Clinical manifestations of ________ include:

Sudden or gradual onset of:

-Malaise and fever

-Stiff neck

-Headache

-Dizziness

-Nausea/vomiting

-Ataxia

-Tremors or speech difficulties

Within the United States, the vector reservoir for ______ is mosquitos and ticks. This means most cases of _________ appear during the hot summer months and subside during autumn.

Nursing care management for encephalitis includes which of the following?

Select all that apply!

In encephalitis, there can be a variety of causative organisms, with most infections being associated with viruses. Therefore, the enterovirus tends to be the most common etiology.

Which of the following diseases or diagnoses would require a child to be under droplet precautions while hospitalized?

Select all that apply!

If a child is suspected of having meningitis, he/she will need a private room or a room with patients who have an infection from the same microorganism. The child will have equipment dedicated only to him/her. Providers and visitors will also need to wear a mask. This describes what type of infection control precaution?

Name the type of infection control precaution:

Generated from the source person mainly through coughing, sneezing, or talking, and during procedures like suctioning and bronchoscopy.

Transmission requires close contact between source and recipient.

The particles do not remain suspended in the air very long and generally travel short distances (3 feet or less).

Normal pulse for a 3 year old is what?

Normal respirations for a 3 year old is what?

Normal blood pressure for a 3 year old is what?

Select 2!

The adrenal cortex is responsible for the secretion of sex hormones, which of the following hormones does that include?

Select all that apply!

Which of the following hormones are secreted by the anterior pituitary?

Select all that apply!

Virazole (Ribavirin) is an anti-viral medication used to treat infants and young children who have a severe lung infection caused by a certain virus (RSV). Nearly all children become infected with RSV before they are 3 years old and is used to treat severe RSV infections that require hospitalization. How is this medication administered?

Following an amputation (such as for osteosarcoma), about 60% to 80% of patients will develop phantom limb pain. They may experience tingling, itching, and pain felt in the amputated limb. How is this treated?

Select all that apply!

In looking at burns in children, the front and back of the child's head EACH represents what percentage of total body surface area injured?

In looking at burns in children, the front and back of the child's arms EACH represents what percentage of total body surface area injured?

In looking at burns in children, the front and back of the child's torso EACH represents what percentage of total body surface area injured?

In looking at burns in children, the front and back of the child's legs EACH represents what percentage of total body surface area injured?

Severity of the child's burn depends on several things, with the acronym of SLASH being used. How big the burn is represents what?

Severity of the child's burn depends on several things, with the acronym of SLASH being used. Burning your pinky vs burning your mouth and esophagus represents what?

Severity of the child's burn depends on several things, with the acronym of SLASH being used. Very young children are at an increased risk following a burn because their immune systems are still not fully developed yet is an example of what?

Severity of the child's burn depends on several things, with the acronym of SLASH being used. Looking at how the child got injured, whether it be from drinking something like Drano or touching a hot stove represents what?

Severity of the child's burn depends on several things, with the acronym of SLASH being used. Whether the child is a cancer patient, is receiving tube feedings, or is already immunocompromised at the time of the burn represents what?

Which of the following are potential sources of burns in children?

Select all that apply!

True or false:

Following a child getting burned and the burn was accidental and unintentional, one of the most important things for the parents/caregivers is to teach them how to avoid something like this happening again in the future. Blaming or pointing fingers is not helpful.

In order to help prevent burns in children, the water heater should be set BELOW what temperature?

When managing care for a child that has experienced a burn, the nurse will assess the status and timeframe of fluid resuscitation. The calculation of fluid replacement begins when?

Following a rape or sexual assault, a SANE nurse (sexual assault nurse examiner) will do a diagnostic evaluation with the survivor which will include what?

Select all that apply!

A SANE nurse will collect physical evidence following a rape or sexual assault. Collection of physical evidence includes what?

Select all that apply!

Name the term:

The lateral inward curve of the cervical or lumbar curvature (AKA an inward curvature of the lower back). During pubertal growth spurts, it can be seen in varying degrees in teenagers, especially girls. Will usually be accompanied by pain.

