Term
| What is the formula for meds of a ped pt.? **** |
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Definition
| (BSA in meters sq. x adult dose) / 1.7 |
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Term
| What is the formula for body surface area? |
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Definition
BSA in sq. meters= 4 W( child's wt. In kg.) + 7/
W + 90 |
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Term
| What is the FLACC method for pain assessment? |
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Definition
| Face, Legs, Activity, Cry, COnsolability |
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Term
| Methods for Ped pain management |
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Definition
No IM's for pain in children
distract child
visualization |
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Term
| What are the primary questions the child needs anawered in regards to death? |
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Definition
Did I cause this to happen?
Could I die too?
Who will take care of me now? |
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Term
| At what age do the fontanels close? |
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Definition
Anterior fontanel - 18 mos
Posterior fontanel - 2-3 mos. |
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Term
| Infants brain is highly vascular |
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Definition
Dura can strip away from pericranium
Brain more susceptible to hemorrhage from force or if shaken
Less CSF to cushion the brain
Greater risk for cervical spine injury and compression fractures
Vertebrae not completely ossified
BRain reaches full size at 10 yrs. |
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Term
| What do bulging/depressed fontanels indicate? |
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Definition
Inc. volume of brain mass
Inc, volume of CSF
Inc. volume of blood
Depressed: dehydration, renal insufficiency, clots/strokes
vomiting/diarrhea |
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Term
| What indicates hydrocephalus in infants? |
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Definition
Inc. head circumference
split cranial sutures
bulging fontanels
stretched out paper thin skin
high pitched cry, irritable when awake
seizures |
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Term
| S/S hydrocephalus in toddlers & older children |
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Definition
Setting sun eyes, papilledema
Irritability
Seizures
Dec. LOC
Change in V/S??? |
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Term
| What is post op care for a shunt? |
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Definition
Mtr. for infection & shunt malfunction
Mtr. for abdominal distention
Mtr. for CSF infection
I&O; NPO 24 hrs.
Place flat on un-operative side
Meticulous skin care, neuro checks, medicate as ordered, education, referrals for rehab
Inc. risk for latex allergies
** If inc. ICP sit them up notify Dr.** |
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Term
| What are S/S on inc. ICP? |
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Definition
Early: Visual disturbances, diplopia, N/V, Slight change is V/S Change in papillary response, equality
Sunsetting eyes, nystagamus
Slight change in LOC
Late: significant dec. in LOC
Cushings triad (inc. SBP, widened pulse pressure, irregular respirations)
Decorticate/decerebrate posturing, fixed dilated pupils |
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Term
| What are the different types of spina bifida? |
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Definition
Occulta - posterior vertebral arches fail to fuse, no herniation
Meningocele - sac like protrusion with meninges & CSF
Myelomeningocele - sac like herniation w/ meninges, CSF, and a portion of spinal cord and nerve roots
Encephalocele - brain and meninges through defect in skull |
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Term
| Planning and intervention for Spina Bifida |
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Definition
Immediate care involves heated incubator and sterile moist dressings
Sx. repair
Sterile salind dressings; check frequently |
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Term
| Post op interventions for spina bifida |
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Definition
Pressure off back
keep clean of urine and feces |
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Term
|
Definition
| non progressive motor disorder resulting in alterations of movement and posture |
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Term
| What are the classifa=ications of CP? |
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Definition
Spastic - excessive tone;awkward stiff movements
Dyskinetic/Atheoid: worm like writhing;more severe distally
Mixed
Ataxic: disturbrd coordination; irregularity in muscle coordination or action; often walk on toes |
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Term
|
Definition
Extrusion reflex present > 6 mos.
Extreme irritability
Failure to smile by 3 mos |
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Term
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Definition
Nutrition - inc. calorie intake
Safe environment/ protective headgear
Aspiration precautions
Meds: baclophen - muscle relaxer
Possible release of tendons, intrathecal pump |
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Term
| What are the 5 stages of Reyes Syndrome |
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Definition
1. v/ lethargy
2. Combativeness, confusion (like drunk)
hyperactive reflexes
sluggish pupils
3. coma, decorticate positioning
4. decerebrate positioning
5. seizures, loss of DTR, respiratory arrest |
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Term
| What labs are used to diagnose Reye's Syndrome? |
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Definition
Liver enzymes and ammonia levels high
BS low
Elevated BUN, serum amylase, WBC
Delayed PT/PTT
***Liver biopsy - small fat deposits gold standard for Dx.*** |
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Term
| What is the P&I for Reye's syndrome? |
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Definition
Ususlly ICU, mtr. labs, pvt. complications of immobility, emotional support for family
***Meds***
Steroids
Mannitol
Dilantin (for seizures)
Vitamin K |
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Term
| What is status epilepticus? |
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Definition
Continues seizure x 10-15 min or series of short seizures from which child does not regain pre seizure LOC
TX: Airway, O2
IV Valium, phenpbarb or ATIVAN (over 2 yrs old, longer duration, less resp. distress)
Rectal valium (diastat) |
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Term
| What is a ketogenic diet? |
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Definition
Contraversial
High fat, low carb, low protein
Ketosis slows electrical impulses |
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Term
| What tx. are for children w/ seizures who do not respond to meds? |
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Definition
Surgury to remove focus
Implantation of vagal nerve stimulator |
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Term
| What are the S?S of trisomy 21? |
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Definition
Epicanthal fold
Palprebral fissure slants upward
Broshfirld's spots (white specks in iris)
Nose is broad and flat
Protruding tongue (because oral cavity is smaller than normal)
Ears low set
Back of head is flat,neck is short joints hyper extensive, fingers short, simean crease of palm
often rumination |
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Term
| What other defects are associated with trisomy 21? |
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Definition
Altered immune function
Congenital heart disease
Duodonal stenosis or atresia
strabismus, cataracts
acute lymphocytic leukemia 20x more fqt. |
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Term
| What are the different classifications of Mental Retardation? |
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Definition
Mild - capable of independant living w/ assistance during times of stress ~ 6th grade level
Moderate- can perform some activities independently; needs supervision ~ 2nd grade level
Severe - may be trained in elementary hygiene skills; needs constant supervision; minimal verbal skills
Profound- no capacity for independant living; requires constant supervision; no capacity for socialization skills |
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Term
| What is the name of the standard developmental test for IQ? |
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Definition
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