Practice Peds Exam 2
51 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a significant risk associated with untreated intracranial pressure (ICP)?

  • Brain herniation leading to death (correct)
  • Reduction in intracranial volume
  • Increased cognitive function
  • Development of meningitis

    • Which of the following symptoms is indicative of increased intracranial pressure?

  • Increased appetite
  • Vomiting and headache (correct)
  • Lower heart rate
  • Dehydration

    • What condition is characterized by the premature closure of skull sutures leading to head deformation?

  • Microcephaly
  • Hydrocephalus
  • Craniosynostosis (correct)
  • Encephalitis

    • What specific action should be taken to manage a patient exhibiting symptoms of meningitis?

    <p>Isolation precautions and antibiotics</p> Signup and view all the answers

    What developmental consideration is crucial for infants regarding brain growth and the need for whole milk until age two?

    <p>Support for myelin sheath development</p> Signup and view all the answers

    Which of the following signs is characteristic of bacterial meningitis?

    <p>Photophobia and stiff neck</p> Signup and view all the answers

    Which condition involves a buildup of cerebrospinal fluid (CSF) in the brain?

    <p>Hydrocephalus</p> Signup and view all the answers

    What is the primary precaution necessary for a patient experiencing seizures?

    <p>Side rails up and bed lowest position</p> Signup and view all the answers

    What is a characteristic of metabolic acidosis?

    <p>Low pH, normal CO2, low HCO3</p> Signup and view all the answers

    Which condition is associated with increased pulmonary blood flow?

    <p>Ventricular septal defect</p> Signup and view all the answers

    What is the treatment for a Tet spell in an infant?

    <p>Knee-to-chest position</p> Signup and view all the answers

    In coarctation of the aorta, what is a typical sign observed in physical examination?

    <p>Diminished pulses in the feet</p> Signup and view all the answers

    Which of the following is NOT a manifestation of Kawasaki Disease?

    <p>Erythema migrans</p> Signup and view all the answers

    For what condition is Indomethacin primarily used?

    <p>To promote patent ductus arteriosus (PDA) closure</p> Signup and view all the answers

    What dosage calculation method is used for pediatric fluids?

    <p>100ml/kg/day for the first 10 kg, 50ml/kg/day for the second 10 kg, and 20ml/kg/day for each kg thereafter</p> Signup and view all the answers

    What is the initial heart rate criterion for administering Digoxin in infants?

    <p>90 beats per minute or greater</p> Signup and view all the answers

    Which heart condition results from the swapping of the aorta and pulmonary artery?

    <p>Transposition of the great arteries</p> Signup and view all the answers

    What is a common complication of untreated rheumatic fever?

    <p>Carditis</p> Signup and view all the answers

    What is the most common cause of impetigo in children?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which condition is characterized by honey crusted plaques?

    <p>Impetigo</p> Signup and view all the answers

    In cases of cellulitis, what is the recommended treatment?

    <p>Oral antibiotics, such as cephalexin</p> Signup and view all the answers

    Which symptoms are characteristic of measles?

    <p>Koplik spots and rash</p> Signup and view all the answers

    For which condition might a patient be treated with IVIG and aspirin?

    <p>Kawasaki disease</p> Signup and view all the answers

    What is the primary concern when managing mumps in a patient?

    <p>Airway obstruction due to parotid swelling</p> Signup and view all the answers

    Which type of dermatitis is primarily caused by repetitive contact with irritants?

    <p>Irritant dermatitis</p> Signup and view all the answers

    What should be included in a treatment plan for scabies?

    <p>Treat all family members and clean the home</p> Signup and view all the answers

    What percentage of total body surface area (TBSA) does a burn on both arms and the head account for in adults?

    <p>27%</p> Signup and view all the answers

    What represents a hallmark sign of chickenpox infection?

    <p>Crusted lesions</p> Signup and view all the answers

    How is the presence of erythema multiforme classified?

