NR 602 Final Exam
COLIC - Unknown abdominal discomfort;
"cries for more than 3 hours a day, for more than 3 days a week, and more than 3 weeks"
Colic Management - Probiotics may be offered; Consideration of hydrolyzed protein formula
DEHYDRATION Management - Commercially available oral hydration solutions (ORS)
Continue breastfeeding with ORS supplementation
Offer young children 20 ml/kg per hour
Offer older children 100 mL of ORS every 5 minutes
Combine with IV therapy as needed
Reassess after 4 hours; repeat if needed
Avoid juice, soft drinks, and sports drinks
Appendicitis S/S - Presence of involuntary guarding,
RLQ rebound tenderness, maximal pain over McBurney point
Heel-drop jarring test
inability to stand straight or climb stairs; winces when getting off examination table or riding in a car
over bumps;
child most comfortable with bent knees.
Positive psoas sign or obturator sign
Rovsing sign or rebound tenderness strongly suggests peritoneal irritation.
Tenderness and possibly a mass (abscess) on the right side on rectal examination.
McBurney point/sign - Pain w/ palpation and release; Rebound tenderness is most reliable.
, 1.5 to 2 inches in from the right anterior superior iliac crest (on a line toward the umbilicus) on
abdominal examination (most reliable finding
positive psoas sign - retract R thigh while on left side; illicit pain consistent with appendicitis
Positive Rovsing Sign - Pain RLQ w/ pressure and release of LLQ; R/O appendicitis
Positive Obturator Sign - Supine; bend R leg and rotate inward; illicit pain in RLQ
Intusscuception - Anterograde intestine into proximal bowel; Most common cause of for Pediatric GI
obstruction
S/S of intussusception - S/S of intussuception
intermittent abdominal pain
currant jelly stools
Dance Sign (sausage like mass)
Management of Intussusception - Therapeutic Air Contrast Enema under fluoroscopy
Failure to Thrive (FTT) - The most common cause is nutritional deficiency without an underlying medical
condition (greater than 80%).
Asymptomatic bacteriuria - bacteria in the urine without other symptoms, is benign, and does not cause
renal injury.
COLIC - Unknown abdominal discomfort;
"cries for more than 3 hours a day, for more than 3 days a week, and more than 3 weeks"
Colic Management - Probiotics may be offered; Consideration of hydrolyzed protein formula
DEHYDRATION Management - Commercially available oral hydration solutions (ORS)
Continue breastfeeding with ORS supplementation
Offer young children 20 ml/kg per hour
Offer older children 100 mL of ORS every 5 minutes
Combine with IV therapy as needed
Reassess after 4 hours; repeat if needed
Avoid juice, soft drinks, and sports drinks
Appendicitis S/S - Presence of involuntary guarding,
RLQ rebound tenderness, maximal pain over McBurney point
Heel-drop jarring test
inability to stand straight or climb stairs; winces when getting off examination table or riding in a car
over bumps;
child most comfortable with bent knees.
Positive psoas sign or obturator sign
Rovsing sign or rebound tenderness strongly suggests peritoneal irritation.
Tenderness and possibly a mass (abscess) on the right side on rectal examination.
McBurney point/sign - Pain w/ palpation and release; Rebound tenderness is most reliable.
, 1.5 to 2 inches in from the right anterior superior iliac crest (on a line toward the umbilicus) on
abdominal examination (most reliable finding
positive psoas sign - retract R thigh while on left side; illicit pain consistent with appendicitis
Positive Rovsing Sign - Pain RLQ w/ pressure and release of LLQ; R/O appendicitis
Positive Obturator Sign - Supine; bend R leg and rotate inward; illicit pain in RLQ
Intusscuception - Anterograde intestine into proximal bowel; Most common cause of for Pediatric GI
obstruction
S/S of intussusception - S/S of intussuception
intermittent abdominal pain
currant jelly stools
Dance Sign (sausage like mass)
Management of Intussusception - Therapeutic Air Contrast Enema under fluoroscopy
Failure to Thrive (FTT) - The most common cause is nutritional deficiency without an underlying medical
condition (greater than 80%).
Asymptomatic bacteriuria - bacteria in the urine without other symptoms, is benign, and does not cause
renal injury.
