Peds/amy H.

Front 1

Number one sign of fatigue/intolerance in a baby:

Back 1

Poor feeding/fall asleep feeding

Front 2

Ask what history from mother:

Back 2

Maternal/Paternal history of cardiac problems.

Front 3

What should be assessed prior to heart cath:

Back 3

Ht/Wt/VS/Allergies/Rash- if diaper rash present, procedure will not happen.

Front 4

What should be assessed after heart cath:

Back 4

Check site for bleeding, VS, and distal pulses(DP, PT). Remember, hypotension in a baby is a LATE sign of hemorrhage.

Front 5

What is baby/child at risk for with the dyes used in cardiac cath:

Back 5

Dehydration, monitor fluid status.

Front 6

What anomaly should be checked with down syndrome children:

Back 6

Cardiac defects is prominent with these children.

Front 7

What types of impaired blood flow is acyanotic:

Back 7

ASD,VSD, Patent ductus arteriosis,atrioventricular canal
(Obstruction-coartication of aorta, aortic stenosis,pulmonic stenosis)
(INCREASED PUL BLOOD FLOW)

Front 8

What types of impaired blood flow is cyanotic:

Back 8

Tetralogy of Fallot, Tricupsid Atresia and Mixed blood flow
DECREASED PULMONARY BLOOD FLOW

Front 9

VSD murmur is heard where:
Patients are at risk for:

Back 9

Left sternal border
Bacterial Endocarditis and Pulmonary vascular obstructive disease.

Front 10

Which defect is worse ASD/VSD:

Back 10

VSD- ventricle pushes blood back into right ventricle which causes hypertrophy and can lead to pulmonary vascular resisitance.

Front 11

What are symptoms of corartication aorta:

Back 11

Bounding pulses in upper extemities, Higher BP
Weaker pulses and Low BP in lower extemites.

Front 12

Surgery in an infan should be at what age:

Back 12

< 6 months

Front 13

What are some s/s in older child:

Back 13

Dizziness, HA, fainting, epistaxis from htn. Risk for ruptured aneurysm and stroke.

Front 14

Children that have this disease are at risk of having this the rest of their lives:

Back 14

Hypertension.

Front 15

Older children may have this surgery for repair of the coartication of the aorta:

Back 15

Balloon angioplasty or stents placed.

Front 16

A murmur will be heard with this prognosis, what is it:

Back 16

Loud murmur Left sternal border, the softer the murmur the more severe the narrowing and decreased cardiac output.

Front 17

With increased pulmonary blood flow, what is decreased in the body:

Back 17

Decreased systemic blood flow. Pt may have s/s of CHF, #1 symptom is exercise intolerance in a child.

Front 18

What kind of blood flow is Tetraology of Fallot:

Back 18

Decreased pulmonary blood flow- 4 key defects
VSD
Pulmonic stenosis
Overriding Aorta
Right Ventricular hypertrophy

Front 19

Clinical manifestations of Tetraology of Fallot:

Back 19

Cyanosis and hypoxia, TET spells. Place baby in knee to chest position immedietly.

Front 20

The baby will look what way at birth:

Back 20

Cyanotic and will have systolic murmur

Front 21

What happens with tricupsid atresia:

Back 21

Tricuspid valve fails to develop, no communication from right to left ventricle. Blood flows from ASD or through patent foramen ovale.

Front 22

What are the manifestations of this disorder:

Back 22

Cyanosis in newborn
Tachycardia
Children may have clubbing and chronic hypoxemia.

Front 23

In neonate, a continious infusion of what is infused until surgical intervention:

Back 23

Prostoglandin E

Front 24

S/S of CHF in peds patient:

Back 24

Tachycardia/Tachypnea at rest
Dyspnea
Retractions,nasal flaring
Activity intolerance,weight gain
Cardiomegaly, Increased pul blood flow. Ventricular hypertrophy.

Front 25

Nursing interventions for peds pt with CHF:

Back 25

Bedrest, Tube feeding, reduced stimuli, oxygen, strict I/O's. Lasix and Dig

Front 26

Digoxin parameters in a child:

Back 26

Hold if apical pulse is less than 90-110 in infants
and less than 70 in older kids.

Front 27

When is cyanosis usually apparent in a child:

Back 27

When oxygen sat is 80-85%

Front 28

What is thought to cause clubbing of digits:

Back 28

Increased polycythemia and tissue hypoxemia.