Name the term:

Lateral convex angulation in the curvature of the thoracic spine (AKA an outward curvature of the upper back). Children, especially during time when skeletal growth outpaces growth of muscle, are prone to exaggeration of this. Especially common in adolescent girls who assume a round, shouldered slouching posture in an attempt to hide developing breasts and increasing height.

Name the term:

A complex spinal deformity in three planes, usually involving lateral curvature and spinal rotation causing rib asymmetry. All school-age children get screened for this by examining for a lateral curvature of the spine before and during growth spurts. Observer stands behind child and may note asymmetry of shoulder height and hip height. Child bends forward at waist so trunk is parallel to the floor with arms hanging free.

Name the term:

Limited range of motion may indicate ________, in which the child holds the head to one side with the chin pointing toward the opposite side as a result of a congenital disorder or injury to the sternocleidomastoid muscle.

What is important to know about growth plate (physeal) injuries?

Select all that apply!

This is a clinical finding associated with hypocalcemia (low levels of calcium in the blood). This sign is positive when twitching in the facial muscle is evident upon gently tapping the child's cheek, in front of the ear. Can be a sign of tetany and may be present in chronic renal failure and acute renal failure.

Name the hormone:

Feminizing hormone

Low production during childhood for both males and females

Gradual production of this hormone for males throughout maturation

In females, this level increases until approximately 3 years after menarche. Then, ______ remains at the maximum level through female's reproductive life.

Male feminization of a young child results from more _____.

Name the hormone:

Masculinizing hormone.

Secreted in small and gradually increasing amounts up until 7 to 9 years of age.

Following this, levels will rapidly increase in both sexes until the age of 15.

______ are responsible for rapid growth of early teenagers.

Name the hormone:

Secreted by the testes.

Promotes development of secondary sex characteristics.

Plays a role in sexual function.

Stimulates the testes to produce spermatozoa.

Accelerates protein anabolism for growth.

Name the hormone:

Is a glucocorticoid secreted by the adrenal cortex.

Mobilizes body defenses during periods of stress.

Helps manage how our body uses carbohydrates, proteins, and fats.

Suppresses inflammatory reaction.

Name the term:

A classification aimed at grouping individuals who share common characteristics unique in comparison to others in a society, resulting in a distinctive, cultural behavior. _____ can be differentiated from one another by customs and language, and may influence family structure, food preferences, and expressions of emotion.

Name the term:

A term that groups together people by their outward, physical appearance.

Name the term:

From very early infancy, children show interest and pleasure in the company of others. Initial social contact is with the mothering person. Through interactions with other children, they learn to establish social relationships and solve problems associated with these relationships. Learn to give and take, learn sex roles that society expects them to fill, and learn approved patterns of behavior. Children also develop morals and ethics (right from wrong and taking responsibility for their actions).

Name the term:

Is dynamic in nature. It not only includes race and ethnicity, but also social class, age, sexual orientation, sexuality, gender, ability, and professional discipline. It is a way of life for a group of people.

How is acute streptococcal pharyngitis (strep throat) treated?

Select all that apply!

True or false:

If a child is being treated for acute streptococcal pharyngitis (strep throat), it is generally recommended that the child not return to school or daycare until he/she has been taking antibiotics for a full 24-hour period. School nurse should recommended parents discard child's toothbrush and replace it with a new one after taking antibiotics for 24 hrs.

True or false:

When taking antibiotics, the child MUST take the entire course (typically 10 days), even if the child is feeling better and symptoms disappear? For strep throat, for example, if the child does not take the full course of antibiotics, they are at risk of developing additional complications such as scarlet fever or acute rheumatic fever.

If a child is receiving an IV antibiotic (like amoxicillin) for a bacterial infection (such as to treat meningitis) and develops a rash, what should be done?

Select all that apply!

Which of the following foods are high in potassium?

Select all that apply!

