PEDS Q3 Review

Definition: A condition in infants characterized by the narrowing of the pylorus.
Most Significant Manifestation:
- Projectile vomiting is the hallmark sign associated with pyloric stenosis.
Laboratory Findings in Pyloric Stenosis:
- Metabolic Alkalosis: Results from vomiting, leading to a depletion of stomach acids.
- Serum Electrolyte Changes:
- Decreased serum potassium and sodium levels
- Increased pH and bicarbonate levels
- Decreased chloride levels

Manifestation: Passage of currant jelly-like stools is often seen in infants with this condition.

Diagnosis: Requires a complete history and physical examination, particularly if the child presents with fussiness and vomiting during feeding.

Definition: A pouch that forms due to the failure of the vitelline duct to completely disappear after birth.
Description: When the duct does not vanish, it can create a blind pouch, which may cause complications.

Primary Cause: Deteriorating paint in older buildings is the leading cause of lead poisoning in children.

Management: Include dietary modifications such as increasing roughage through whole grain breads or whole grain cereals.

Prevention: Keep children's nails trimmed to prevent scratching and spreading.
Symptoms: If a child is scratching the anal area, they may have pinworms.
Diagnosis Test: The scotch tape test, where a piece of tape is applied to the anus and then examined for eggs.

Safety Hazard: Tablecloths can pose dangers to curious toddlers who may pull them down, risking injury by causing items on the table to fall.

Indicators: A toddler is ready for toilet training if they can communicate when they are wet and express the urge to urinate or defecate.
Developmental Play: Typical play behavior includes parallel play, where toddlers play next to each other but not directly with one another.

Walking: A toddler should be able to walk independently by the age of 16 months.
Concern: If a child is not walking alone by 18 months or 2 years, they may be considered developmentally delayed.
Favorite Possessions: Toddlers often carry toys or blankets for comfort and security.

Assessment: When a toddler shows signs of fatigue and dehydration, the first nursing action should be to assess if they are voiding.
Potassium Administration Warning: If potassium is given to a child who is not voiding, this could lead to hyperkalemia, which is dangerous.

Characteristics: Infants with failure to thrive often present with very low birth weight and inadequate growth compared to peers.

Common Manifestation: This condition often causes profuse watery diarrhea and can result in vomiting. Parents may witness fatty traces in their child’s stools.
Dietary Consideration: Rice is gluten-free and is the most common dietary option for those with celiac disease.

Common Symptoms: Initial pain typically occurs in the lower abdomen, between the umbilicus and the iliac crest (McBurney's point).
Pain Progression: After the first four hours, if a child reports that their belly no longer hurts, it can indicate potential appendiceal rupture.

Description: A congenital condition where there is an absence of ganglion cells in the rectum, causing functional obstruction and megacolon.
Common Stool Characteristic: Children with this condition typically pass ribbon-like, foul-smelling stools.
Initial Surgical Treatment: Often involves ostomy to bypass the affected areas of the intestine, usually temporary until repair can be made around 12 to 18 months of age.

Potassium Levels: Normal potassium levels are between $3.4$ and $4.7$ milliequivalents per liter. As a nurse, identifying levels outside of this range is crucial to avoid cardiac complications.
Severe Diarrhea Management: When encountering severe diarrhea, priority nursing actions should revolve around assessing fluid balance to evaluate the severity of dehydration.
Emergency Situations: If an infant presents with projectile vomiting accompanied by hunger after meals, this requires immediate medical attention.

Snack Options: Suitable snacks include applesauce and sliced bananas as they are easy to chew and swallow.
Vegetarian Diet Considerations: For toddlers on vegetarian diets, soy products, soy milk, and tofu are recommended as sources of complete protein.

Leading Cause of Mortality: Unintentional injuries are the leading cause of toddler mortality in the US, often due to accidents during this developmental stage.
Social Skills Development: As toddlers grow, they assert their need for autonomy, often displaying negativism and needing structured choices to avoid confusion.
Managing Tantrums: Parents should be advised to ignore temper tantrums to discourage this behavior as an effective means of communication.