    <p>Hypersensitivity reaction</p> Signup and view all the answers

    What is the characteristic lesion associated with scabies?

    <p>Circular red marks with wavy lines</p> Signup and view all the answers

    What is a common treatment method for respiratory acidosis caused by CO2 retention?

    <p>Ventilation support</p> Signup and view all the answers

    What therapeutic measure should be prioritized for a child experiencing an asthma attack?

    <p>Using a bronchodilator via MDIs or nebulizer</p> Signup and view all the answers

    What is a defining characteristic of generalized seizures?

    <p>They involve abnormal brain activity throughout the entire brain.</p> Signup and view all the answers

    What is the primary treatment for status epilepticus after 5 minutes?

    <p>Intravenous fluids and lorazepam.</p> Signup and view all the answers

    Which of the following is true regarding febrile seizures?

    <p>They are due to a rapid increase in body temperature.</p> Signup and view all the answers

    What is a common treatment method used for children diagnosed with strabismus?

    <p>Occlusion therapy over the stronger eye.</p> Signup and view all the answers

    Which of the following indicates an emergency condition related to epiglottitis?

    <p>Drooling and tripod positioning.</p> Signup and view all the answers

    What condition is characterized by thick, sticky mucus in the lungs and requires genetic testing for diagnosis?

    <p>Cystic fibrosis</p> Signup and view all the answers

    How is the Glasgow Coma Scale used in pediatric care for assessing head trauma?

    <p>Scores of 8 or lower indicate a need for intubation.</p> Signup and view all the answers

    When assessing for respiratory failure in pediatric patients, which of the following findings should be prioritized?

    <p>Chest pain and ability to cough.</p> Signup and view all the answers

    Which statement correctly describes the mechanics of respiratory acidosis compensation?

    <p>The body decreases respiratory rate to retain CO2 and maintain pH.</p> Signup and view all the answers

    What is the importance of the peak-flow meter in managing asthma?

    <p>It helps assess the peak expiratory flow rate for better asthma control.</p> Signup and view all the answers

    What is the common cause of nasolacrimal duct obstruction in infants?

    <p>Not fully formed tear ducts.</p> Signup and view all the answers

    During a respiratory assessment, which lung sound would most likely indicate the presence of fluid?

    <p>Crackles</p> Signup and view all the answers

    Which of the following symptoms is most indicative of foreign body aspiration in children?

    <p>Complete silence followed by cough and dyspnea.</p> Signup and view all the answers

    What characterizes the self-limiting nature of spasmodic laryngitis?

    <p>Symptoms usually resolve on their own.</p> Signup and view all the answers

    What is a critical risk when intracranial pressure (ICP) remains unaddressed?

    <p>Brain herniation and potential death</p> Signup and view all the answers

    Which condition is associated with abnormal brain development due to inadequate nutrition in early life?

    <p>Microcephaly</p> Signup and view all the answers

    What precaution is essential for a patient with bacterial meningitis?

    <p>Droplet precautions</p> Signup and view all the answers

    In cases of hydrocephalus, which of the following is a common treatment approach?

    <p>VP shunt placement</p> Signup and view all the answers

    Which of these signs is NOT typically associated with Reye Syndrome?

    <p>Use of aspirin in children</p> Signup and view all the answers

    Study Notes

    Intracranial Pressure (ICP)

    • Sudden onset headache and vomiting in the morning are potential warnings of increasing ICP
    • High ICP leads to brain herniation and death if not managed quickly
    • Causes include: bleeding (low INR), tumors, anything increasing cranium pressure
    • Mechanism: swelling pushes medulla into C1/C2, compressing it, causing breathing/heartbeat cessation
    • Symptoms: headaches, nausea, vomiting (body's pressure reduction attempt), hypertension
    • Treatment: elevate head of bed