Front 29

What causes endocarditis:

Back 29

Streptococcus, staph aureus or candida albicans

Front 30

S/S infective endocarditis:

Back 30

Anorexia
Malaise
Weight loss
Unexplained fever

Front 31

Another symptom of CHF in a child :

Back 31

Profuse scalp sweating, Edema, SOB, retractions.

Front 32

Rheumatic fever is caused by:

Back 32

Group A/B hemolytic strep pharyngitis.

Front 33

What can rheumatic fever affect:

Back 33

Joints,skin and brain.

Front 34

What causes hyperlipidemia in children:

Back 34

Poor diet, obesity and Type 2 diabetes.

Front 35

What valve is damaged with rheumatic fever:

Back 35

Mitral valve

Front 36

What is the drug of choice to treat rheumatic fever:

Back 36

PCN

Front 37

Systemic htn can be caused by:

Back 37

Endocrine, neurologic, renal, and cardiovascular disease

Front 38

Clinical manifestations of htn in older children:

Back 38

Frequent headaches
Dizziness
Changes in vision

Front 39

HTN in young children:

Back 39

Irritability
Head banging
Waking up screaming in the night.

Front 40

This is a disease that causes systemic vasculitis, rash, fever of unknown origin and can cause a strawberry tongue:

Back 40

Kawasaki disease

Front 41

There are 3 phases in Kawasaki disease,what are they:

Back 41

Acute-high fever unresponsive to antipyretics or abx, pt is very irritable.

Front 42

Stage 2 of Kawasaki:

Back 42

Is the sub-acute phase, still very irritable.Resolutiuon of fever and lasts until all clinical symptoms resolve. GREATEST risk for coronary artery aneurysm (ECHO to check heart)

Front 43

Stage 3 of Kawasaki:

Back 43

All clinical signs have resolved but lab values still remain elevated. Mood should return to normal in this stage- 6-8 week after onset.

Front 44

Treatment of Kawasaki disease includes:

Back 44

IV Y globulins and Asprin therapy. (Ok to take ASA)

Front 45

What comfort measures should be taken with Kawasaki disease:

Back 45

Cool cloths, ointment to lips, oral care, lotions and loose clothing.

Front 46

What meds may be given with Kawasaki:

Back 46

Dig to improve cardiac function
Lasix-remove fluids
Angiotensin enzyme inhibitors- improve contractility
ASA- for pain and also for anti-platelet therapy.

Front 47

Teach family after care of disease:

Back 47

Arthritis may persist for weeks
Monitor for symptoms of MI
Irritability for up to 2 months
Morning stiffness
Peeling of hands/feet 2nd/3rd wk

Front 48

Parents should use these measures to help child with pain:

Back 48

Passive ROM in bathtub
No live immunizations for 11 months. Check fever everyday until afebrile for a few days after discharge.

Front 49

Vessels in the heart may not reach full diameter until:

Back 49

4-6 weeks after onset of the disease, which means MI could still happen to child. Teach s/s of MI/ischemia
Recommend parents learn CPR.

Front 50

Y globulin is a blood product and should be monoitored as:

Back 50

Monitor VS. Check for allergic reactions and monitor cardiac status for overlaod.

Front 51

Most common kind of cardiac disease is :

Back 51

Congenital heart disease.

Front 52

Prenatal factors that predispose child to CHD:

Back 52

Maternal rubella
AMA>40
Type I Diabetes
Alcoholism

Front 53

Common tests used to dx cardiac:

Back 53

EKG, Echo, Xray, cardiac cath

Front 54

Signs and symptoms of chd:

Back 54

Delayed growth pattern
Poor feeding
Fatigue
Frequent URI

Front 55

Which stage in Kawasaki disease is the most dangerous:

Back 55

Sub -acute , Stage 2- coronary artery aneurysm

Front 56

How long may it take for the aneurysm to appear:

Back 56

4-6 weeks after onset of symptoms.

Front 57

What is the key sign in an infant for cardiac disease:

Back 57

Poor feeding

Front 58

Key sign in child for cardiac disease:

Back 58

Exercise intolerance

Front 59

What must be given to a pt with rheumatic heart disease the rest of their life:

Back 59

Antibiotic prior to procedures9 DENTAL

Front 60

What position would a child take if they have tet spells:

Back 60

Squatting
Baby-place in knee to chest position.

