Peds Exam Iii

Front 1

Define Anemia

Back 1

reduction in the number of RBC &/or Hgb

Front 2

Name the most common hematologic disorder in infancy and childhood

Back 2

Anemia

Front 3

List three main causes for Anemia

Back 3

Inadequate RBC Prod, Increased RBC Prod, Excessive Loss RBC

Front 4

S/S of Decreased Production of RBC

Back 4

Pallor, Tachycardia, Fatigue, Muscle Weakness, Systolic Murmur

Front 5

S/S of Increased Destruction of RBC

Back 5

Jaundice, Tachycardia, Dark Urine, Splenomegaly, Hepatomegaly, Low BP (late sign of shock), Frontal bossing

Front 6

S/S of Inc RBC Loss

Back 6

Pallor, Fatigue, Muscles weakness, Cool Skin, Tachycardia, Decrease Peripheral Pulse

Front 7

This is the most prevalent nutritional disorder in US

Back 7

Iron deficiency

Front 8

If a baby is premature how long with Iron Store last

Back 8

No Iron Store build up available

Front 9

Full term infants Iron Store will last how long

Back 9

5-6 months

Front 10

Preterm or multiple birth babies will have an Iron Store lasting how many months

Back 10

2-3 months

Front 11

What is the primary therapeutic management goal

Back 11

Prevention

Front 12

What is a good way to get IRON in to the diet if they are 4 to 6 mo of age

Back 12

Iron fortified formula, cereal

Front 13

Define Retic

Back 13

immature Red Blood Cell

Front 14

Ferrous Sulfate by another name is

Back 14

Iron Supplement

Front 15

Common Side Effects of Iron Supplement

Back 15

Nausea, GI Irritation, Diarrhea, Constipation

Front 16

An Acidity Aid is given to help with Iron absorption what specific kind of food or beverage should the supplement be given with

Back 16

Citrus Food or Juice

Front 17

What is the color of the stool of an individual that is taking iron supplements

Back 17

tarry green or black

Front 18

With Sickle Cell which part of the Hgb is defective

Back 18

Globin in Hgb

Front 19

Sickle Cell is a has a multi system impact, List other systems & organs impacted

Back 19

Spleen, Liver, Gallbaddler, Kidney’s, Bones, Cardiac, CNS,

Front 20

What is Dactylitis

Back 20

Inflammation of the digits

Front 21

Explain Sequestration Crisis

Back 21

Pooling of large a quantities of blood, usually spleen

Front 22

True or False 70% of individuals with sickle cell will experience repeat strokes

Back 22

True without Transfusions

Front 23

A Electrophoresis can help determine and diagnosis what two types of Sickle Cell

Back 23

Trait & Disease

Front 24

Things the Nurse will due to manage a PT with Sickle Cell

Back 24

IV Fluids, PCA Narcotics, Transfusion of Blood, Oxygen for hypoxia

Front 25

Explain Chelation Therapy related to Sickle Cell

Back 25

Removes Iron Overload with transfusion bind to remove iron from blood.

Front 26

Excessive destruction of platelets

Back 26

Idiopathic Thromboyctopenia Purpura (ITP)

Front 27

ITP is Acute or Chronic

Back 27

ITP can be both

Front 28

S/S of ITP

Back 28

Bruising, petichiae, bleeding

Front 29

When DX ITP what two disease processes are you trying to rule out

Back 29

Lupus & Leukemia

Front 30

Chronic ITP TX is

Back 30

Spleenectomy

Front 31

With a Spleenectomy Ibuprofen is preferred over Tylenol, True or False

Back 31

False Tylenol is preferred

Front 32

Secondary disorder of coagulation, Characterized by bleeding and clotting simultaneously is

Back 32

Disseminated Intravascular Coagulation (DIC)

Front 33

Sepsis, Injury, Hypoxia/LTE, Shock States are all common trigger for what bleeding and clotting disorder

Back 33

Disseminated Intravascular Coagulation (DIC),

Front 34

Telling sign of DIC is Accelerated clotting, ______________, tissue ischemia, _______________& limbs

Back 34

Micro clotting in vessels, Loss of organ function

Front 35

True or False with DIC if supportive TX is successful function will return to limb or organ?

