Pediatrics Unit 3 Exam

Dietary modification to prevent dyslipidemia

adopt a heart healthy diet (Mediterranean/CHILD diet).

Foods to LIMIT in dyslipidemia

saturated and trans fats, fatty fried foods, full fat dairy, sugary drinks and sweets.

Foods to INCREASE in dyslipidemia

olive oil, fruits and vegetables, whole grains, legumes, nuts, lean proteins (fish and poultry)

Health promotion and disease prevention for endocarditis

emphasize good oral hygiene; prophylactic antibiotics before dental or invasive procedures for high-risk children

How to prevent lead exposure in children

lead poisoning can be avoided by preventing exposure to or ingestion of lead-based paint (in houses built before 1978), contaminated dust, soil, food, or water, lead-containing household items

Key teaching points for diaper dermatitis

frequent diaper changes, prompt treatment prevents skin breakdown and infection, seek medical evaluation if rash worsens, does not improve or shows signs of infection

Nursing and parent education for lead poisoning

teach the importance of routine lead screening, children under 6 should be assessed for possible environmental lead exposure, screen for developmental delays/academic concerns, refer families to community resources or public health agencies, follow up to ensure exposure source has been removed and lead levels are decreasing, do not allow children to play in areas that lead paint has been used

Signs of complications to report with eye trauma

increased pain, vision changes, bleeding, signs of infection, wound leakage, symptoms of endophthalmitis

Common manifestations of botulism

muscle weakness, flaccid paralysis, decreased muscle tone, difficulty feeding or swallowing, resp. weakness

Common manifestations of migraines

throbbing/pulsating headache, N/V, photophobia, phonophobia, visual disturbances, facial pallor in younger children

Hallmark finding for coarctation of the aorta

Upper extremity hypertension with lower-extremity hypotension

Infant clinical presentation of heart failure

tachypnea, diaphoresis with feeding, poor feeding, failure to thrive/poor weight gain, irritability

Restricted and repetitive behaviors seen in autism spectrum disorder

strong preference for routines, distress with schedule changes, repetitive movements (rocking, hand flapping), intense focus on specific topics/objects, sensory sensitivities, arranging objects in specific ways, may display aggression or self-injurious behaviors

Tetanus clinical presentation for severe disease

resp. compromise, back arching, autonomic instability, cardiac arrest or death

What is hemophilia

an inherited bleeding disorder caused by deficiency of clotting factors needed for normal coagulation.

What is the clinical presentation of hemophilia in older children

Joint pain, warmth stiffness, swelling, oral/GI bleeding, hematuria, CNS bleeding in severe cases

Aplastic anemia diagnostic testing

CBC (↓ RBCs, WBCs, and platelets); BONE MARROW BIOPSY TO CONFIRM DIAGNOSIS (shows markedly decreased cellularity and reduced blood cell production)

Diagnosis for autism spectrum disorder

developmental hx., behavioral observations, communication assessment, autism-specific screening tools, DSM-5-TR dx. criteria

Diagnostic testing for a spinal cord injury

imaging (x-ray for fractures/spinal misalignment, CT for bone injury, bleeding, spinal stenosis, MRI for soft tissue injury); SSEP to assess nerve conduction

Diagnostic testing for infected bite wounds

Blood cultures; CT for head bites in young children, ultrasound for suspected abscess. Bartonella serology if cat scratch disease is suspected.

Do not do this diagnostic image test with eye trauma

MRI if metallic foreign body is suspected

Head injury screening

Pupil assessment to evaluate neurological status and response to stimuli; Glasgow Coma Scale (GCS) measures eye opening, verbal response, and motor response (↑ GCS=better neurological function)

How a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) is made

Acne risk factors

family hx. of acne, puberty/hormonal changes, steroids and anticonvulsants, excessive sun exposure, friction from clothing/sport equipment, high sugar diet, oil-based skin products, stress, anxiety, or anger, and endocrine disorders (e.g., PCOS)

Cause of febrile seizures

high fever, usually from viral infections, influenza, upper resp. infections (cold)

Conservative treatments for seborrheic dermatitis

EMOLLIENTS to soften scales, SOFT BRUSH or COMB to remove scales, WASH SCALP regularly with MILD SHAMPOO

Considerations for the pediatric client with epilepsy

they might outgrow epilepsy; many can DC medications after ~2 years without a seizure under provider supervision. INFORM SCHOOLS THAT PEDI PT. HAS SEIZURE DISORDERS AND HAVE A SEIZURE ACTION PLAN IN PLACE

Diet for a patient with burns

high protein nutritious diet

Fragile X Syndrome treatment and management

no cure for Fragile X syndrome, however, SPEECH THERAPY, OT, BEHAVIORAL THERAPY, EDUCATIONAL SUPPORT AND INDIVIDUALIZED SERVICE, and ongoing interdisciplinary care MAXIMIZED development and functioning.