True or false:

Side effects of abruptly stopping cortisone (a glucocorticoid) are adrenal insufficiency (fever, fatigue, muscle weakness, anorexia). You should not abruptly discontinue the medication and child must be tapered off the medication. Can also lead to manifestations of Cushing's syndrome (round face, edema, weight gain).

Name the level on consciousness:

No motor or verbal response to noxious (painful) stimuli.

A state of unconsciousness from which the patient cannot be aroused, even with powerful stimuli.

Name the level of consciousness:

Arousable with stimulation.

Is a dulled, reduced, or diminished level of alertness or consciousness.

Child will experience a diminished responsiveness to stimuli.

Name the level of consciousness:

A serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment.

Develops suddenly and can be reversible.

Name the level of consciousness:

Impaired decision making.

Is a hallmark sign of a head injury.

Inability to think as clearly or quickly as you normally do.

Can be disoriented and have difficulty paying attention, remembering, and making decisions.

May be confused regarding time, place, and/or person; decreased level of consciousness.

Known as a nephroblastoma

A malignant renal and intra-abdominal tumor of childhood

Three times more common in African American children

Peak age of diagnosis is 3 years old

Occurs more frequently in males

Initial assessment finding is abdominal swelling

True or false:

If a Wilms tumor is suspected, DO NOT palpate the child's abdomen.

Expected findings for Wilms tumor include what?

Select all that apply!

True or false:

For viral pneumonia, treatment is symptomatic. Includes measures to promote oxygenation and comfort (like administering oxygen, chest percussion, and postural drainage), antipyretics (to treat fever), monitoring fluid intake, and family support. NO ANTIBIOTICS ARE GIVEN!

An inflammatory disease that occurs as a reaction o GABHS infection of the throat.

Will typically occur within 2 to 6 weeks following an untreated or partially treated upper respiratory infection (strep throat) with GABHS.

S/S: tachycardia, cardiomegaly, new or changed heart murmur, large joints with painful swelling; pink, non-pruritic macular rash on trunk and inner surfaces of extremities that appears and disappears rapidly.

Which of the following are developmentally appropriate gross motor skills for an 18 month old?

Select all that apply!

Which of the following are developmentally appropriate fine motor skills for an 18 month old?

Select all that apply!

Is the diminished or deficient secretion of pituitary hormones (primarily growth hormone or somatotropin). The consequences of the condition will depend on the degree of the deficiency.

Growth hormone deficiency (somatotropin) can result in which of the following?

Select all that apply!

True or false:

If a child is being given a growth hormone, it should be done at night because that is when the child typically does the most growing. It is done through subcutaneous injection.

Occurs more frequently in boys and may be visible as a mass in the scrotum.

Is a protrusion of peritoneum through the abdominal wall in the inguinal canal.

Will most often be visible when an infant cries or strains (like during a bowel movement) or when older children strain, cough, or stand for long periods of time.

How is an inguinal hernia treated?

Select all that apply!

This is the most common permanent physical disability in childhood that may involve sensation, perception, communication, cognitive, and behavior.

This type of cerebral palsy is hypertonicity (muscle tightness or spasticity), increased DTRs, clonus (involuntary muscle contractions), and poor control of motion, balance, and posture

In what percentage of cases of cerebral palsy is there no identifiable cause?

This type of cerebral palsy includes:

-Involuntary jerking movements that appear slow, writhing, and wormlike (can involve the extremities, trunk, neck, face, and tongue)

-Drooling and speech impairment

-Emotional stress can make the movements worsen

This type of cerebral palsy is characterized by:

-Wide-based gait and difficulty with coordination

-Poor ability to do repetitive movements

-Lack of coordination with purposeful movements (like reaching for an object)

-Inability to hold onto objects

Characterized by:

Abnormal muscle tone

Decreased sensation

Decreased communication

Decreased cognition

Decreased coordination

Altered mobility

Seizures

Hearing and vision impairment

True or false:

Cerebral palsy is a group of permanent disorders involving the development of movement and posture. It limits activity related to a non-progressive disturbance in the developing fetal or infant brain.

