PEDIA (NCM 109)2nd Sem (Unwell Newborns-Children) PRELIMS-FINALS

Refers to the accumulation of CSF in the brain

Hydrocephalus

Signs of Hydrocephalus on an infant

-Wide eparation of cranial sutures

-downward eye rotation

-enlarging head >34-35cm

-bulging separating anterio4 fontanels

Signs of Hydrocephalus on children-adolescent

-papilledema

-headaches on awakening

-ataxia,vomitting

A shunt that goes to peritoneum

Ventriculoperitoneal shunt

A baby girl is post-op after the procedure of ventriculoatrial shunt on left side, how will position the patient?

flat on unoperated side (right )

A baby boy named Bob has an increased BP but decreased PR and RR, noted tense fontanelles. This is a sign of?

ICP-Increased Intracranial Pressure

Assessments for Hydrocephalus

PERRLA and LOC

Medication used to treat overactive bladder

Oxybutynin

Medication that improves bladder capacity +less frequent catheterization

Ditropan

Normal opening pressure

8-10cm H20 -NB

10-18cm-Child

Head circumference

34-35 infant

47 cm by 1 year old.

Decorticate posturing

arms flexed inward and bent in toward the body and the legs are extended

Decerebrate posturing

rigid extensor posturing:secondary midbrain or pons trauma.

Flaccid are flexia

absence of response

Glasgow Coma Scale

A-Alert and awake

V-Responsive to verbal stimuli

P-painful stimuli

U-unresponsive

Failure of the neural tube to close completely during the 4th week of gestation

Spina Bifida (Myelodysplasia)

A newborn has a dimple and a tuft of hair on the spine. what is this type of spina bifida?

Spina bifida occulta

A newborn presents a lack of sensation of the lower extremities & loss of bowel & bladder control. upon inspection there is an orange-sized protrusion on his back.What is this condition?

Myelomeningocele

Amniocentesis result for positive spina bifida

Increased alpha fetoprotein level prior 18th week of gestation.

What is the proper management of the spina bifida sac before operation?

Cover sac with sterile dressing moistened by PNSS

Positioning of a Spina bifida patient

prone

What is an appropriate advice to parents whose child underwent post op from spina bifida?

Advice parents about the importance of positioning,casting and splinting

Inflammation of the cerebral meninges of the brain & spinal cord, younger than 24months old

Meningitis

Causative agent of meningitis

Streptococcus pneumoniae, or group B Strep.

Signs of meningitis

-nuchal rigidity

-headache,photophobia, irritability

contraction or pain in thehamstring muscle when attempting to extend the leg when hip is flexed.

Kernig's sign

flexion at the hip & kneein response to forward flexion of the neck.

Brudzinski's sign

A baby is for q lumbar puncture test,how will you position the patient?

Fetal position, edge of table, knee/leg-chest

Nursing intervention for Meningitis

Maintain respiratory isolation

Monitor dehydration

Dark environment

Seizure precautions

Diet of a meningitis patient

High protein, high calorie, small frequent feedings

Talipes deformities

deformities of the feet/leg

lateral bowing of the tibia- malleo. touching & the medialsurface of the knees will be more than 2inches (5cm) apart.

Genu Varum (Bow legs)

opposite of genu varum- the medialvsurfaces of the knees touch, & the medial surfaces of the ankle malleoli are separated by more than 3 in. (7.5cm).

Genu Valgum (Knocked knees)

High top shoes- attached to a metal bar

Dennis Brown splints

improper formation & function of the hip socket

Developmental hip dysplasia

The palpable sensation of the femoral head slipping into the acetabulum.

Ortolani's sign

A baby girl named Maomao has hip dysplacia, what is an appropriate nursing intervention?

Let the client wear multiple diapers or splints

FREJKA SPLINT

made of plastic & buckles onto the child like a huge confining diaper.

SPICA CAST

frog-legcast

Has 47 chromosomes, most common chromosomal abnormality

Down Syndrome (Trisomy 21)

Brushfield's spots.

white specks in iris

simian crease

a single straight palmar crease; an abnormal finding that is associated with Down Syndrome.

condition in which children have an extra chromosome 13.

Trisomy 13 Syndrome (Patau's syndrome,47XX13+ or 47 XY 13+)

Microcephaly characterized with what condition?

Patau's syndrome

Assessment on Down Syndrome

-Single palmar flexion crease- the palmcrease is only 1 called the simian crease(one straight lang sya)

-Malaki yung tongue tas maliit bibig o Flat nasal bridge o

-Nuchal folds sa leeg o Upslanted palpebral fissureso

-Clinodactyly of the 5th finger

-Hypotonia

Assessment features of Patau's syndrome

-Midline disorders such as cleft lip & cleftpalate

-Microcephaly with forebrain & forehead abnormalities of the Eyes that are smaller than normal(microphthalmia) or

- absent of eyebrow

-Low set ears (Dysplastic or malformed ears)

- Heartdisorders,particularlyventricularseptal disorder & abnormal genitalia.

