peds exam 3 review

The emotional impact of a nurse losing a patient and its effect on family dynamics, especially for families with children who have autism.
Understanding autism as a spectrum disorder:
- Spectrum: Autism presents differently in every individual, making outcomes unpredictable.
- Variation in treatment effectiveness among individuals.
Importance of various interventions for children with autism.

Key symptoms:
- Inattention: Difficulty focusing or paying attention.
- Impulsivity: Acting without thinking, often leading to unintended consequences.
- Hyperactivity: Excessive movement or restlessness.
Misconception: Children with ADHD are not “naughty” but have an internal drive to act impulsively.
Example: A personal anecdote involving the speaker's nephew demonstrating impulsivity (throwing potatoes).
Recommended interventions:
- Behavioral therapy.
- Environmental modifications in school and hospital settings.
- Short interventions to give families respite.

Overview of cerebral dysfunction as recorded in Sakai (specific content not detailed).
Key concerns for infants:
- Weak neck muscles and underdeveloped vertebrae increase risk of head injury.
Signs and symptoms of increased intracranial pressure (ICP):
- Bulging fontanelle in infants.
- Headaches, nausea, and blurred vision in older children.
- High-pitched cry in infants indicating distress.
- Changes in activity or alertness.
Assessment: Fast neurological assessment to determine symmetry and interaction.

Explanation:
- Hydrocephalus is the abnormal accumulation of cerebrospinal fluid (CSF) in the brain.
- Treatment typically involves placement of a shunt for drainage (to peritoneum or pericardial sac).
Pre-operative interventions for managing ICP:
- Positioning (head elevated and midline).
- Low-stimulation environment.
Post-operative concerns:
- Infection risks (approximately 12% shunt infection rate in the first three months).
- Signs that the shunt may not be functioning (return of ICP symptoms).

Vulnerability of infants to trauma.
Assessment of injury severity and signs of increased pressure leading to severe complications (e.g., hemiplegia).
Return-to-play protocols for athletes to prevent complications.

Distinction between bacterial meningitis and aseptic (viral) meningitis:
- Diagnostic procedure: Lumbar puncture to obtain CSF for analysis.
- Bacterial meningitis requires aggressive treatment with antibiotics.
- The role of symptom management and monitoring for ICP.
Aseptic meningitis typically resolves on its own with minimal intervention.

Types of seizures:
- Focal seizures (start on one side of the body).
- Absence seizures (often go unnoticed as they resemble daydreaming).
Management during a seizure:
- Protect the child (e.g., cushioning the head).
- Timing and describing the seizure to aid diagnosis and medication adjustment.
Criteria for diagnosing epilepsy and considerations regarding febrile seizures.

Definition: Often a result of a one-time brain injury; unpredictable outcomes based on the injury.
Symptoms often observed include atypical crawling patterns.
Importance of multimodal therapy:
- Physical therapy (PT), occupational therapy (OT), and speech therapy.
Challenges with mobility and common concerns related to feeding and constipation management.

Description of defects commonly affecting spinal structure:
- Diagnosis often revealed through physical signs (e.g., dimples or tufts of hair).
- Potential for nerve damage if left untreated.
Surgical intervention necessary if significant deficits are identified.
- Concerns surrounding bowel and bladder control.

Condition characterized by brittle bones due to genetic mutations.
Diagnosis through ultrasounds showing fractures during pregnancy and genetic testing confirming type of OI.
Care management:
- Emphasis on safety during routine care (e.g., diaper changes).
- Regular physiotherapy and speech therapy interventions for quality of life.
Importance of supportive measures in daily activities to reduce fractures.

Notably faster healing rates in children:
- Pediatric fractures can heal in as little as two weeks.
- Bones can bend up to 45 degrees before breaking.
Signs of fracture:
- Deformity, warmth, pain, and guarding of the area.
Growth plate injuries can lead to lifelong complications.
Assessment protocols including the Six Ps:
- Pain, Pulses, Pallor, Paresthesia, Paralysis, Pressure assessment.

Definition and Symptoms:
- Acetabulum not fully engaging with the hip socket.
- Diagnosis often relies on observing asymmetries in knee heights and skin folds.
Treatment protocols vary based on severity:
- Use of Pavlik harness for infants; surgical interventions if non-invasive methods fail.

Treatment involving gradual adjustments using special casting techniques to correct foot position.

Types of scoliosis:
- Compensatory and idiopathic.
- Diagnosis may involve bracing or surgery if significant curvature is present.
Osteomyelitis defined as infection within the bone; treatment may require surgical intervention to remove infected tissue.

Diagnosis based on the number of joints involved; treatment typically involves corticosteroids and symptom management.

The presentation emphasizes both the complexity and optimism in pediatric neurology and rehabilitation, promoting advances in treatment and individual patient stories that inspire hope for better outcomes in future generations.