True or false:

Cerebral palsy is non-progressive. Some children may have cerebral palsy and we will not even know it due to the varying degrees of this disorder.

Signs and symptoms:

-Barking cough

-Hoarse cry

-Retractions

-Stridor

-Cyanosis

-Decreased level of consciousness (LOC)

The Westley Croup Scale can categorize croup as mild, moderate, or severe based on scores (0 to 2) for each of which of the following categories?

Select all that apply!

(Score less than 3 = mild disease; score of 3 to 6 = moderate disease; score greater than 6 = severe disease)

Croup syndrome is considered an emergency. While you are waiting for the ambulance or for someone to arrive to take the child to the hospital for immediate treatment, what should you do?

In regard to Freud, what stage of development would an 8 year old school-age child be in?

This is the time of the child elaborating on previously acquired traits and skills. Phyiscal and psychic energy are channeled into acquisition of knowledge and vigorous play.

In regard to Erikson, what stage of development would an 8 year old school-age child be in?

The child is exploring the physical world with all their senses and powers. They have an inner voice that warns and threatens and are no longer guided by outsiders. The child knows he/she cannot master every skill and will feel bad if they cannot measure up to the standards that are set for them by others. They need and want achievement and engage in tasks they can carry through to completion.

In regard to Piaget, what stage of development would an 8 year old school-age child be in?

The child is able to tell time and can see the perspectives of others and can solve problems. Have sense of conservation (physical factors stay the same even though outward appearances will change). Transition to conceptual thinking and can deal with a number of different aspects at the same time.

Drowning prevention for infants include what?

Select all that apply!

Drowning prevention for this age group include:

Do not leave them unattended in bathtubs

Keep toilet lids closed

Closely supervise when near pools or any body of water

Teach them how to swim

Drowning prevention for this group includes:

Do not leave unattended in bathtubs

Closely supervise them near the pool or any body of water

Teach them how to swim

Drowning prevention for this group includes:

Supervise them when swimming or when near a body of water

Teach them to swim

Encourage breaks to prevent them from becoming over-tired

Check depth of water before allowing them to dive

True or false:

Drowning prevention for adolescents includes:

Teaching them to swim and to not swim alone

Prevention for motor vehicle accidents for this group includes:

Encourage them to attend driver's ed courses

Adhere to seat belt use at all times

Discourage use of cell phones when driving and abide by all laws

Insist on helmet use when riding a bike, motorcycle, skateboard, etc.

Teach dangers of combining substance use with driving

Role model desired behaviors

Prevention of motor vehicle injury for this age group includes:

Use of approved car seat restraint system until they achieve a height for 4 ft 9 in

Teach appropriate seat belt use when no longer using a car restraint system or booster seat

Safest place is in the backseat of the car

Never let them ride in bed of a pickup truck

Always wear a helmet and/or pads when riding a bike

Prevention of motor vehicle injury for this group includes:

Use of federally approved car restraint

When forward-facing car seat is outgrown, use of a booster seat

Safest area for child is in the backseat

Supervise them when playing outside and do not allow them to play near cars or the curb

Important pedestrian safety for preschoolers include:

Select all that apply!

Prevention of motor vehicle injury for this age group includes:

Remain in rear-facing car seat until the age of 2

After 2 years of age, move to forward-facing car seats

Safest place is in the backseat

Do not place rear-facing car seats in the front seat of vehicles with deployable passenger airbags

True or false:

To treat ottitis media, the child will be prescribed antibiotics. In addition, treatment will include supportive care (treating pain and fever). If severe or recurrent chronic ottitis media takes place, myringotomy (surgical incision of the eardrum to alleviate pain) or tympanovstomy tube placement and adenoidectomy.

Treatment for a child who had tonsils and adenoids removed include what?

Select all that apply!

