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WorksheetsQuiz 3 pediatrics GVLTEC
Total questions: 133
Worksheet time: 2hrs 3mins
s/s of hypercalcemia
polyuria and polydipsia
lethargy
nausea and vomiting
hypotension
if an immobilized patient is going to develop hypercalcemia it's usually (a) weeks after they've been immobilized
physical effects of immobility include
hypercalcemia
decrease metabolic rate
increased metabolic rate
decrease production of hormones
what are some of the effects of immobility r/t cardiovascular system
diminished vasopressor mechanism
venous stasis
dependent edema
hypertension
damage to soft tissue, subcutaneous tissues, and muscle. This occurs when blood escapes into the tissue and causes ecchymosis
(a)
when the force of stress on a ligament is sufficient to displace the normal position of the bone ends or bone ends to the socket
(a)
most vulnerable joint for dislocation
(a)
the dislocation that occurs frequently in pediatric patients
(a)
trauma to a joint from a ligament partially or completely torn or stretched by the force
(a)
stretching or tearing of the muscle or tendon
(a)
what's the difference between sprain and strain
a sprain is trauma to a joint from a ligament torn or stretched by the force
a strain is trauma to a joint from a ligament torn or stretched by the force
strains are caused by stretching or tearing of the muscle and ligaments
sprains are caused by stretching or tearing of the muscles and ligaments
(a) happen overtime and are painful
(a) have a rapid onset with disability
occurs when the resistance between a bone and an applied stress yields to the stress, resulting in a disruption to the integrity of the bone
(a)
common ways fractures occur
falls
bikes, scooters, etc.
sports
abuse
2 most common fractures
(a)
fractures heal much faster in pediatric patients becasue (a) is faster due to a thicker periosteum and good blood supply
the bone is bend no more than 45 degrees without breakage
(a)
compression of the bone resulting in a bulge or raised area at the fracture site
(a)
incomplete fracture of the bone
greenstick
buckle
plastic deformation
spiral
break is straight across the bone
transverse
oblique
spiral
stress
the break is diagonal across the bone
(a)
small fractures/cracks in the bone due to repeated muscle contractions
(a)
clinical signs of fracture
generalized swelling
bruising
muscle weakness
crepitus
what are some therapeutic management used for fractures
reduction
immobility
Pavlik
pamidronate
typically made of either plaster of Paris or synthetic lighter material (ex. ortho glass)
(a)
know 6 P's
pain
pulse
pallor
paresthesia
paralysis
poiklothermia
uses a pulling force that is applied by weights
skin traction
skeletal traction
halo traction
Can't be used in patients over (a) lbs
uses a continuous pulling force that is applied directly to a skeletal structure or specific bone
(a)
something that should always be available when caring for patients with halo
(a)
nurses should never remove____ or ____
(a)
a complex deformity of the ankle and foot; can affect one or both feet, occur as an isolated defect, or in association with other disorders
(a)
risk factors for developmental dysplasia of the hip
firstborn
female
breech intrauterine position
age between 2-12 y/o
treatment option for club foot
serial casting
heel cord tenotomy
Pavlik harness
harrington rod placement
complication of club foot
skin breakdown
growth and developmental delays
neurovascular alterations
infection
consist of a variety of disorders resulting in abnormal development of the hip structures
(a)
types of developmental dysplasia of the hip
acetabular dysplasia
subluxation
dislocation
disassoiation
how to diagnose developmental dysplasia of the hip
ultrasound at 2 weeks of age
ultrasound at 4 weeks of age
x-ray: in infants older than 4 months
CT scan
2 diagnostic tests used for developmental dysplasia of the hip
(a)
in older children what test is used to diagnose developmental dysplasia of the hip
(a)
infant presents with a shortened limb on the affected side, limited hip abduction. You notice uneven gluteal folds when the infant is prone. What would you suspect?