Back 35

True

Front 36

In CPR what do the three C’s Stand for

Back 36

Compressions Compressions Compressions

Front 37

Rate of _______ compressions per minute

Back 37

100

Front 38

If a team is involved in CPR how often should you rotate compressions?

Back 38

2-3 Minutes

Front 39

AEDS are acceptable for children great than _____ years of age?

Back 39

> or = to 1 year of age

Front 40

Name the Cancer with the Highest Survival Rate

Back 40

Hodgkin’s Lymphoma & Non Hodgkin’s Lymphoma 94%

Front 41

These three types of Cancer have the highest incidence, what are they

Back 41

Leukemia, Brain & Spinal Cord & Neuroblastoma

Front 42

To DX childhood cancer the following steps will be taken

Back 42

Complete History, ROS, Physical, Lab Test, Imagining, Biopsy

Front 43

List Multimodal Therapy that might be used to treat childhood cancer

Back 43

Surgery, Radiation, Chemo, BMT (bone marrow transplant), Genetics (stem cell), Vaccines (HPV)

Front 44

Monocolonal Antibodies & G-CSF as well as GM-CSF & Interleukin 1-6 are all what types of treatment

Back 44

Biotherapy

Front 45

What is the primary purpose of G-CSF (Neupogen) Biotherapy treatment

Back 45

To increase WEB production of Neutrophils as to decrease the risk for infection

Front 46

True or False the National Cancer Institute plans and initiates comparative clinical trials, Prevention, Treatment, Long term effects & investigational drugs related to cancer?

Back 46

True

Front 47

How many Phases are included in the Investigational Drug Trial process

Back 47

3 Phases

Front 48

Phase 1 of the Investigational Drug Trail

Back 48

Assess the maximum does tolerated

Front 49

Phase 2 of the Investigational Drug Trail

Back 49

Assess tumors reaction to the drug

Front 50

Phase 3 of Investigational Drug Trail

Back 50

Looks at most effective routs, length of TX & combinations of drugs

Front 51

List cardinal signs of cancer

Back 51

Unusual mass or swelling

Front 52

List cardinal signs of cancer

Back 52

Unusual mass or swelling, Paleness & loss of energy, Bruising, Pain or limping, Fever, HA w Vomiting, Vision Changes,Excessive or rapid wt loss

Front 53

Cellular destruction from infiltration of immature cells and competition for metabolic elements is also known as

Back 53

Leukemia

Front 54

The type of cancer is more common in Preschool Age children

Back 54

Acute Lymphocyctic Leukemia (ALL)

Front 55

Adolescents generally have this type of cancer usually related to a genetic disorder

Back 55

Acute Myelogenous Leukemia (AML)

Front 56

Which cancer is less responsive to Chemo AML or ALL

Back 56

AML Acute Myelogenous Leukemia

Front 57

Characteristics of AML

Back 57

10 Yrs or Older, More CNS & organ involvement at DX

Front 58

First Treatment for AML is usually

Back 58

BMT (Bone Marrow Transplant)

Front 59

ALL is Acute lymphocytic Leukemia which has a good or poor prognosis

Back 59

GOOD

Front 60

True or False ALL is very responsive to chemotherapy?

Back 60

True

Front 61

What type of cell is involved in AML

Back 61

Myeloblasts

Front 62

Name cells involved in ALL

Back 62

B Cells, T Cells, Pre T Cell, Early Pre B Cells

Front 63

Is CALLA a Good Prognostic Indicator True or False

Back 63

True

Front 64

B Cell usually results in a Good or Poor Prognosis

Back 64

Poor

Front 65

Pre B Cell usually results in a Good or Poor Prognosis

Back 65

Good

Front 66

T Cell usually results in a Good, Fair or Poor Prognosis

Back 66

Fair

Front 67

Immature white blood cell production decreased all of these BM, Hypermetablism, Reticuloendotheial except

Back 67

CNS Increased ICP

Front 68

Bone Marrow Depression Resulting in the 3 following things, Neutropenia (inc infection), Decreased RBC (inc Anemia) &

Back 68

Thromboyctopenia (increased bleeding)

Front 69

With Leukemia which Lab value is generally normal or increased, while all other Labs such as RBC’s, Plts, Neutrophils, Hemoglobin are all decreased