Laboratory tests for this include:

-Elevated blood sugar

-Glucosuria

-Ketones in the urine

Signs and symptoms include:

-Polyphagia (excessive hunger)

-Polyuria (excessive/frequent urination)

-Polydipsia (excessive thirst)

-Weight loss

-Fatigue

-Dry skin

-Headache

-Shortened attention span (differs from what their normal is)

-Flushing of skin

-Slowed wound healing

True or false:

If a child needs insulin, there is no "set" age or time for when they can become active participants. When the child expresses interest in wanting to help with the insulin process, the parent or caregiver should let them!

Can start out with prepping site with alcohol swab or picking a site they want the injection in or pinching their skin while you inject the insulin.

True or false:

If the glucometer reading is high when you check the blood glucose of a child, you should immediately begin treating the high reading. There is no need to recheck or use a different glucometer

This is characterized by a total or partial deficiency of the hormone insulin.

It is the most common endocrine disorder of childhood.

Peak incidence is in early adolescence (between 10 and 15 years).

This is characterized by the destruction of beta cells, usually leading to absolute insulin deficiency.

Typically, the onset is in childhood and adolescence but can occur at any age.

Most cases in childhood are this type.

Can be idiopathic, meaning rare form with no known cause

Arises because of insulin resistance

Onset is typically after age of 45

Affected persons may or may not require insulin injections.

Signs and symptoms include:

-Wheezing

-Breathlessness

-Chest tightness

-Cough

-Retractions

-Use of accessory muscles to breathe

This term is a physical sign that you are not getting enough air and your body is working harder in order for you to breathe. You can physically see the child's chest going in and out as they breathe. Common symptom of asthma and croup syndrome.

In asthma, the more frequent onset is when?

Select all that apply

True or false:

Children with asthma should not play outside at dawn or dusk. This is when the air is considered to be "too heavy," meaning pollen and mold counts tend to be the highest.

Triggers for this include:

-Allergens

-Respiratory tract infections (RTIs)

-Exercise

-Environmental irritants (like mold or pollen)

-Environmental temperature changes (such as when the air suddenly turns cold)

True or false:

When your child has asthma, it is not about avoiding triggers (such as cat or dog hair), it is about proper care and management

-After petting a cat or dog, teach the child to wash hands and face and change his or her clothes

-Use an inhaler if asthma is exercise induced

This is the most common malignant extra-cranial solid tumor of childhood. The majority of these tumors will develop in the adrenal or retroperitoneal sympathetic chain but can also develop in the head, neck, chest, and pelvis.

While signs and symptoms of a neuroblastoma tend to vary depending upon the location and stage of the disease, typical signs and symptoms include what?

True or false:

If a neuroblastoma is diagnosed in infancy, the prognosis will be very good.

True or false:

Metastasis may have already occurred before a diagnosis of neuroblastoma has been made?

True or false:

During the preschool years (3 to 6), prolonged separation can provoke anxiety. Favorite toys and appropraite play should be used to help ease their fears.

Explain procedures using simple, clear language. Avoid medical jargon.

Encourage independence by letting child provide self-care.

Encourage them to express feelings.

Validate the child's fears and concerns.

Provide toys that allow for emotional expression.

Provide consistency to assigning caregivers.

Give choices when possible ("Do you want your medicine in a cup or spoon?")

Allow younger children to handle equipment if it is safe.

True or false:

Bacterial conjunctivitis is often referred to as "pink eye."

Clinical manifestations of bacterial conjunctivitis include:

Select all that apply!

True or false:

To treat bacterial conjunctivitis, antibiotic eyedrops will often be prescribed? The eyedrops should immediately be instilled after the eyes have been cleaned to remove crusting that can accumulate on the eyes. Washcloth and towel used to clean eyes should be kept separate from other family members to prevent infection.

Signs of ICP in newborns and infants includes what?

Select all that apply!

Manifestations of ICP in children include what?

Select all that apply!

True or false:

ICP is a complication of bacterial meningitis?

In Down syndrome (also known as trisomy 21) there is an extra chromosome 21 in approximately ____ to ____ of cases.

True or false:

In Down syndrome, the etiology is known

True or false:

Down syndrome is the most common chromosomal abnormality (about one in 800 to 1000 live births). In addition, it is also the most common genetic cause of intellectual disability. 