(a)
Treatment for DDH for newborns-6 months
(a)
treatment for DDH 6 months-2 years
(a)
treatment of DDH for older children
(a)
aseptic necrosis of the femoral head either unilateral or bilateral
(a)
stages of legg-calve-perthes disease
synovitis
necrotic
fragmentation
reconstruction
risk factor for Legg-calve-Perthes disease
age (between 2-12 y/o, most common between 4-8 y/o)
trauma
short stature
genetic factor
x-ray of the hip and pelvis and MRI are diagnostic procedure for
(a)
assessment and evaluation of a patient with Legg-Perthes disease
intermittent painless limp
shortening of the affected leg
limited ROM
muscle weakness
complication of Legg-calve-Perthes disease
joint degeneration
permanent disability
osteoporosis
hearing loss
an inherited connective tissue condition that results in bone fractures and deformity along with restricted growth
(a)
diagnostic for osteogenesis imperfecta
(a)
multiple bone fractures, blue sclera, early hearing loss, and small discolored teeth are s/s of
(a)
treatment for osteogenesis imperfecta that is given IV over at least 2 hours and up to 24 hours.
(a)
a complication of osteogenesis imperfecta
disuse osteoporosis
hearing loss
permanent deformities
necrosis of affected limb
type of DDH where there's a delay in acetabular development (acetabular roof is shallow and oblique)
(a)
incomplete dislocation of the hip is what type of DDH
(a)
type of DDH where the femoral head does not have contact with the acetabulum
(a)
a complex deformity of the spine that also affects the ribs
(a)
The 2 most common types of scoliosis
(a)
bracing is used with a curve of (a) degrees
post-op infection, spine or nerve damage, small bowel obstruction, and breathing difficulties are complications associated with
(a)
non-progressive impairment of motor function, especially that of muscle control, coordination, and posture
(a)
cerebral palsy risk factors
existing brain anomalies
head trauma or interruption of oxygen
maternal drug use or genetic factor
premature and VLBW infants
maternal infection
cerebral palsy can be spastic or non-spastic, what are some s/s associated with spastic
hypertonicity, increased deep tendon reflexes, poor control of motion, balance and posture
wide-based gait and difficulty with coordination
can be present in different extremities
impairment of fine and gross motor skills
Babinski reflex
how can you diagnose for scoliosis
forward bend
X-RAY
CT
MRI
diagnostics for cerebral palsy
neuro assessment
genetic and metabolic testing
MRI
EEG
interprofessional care for CP includes
PT
OT
speech therapy
medication for CP that is a skeletal muscle relaxant. decreases muscle spasms and severe spasticity. Given orally or by a surgically implanted pump.
(a)
complications of cerebral palsy
aspiration
falls
none
a chronic autoimmune inflammatory disease affecting joints and other tissues
(a)
risk factors for juvenile idiopathic arthritis
immunogenic susceptibility
environmental triggers
genetic predisposition
multiple births
C-reactive protein, ESR, antinuclear antibodies, x-rays, and eye exams and diagnostic exams for
juvenile idiopathic arthritis
scoliosis
muscular dystrophy
cerebral palsy
expected finding of juvenile idiopathic arthritis
joint swelling
fever/rash
limp
delayed growth
medication used for pain and inflammation for a patient with JIA
non-steroidal anti-inflammatory
ibuprofen
naproxen
indomethacin
a cytotoxic disease modifying antirheumatic drug that slows joint degeneration and progression of rheumatic arthritis when NSAIDs do not work alone
(a)
a corticosteroid that provides relief of inflammation and pain. They are reserved for life-threatening complications, severe arthritis, pericarditis, and uveitis
(a)
complications of JIA
(a)
a group of inherited disorders with progressive degeneration of symmetric skeletal muscle groups, causing progressive muscle weakness and wasting that leads to disability and deformity
(a)
risk factors of muscular dystrophy
(a)
diagnostic test for muscular dystrophy
labs to check for gene mutation
blood creatinine kinase level
muscle biopsy
C-reactive protein
signs and symptoms of muscular dystrophy
gower's sign
muscle weakness
progressive difficulty walking
unsteady gait
complications of muscular dystrophy
obesity
contractures
scoliosis
cardiac difficulties
normal pediatric urine output
(a)
less than 1 mL/kg/hr
oliguria
polyuria
normal urine output
polyuria is how many mL/kg/hr
(a)
normal BUN
(a)
normal creatnine
(a)
normal pH of urine
(a)
uncontrolled or unintentional urination past the age of bladder control
(a)
a child has never been free of bed-wetting for an extended period of time
(a)
a child who started bed-wetting after the development of urinary control
(a)
treatments for enuresis
conditioning therapy
kegel/pelvic control exercise
retention control measures
medications
placing an alarm sensor on the bed that goes off when the child voids to awaken the child to get up and use the bathroom
(a)
treatment for enuresis where they have the child consumes a large amount of water to stretch the bladder
(a)
type of medications for enuresis
desmopressin acetate
imipramine hydrochloride
oxybutynin chloride
antibiotics
most commonly used medication for enuresis
(a)
inflammation of the bladder
(a)
inflammation of the urethra
(a)
inflammation of the upper urinary tract and kidneys
(a)
risk factors for UTI
urinary reflux
constipation
potty training
age 6-12 y/o
s/s in infants with UTI
increased irritability
abdominal, flank, or back pain
poor feeding
foul smelling urine
s/s of UTI in children
abdominal, flank, or back pain
pain with urination
increased irritability
stong smelling urine
the most accurate method for obtaining urine for urinalysis and culture in children less than 2 years of age
sterile catheterization
suprapubic aspiration
clean-catch urine
complications of UTI include
progressive kidney injury
pyelonephritis
urosepsis
hydrocele
s/s of urosepsis
tachycardia and tachypnea
febrile and weak pulses
change in mental status
hypertension
ventral curvature of the penis
(a)
surgical release of the fibrous band is a treatment for
(a)
narrowing of the preputial opening of the foreskin. inability to retract the foreskin of the penis. usually resolves as the child gets older.
