Peds exam 3

1. If you have cardiogenic shock, what would that look like?
+ Hypotension (decreased CO), impaired tissue perfusion (cool extremities, pale

skin)
2. If you just gave epinephrine for severe allergy attack, what would you observe for 30

minutes after administration?
+ Monitor blood pressure because epinephrine has alpha-adrenergic effects → can cause

HTN and hypotension

  1. Patient that has emergency room motor vehicle accident with backboard cervical collar

    with bleeding bruising, temp is 99, resp is 14 and labored, 17yo, 82/54, what shock is this?

    + neurogenic shock

  2. 12 month old has a HR 240, temp 106, BP 50/20, and tachypnea, what does the patient

    displaying?

+ Hypovolemic shock (fast HR + resp and low BP)

5. What are you going to do for a shock patient that loss about 15% body weight from previous days, 240bpm

+ Fluid resusictation
6. You have a patient who had fluid replacement, how do you know if the fluids are working

for the patient?
+ Increased urine output

7. If we have a patient with decreased BP, increased HR and now has suddently developed bruises all over body?

+ Disseminated intravascular coagulation (DIC)
8. Patient has diabetic ketoacidosis (BG>200), what would the pH be?

a. Acidotic, pH less than 7
9. You are at risk for cerebral edema with pt with DKA, what do u not wanna do?

+ Correct glucose too fast = encephalopathy
10. Diabetes insipidus (DI), what serum osmolarity would you see?

+ High levels of sodium, Elevated serum osmolarity (heme concentrated) 11. Diabetes Insipidus, what specific pt teaching so others know she has this?

+ Bracelet or identification
12. Child with DI, you would you encourage them to do?

+ Drink lots of water
13. If they have a child with SIADH, what would you expect them to be?

+ Low levels
14. What are we going to do for our treatment for SIADH?

+ Restrict fluids
15. We have a child with hemophilia, he has bleeding in the joints what do we do?

+ RICE
16. You have a child who is 4 years old, and they have iron deficiency anemia?

+ Too much milk, PICKY eaters → not eating enough green, leafy vegetables 17. Von-Willebrand Disease, what to do for epistaxis?

+ Gentle pressure for at least 10 minutes
18. You have a child with acute lymphoid leukemia, what do you expect from assessment

findings (i.e., appearance)?
+ Bruising, fever, pallor, joint pain, pain, swollen lymph nodes

19. What would be a bad prognosis for a cancer patient?

+ Mestastsis of cancer
20. What would you give if patient is having adverse effects from chemotherpay?

+ Antiemtics (30 minutes before!!)

  1. Neutrophil 100, plt 25, child got chemo, slight temp, hgb 9.5 10 days ago, what is the

    child manifesting as a side effect + Neutropenia

  2. You have the same child as above, what precautions would you take?

+ Reverse isolation

  1. Management of acute tumor lysis syndrome, what do we want the urine pH to be? + 7-7.5

  2. Same patient as above, how are we going to make it alkatonic??? + Sodium

  3. You have a child that has Wilms tumor and now it is removed, what kind of post-op care would we do?

+ BP, I&O
26. You have a child that just had chemotherapy for osteosarcoma (bone tumor), what

teaching would you give to the patient and parents after completeing the first round of chemo?

+ Keep away from sick people
27. You have a child with acute lymphatic leukemia, ANC of 105 and now she is hungry.

Which would you suggest her eat?
+ Peaches (dont pick ones with bacteria)

28. You have a 12 year old with ALL and had chemo and parethesia and alepacia, what issues would he have?

+ Disturbed body image 29. What s/sx for concussion?

+ Change in sleep and eating patterns
30. What signs would you see with bipolar disease?

a. Grandiosity, changes in sleep, and extreme behaviors 31. What signs would you see with suicide?

+ Isolation + self destructive

32. What s/sx with schizophrenia?
+ Hallucinations → affects cognition and social functioning

33. You have a 15yo teenager failing 10th grade who wants to leave home bc parents dont get her and she feels depressed?

+ Have u ever took drugs/alch? Open end questions abt her feelings? Appetite? Trouble concentrating?

34. You have a client who is depressed and has suicidal potential, what questions would you ask?

+ “Do you have a plan?” “Have you thought about taking your own life?” “What’s it like when you’re depressed?”

35. What is our goal for palliative care?
+ Comfort and symptom management

36. For parents that have infants who end up dying, what do they not want their child to go through?

+ Don’t want them to be in pain
37. You have a family who just lost their child, what would be inappropriate?

+ Minimize visitors
38. You have a family who just lost their child, what would be an appropriate statement?

+ I am so sorry that you lost your child. 39. Example of what to do for compassionate care?

+ Sit and listen

  1. You have a child with thalassemia, which one would be mild anemia?

    + A → 1 gene defect, symptom-free and mild

    + B → major and severe while

  2. What are monocytes for?

    + Fight infection, inflammatory reaction

  3. Whats a long term complication of thalassemia?

+ Anemia and have iron overload
43. How does tissue damage result from sickle cell disease?

+ Crescent shape gets stuck and causes occlusion 44. How are we going to treat sickle cell disease?

+ Hydration, O2, pain management (HOP) - keep them out of remission (manage individual features)

  1. How do you get sickle cell disease?
    + GENETICS → inherited with 2 genes bc its recessive

  2. What is a common age range for lice? + 3 to 11 years old

  3. Diaper dermatitis, what could we do?

+ Barrier cream aka zinc oxide + open to air, pt education

48. What would be the greatest risk for suicide?

+ Active psychotic disorder