and special appliances to help child perform ADL’s ( adapted eating utensils or a low toilet seat with arms). Orthopedic surgery to correct contractures, ROM exercises to minimize contractures. Muscle relaxants to decrease spasticity, if appropriate, anticonvulsants to control seizures.
Provide an overview of MUSCULAR DYSTROPHY
genetic disorder that occurs only in males, marked by muscular deterioration that progresses throughout childhood. It is due to a defect on the X chromosome. There is no known cur
MUSCULAR DYSTROPHY
begins with pelvic girdle weakness, indicated by waddling gait and falling, cardiac or pulmonary failure, eventual muscle weakness and wasting. Gowers’ sign
MUSCULAR DYSTROPHY maybe confirmed by
electromyography demonstrates short, weak bursts of electrical activity in affected muscles. Muscle biopsy shows varied muscle fiber sizes and fat and connective tissue deposits.
MUSCULAR DYSTROPHY tx is
physical therapy, high-fiber, high-protein, and low, calorie diet, surgery to correct contractures, use of devices to preserve mobility.
Gowers’ sign is
use of hands to push self up from the floor