Podcast
Questions and Answers
What is a characteristic sign of increased intracranial pressure (ICP) in infants?
Which of the following is included in Cushing’s Triad?
How does increased ICP affect the optic nerve?
Which position is recommended for a patient to help decrease ICP?
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What is a common early symptom of increased ICP in young children?
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What does anisocoria indicate when observed in a patient?
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What is a potential consequence of projectile vomiting associated with increased ICP?
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What does PERRLA stand for in relation to pupil assessment?
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Which medication is the first choice for treating the condition described?
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What is a common symptom associated with right-sided heart failure?
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Which of the following is NOT a part of the management for the condition?
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During exacerbation and remission, how long should treatment continue?
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Which inflammatory marker indicates acute inflammation?
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Which symptom is characteristic of left-sided heart failure?
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What is the primary problem associated with Pulmonary Stenosis?
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What role do corticosteroids play in the management plan?
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Which surgical procedure is considered curative for Pulmonary Stenosis?
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What condition helps keep a patient alive in cases of Transposition of the Great Arteries?
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Which major symptom would be associated with Rheumatic Heart Fever according to Jones Criteria?
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Which sign is indicative of chronic hypoxia?
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Which of the following indicates the need for monitoring during salicylate treatment?
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What is the primary management for a newborn with Transposition of the Great Arteries?
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Which of the following is NOT a sign or symptom of Tetralogy of Fallot?
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What diagnostic imaging technique is used to identify a Boot Shaped Heart?
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Which diagnostic result indicates Left-Sided Heart Failure (LSHF)?
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What management strategy is recommended to maximize lung expansion?
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Which symptom would most likely indicate a complication of Kawasaki disease?
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What is a common sign of gastrointestinal disorders in children, like cleft lip and palate?
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What laboratory finding is associated with the inflammatory response in Kawasaki disease?
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Which medication is used to enhance immune response in Kawasaki disease?
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What condition can lead to the necessity for CPR in Kawasaki disease patients?
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Which symptom is commonly associated with heart failure in pediatrics?
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Which of the following is NOT a typical symptom of Right-Sided Heart Failure?
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What is the typical presentation of a patient with Digoxin toxicity?
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What is a primary sign of Gastroesophageal Reflux Disease (GERD)?
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What dietary adjustments should be made for a patient diagnosed with GERD?
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Which of the following is NOT a symptom of Celiac Disease?
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What is a potential surgical intervention for Pyloric Stenosis?
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In the management of Gastroesophageal Reflux Disease (GERD), what position should the head be elevated during sleep?
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What is a key feature of symptoms for Pyloric Stenosis?
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Which of the following foods should be avoided in a gluten-free diet for Celiac Disease?
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What medication type is used to neutralize acidity in GERD management?
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What is essential to monitor in infants with Pyloric Stenosis?
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Which symptom is characteristic of Cholecystitis?
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What type of feeding pattern is recommended for patients with GERD?
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Which of the following is a common sign of Celiac Disease?
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What is an expected result in a bowel biopsy for Celiac Disease?
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What should patients with Pyloric Stenosis do to prevent aspiration during feeding?
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Study Notes
Pediatric Neurologic Disorders
- Increased Intracranial Pressure (ICP): Normal range is 5-15 mmHg.
- Cushing’s Triad: Consists of hypertension, bradycardia, bradypnea; indicates severe ICP.
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Signs of Increased ICP in Young Children:
- Bulging fontanels in infants, aggravated by crying.
- High-pitched, shrill cries in infants.
- Irritability or agitation in children; restlessness in adults; confusion in geriatrics.
- Increased head circumference and projectile vomiting can indicate cerebral edema.
Pediatric Cardiac Disorders
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Congenital Heart Defects:
- Tetralogy of Fallot: Characterized by cyanosis, squatting behavior to decrease cardiac workload, and "tet spells" causing irritability and pallor. Diagnosed via 2D Echo showing a boot-shaped heart.
- Transposition of the Great Arteries (TGA): Severe cyanosis; managed with Prostaglandins and arterial switch surgery.
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Rheumatic Heart Disease: Caused by Group A Beta-hemolytic Streptococcus (GABHS). Diagnosed using Jones Criteria:
- Major symptoms: carditis, polyarthritis, subcutaneous nodules, erythema marginatum, and elevated acute phase reactants.
- Minor symptoms include low-grade fever, arthralgia, and increased ESR.
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Management of Heart Failure:
- Recognized by RSHF (right-sided heart failure) with edema and LSHF (left-sided heart failure) with dyspnea and orthopnea.
- Diagnostics include CXR, 2D Echo, and central venous pressure readings.
- Poor cardiac output addressed with fowlers position, supplemental oxygen, and diuretics.
Pediatric Gastrointestinal Disorders
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Cleft Lip and Cleft Palate: Associated with feeding difficulties and risk for aspiration. Surgical interference includes cheiloplasty for cleft lip and palatoplasty for cleft palate.
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Gastroesophageal Reflux Disease (GERD): Characterized by forceful vomiting and heartburn due to incompetent lower esophageal sphincter.
- Managed with dietary modifications and medications such as antacids, H2 blockers, and PPIs.
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Pyloric Stenosis: Narrowing of pyloric sphincter, leads to projectile vomiting without bile. Key signs include "olive-shaped" mass in the abdomen and metabolic alkalosis.
- Surgery involves pyloromyotomy to relieve obstruction.
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Celiac Disease: A chronic disorder characterized by gluten sensitivity, malabsorption leading to diarrhea and severe abdominal distention.
- Diagnosed via bowel biopsy demonstrating mucosal atrophy. Management focuses on a lifelong gluten-free diet, avoiding barley, rye, oats, and wheat.
Kawasaki Disease
- An acute, self-limiting vasculitis leading to inflammation of blood vessels.
- Symptoms include high spiking fever, strawberry tongue, photophobia, polymorphous rash, and desquamation.
- Managed with immunoglobulins and aspirin to reduce inflammation and prevent coronary artery complications.
General Pediatric Nursing Considerations
- Positioning for reducing ICP: Semi-fowler's position recommended to allow gravity to decrease pressure on the brain.
- Continuous monitoring for vital signs and symptoms reflecting changes in condition, especially in congenital heart defects and ICP management.
- Importance of educating families about signs of decompensation or increasing severity in pediatric conditions for timely interventions.
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