EXAM #4 Notes~Need to know
Neurosensory
Parent that keeps taking child to ED 6 times in 6 months with nothing wrong
is concerning
CPS is contacted if frequent visits to ED with nothing wrong
Child abuse~spiral fracture
Down syndrome~typically have small nose (know clinical manifestations) Born with
VSD,facial structure, increased risk of upper respiratory infections, at risk for
pneumonia, wide space between big and second toe
Child with near drowning~4 minutes without oxygen causes brain damage
(administer oxygen via face mask)
Complications: May not swallow till 72 hours
Autism~manifestations (social and communication challenges, thrive on repetitive
behavior,aniticipate verbal delay)
ADHD~difficulty completing tasks,highly distractable,safety issues
Review ICP(Intracranial Pressure)~irritable or drowsy, high-pitched cry,iriitability
Be careful with IV fluids (can cause cerebral edema) Strict I’s and O’s, avoid pain
meds as possible (opioids) Only suction if absolutely necessary, avoid, if at all
possible, supine and in proper alignment
The brain will suffer irreversible damage after 4 minutes without oxygen. Restore
oxygen delivery via facemask
Use Pain meds sparingly and cautiously, widely dilated pupils indicate damage
to(cranial nerve III),pupils fixed for more than 5 min indicates damage
Head Injury~Assess LOC,neuro,pupillar response- Priority is to check Pupillary
response every 4 hours
MUST KNOW DÉCOR AND DECER POSTURING
, Meningitis(Manifestations) Medical emergency, treat as if bacterial meningitis.
Bacterial first, administer antibiotics(antimicrobials),treat symptoms
Viral meningitis resolves faster than bacterial
Safety is a priority for seizures, observe seizure response,postyctal
(Two or more unprovoked seizures are considered epilepsy)
Baby with seizure in crib~remove items inside crib first
Hydrocephalus~assessment check for VP placement, neuro assessment(If
obstructed vomiting will be present)
Know signs and symptoms of cerebral palsy~feeding difficulty, Moro reflex,
verbal delay
Spina Bifida{Myelomeningocele}~cyst like sac at base of spine, saline soaked
gauze around sac,position prone before surgery unless feeding, treat child as if they
have latex allergy ,cannot have banana or kiwi
Cerebral palsy~(know manifestations) difficulty feeding, Moro reflex, rigid arms, and
legs
Muscular dystrophy~duchenne’s
PAH(PHENYLKETONURIA)~Avoid NutraSweet or aspertane, Manifestations{failure
to thrive,vomiting,irritability,hyperactivity,erratic behavior} special diet for life, special
formula, special supplements even as adults
Percocious puberty~dress appropriate for chronological age
Juvenile Hypothyroidism~give levothyroxine first thing in the morning on an empty
stomach. If missed dose, double up. For baby, crush med and give small amount of
formula.
(How to know if levothyroxine is not working)~ levels aren’t therapeutic if
seeing symptoms of congenital hypothyroidism (fatigue,constipation,sleepiness)
Grief and Loss
Toddler~will imagine deceased person is still alive
Preschoolers~think deceased person is sleeping, feels guilty and responsible for
individuals’ death
Adolescents~ consider funeral to be barbaric and money making
Signs of Death~bradycardia,slurred speech, decreased BP,decreased appetite,
difficulty swallowing
Hematology and Oncology
Hemophilia~know signs and symptoms(Manifestation)excessive PROLONGED
bleeding (hemoarthrosis) edema and limited movement of joint,bruising,hemorrhage
Kid with Leukemia~ low wbc’s (think they have infection) DO NOT GIVE FRESH
FRUITS AND FLOWERS
Neurosensory
Parent that keeps taking child to ED 6 times in 6 months with nothing wrong
is concerning
CPS is contacted if frequent visits to ED with nothing wrong
Child abuse~spiral fracture
Down syndrome~typically have small nose (know clinical manifestations) Born with
VSD,facial structure, increased risk of upper respiratory infections, at risk for
pneumonia, wide space between big and second toe
Child with near drowning~4 minutes without oxygen causes brain damage
(administer oxygen via face mask)
Complications: May not swallow till 72 hours
Autism~manifestations (social and communication challenges, thrive on repetitive
behavior,aniticipate verbal delay)
ADHD~difficulty completing tasks,highly distractable,safety issues
Review ICP(Intracranial Pressure)~irritable or drowsy, high-pitched cry,iriitability
Be careful with IV fluids (can cause cerebral edema) Strict I’s and O’s, avoid pain
meds as possible (opioids) Only suction if absolutely necessary, avoid, if at all
possible, supine and in proper alignment
The brain will suffer irreversible damage after 4 minutes without oxygen. Restore
oxygen delivery via facemask
Use Pain meds sparingly and cautiously, widely dilated pupils indicate damage
to(cranial nerve III),pupils fixed for more than 5 min indicates damage
Head Injury~Assess LOC,neuro,pupillar response- Priority is to check Pupillary
response every 4 hours
MUST KNOW DÉCOR AND DECER POSTURING
, Meningitis(Manifestations) Medical emergency, treat as if bacterial meningitis.
Bacterial first, administer antibiotics(antimicrobials),treat symptoms
Viral meningitis resolves faster than bacterial
Safety is a priority for seizures, observe seizure response,postyctal
(Two or more unprovoked seizures are considered epilepsy)
Baby with seizure in crib~remove items inside crib first
Hydrocephalus~assessment check for VP placement, neuro assessment(If
obstructed vomiting will be present)
Know signs and symptoms of cerebral palsy~feeding difficulty, Moro reflex,
verbal delay
Spina Bifida{Myelomeningocele}~cyst like sac at base of spine, saline soaked
gauze around sac,position prone before surgery unless feeding, treat child as if they
have latex allergy ,cannot have banana or kiwi
Cerebral palsy~(know manifestations) difficulty feeding, Moro reflex, rigid arms, and
legs
Muscular dystrophy~duchenne’s
PAH(PHENYLKETONURIA)~Avoid NutraSweet or aspertane, Manifestations{failure
to thrive,vomiting,irritability,hyperactivity,erratic behavior} special diet for life, special
formula, special supplements even as adults
Percocious puberty~dress appropriate for chronological age
Juvenile Hypothyroidism~give levothyroxine first thing in the morning on an empty
stomach. If missed dose, double up. For baby, crush med and give small amount of
formula.
(How to know if levothyroxine is not working)~ levels aren’t therapeutic if
seeing symptoms of congenital hypothyroidism (fatigue,constipation,sleepiness)
Grief and Loss
Toddler~will imagine deceased person is still alive
Preschoolers~think deceased person is sleeping, feels guilty and responsible for
individuals’ death
Adolescents~ consider funeral to be barbaric and money making
Signs of Death~bradycardia,slurred speech, decreased BP,decreased appetite,
difficulty swallowing
Hematology and Oncology
Hemophilia~know signs and symptoms(Manifestation)excessive PROLONGED
bleeding (hemoarthrosis) edema and limited movement of joint,bruising,hemorrhage
Kid with Leukemia~ low wbc’s (think they have infection) DO NOT GIVE FRESH
FRUITS AND FLOWERS