    Child vs. Adult Neuro Systems

    • Child development: Rapid brain development, myelin sheath formation needs whole milk until age 2
    • Fontanelles: Anterior fontanelles close by 18 months
    • ICP risk (children): Risk of ICP after falls is prominent after 18 months due to skull closure
    • Neurological impairments: Conditions like ???? lead to bowel/bladder dysfunction and inability to walk
    • Skull sutures: Do NOT need to memorize skull sutures
    • Craniosynostosis: Sutures close prematurely, leading to head deformation
    • Deformational plagiocephaly: Flat back of the head, potentially from prolonged positioning
    • Microcephaly: Cognitive impairments, head circumference significantly below normal
    • Hydrocephalus: CSF buildup in the brain; no bulging or firmness; sunken head indicates dehydration in babies; treatment is VP shunt (measuring head/abdomen circumference to ensure appropriate functioning)
    • Intracranial Arteriovenous malformations (AVMs): Abnormal connections between arteries and veins
    • Meningitis: Viral/bacterial infection; potential sepsis, different treatments depending on type (Viral is self-limiting, Bacterial: antibiotics, isolation precautions, life-threatening)
    • Kernig/other sign: Specific meningitis symptoms (look for the full detail)
    • Reye Syndrome: Rare multi-organ failure; avoid aspirin in young children
    • Encephalitis: Inflammation of meninges (viral); seizure precautions
    • Seizures: Electrical disturbances; focal (one spot), generalized (whole brain), status epilepticus (seizure longer than 5 minutes requires intervention)
    • Epilepsy: Two unprovoked seizures more than 24 hours apart; vagal nerve stimulator used if medication is ineffective
    • Seizure Precautions: Don’t put hands in mouth; intermittent suction; side rails up
    • Status Epilepticus: Urgent action; IV fluids, oxygen, IV meds (lorazepam, diazepam)
    • Febrile Seizures: Common in children under 7; due to high temperature; self-limiting; EEG for diagnostic testing
    • Antiepileptic Medications: Carbamazepine is example
    • Head Trauma: Glasgow Coma Scale (GCS) used for head injury severity; 8 or lower needs intubation. Observe for posturing (decorticate)
    • Headaches: Keep headache journals (children) to determine the cause, Abortive medicines are taken during headache onset
    • Eye disorders: Nystagmus (abnormal eye movement) and strabismus (cross-eye): occlusion therapy for strabismus
    • Nasolacrimal Duct Obstruction: Fluid buildup in tear duct region (self-limiting, redness, conjunctivitis)
    • Periorbital Cellulitis: Eyelid/tissue infection; very serious; IV antibiotics and hospitalization; blindness is possible without treatment; facial infections increase likelihood
    • Hearing Deficits: Suspect hearing loss at 6 months if no startle response/verbal stimuli response

    Respiratory

    • Respiratory failure: Quick onset in pediatrics; assess rate, rhythm, pain, contractions, cough
    • Assessment: Lung sounds (wheeze, stridor, crackles); odors (breath, mucus); mucus characteristics (color, consistency); positioning (head of bed elevation)
    • Croup Disorders: Laryngotracheobronchitis (viral, common): steroids, fluids, racemic epinephrine; Spasmodic Laryngitis (not seen after age 8, viral, self-limiting, cool mist)
    • Epiglottitis: Bacterial infection; airway obstruction; medical emergency (tripod positioning, drooling, "croaking," steeple sign on x-rays); immediate intubation and antibiotics
    • Pertussis (Whooping Cough): Prolonged duration; starts like a cold-like infection then progresses to coughing fits
    • Pneumonia: Lower airway infection/inflammation (bacterial or viral); fever, tachypnea, cough, nausea, vomiting, irritability, lethargy; antibiotics if bacterial; monitor respiratory distress
    • RSV Bronchiolitis: Respiratory symptoms get worse after 2 days, congestion
    • Asthma: Airway inflammation; prioritize medications, triggers, education; peak-flow meter
    • Cystic Fibrosis: Genetic; thick, sticky mucus in lungs; manifestations; pancreatic enzymes
    • Acid-Base Imbalances: Understand pH scale, blood pH range (7.35-7.45); respiratory acidosis, respiratory alkalosis, metabolic acidosis, metabolic alkalosis
    • Foreign body aspirations: Small objects obstruct airway; symptoms of silent cough, dyspnea, stridor, hoarseness.