While the exact etiology of Down syndrome is unknown, there appears to be a maternal age component as a risk factor for having a child with Down syndrome. For 80% of Down syndrome infants, the mother is older than _______.

Manifestations of Down syndrome can include which of the following?

Select all that apply!

In a child with Down syndrome, heart defects, especially septal defects, are present in ______ to ______ of cases.

Many medical conditions can accompany Down syndrome, including which of the following?

Select all that apply!

True or false:

Infants with Down syndrome may be difficult to hold because they may have limp, extended body position. Therefore, the nurse may need to assist the parents/caregivers with holding and bonding with their child.

Nursing considerations for a child with Down syndrome include what?

Select all that apply!

True or false:

Bone age refers to a method of assessing skeletal maturity by comparing the appearance of representative epiphyseal centers obtained on x-ray examination with age-appropriate published standards.

True or false:

When assessing for hypopituitarism, a skeletal survey in children younger than 3 years old and radiographic examination of the hand and wrist for centers of ossification (bone age) in older children are important in evaluating growth.

Laboratory tests for ________ meningitis include CSF analysis. The results will be as follows:

Cloudy clear color

Elevated WBC count

Elevated protein content

Decreased glucose content

Postiive gram stain

True or false:

A diagnostic procedure for bacterial meningitis is a lumbar puncture

Nursing care for bacterial meningitis include what?

Select all that apply!

Nursing actions for a lumbar puncture for suspected bacterial meningitis include what?

Select all that apply!

True or false:

An osteosarcoma peaks at age 15 during growth spurts and is more common in boys than girls.

True or false:

With an osteosarcoma, the child may need to have an amputation, which is when phantom limb pain can take place

Cast care can include which of the following?

Select all that apply!

Important cast care teachings include what?

Select all that apply!

True or false:

If an adolescent comes to the clinic with her father, the nurse knows that it may be best to ask the father to step out of the room when talking to the adolescent. This could facilitate discussion with the adolescent as she may be more likely to speak with you regarding things like drug and alcohol use or engaging in sexual activity

When having a conversation with an 18 year old regarding sexuality, which of the following methods should the nurse include?

Select all that apply!

True or false:

Shaken baby syndrome is a type of contusion a child may receive. It is due to the brain bouncing back and forth inside the skull.

Results in profound neurologic impairment, seizures, retinal hemorrhages, and intracranial hemorrhage, along with other skeletal injuries

True or false:

A caregiver's frustration, such as the baby continuously crying combined with maternal fatigue and exhaustion, can lead to shaken baby syndrome? We want to ensure the parents or caregivers that it is okay to leave the baby in a safe space, like his or her crib, for a few minutes while the baby just cries. This can give the caregivers or parents a few moments to collect themselves before caring to the baby.

A diagnosis of epilepsy is made if a child has two unprovoked seizures at least _____ hours apart, or if a single unprovoked seizure occurs during a time period of 10 years following two unprovoked seizures

Risk factors for ________ include:

Trauma

Hemorrhage

Congenital defects

Anoxia

Infection

Hypoglycemic injury

Migraine

Cardiovascular dysfunction

True or false:

The onset of epilepsy in children is highest during the first few months of life. In addition, children with an intellectual disability, cerebral palsy, and/or autism spectrum disorder are more likely to have epilepsy compared to their peers.

Name the type of seizure:

Considered a type of epilepsy

Onset is in the first 6 to 8 months of life and rarely occurs after 2 years of age

Usually is associated with some degree of cognitive impairment, cerebral anomalies, or a congenital metabolic defect

Cause is a possible disturbance of the central neurotransmitter regulator at a specific phase of brain development

True or false:

During an infantile spasm, the infants head and neck will flex forward with the knees drawn up. There is no postictal drowsiness and the infant may or may not lose consciousness. Typically is 2x more frequent in male infants.

Acute or chronic:

Inability of the kidneys to excrete waste material, concentrate urine, and conserve electrolytes

Acute or chronic:

Begins when the diseased kidneys can no longer maintain the normal chemical structure of body fluids under normal conditions, and there is extensive irreversible damage to the nephrons.