Back 69

WBC count

Front 70

How do they DX for Leukemia

Back 70

BM, Lumbar Puncture, CBC, Live & Renal Function Study

Front 71

What is the location of the BM draw

Back 71

Iliac Crest

Front 72

Allopurinol (Zyloprim) is to treat what that common occurs with Chemo & Radiation Tx

Back 72

Uric Acid

Front 73

What is the rescue drug for Methotrexate

Back 73

Leukovorin

Front 74

What is the Function of G-CSF

Back 74

Increase Neutrophil Count to “STIMULATE BM”

Front 75

What do these meds have in common Vincristine, L-Asparaginase

Back 75

IV Route

Front 76

ALL is usually treated with Prednisone what is a common S/E (hint steroids)

Back 76

Increased Blood Glucose Level

Front 77

This drug can result in neurotoxicity, such as foot drop & illeus

Back 77

Vincristine

Front 78

With the 1st round of Chemo a decrease of __% of blast should occur to have a positive prognosis and remission

Back 78

5%

Front 79

A Nurse must calculate and draw Epi when giving what drug

Back 79

L-Asparaginase

Front 80

When monitoring the Temp on a PT with Leukemia the best result comes from an Axillary or Rectal Temperature

Back 80

NO Rectal

Front 81

What is the #1 way to protect a PT with Altered Immunity

Back 81

GOOD HAND WASHING!!!!

Front 82

A PT with an altered immunity can have a banana and orange just no strawberries

Back 82

True Anything with peel .

Front 83

List a positive side effect of Prednisone for Cancer PT

Back 83

Increase Appetite

Front 84

Post irradiation Somnolence is a result of what

Back 84

Neurotoxicity

Front 85

Hodgkin’s Disease has a _____ Prognosis for Adolescents and Young Adults

Back 85

Good

Front 86

Tx for Hodgkin’s is

Back 86

Radiation, Chemo, Body Image and Reproduction

Front 87

DX of Hodgkin’s with Biopsy, ______ & _____?

Back 87

Lymphangiogram, Staging

Front 88

Non-Hodgkin’s impact the CNS & BM, True or False

Back 88

True

Front 89

A BM aspiration is used to DX Non-Hodgkin’s

Back 89

True

Front 90

TX for Non Hodgkin’s is

Back 90

Irradiation & Chemo

Front 91

True or False more tumors in children are in the Supratentorial area (lower brain stem)

Back 91

False , Infratentorial

Front 92

Optic Brain Tumor in a child

Back 92

Optic Glioma

Front 93

Childhood Cancer in the Medulla

Back 93

Medullablastoma

Front 94

S/S of Brain Tumors

Back 94

Ataxia, HA, Motor Weakness, Vomiting, Visual Defect, Cranial Enlargement, Papilla Edema, SZ

Front 95

A PT has returned to PAC, what Post –Op care should you the Nurse be checking

Back 95

Neuro LOC, ICP, Pupil Check, Head Circ, SZ, Fluid Balance, Position

Front 96

The Silent Tumor is known as the

Back 96

Neuroblast

Front 97

Common site for Neuroblast are

Back 97

Abd, Neck, Head, Chest , Pelvis

Front 98

When a Neuroblast is present an individual PT will see an increase in Adrenal

Back 98

Catecholamine

Front 99

Increased Catecholamine’s will also increase what vital sign

Back 99

BP

Front 100

Neuroblast are often Dx at what Stage

Back 100

Stage 3 & 4

Front 101

A 24hour UA is used to DX Neuroblastoma, increased levels of what should be present

Back 101

Catecholamine’s

Front 102

DX Neuroblastoma Scans, _____, Renal Function & 24 hour UA

Back 102

Liver Function Test

Front 103

Define Aniridia

Back 103

No Iris

Front 104

S/S of Neuroblastoma

Back 104

ABD Mass, Bone Mets, Spinal Cord Paralysis, Wt loss, Weakness,

Front 105

If a child Dx with Neuroblastoma has an increased FE level is this a good or bad marker for prognosis

Back 105

BAD

Front 106

Neurblastoma prognosis is poor

Back 106

2 year survival rate and 5%