-Do not survive past early infancy.

-The baby will die during the infancy stage Small head

-Clenched hands and polydactyly or extrafingers

- Undescended or abnormal testes

Small jaw, misshapen fingers & toes,The soles of the feet are often rounded instead

TRISOMY 18 SYNDROME

46XX- or 46 XY B (5p) is the result of a short armon chromosome B5.

CRI DU CHAT SYNDROME

Characteristics of Cri du Chat

Characteristic "cry of the cat" sound made when crying, low birth weight, severe mental retardation, microcephaly, heart defects, and the typical facial appearance.

Child presents findings of abnormal cry like a cat, wide-set eyes, downward slant to palpebral fissure of the eye, moon-shaped face

Cri du chat syndrome

In giving ferrous sulfate to a child with Thalassemia major, what should the nurse look out for the lab results?

Ferritin

A child is admitted with acute glomerulonephritis. The nurse expects the urinalysis during this acute phase to show

Hematuria and proteinuria

It pertains to the disorder causing altered glomerular permeability or the fusion of the glomerular membrane surfaces

Nephrotic syndrome

Closure of the sac should be done within how many hours after birth to prevent infection and pressure neural tissue?

48 hours after birth

An infant who was born with a myelomeningocele With accompanying hydrocephalus has had a shunt procedure to alleviate the hydrocephalus. Which position will you place the infant?

Prone

A 10 - year - old child has Down's syndrome. In planning his care, it is most important for the nurse to take into consideration

His mental age

John is 20 days old with a diagnosis of meningitis. Lumbar tap was done by Dr. Fajardo. Which of the following results is an abnormal finding of CSF?

Protein- more than 15-45 mg/dl

To increase bladder capacity, and lower intravesical pressure, which drug is appropriate to give her doctor's order in myelomeningocele?

Anticholinergic Drugs

A child was admitted because of meningitis. Which microorganism causes meningitis in newborns?

Group B streptococcus

When caring for this child with meningitis, is it essential that the nurse evaluate for a positive Brudzinski's sign? Which would indicate

Meningeal irritation

You anticipate the onset of manifestation related to Thalassemia to occur by:

6 months of age

Which of the following is the most severe form of beta thalassemia?

Thalassemia Major (Cooley's anemia)

It pertains to the disorder causing altered glomerular permeability or the fusion of the glomerular membrane surfaces

Nephrotic syndrome

The most appropriate nursing diagnosis for the child with acute glomerulonephritis is a. Risk for Injury related to malignant process and treatment

Risk for Imbalanced Fluid Volume related to a decrease in plasma filtration

What is the most common type of Cerebral palsy?

Spastic type

Which of the following drugs is Not given to ADHD?

Digoxin

The parents ask the nurse what they should look for if they suspect their school-age child has ADHD. The nurse will instruct them to report to their doctor the following, Except:

Quiet

Persistent pattern of inattentiveness or impulsive symptoms for children with ADHD are present before

12 years old

Most common neurological conditions in childhood that can persist into adulthood

ADHD

A child was admitted in the pediatric ward with a diagnosis of ADHD with a medication of Ritalin. Which of the following is the side effect of Ritalin?

Insomnia

What is the least common type of Cerebral palsy?

Ataxic Type

What is the most common type of Cerebral palsy?

Spastic type

The parents of a child diagnosed with autism spectrum disorder are trying to determine why their child has the disorder. In response, the nurse should include which etiology?

Genetic factors

The nurse is teaching about congenital clubfoot in infants. The nurse evaluates the teaching as successful when the parent's states that clubfoot is treated:

Immediately after diagnosis

Bringing the thighs towards the midline of the body is

Barlow's sign

Which of the following signs indicate that the shunt is functioning properly in hydrocephalus?

Decreasing daily head circumference.

Which sign/symptom should the nurse expect to assess in the client diagnosed with hemophilia?

Epistaxis

A student nurse is conducting health teaching to parents of a child with Hemophilia B, which statement indicates that the student needs further

"Your child may take OTC Drugs containing Aspirin and Ibuprofen"

You are conducting first aid on a child with hemophilia C that is currently bleeding. How many minutes Should you apply pressure

10-15 mins

Medication that closes patent ductus arteriosus

Indomethacin

What heart conditiob needs PDA

Tetralogy of fallot

What are heart conditions/4 cardinal signs included in the Tetralogy of fallot?

-VSD

-Overriding Aorta

-Pulmonary Stenosis

-Right Ventricular hyperthropy

[NO ASD]

Management for coarctation of the Aorta

BP all extremities

Invagination of the portion lf the intestine to another.

Intussusception

A congenital disorder where the back of the nasal cavity is blocked

Choanal atresia