Front 61

In peds, what is the number one sign of CHF:

Back 61

Tachycardia

Front 62

Down syndrome baby usually have this defect caused by:

Back 62

Endocardial cushion defects:
ASD/VSD

Front 63

Fractures usually heal in what period of time for
Neonates:
Early child:
Later child:
Adolescence:

Back 63

2-3 weeks
4 weeks
6-8 weeks
8-12 weeks

Front 64

Most common type of fx and bone:

Back 64

Greenstick and Femur

Front 65

What are the 5 P's:

Back 65

Pain
Pallor
Pulses-distal to site
Paraesthesia-distal to site
Paralysis-distal to site

Front 66

What does the spica cast immoblize:

Back 66

Hip/Knee

Front 67

Hip spica may take this long to dry and how do you know when it is dry:

Back 67

24-48 hours, child must be turned q 2hours to help dry, will make a hollow sound when dry.

Front 68

What is major concern after cast is applied:

Back 68

Exremity may continue to swell, may produce neurovascular complications.
KEEP EXTREMITY ELEVATED

Front 69

Avoid using ___ when touching the cast, use this instead:

Back 69

Fingers(will cause indentations) use palms of hans when touching cast.

Front 70

To reduce or realign a fracture, forward force is used called:

Back 70

Traction

Front 71

Backward force and body weight provides this:

Back 71

Countertraction

Front 72

The bed provides this kind of force:

Back 72

Frictional force

Front 73

Bryant traction is what kind of traction:

Back 73

Skin traction applied to the leg, which keep hips at 90 degree angle. (buttocks will be slightly raised off bed)

Front 74

This traction keeps hips and legs in this position:

Back 74

90/90 degree traction, skeletal tractioln. Boot cast or calf sling is used.

Front 75

This is used to seperate an opposing bone to encourage regeneration of new bone:

Back 75

Distraction ( for unequal lengths in bones) New bone is needed to elongate shorter limb.

Front 76

Three forms of DDH:

Back 76

Acetabular dysplasia-mild
Sublaxation-imcomplete dislocation of hip
Dislocation-femoral head loses contact with acetabulum

Front 77

Most common form of DDH:

Back 77

Sublaxation- femoral head remains in contact there is a flattening in the socket.

Front 78

What is tx for newborn:

Back 78

Pavlik harness( abducts hip), 24 hours a day,straps to be adjusted biweekly by practioner, not FAMILY.

Front 79

After harness what is then used:

Back 79

Skin traction (bryants/surgery) and then a spica traction for 3-6 months

Front 80

In a child that is 6-18 months. this is used:

Back 80

Traction, then attempted close reduction , then spica cast for 2-4 months until hip is stable.

Front 81

Older child with DDH is more difficult to treat but this is used:

Back 81

Closed reduction(surgery), tenotomy of contracted muscles, osteotomy.

Front 82

No surgery or correction after what age:

Back 82

4-6 years

Front 83

Signs/Symptoms of infant DDH:

Back 83

Shortening of limb
Restricted abduction of hip
Unequal gluteal folds
Positive + Ortolani test
Positive + Barlow test

Front 84

Older child DDH signs:

Back 84

Affected leg shorter than others, greater trochanter prominent and higher,waddeling gait, marked lordosis.

Front 85

Skin care for DDH:

Back 85

Always place diaper under straps, avoid lotions and powders,gently massage healthy skin, always put an undershirt under straps.

Front 86

Baby should be in what position for feeding and playing:

Back 86

Prone postition- may or may not be removed for bathing (up to practioner)

Front 87

This is a complex conformity of ankle and foot:

Back 87

Congenital clubfoot- 4 types

Front 88

An inversion or bending inward:

Back 88

Talipes varus-inversion

Front 89

An eversion or bending outward:

Back 89

Talipes valgus

Front 90

Plantar flexion, toes are lower than the heel:

Back 90

Talipes equinus

Front 91

Dorsiflexion, in which the toes are higher than the heel:

Back 91

Talipes calcaneus

Front 92

True club foot is described as:

Back 92

Talipes equinovarus/defect is rigid and immovable. Leg length is normal, muscles atrophy in lower leg. Shortened achilles tendon

Front 93

What is the treatment for club foot:

Back 93

Serial casting after birth, changed every few days then changed every 1-2 weeks, maximum correction is 8-12 weeks.

