Nursing Pediatric Test

Front 1

signs of developmental delay after independently walking for months

Back 1

persistent tip toe walking, failure of develop a mature walking pattern

Front 2

signs of developmental delay by 18 months

Back 2

not walking, not speaking 15 words, doesn't understand function of common household items

Front 3

signs of developmental delay by 2 years

Back 3

does not use two word sentences, doesn't imitate actions, doesn't follow basic instructions, can't push a toy on wheels

Front 4

signs of developmental delay by 3 years

Back 4

difficulty with stairs, frequent falling, can't build a tower of 4 blocks, difficulty manipulating small objects, extreme difficulty separating from parents, can't copy a circle, doesn't engage in make believe play, can't communicate in short phrases, doesn't understand simple instructions, little interest in other children, unclear speech, persistent drooling

Front 5

signs of developmental delay by 4 years old

Back 5

can't jump in place or ride a tricycle, can't stack 4 blocks, can't throw ball overhand, doesn't grasp a crayon with thumb and fingers, has difficulty scribbling, doesn't use sentenced with three or more words, can't use the words I and you properly, doesn't respond to people outside the family, resists using toilet or dressing or sleeping, doesn't engage in fantasy play

Front 6

signs of developmental delay at age 5

Back 6

unhappy or sad often, has little interest in playing with other children, extremely aggressive, can't build a tower of 6-8 blocks, easily distracted or can't focus on an activity for 5 minutes, rarely engages in fantasy play, can't use plurals or past tense, can't brush teeth or wash and dry hands

Front 7

Erikson's stage at birth to one year

Back 7

trust vs mistrust

Front 8

Erikson's stage at 1-3 years old

Back 8

autonomy vs shame and doubt

Front 9

Erikson's stage at 3-6 years

Back 9

initiative vs guilt

Front 10

Erikson's stage for school aged children

Back 10

industry vs inferiority

Front 11

early signs of hypoxia

Back 11

mood changes, headache, altered depth and pattern of respirations, htn, anorexia, anxiety, confusion, lethargy, nasal flaring, retractions, expiratory grunt, wheezing, absent or decreased breath sounds

Front 12

signs of severe hypoxia

Back 12

bp changes, dimness of vision, somnolence, stupor, coma, dyspnea, decreased respirations, bradycardia, cyanosis

Front 13

RSV season

Back 13

fall to spring

Front 14

meds to treat RSV

Back 14

humidified air, bronchodilators,corticosteroid, ribaviron

Front 15

medication to prevent RSV

Back 15

palivizumab (synagis)

Front 16

pefr

Back 16

used in asthma patients to detect child's personal best

Front 17

chest x ray for asthma patients

Back 17

shows hyperinflation

Front 18

asthma symptoms

Back 18

dyspnea, wheezing, coughing, produces frothy clear gelatinous sputum, lips deep red that progress to cyanosis, hyperresonance on percussion of chest.

Front 19

chest sounds on severe asthmatic attack

Back 19

may become inaudible

Front 20

asthma triggers

Back 20

dust mites, dander, foods, humidity or cold.

Front 21

medications for asthma

Back 21

albuterol, aminophylline, atropine

Front 22

decreased pulmonary blood flow

Back 22

tetralogy of fallout, tricuspid atresia

Front 23

mixed blood flow

Back 23

transposition of great vessels, total anomalous pulmonary venous connection, truncus arteriosus, hypoplastic left heart syndrome

Front 24

increased pulmonary blood flow

Back 24

atrial septal defect, ventricular septal defect, AV canal defect, patent ductus arteriosus

Front 25

obstruction to blood flow from ventricles

Back 25

coarction of the aorta, aortic stenosis, pulmonic stenosis

Front 26

atrial septal defect

Back 26

if jot closed by 3 needs surgery but it usually closes by 18 months, will hear split second heart sound over pulmonic valve and have a systolic ejection murmur

Front 27

ventricular septal defect

Back 27

signs of heart failure appear at 4-8 weeks, palpate chest for thrill

Front 28

AV canal defect

Back 28

contains both atrial and ventricular septal defects, loud murmur noted in first 2 weeks of life, happens more in down syndrome, may show first degree heart block on EKG

Front 29

patent ductus arteriosus

Back 29

frequent respiratory infections, widened pulse pressure,harsh continuous machine like murmur that's louder under the clavicle. indomethacin closes PDA