(a)
the urethral opening is located just below the glans penis, behind the glans penis, or on the ventral (underside) surface of the penile shaft. The meatus opening is below the glans penis, along the ventral surface of the penis, scrotum, or perineum
(a)
fluid in the scrotum, enlarged scrotal sac
(a)
occurs when an opening is present in the abdominal wall through which a sac protrudes and part of the abdominal content, such as intestines, can be pushed through this opening
(a)
a twisting of the testicles. when the testicle rotates it twist the cord supplying blood to the scrotum. This may occur after vigorous activity, a minor injury to the testicle, or sleep.
(a)
the swelling of one or both kidneys, this occurs when the urine cannot be drained from the kidneys and instead builds up in the kidneys
(a)
there are 4 grades to this (grade 4 is the worst); s/s include pain in the flank, pain with urination, fever, n/v. Treatment includes resolving the underlying problem or nephrostomy tube
(a)
abnormal flow of urine from the bladder back up the ureters and into the kidneys
(a)
children are BORN with a defect in the valve that prevents backflow to the kidneys; Most common type of VUR
(a)
abnormal high pressure sends urine back to kidneys (i.e., neurogenic bladder)
(a)
risk factors for VUR
female
genetic
family history
male
symptoms of VUR
febrile UTI at young age
flank pain
nausea and vomiting
asymptomatic
diagnostic procedure for VUR
abdominal US if abnormal VCUG
2 step procedure
VCUG: a small catheter is placed to fill the bladder with IV contrast dye. Images are taken before , during and after the child urinates
treatment for VUR
depends on severity
mild; no treatment may outgrow the disorder
moderate; prophylactic antibiotic
severe (grade 5+) surgical repair
complications of VUR
Kidney scarring
kidney damage
pyelonephritis
usually occurs when a part of the kidney is blocked, usually occurs at the renal pelvis, which is where the kidneys attach to the ureters. This blocks or stops urine flow which can then lead to hydronephrosis
ureteropelvic junction
vesicoureteral reflux
hydronephrosis
testicular torsion
diagnostic test for ureteropelvic junction obstruction is usually dependent on where the obstruction is and may include:
fetal ultrasound
IV pyelogram
CT/MRI
fibrin
abdominal mass, febrile UTI, flank pain, kidney stones, bloody urine, vomiting, and failure to thrive are s/s associated with
ureteropelvic junction
acute renal failure
hemolytic uremic syndrome
nephrotic syndrome
s/s of ureteropelvic obstruction
abdominal mass
NON-febrile UTI
flank pain
bloody urine and kidney stones
treatment for ureteropelvic obstruction
resolve the blockage
pyeloplasty surgery
oxybutynin
it will resolve it self in most cases
alteration in the glomerular membrane allow protein to pass into the urine
(a)
the decrease blood osmotic pressure in nephrotic syndrome leads to
proteinuria
hyperlipemia
edema (face)
febrile UTI
minimal, secondary, and congenital are all types of
(a)
frothy urine, facial and periorbital edema, normal BP, and weight gain are s/s of
(a)