Front 94

If not fixed by serial casting in 3 months, then what tx:

Back 94

Surgical intervention at age 6-12 months.

Front 95

What are subjective signs of scoliosis:

Back 95

Rib hump-flank higher than one side, Adams test( arms hanging asymmetry of arms and waist)

Front 96

Diagnostic dx of scoliosis:
More prominent in:

Back 96

XRAY or MRI
GIRLS

Front 97

Brace does not what to ___ scoliosis.

Back 97

Does not cure, but rather it may slow downt the progression of the curvature.

Front 98

If postural variation is less than__, not worried, not tx:

Back 98

less than 10 degrees and if less than 20 degrees it is deemed mild and no tx.

Front 99

If surgery is needed for scoliosis what is important to do post op:

Back 99

LOG ROLL pt- pain mgmt and don't minimize pain or treatment therapy.

Front 100

Surgical intervention is normally done with curvature is greater than:

Back 100

45 degrees( immature patient)
50-55 degrees( in mature skeletal pt)

Front 101

Child must be taught they may have what post op after spinal fusion:

Back 101

Considerable pain, foley cath or chest tube. Encourage teaching of pain control via PCA.

Front 102

Common post-op problems after spinal fusion are:

Back 102

Large EBL, wound infection, SIADH, ileus, delayed neuro injury and rarely a Superior mesenteric artery syndrome involves compression of aorta and duodenum.

Front 103

Range of motion exercises begin when after surgery:

Back 103

First day post op- patient will also be starting ADL'S in the following days.

Front 104

What kind of mattress should be used post op:

Back 104

Pressure relieving mattress

Front 105

These infections can trigger an autoimmune affect with arthritis:

Back 105

Parovirus B19,Epstein Barr, Mono, and Rubella.

Front 106

JIA starts before age:
Onset:

Back 106

16 and has an onset of age between 1-3. Girls are more affected than boys

Front 107

Some s/s of JIA:

Back 107

Awaking pain, heat and warmth of joint, fatigue after being awake 4-5 hours.

Front 108

If less than 4 joints are involved it is called:

Back 108

Pauciarticular arthritis( Oligioarthritis)

Front 109

If greater than 5 joints are involved:
Is it diagnosed with RA factor:

Back 109

Polyarthritis
90% will not show up as positive.(negative result)

Front 110

What drugs are used to tx:

Back 110

NSAIDS (1st line)
Methtrexate (2nd line)
Corticosteroids( monitor for edema, blood sugar)
Etanercept for tumor necrosis factor.

Front 111

Teaching is important with methotrexate because:

Back 111

Birth defects with pregancy and alcohol use with teens. Cannot drink alchohol while on this med.

Front 112

Best form of therapy and exercise for child with JIA:

Back 112

Pool therapy-ROM in warm bath for small child, swimming for older child.

Front 113

How can we treat symptoms:

Back 113

Hot water bottle, pacing activities, firm mattress, heat applied to joints one hour prior to getting out of bed.

Front 114

Give JIA meds on a:

Back 114

Regular schedule in am prior to school. Give NSAIDS with food.

Front 115

What is s/s of systemic arthritis:

Back 115

Hepatospleenomegaly caused by MONO, Lymphadenopathy, fever, rash and serositis for 2 weeks in one or more joints.

Front 116

This is an inflammation of the eye that is exclusive to JIA:

Back 116

Uveitis which can cause blindness if not treated. Inflammation of the anterior chamber of the eye (oligioarthritis)

Front 117

Goals of therapy for JIA:

Back 117

Control pain
Keep Joint ROM
Growth and Development
Well Balanced diet
Treat minor illnesses aggresively as they can cause flare up of symptoms.

Front 118

Most severe and common kind of MD:

Back 118

Duchenne Muscular Dystrophy
Affects males more -X linked dominance

Front 119

Onset at what age usually:

S/S:

Back 119

3-7, parents will notice muscle weakness, atrophy of calf muscles. contractures, wasting

Front 120

Walking with their hands instead of feet is called:

Back 120

Gower's sign

Front 121

Death is usually caused by:

Back 121

Resp and Cardiovascular complications.