A variety of diseases and disorders can result in this.

Acute or chronic:

Expected findings may include-

Occasional elevated blood pressure

Decreased or increased urinary output and compensatory increase of fluid intake

Uremic odor to breath

Weight loss

Puffiness to face

Itchy, bruised skin

Circulatory overload (hypertension, congestive heart failure, and pulmonary edema)

Neurologic involvement (tremors, muscle twitching, seizures, coma)

Acute or chronic:

Nursing care may include-

Restricting fluids if edema is present

Monitor daily weights

Manage hypertension

Maintain sodium restriction

Provide rest and monitor for infection

Encourage parents to maintain dialysis schedule

Chronic or acute:

Risk factors can include

Pre-renal (most common cause is classified as this)-

Dehydration secondary to diarrheal disease or persistent vomiting

Accidental poisoning

Prolonged anesthesia

Surgical shock and trauma (including burns)

Acute or chronic:

Expected findings may include any of the following-

Oliguria

Abrupt diuresis with return to normal urine volumes

Edema

Circulatory collapse

Cardiac arrhythmia from hyperkalemia (irregular, weak pulse, abdominal cramps)

Seizures from hypocalcemia (tetany)

Acute or chronic:

Nursing care can include-

Treating the underlying cause

Monitor strict I&O

Limit fluid intake

Obtain daily weights

Assess for behavioral changes or seizure activity/implement seizure precautions

Provide replacement IV fluids slowly

Urinary catheterization

True or false:

Immediately following a head injury, the child's spinal cord should be stabilized until spinal cord injury is ruled out.

True or false:

Most spinal cord injuries occur in the adolescent age group

Clinical manifestations of a spinal cord injury can include what?

Select all that apply!

Therapeutic management of a spinal cord injury includes which of the following?

Select all that apply!

True or false:

Following a spinal cord injury, the child may experience a neurogenic bladder. This is when the bladder is denervated (the bladder wall will become flaccid). This lack of muscle tone inhibits bladder's ability to respond to changes in passive pressure, leading to over-distention. Periodic emptying is needed.

This is the inflammation of the vermiform appendix caused from an obstruction of the lumen in the appendix.

Average age of the child is 10 years.

Common symptoms:

-Anorexia

-Periumbilical pain, followed by right lower quadrant pain

-Fever

-Vomiting

-Focal tenderness

-Decreased or absent bowel sounds

Rebound tenderness is a common indicator of what?

Where is McBurney's Point?

This is typically assessed at McBurney's point for acute appendicitis. It is a clinical sign in which there is pain upon removal of pressure rather than application of pressure to the abdomen.

Management for this includes

-Preoperative IV antibiotics

-Replacement IV fluids and electrolytes

-Surgery

-Keep them NPO (have a "hot abdomen")

Acute or chronic:

Most common cause is severe dehydration

Acute or chronic:

Common complication is water and sodium retention

Which statements are true regarding Wilms tumor (nephroblastoma)?

Select all that apply!

A child that has chronic kidney failure may have a uremic fetor and bad breath that can be described as tasting like what?

Treatment for central precocious puberty includes which of the following medication?

This is defined as sexual development before:

-Age of 9 in boys

-Before age 7 in Caucasian girls

-before age of 6 in African American girls

If a child is taking Lupron to treat central precocious puberty, when should the child be taken off of it?

Which type of dialysis is this (for CRF)?

-Can be done at home

-Is a more convenient form of dialysis

-Family members can be taught how to do this to the child

-Can take place at night while child is sleeping

-Children may choose this form of dialysis because it is less likely to cause changes/disruptions to the child's school schedule

Which type of dialysis is this?