Psychosocial Impacts of Down Syndrome

Anxiety, depression, OCD, social isolation and loneliness

Rhabdomyosarcoma treatments

surgery, chemotherapy, radiation therapy, stem cell transplant in selected case

Risk factors for burns

inadequate supervision, young age, low socioeconomic resources, limited access to burn prevention education

Risk factors for spina bifida (myelomeningocele)

FOLIC ACID deficiency (see slide 19 of Pedi Week 7 Tutoring Slides for the rest)

Stages of disseminated intravascular coagulation (DIC)

Overactive clotting and bleeding phase

Overactive clotting (DIC)

formation of microthrombi, organ ischemia and damage

Bleeding Phase (DIC)

platelets and clotting factors become depleted; bleeding from skin, mucous membranes, and invasive sites.

Symptom management for exanthematous drug reaction

TOPICAL CORTICOSTEROIDS to reduce inflammation, PO ANTIHISTAMINE to reduce itching

Tetanus sources of infection

soil, dirt, dust, and animal faces, contaminated wounds–puncture wounds, splinters, burns, crush injuries, open fractures, neonatal tetanus from unsanitary birth practices

Treatment and therapy for moderate to severe burns

ABCs, FLUID RESUSCITATION (two large-bore IV access), pain management (IV opioids), infection prevention, sterile wound care and debridement, topical antimicrobial dressings, escharotomy for circumferential, tetanus booster if partial- or full-thickness burn and vaccination not current (within 5 years)

Treatment for poison ivy

PO and topical antihistamine to reduce itching and improve sleep, corticosteroids (e.g., prednisone) esp. if started early, topical immunosuppressants for persistent or severe cases

What can untreated strabismus lead to

decreased visual acuity, poor depth perception, amblyopia (“lazy eye”)

What causes hemophilia A

Deficiency of Factor VIII

hemophilia B cause

Deficiency of Factor IX

von Willebrand disease cause

low, absent, or dysfunctional von Willebrand factor

What does leukopenia put you at risk for

infection

What is a concussion caused by

falls, sports injuries, motor vehicle accidents, physical violence, child abuse

What is a Hypercyanotic ("Tet") Spell

what are the manifestations of Tet Spell

sudden cyanosis, deep rapid breathing, hypoxia

and what is the treatment for it

knee-to-chest position + oxygen + calm environment

What is aplastic anemia

bone marrow failure disorder in which hematopoietic stem cells are damaged or destroyed

What is considered to be complete blindness

No vision, including inability to perceive light

What is Tetralogy of Fallot

most common cyanotic congenital heart defect, consisting of four defects

Tetralogy of Fallot is consists of

Pulmonary stenosis, ventricular septal defect (VSD), overriding aorta, right ventricular hypertrophy (RVH)

What is watchful waiting in otitis media

watching mild OM for 48 to 72 hours to see how it’s progressing, allowing the immune system to get rid of the infection without prescriptions, esp. when a viral cause is suspected

What play and activity is appropriate for Beta-Thalassemia

low-impact activities (e.g., swimming, biking, walking, yoga)

What should be prevented with poison ivy dermatitis; teach children and parents to identify poison ivy, oak, and sumac.

Why you should not burn poison ivy, oak or sumac

Urushiol from the poison ivy, oak, or sumac can be airborne and inhaled, causing severe resp. reactions

Contraindications for taking Azithromycin for otitis media

hx. of prolonged QT intervals, taking medications for unexpected heart rhythms

What atropine drops do to the eyes

blur vision in the stronger eye to strengthen the weaker eye

What to monitor when taking Isotretinoin for acne

liver and lipid, pregnancy, mood changes, depression, suicidal thoughts