Front 122

Teach parents:

Back 122

Keep child active as possible, keep muscle function as long as possible. ROM, bracing, and genetic counseling for parents X linked.

Front 123

DMD is confirmed by:

Back 123

Muscle biopsy, EMG, Serum enzyme measurement.
NO TREATMENT

Front 124

Two tests that may be indicative of JIA:

Back 124

Latex fixation and Sed rate

Front 125

Do opiods help with JIA:

Back 125

Only temporary- NSAIDS is the drug of choice.

Front 126

The kidneys in a newborn are immature at birth and cannot do this effectively:

Back 126

Concentrate urine , conserve or excrete sodium.

Front 127

Diarrhea may be associated with what:
Acute is:
Chronic is:

Back 127

Upper resp or urinary tract infections.
Considered less than14 days
Increase of more than 14 days.

Front 128

Irritable colon (chronic nonspecific diarrhea) have what no symptoms:

Back 128

No evidence of malnutrition, no blood, grow normally,they think related to sweeteners and food sensitivites.

Front 129

Infants and children with diarrhea should be treated first with what:

Back 129

Oral rehydration- this is most effective with diarrhea.

Front 130

What foods/fluids should be avoided for rehydration:

Back 130

Caffeine, chix broth, fruit juices or carbonated drinks,Jello. This does not manage their nutritional needs. Pedialyte is encouraged. Ratio of electrolytes are proportinate with needs.

Front 131

This disease consists of no ganglion cells which leads to no peristalisis:

Back 131

Hirshsprung's disease.

Front 132

What are some common s/s of this disease:

Back 132

Severe constipation, distended abdomen, green vomitus, fever, explosive diarrhea.(EMPTY RECTUM and SMALL ANUS)

Front 133

Stool looks like what:

Back 133

Ribbon like, foul smelling and can visualize peristalisis in bd moving down towards lower bowel.

Front 134

Stool builds up in child , which can lead to explosive diarrhea and infection called:

Back 134

Enterocolitis

Front 135

How is this dx:

Back 135

Barium enema and anal exam, rectal biopsy.

Front 136

What is the tx for Hirshsprung disease:

Back 136

Temp colostomy and then at 20 pounds. reversal of colostomy and pull through procedure if child is stable.

Front 137

Baby will most likely be what with this disease:

Back 137

Malnourished and anemic

Front 138

FIndings for dx:

Back 138

Contracted anal sphincter and distended abdomen- small anus and empty rectum.

Front 139

Older children may receive this for tx as well:
What are we gonna measure:

Back 139

Saline enemas and antibiotics within enemas.
Abdominal girth at umbilicus with each set of VS.Mark spot after the procedure. ( make sure bowel is working)

Front 140

This involves transient relaxation of lower esphageal spincter (LES)

Back 140

GER-

Front 141

Factors that increase abd pressure that contributes to GER:

Back 141

coughing,sneezing, scoliosis, and overeating.

Front 142

Signs and symptoms of GER:

Back 142

excessive crying, arching back, failure to thrive and cal lead to aspiration.

Front 143

Treatment for GER:

Back 143

30 minutes prior to feeding, give pepcid, thicken fluids have baby upright for an hour at least 30 degrees HOB.

Front 144

What age is it mostly diagnosed:

Back 144

Less than 2 months and resolves by 1 year.

Front 145

If baby has increased abd distention may be a sypmtom of:

Back 145

Enterocolitis- check temp regularly, Increased tenderness, distention, vomiting could be signs of perforation.

Front 146

Saline infused with abx enemas and systemic IV antibiotics to help decrease bacteria when:
(Hirshsprungs)

Back 146

After surgery- in older child.

Front 147

To prevent aspiration with vomiting:

Back 147

Place child on side- never prone. Monitor amounts of emeisis-dehydration.

Front 148

GER is different than GERD, why:

Back 148

The disease has cause damage.

Front 149

GER normally occurs at:

Back 149

After meals and at night.

Front 150

DX GER with:

Back 150

Endoscopy and hx from parents. Forceful vomiting.