-Done at a center

-Done 3x a week for a few hours at a time

-Dialysis machine is used to filter waste products and water from the blood

True or false:

When a child gets a renal transplant (like for CRF), they will be on immunosuppressant medications. The child cannot stop taking these medications unless the doctor orders the child to do so

Congestive heart failure in children:

This is characterized by-

Tachycardia

Fatigue

Weakness

Restlessness

Pale, cool extremities

Decreased blood pressure

Decreased urinary output

Congestive heart failure in children:

This is characterized by-

Tachypnea

Dyspnea

Respiratory distress

Exercise intolerance

Cyanosis

Congestive heart failure in children:

This is characterized by-

Peripheral and periorbital edema

Weight gain

Ascites (excess abdominal fluid)

Hepatomegaly

Neck vein distention

Inflammatory disease occurring after GABHS infection (strep throat).

Infrequently seen in the United States but is a big problem in developing countries.

Is self limiting (affects joints, skin, brain, serous surfaces, and the heart).

True or false:

Rheumatic heart disease is the most common complication of rheumatic fever.

It is damage to the valves of the heart as a result of rheumatic. fever.

Pre-pubescence takes place about ____ years prior to puberty that brings about physical changes

True or false:

Puberty is the time when sexual maturation is achieved

Post-pubescence is ________ years after puberty. This is the time when skeletal growth is complete and reproductive functions become established.

True or false:

Primary sex characteristics play a direct role in reproduction while secondary sex characteristics play no direct role in reproduction

Sexual maturation in females:

From 8 to 13 years of age.

Breast buds present (the initial indication of puberty).

Sexual maturation in females:

8 to 13 years old.

Pubic hair growth on the mons pubis.

Sexual maturation in females:

Occurs about 2 years after the appearance of the first pubescent changes (thelarche).

Mean age is 10 1/2 to 15 years old

Time when menstruation begins.

Sexual maturation in males:

9 1/2 to 14 years old

Time when there is sparse pubic hair.

Testicular enlargement takes place

Sexual maturation in males:

Penile enlargement.

Voice changes.

Early facial hair.

Gynecomastia may take place (temporary breast enlargement that will occur in about 1/3 of males in mid-puberty).

Sexual maturation in males:

Penile growth (will now be adult in size and shape).

First ejaculation will take place.

Axillary, groin, and facial hair growth.

Final voice changes will take place.

True or false:

During puberty, adolescents will experience a growth spurt. They will gain about 20% to 25% of their total height.

For example, if someone is 5 feet tall, they will grow about 1 to 1.5 feet during puberty.

Will typically occur in a 24 to 36 month period.

Repetitive microtrauma.

Inflammation of the involved structure.

Coplaints of tenderness, swelling, and disability.

Examples are tennis elbow and Osgood-Schlatter disease.

Stress fractures which can occur as a result of repeated muscle contractions.

Are seen most often in repetitive weight-bearing sports.

Common symptoms are sharp, persistent, progressive pain or deep dull aches.

Pain will usually occur over the involved bony prominence.

Diagnosis is made based on clinical observations and possibly a bone scan.

True or false:

For overuse syndrome-

If a child comes in with a lower back injury (like from playing baseball) we check the child for bruising. We also may need to have the child's urine checked for presense of blood (hematuria). We have to think outside the box to determine what is going on.

Child may have a bruised kidney or some form of damage to the kidney(s).

A child sustained a lower back injury playing baseball. It is suspected he may have bruised his kidney. What diagnostic tests may be performed?

Select all that apply!

Which of the following are treatment options for a bruised kidney?

Select all that apply!

For children, what is proper positioning for pneumonia?

Select all that apply!

True or false:

A sprain occurs when trauma to a joint is so severe that a ligament is partially or completely torn or stretched. Common sites are ankles and knees. In severe injuries, child may complain that "something is coming apart," or may describe hearing a "pop," "snap," or "tearing."

Basic therapeutic management for a possible ankle sprain can be thought of using the acronym RICE, which stands for what?

Select all that apply!

Basic therapeutic management for a possible ankle sprain can be thought of using the acronym ICES, which stands for what?

Select all that apply!

When treating an ankle sprain, ice will help to reduce edema and pain. It should NEVER be left on longer than ______ min.