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76 Cards in this Set
- Front
- Back
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6 s/s Kawasaki disease
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fever (must be present plus 3 of the remaining)
strawberry tongue swollen extremities swollen lymph nodes bilateral conjunctival redness polymorphous rash |
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Acute phase Kawasaki
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1-10 days
unresponsive fever even w/antiobiotics & anti-pyretics dry, cracked lips incr ESR, WBC & platelets |
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subacute phase Kawasaki
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day 11-25
fever subsides cardiac problems may surface still irritable hands & feet peel |
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convalescent phase Kawasaki
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day 26-40
all clinical S&S resolved complete recovery when labs back to normal (6-8 wks) |
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aspirin regimen for Kawasaki
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used to reduce inflammation & block platelet aggregation
1st 14 days 100 mg/kg/day decr to 3-10 mg/kg/day after may last 2-3 months |
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treatment for Kawasaki
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IVIG
2G/kg dose over 10-12 hr VS same as blood products |
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S&S Bacterial endocarditis
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similar to flu
fever fatigue malaise headache coughing body aches & pains |
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most common culprit in bacterial endocarditis
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staph
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who is at highest risk for bacterial endocarditis
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kids with septal defects, valve disease, cyanotic heart disease (TOF & COA) & high risk procedures
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treatment bacterial endocarditis
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prophylactic antibiotics
IV antibiotics thru central line 2-4 wks |
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characteristics of middle childhood
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calm before the storm
industry vs inferiority eager to build new skills conservation & reversibility concrete thought processes cooperative play |
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tx for 25-40 degree curve in scoliosis
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bracing
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tx for less than 25 degree curve
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wait & see
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tx for more than 40 degree curve
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surgery
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characteristics of adolescence
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largest growth spurt
identity vs. role confusion formal operational thought (abstract thinking) |
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female body reaches adult measurements
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16-17 yo
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boy body reaches adult measurements
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19-21 yo
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spina bifida with small tuft of hair & deep dimple
best kind to have no neuro problems |
occulta
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spina bifida with portion of membrane & CSF in sac on outside of spine
no neuro problems rare |
meningocele
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spina bifida with membrane, CSF & spine in sac outside of spine
neuro problems below sac bladder & bowel problems |
myelomeningocele
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highest risk for spina bifida prior to surgery
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meningitis
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spina bifida has strong correlation w/what deficiency
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folic acid deficiency
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clinical manifestations of spina bifida
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external sac
paralysis & paresthesia incontinence hydrocephaly club foot |
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how is spina bifida diagnosed
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US & amniocentesis
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how is club foot treated
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serial manipulation & casting
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mixing of oxygenated & deoxygenated blood where blood flows from low pressure to high pressure or right to left shunting)
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cyanotic cardiac problem
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3 examples of cyanotic cardiac problems
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TOF
truncus arteriosus transposition of great vessels |
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no mixing of blood but it flows from high pressure to low pressure or left to right shunting
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acyanotic cardiac problem
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3 examples of acyanotic cardiac problems
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ASD
VSD patent ductus arteriosus |
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4 diseases of TOF
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VSD
pulmonary stenosis right ventricular hypertrophy overriding aorta |
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characteristics of TOF
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blue babies
circumoral cyanosis PO2 88-90% normal don't raise sats about normal PO2 |
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characteristics of transposition of blood vesslels
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pulmonary artery & aorta are reversed
no communication between systemic & pulmonary circulation |
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characteristics of coarctation of aorta (COA)
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localized narrowing of aorta
increased pressure proximal to defect decreased pressure distal to defect collateral vessels develop to supply blood to lower extremities |
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meds that increase cardiac efficiency (2)
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digoxin
ace inhibitors |
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med that improves cardiac contractility
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digoxin
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med that reduces afterload of the heart
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ACE inhibitors
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common ACE inhibitor
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lisinopril
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hold digoxin in <1 yr old ___
> 1 yo _____ |
90 <1yo
70 >1yo |
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normal digoxin level
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0.8-2 mcg/L
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s/s digoxin toxicity
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bradycardia
n/v |
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meds used to reduce accumulated fluids
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lasix, aldactone, diuril
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caution about giving diuretics
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watch potassium level
may need to give supplemental K may need to restrict sodium |
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S/S of diabetes
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polyuria
polydipsia polyphagia unexplained weight loss hyper/hypoglycemia weak/tired feel edgy, sick |
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Diagnosis
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plasma BS >200 then
fasting BS >126 also A1C 7% or less, a little higher pre-puberty serum ketone if 250-300 |
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Novolog
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rapid-acting
peak 1-3 hr |
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Regular insulin
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short-acting
peak 2-3 hr |
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NPH
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intermediate acting
peak 4-6 hr |
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hypoglycemia tx
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15 G simple carbs (1/2 c OJ, 1/2 can soda, 10 jelly beans)
wait 15 min take BS again if still <80 repeat wait 15 min take BS again give complex carb if over 80 (peanut butter & crackers) |
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nutritional goal of diabetes management
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balance food, insulin & exercise
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cornerstone of diabetes management
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education
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3 P's of diabetes
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polyuria
polydipsia polyphagia |
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Best way to assist teen in completing core decisions
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allow them to participate in decision making
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1st sex change noticed in girl
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breast buds
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age of completion of male growth
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18-20
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#1 cause of death in school age children
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accidents
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treatment for club foot
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serial manipulation & casting
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Most frequently seen symptom in congenital heart disease
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tachycardia
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Abnormal collection of CSF in brain
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hydrocephaly
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Chief task of school age child
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industry vs inferiority
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Most serious complication of spina bifida
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meningitis
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Most serious complication of uncontrolled diabetes
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DKA
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Chief task of adolescent
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identity vs. role confusion
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Most important developmental task of school agers
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reading
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Time when primary physical changes occur in childhood
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puberty
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Most common form of scoliosis
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idiopathic
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Acute febrile multi-system disorder of unknown origin
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kawasaki disease
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Play focusing on team activities
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cooperative
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Most serious form of spina bifida
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myelomeningocele
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25-45% curvature of spine treated this way
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bracing
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Congenital deformity w/portions of foot twisted out of normal position
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club foot
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Result of too much insulin
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hypoglycemia
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Communicable disease risky in Kawasaki disease
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chicken pox
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Used to treat Kawasaki disease
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IVIG
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Complication resulting from strep or staph infection
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bacterial endocarditis
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Blood shunts from left to right
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acyanotic
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Blood shunts from right to left
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cyanotic
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