Front 151

SIgns of GER:

Back 151

Weight loss, failure to thrive vomitng food. Resp issues may be present- worry for ASPIRATION

Front 152

Children prone to GER are:

Back 152

Premature infants, bronchial pulmonary dysplasia , esophageal atresia, scoliosis, CP, neuro, CF

Front 153

Older kids with GER avoid what foods:

Back 153

Caffeine, chocolate, citrus, spicy foods, no peppermint candies, second hand smoke.

Front 154

Intestinal parasitic most common:

Back 154

GIardiasis and Pin worms in daycare.

Front 155

Appendicitis if pain better suspect what:

Back 155

Peritonitis- stool and infection in abd cavity.

Front 156

Cardinal feature of appy:

Back 156

Pain- (rebound tenderness- Mcburneys point.) Elevated bands in Diff - use slight percussion around peri-umbilcal pain. Nausea, fever. Don't use Mcburneys on child- painful

Front 157

Tx of appy:

Back 157

Triple abx therapy- rehydrate- if ruptured surgery-NGT-side lying knees flexed and decrease ROM in R hip

Front 158

Sign of worsening of symptoms:

Back 158

Child refusing to play- change in behavior.

Front 159

Older child will reposition themselves for pain, never give what to a child to relieve pain prior to appy surgery:

Back 159

Enemas, heat or laxatives prior to appy

Front 160

What is the key difference between Meckels and appy:

Back 160

Meckels is a vague pain with bloody stools and pain does not increase with movement- APPY does.

Front 161

Meckels dx can cause what:

Back 161

GI hemorrhage and bowel obstruction-( remember no rebound pain with this)

Front 162

Facial malformations in utero development (first trimester)

Back 162

Cleft lip/palate more common in Native Americans Teratogens in mom (passive smoking, nut defects)

Front 163

Cleft lip is increased greatly with a mom that :

Back 163

Smokes-

Front 164

Lay baby on back with what deformity and restrained:

Back 164

Cleft lip

Front 165

Lay on abdomen with:

Back 165

Cleft palate/prone

Front 166

Cleft lip is done ___ cleft palate:

Back 166

Before-because cleft palate bones are still growing-

Front 167

After surgery it is important to keep area protected by:

Back 167

Restraining baby- via elbow restraints-release one arm at at time and place in infant seat change environment.

Front 168

Clean suture site:

Back 168

Saline on cotton swab and antibiotic ointment.

Front 169

Diet for cleft palate post op:

Back 169

Soft diet , no hard foods and avoid baby crying may cause suture to break open. Must have restraints 6 weeks post op- educate parents. No straws-spoons,pacifiers.

Front 170

Can mother breastfeed with cleft palate/lip:

Back 170

Yes, or use special nipples for feeding. Sit upright- stim suck reflex, steady pressure, burp frequently,rest when baby signals with facial expression.

Front 171

Failed seperation of esophagus and trachea is what:

Back 171

Esophageal Atresia or Tracheoesophageal Atresia

Front 172

Most frequent symptoms:

Back 172

Choking, coughing, cyanosis., apnea, Resp distress after feeding and frothy saliva, abd distention. (MEDICAL/SURGICAL EMERGENCY)

Front 173

Major concern with this:

Back 173

Resp distress, pneumonia and aspiration, Make NPO stat.

Front 174

What is tx for this:

Back 174

Surgery, suction secretion, NPO,( g-tube feedings, IVF broad spectrum abx, HOB 30 degree, AFTER SURGERY)

Front 175

What do we do trial feediing after surgery:

Back 175

G tube feeding first-then Sterile water, then attempt with oral feeding.HOB 30 degrees.. Give pacifer to stim reflex.

Front 176

S/S of pyloric stenosis:

Back 176

Projectile vomiting- non-bilious, dehydration and metabolic alkalosis- stomach will be firm and tight.

Front 177

Vomiting starts at what age:

Back 177

2-5 weeks of life
Vomits 30-60 min after eating

Front 178

What will the nurse feel with this baby:

Back 178

A palpable olive shaped mass in epigastrum , right of the umbilicus.

Front 179

Baby's with pyloric stenosis are not in pain, they are just:

Back 179

HUNGRY- dehydrated and lethargy. Stale emesis will be noted and may be tinged with blood.

Front 180

What will labs show with this baby:

Back 180

Decreased chem's and increase PH and bicarb.

Front 181

Mass will be felt when:

Back 181

Baby is quiet ,resting and belly is not full.