Front 30

coarctation of the aorta

Back 30

bp is increased in the heart and upper extremities in the body and decreased in lower portions of the body, increased risk of hemorrhagic CVA

Front 31

aortic stenosis

Back 31

chest pain similar to angina when active, dizziness with prolonged standing, faint pulses if severe

Front 32

pulmonary stenosis

Back 32

high pitch click following second heart sound and systolic ejection murmur appear on left sternal border, could reopen foramen ovale, typically have normal growth hx

Front 33

tetralogy of Fallot

Back 33

right ventricular hypertrophy, ventricular septal defect, pulmonary stenosis, overriding aorta. load hoarse murmur. Tet spells in which child squats to improve pulmonary blood flow. pit child in knee chest position

Front 34

tricuspid atresia

Back 34

usually needs open foramen ovals and patent ductus arteriosus. cyanosis worsens after ductis arteriosus is closed

Front 35

transposition of the great vessels

Back 35

significant cyanosis without murmur, cyanosis when feeding or crying. loud second heart sounds. unoxygenated body goes out to the body instead of the lungs

Front 36

total anomalies pulmonary venous connection

Back 36

oxygenated blood enters right atrium. you see cyanosis, tires easily, difficulty feeding, retractions with tavhypnea, hepatomegaly, splitting second heart sounds

Front 37

truncus arteriosus

Back 37

only one major artery leaving the heart. will see cyanosis with activity, poor growth, adventitious breath sounds, murmur associated with VSD

Front 38

hypoplastic left heart syndrome

Back 38

all structures of the left side are severely underdeveloped. will see pallor of extremities, gallop rhythm. this is found prenatally on maternal ultrasound

Front 39

infective endocarditis

Back 39

microbial infection of endothelial surfaces of the heart. will see low grade fever, fatigue, anorexia, flu like symptoms, Roth's spots, Janeway lesions and osler nodes

Front 40

acute rheumatic fever

Back 40

10 day course of penicillin needed. may give corticosteroid and NSAIDS. will exhibit rash positive throat culture

Front 41

s&s of heart failure for children

Back 41

failure to gain weight or rapid weight gain, fatigue, syncope, decrease in # of wet diapers

Front 42

nutrition needs for heart failure

Back 42

infants need 150 cal/kg/day. small frequent meals. 24-48 calorie/ ounce formula

Front 43

Kawasaki disease

Back 43

acute systemic vasculitis leading to coronary aneurism or coronary dilation. will see fever that doesn't go down with antibiotics, joint pain, edema in feet and hands, desquamation on palms and soles of feet. provide acetaminophen, ice chips, popsicles. only childhood disease where aspirin maybe used for treatment

Front 44

cleft lip

Back 44

lip should be formed by 5-6 weeks gestation. surgery is usually done between 2-3 months of age.

Front 45

cleft palate

Back 45

palate is usually formed at 7-9 weeks gestation. surgery is complete within 12-18 months of age

Front 46

complications of cleft lip or palate

Back 46

speech impairments, may have hearing loss due to recurrent ear infections, mouth breathe

Front 47

teaching for parents of children with cleft lip and palate

Back 47

feed child with infant in upright position, burp frequently BC they suck in a lot of air, special nipples maybe needed, rest when infant signals exhaustion, spoon feeding thickened formulas may also work, breast feeding can contour to babies mouth shape And may help more.

Front 48

cleft lip post op

Back 48

elbow restraints to prevent rubbing of suture line, clean suture line with swab dipped in saline, keep infant in upright position, keep hard objects away from infants mouth including pacifiers, prevent crying which may rip sutures

Front 49

cleft palate post op

Back 49

no hard foods, opiates first 48 hours after surgery, may resume feeding shortly after surgery with wide spoon, may be allowed to lie on abdomen, elbows maybe retrained.

Front 50

tracheoesophogeal fistula and esophageal atresia

Back 50

suspect if polyhydramnios, suspect if excessive foamy secretions. keep npo until surgery, keep head of bed elevated, Iv hydration, provide suction as needed. might need chest tube to drain fluid. infant at higher risk for other abnormalities (vacterl)

Front 51

biliary atresia

Back 51

chalky white stool, dark urine, jaundice, ascites, enlarged liver, cirrhosis and finally liver failure. vitamin deficiencies of A,D,E, and K. may have a Kasia procedure but may need liver transplant