NR 602 Final exam Study Guide With Practical Questions And Answers.

Step 1 Asthma approach-Intermittent - correct answer symptoms 2x or less per week asymptomatic and normal PED requires SABA 2 days/week no interference with normal activities brief exacerbations nighttime symptoms 2x or less a month lung fx- FEV>80% predicted Step 2 Asthma Approach-Mild persistent - correct answer Symptoms >2 x a week, less than once per day requires SABA more than 2days/week, no more than once a day exacerbations may affect activity nighttime symptoms 3-4x a month FEV> 80% predicted Step 3 Asthma Approach-Moderate Persistant - correct answer daily symptoms daily use of SABA some limitations 2x or more per week exacerbations nighttime symptoms more than 1x per week, not nightly FEV >60% but <80% Step 4 Asthma Approach-Severe Persistent - correct answer continual symptoms requires SABA multiple x a day extremely limited activity nighttime symptoms 7x a week FEV <60% Tx of asthma - correct answer Stepwise approach step 1: SABA PRN step 2: low dose ICS Step 3: low dose ICS+ LABA or medium dose ICS step 4: Medium dose ICS+LABA Step 5: high dose ICS+ LABA Step 6: High dose ICS+LABA + corticosteroid Step 6 Asthma Approach - correct answer Bulbar/palpebral conjunctival infection - correct answer May be unilateral or bilateral Leukocoria - correct answer abnormal appearance of a white film in the pupil; immediate referral to pediatric ophthalmologist warranted Causes: retinal detachment, cataract, retinal dysplasia, newborn retinoblastoma Visual screening in children - correct answer At least once between ages 3-5 y/o according to USPSTF AOM - correct answer RF: genetics, males, Native American, siblings, low economic status, ages 6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke S/S of AOM - correct answer erythema, otalgia, bulging TM, absent cone of light Dx of AOM - correct answer Audiometry, tympanometry, possible lateral neck xray to r/o mass TX of AOM - correct answer uncomplicated: supportive with tylenol/ibuprofen; watchful waiting 48-72 in 6m-2y/o; <5 benzocaine otic drops 1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days if allergy to PCN- augmentin, cefuroxime Bacterial rhinosinusitis - correct answer Preceded by URI-typically worsens after 5-7 days- not resolved in 2 weeks Sx of bacterial rhinosinusitis - correct answer Purulant nasal congestion, drainage, facial pain, headache, fever No imaging required- if no improvement refer to ENT Bronchiolitis - correct answer Usually caused by RSV wheezing present <2 y/o other causes; influenza, adenovirus, rhinovirus S/s of bronchiolitis - correct answer Increased work of breathing, prolonged expiration, grunting, retractions, nasal flaring Croup sx - correct answer Low grade fever, URI symptoms, barking cough, inspiratory stridor can occur Croup dx - correct answer Made from symptoms Croup tx - correct answer Glucocorticoids possibly 0.6mg/kg-1mg/kg humidified air bronchodilators Lead poisoning - correct answer Inactivated heme synthesis by inhibiting insertion of iron-leads to microcytic hy