Front 182

What must we teach parents after surgery:

Back 182

Small frequent feedings with glucose water post op and post op vomiting may occur which is normal. May vomit first 24-48 hrs post op.

Front 183

When one portion of the bowel invaginates into another:

Back 183

Intussusception

Front 184

S/S of this disease:

Back 184

Loud anguish crying, abd swelling,acute pain, CURRANT JELLY stools, vomiting bile.

Front 185

Diagnosed and may be treated by:

Back 185

Pneumoenema- AIR-push with air to try to push bowel out.OR barium enema.

Front 186

Tx non-surgical:

Back 186

Pneumoenema, water enema, NGT, IVF if not perforated.

Front 187

IF child passes brown stool , what does this mean:

Back 187

May have resolved sponataneously- Report immediatly.

Front 188

Post-op watch for:

Back 188

Bowel sounds, stool, passing of barium.

Front 189

Fistula from rectum to GU:

Back 189

Imperforate anus- no opening in anus.Diagnosed normally at birth.

Front 190

Children who imperforate anus may have what:

Back 190

Other anomalies present.

Front 191

This is an immune medicated enteropathy, immune response:

Back 191

Celiac disease-thought to be inherited predispostion environmental factors.

Front 192

Clinical manifestations of this disease:

Back 192

Impaired growth, chronic diarrhea,abd distention,muscle wasting.STEATORRHEA(float stools)

Front 193

Diagnosed by what:

Back 193

Bx of the mucosal inflammation, crypt hyperplasia and villous atrophy.

Front 194

They need to avoid what foods:

Back 194

Avoid high fiber diets( when inflamed), processed foods,no hydrolyzed plant oils. (also may be lactose intolerant) NO WHEAT, RYE, BARLEY, OATS

Front 195

How is celiac disease diagnosed:
Refer parents to:

Back 195

Stool test check for antibodies, Gluten blood test
Celiac Spue Association

Front 196

What do children with this disease have an increased risk for:

Back 196

Lymphoma

Front 197

With poison, what is the rule:

Back 197

Treat child first then poison- ABC, then treat with activated charcoal, gastric lavage or cathartic. NO IPECAC

Front 198

Overdose of ASA s/s:

Back 198

Nausea, disorientation, ,hyperpnea, vomiting, diaphoresis, Tinnitis, coma and convulsion,

Front 199

Treatment of ASA poisoning:

Back 199

CHARCOAL therapy is important with early asa toxicity. SODOIUM BICarb may be used. LAVAGE will not remove concretions of ASA.

Front 200

Acetominophen s/s poison:

Back 200

4 stages
Initial 2-4 hours N/V, sweating,pallor
Latent-24-36 pt improves
Hepatic -may last 7 days and be permanent RUQ pain,Jaundice confusion, stupor, coag issues
Pt's who do not die in hepatic stage may recover.

Front 201

Acetominophen is the __common drug poisoning:

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Common-Toxic at 150 mg/kg

Front 202

Treatment with Acetominphen poison:

Back 202

Mucomyst oral in juice-
Loading dose than usually 17 doses in different dosage.

Front 203

Signs of lead poisoning are what:

Back 203

Nausea, vomiting, constipation, anorexia, abd pain.

Front 204

Low dose exposure s/s:

Back 204

Distractability,impulsivity,hyperactivity, mild intellectual defecits.

Front 205

High dose exposure to lead:

Back 205

Encephalopathy,mental retardation, paralysis, blindness, convulsions, coma and death.

Front 206

Neurologically what can happen:

Back 206

Increased ICP-tissue ischemia and atrophy.

Front 207

What should parents be aware of for lead:

Back 207

Lead based paint( old houses)
Lead based paint chips
Cultural seasonings that have lead in them (mexico,Asia, India)

Front 208

What age is lead screening done:

Back 208

Age 1 and 2
Children that live in high risk areas or if family members have had lead poison in the past.

Front 209

Treatment of lead :

Back 209

Lead level >10
Chelation injections (can cause renal failure)

Front 210

Nursing considerations to teach parents:

Back 210

Cold water for formulas, do not use pottery.ceramics not meant for food. Have water tested. Do not vacuum spreads dust and paint particles.Use wet mop.

Front 211

Do not give EDTA(chelation) if patient has what:

Back 211

Dehydration or poor urinary output.