    Cardiac

    • Newborn blood pressure (BP) and heart rate (HR): 65-85/45-55 mmHg and 110-160 bpm respectively (0-3 months)
    • Prostaglandin E: Relaxes smooth muscle; used to keep patent ductus arteriosus open
    • Indomethacin: Inhibits prostaglandins used to close PDA
    • Inotropes: Alters force/strength or slows rate of contractions to improve CO
    • Conditions with heart: Increased/decreased pulmonary blood flow, obstruction to systemic blood flow, mixed flow
    • Increased pulmonary blood flow: Arterial septal defect (ASD), Ventricular septal defect (VSD)
    • Decreased pulmonary blood flow: Pulmonic stenosis, Tetralogy of Fallot (cyanosis, knee-to-chest/squat position for tet spell); antibiotics preemptively before dental cleaning
    • Obstruction to systemic blood flow: Coarctation of the aorta (increased upper extremity BP, decreased lower extremity BP—diminished pules in the feet, cap refill delay in feet, poor feet color)
    • Mixed flow: Transposition of the great arteries (extreme cyanosis – immediate surgical intervention)
    • Heart Failure Interventions: Maintain oxygenation and CO; cardiac glycosides (digoxin); monitor apical pulse (infant HR needs to be 90 or higher before administration)
    • Rheumatic fever: Autoimmune response to untreated infections (strep, scarlet fever)- inflammation of joints, skin, and heart; possible valve replacement (pig valve, usually mitral valve.)
    • Kawasaki Disease: Inflammation of vessel walls, leading to aneurysms, heart attacks; autoimmune; IVIG therapy, aspirin; strawberry tongue, body rash, skin peeling; high risk of death in acute stage

    Pediatric Fluids

    • Fluid needs: 100ml/kg/day first 10kg, 50ml/kg/day second 10, 20 ml/day for every kg over 20. Example calculations for different weights

    Skin

    • Infant skin: Thicker, greater body surface area than adults

    • Skin integrity promotion: Preventing infection, promoting comfort, and wound care

    • Impetigo: Staph aureus infection (Bullous vs. Non-bullous); topical antibiotics

    • Folliculitis: Staph aureus infection; topical antibiotics

    • Cellulitis: Infection in skin and tissues requiring oral/IV antibiotics

    • Measles: Highly contagious viral infection; droplet precautions; Koplik spots

    • Mumps: Self-limiting viral infection; parotid swelling, potentially airway issues; MMR

    • Rubella: MMR vaccination; pregnant women needs to avoid contact to prevent congenital rubella syndrome.

    • Varicella (Chickenpox): Contagious herpes virus until all lesions are crusted; can reactivate as shingles

    • Contact dermatitis (irritant/allergic): Manage exposure from irritant; treat with topical/oral corticosteroids, antihistamines

    • Erythema Multiforme: Hypersensitivity reaction

    • Urticaria (Hives): Self-limiting; antihistamines

    • Infestations (lice/scabies): Treatment with permethrin; family treatment to prevent res infection; hygiene measures

    Burns

    • Burn classification: Superficial, superficial partial-thickness, deep partial-thickness, full-thickness
    • Body surface area (BSA) percentages: 9% for head, arms, chest/back, each leg; 1% for groin

    Nursing Interventions for Burns

    • Promoting wound healing: Change dressings; silver impregnated dressings
    • Prevent infection: Tetanus vaccination.
    • Psychosocial support: Important for affected individuals
    • Monitor urine output: Important for fluid management

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz covers crucial information about intracranial pressure (ICP), including its symptoms, causes, and potential treatments. Additionally, it highlights key differences in neuro development between children and adults, focusing on the risks associated with ICP in young children. Test your knowledge on these important medical concepts related to brain health.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser