ATI pediatrics Summary Fall 2021
ATI pediatrics Chapter 1 Parenting styles Dictatorial/authoritarian: super strict Permissive: consulting kid about what they want to do. Kid dictates what they do Democratic/authoritative: in the middle not to strict not to permissive Passive parents: uninvolved, indifferent or emotionally removed Chapter 2 Infant vital signs Everything is higher except for blood pressure Expected temp of a 1 year old is 99.9F or 37.7F Pulse 80-180 RR 30-35 BP 65-80/40-50 Fontanel’s Flat and soft Posterior closes 6-8 weeks after birth Anterior closes between 12 and 18 months Teeth 6-8 teeth by 1 year of age in the end they will have 20 deciduous teeth(baby teeth) and 32 permanent erupt between 6 and 10 months Reflexes Moro reflex: present from birth to four months. Have them in a semi sitting position and you let them fall back a little bit and there arms and legs extend out and hands form a C shape Tonic neck reflex: present from birth to three to four months. turning an infants head to one side and they’ll extend the arm and leg on that side and flex the opposite arm and leg Babinski reflex: present for first year. stroke the outer edge of the sole of there foot and the toes span upward and out Cranial nerves 1- olfactory: smell 2- optic: eyes 3- oculomotor: pupils reactive to light 4- trochlear: ability of the eyes to look down and in 5- trigeminal: detect touching on face when eyes are closed 6- abducens: ability to look laterally. tracking 7- facial: looking for symmetrical facial movements8- acoustic: hearing 9- glossopharyngeal: gag reflex 10- vagus: swallowing 11- spina accessory: move shoulders symmetrically 12- hypoglossal: movement of tongue chapter 3 babies/infant babies birth weight will double by six months and triple by 12 months infants will grow 1 inch (2.5cm) per month for the first 6 months at 12 months there birth length has increased by 50% gross motor and fine motor head lag- by 3 months old they should only have slight head lag at 4 months they should be able to role from there back to there side at 5 months they should be able to role from there front to there back at 6 months they should be able to role from there back to there front at 6 months they should be able to hold a bottle at 7 months they should be able to move an object from one hand to another at 8 months they should be able to sit unsupported at 9 months they will have a pincer grasp at 10 months they should be able to go from a prone position to a sitting position and grasp a rattle by its handle at 11 months they should be able to put objects into a container and then have a more neat pincer grasp at 12 months they will try to build a 2 block tower Piagets cognitive development stage Sensory motor stage- birth to 12 months: object permanence. They know an object still exists even when they cant see it. Should be able to say 3-5 words. Know the concept of NO Erikson Trust vs mistrust- birth to one year: is the caretaker meeting the needs of the infant Separation anxiety occurs around 4-8 months Stanger fear becomes evident around 6-8 months Appropriate toys by age Babies up to 1- rattles, blocks, brightly colored toys Immunizations Birth: Hep B 2 month: second Hep B, IPV, RV, PCV, DTap, HIB 4 month: IPV, RV, PCV, DTap, HIB 6 month: third Hep B, IPV, RV, PCV, DTap, HIB6months and 1 year: flu shot Nutrition breast milk first 6 months 4-6 months can introduce solids- iron fortified rice cereal do not need juice or water during first year of life introduce new foods one at a time over a 4-7 day period to check for allergies avoid grapes for risk of choking should stay in a rear facing car seat till 2 years of age make sure crib slats are no more than 6 cm apart keep pillows out of crib and put babies to sleep on there backs chapter 4 toddler By 2.5 years old they will quadruple there weight Grow 3 inches per year Gross motor and fine motor By 15 months child should be able to walk without help and should be able to build a tower of two blocks 18 months able to throw ball overhand 2 years are able to able up and down stairs and build tower of 6-7 blocks 2.5 years can jump with both feet and draw circles Language at 1 year they are using 1 word sentences which are known as hollow phrases at 2 years they use multiword sentences Erikson Autonomy vs shame and doubt: trying to do things themselves, independence, express self by saying no, maintain routine Age appropriate activities Blocks, push pull, thick crayons Begin toilet training when they can sense it Immunizations 12-15 months: IPV, PCV, MMR, varicella, HIB 12-23 months: Hep A six months apart 16- 18 months: DTap, flu shot Nutrition: Full fat milk- whole milk 2 years- low fat milk juice should be limited to 4-6 oz per dayChapter 5 preschooler Gain 4.4-6.6 lbs per year Grow 2.5-3.5 in per year Gross motor and fine motor At age 3 they can ride a tricycle At 4 they can skip and hop on 1 foot At 5 they can jump rope Preschoolers have magical thinking Have animism: when inaminate objects are alive Erikson Initiative vs guilt Age appropriate games Playing ball, puzzels, role playing Immunizations 4-6: DTap, MMR, IPV need 12 hrs of sleep keep routine eruption of teeth finalized during preschool years wear protective gear Chapter 6 school age Gain 4.4-6.6 lbs per year Permanent teeth start to come in Erikson Industry vs inferiority: try to compete during this time and make contribution to society Age appropriate games Board games, organized sports Immunizations 11-12: DTap, HPV 9 hrs of sleep recommended Chapter 7 adolescence Girls will stop growing 2-2.5 years after the start of there period Boys stop growing around 18-20 yearsGirls develop breasts first, then pubic hair growth, then axilla hair, then finally getting there periods Boys develop last testicles first, then pubic hair, then facial hair, then finally voice changes Age appropriate games Video games, sports, music, pets Immunization Flu, meningitis Chapter 8 PO route is always preferred Don’t mix in formula Insert into side of mouth Ear drops- 3 years or less: pull pinna down and back… over 3 years pull up and back IM 22-25g- through vastus laterallis, ventral gluteal or deltoid SubQ- 26-30 gauge 90 degree angel Never do procedures in the childs bed Avoid words like bee sting or stick. Keep equipment out of sight until procedure Chapter 9 4 years and old- self report pain FLACC- 2 months to 7 years FACES- 3 years and above Oucher scale- 3-13 years Numeric scale- 5 years and older Use play therapy to explain procedures Give meds routinely Combine nonopioid and opioid Chapter 10 Infant- don’t understand what is going on at all. may have stranger anxiety.. may express physical behavior Toddler- limited ability to describe illness or follow directions, may regress, separation anxiety Preschooler- magical thinking- may think they caused there illness, experience separation anxiety School aged- can describe pain and understand cause and effect Adolescent- body image issues is key, may feel isolated from peers Age related interventions Preschooler- explain in simple clear language, give them a choice (cup vs spoon)School age- give them facts, encourage expression of feelings Adolescents- give them facts, peers are important Chapter 11 Anticipatory grief- when you know someone is going to die Complicated- extends over a year Ages and how they deal with dying Infants/toddlers- no concept of death, may mirror parents emotions Preschooler- magical thinking, feel guilt or shame, view dying as temporary School age- have adult concept of death, express fear through uncooperative behavior Adolescents- adult concept of death, rely on peers After death Allow family to stay with body Assist in prep of body Chapter 12 Viral or bacterial meningitis Viral can resolve Bacterial more severe, two vaccines PCV and HIV s/s of meningitisphotophobia, nausea, vomiting, irritability in newborns you see poor muscle tone, weak cry, noneating, late sign bulging fontanels, nuchael rigidity positive brudinskis sign, kurnigs sign labs CSF- lumbar puncture: viral= clear, normal glucose, negative gram stain… Bacterial= cloudy, elevated WBC, protein, decreased glucose, positive gram stain Procedure Empty bladder, side lying position Remain in bed for 4-8 hours Droplet precaution Provide quite environment Put on seizure precautions Monitor for ICP= bulging fontanels, high pitch cry, RR changes, bradycardia, headache, seizuresReye’s syndrome Cause liver dysfunction and cerebral edema Associated with giving aspirin for fever Follows the flu, varicella, and gastroenteritis Labs AST, ALT= elevated Ammonia= elevated Liver biopsy=diagnostic test CSF- for rule out Chapter 13 seizures Risks: cerebral edema, fever, trauma, hemorrhaging, lead poisoning, hypoglycemia, electrolyte imbalance Types Tonic- clonic: tonic=body flexes up and head and neck straighten, clonic= jerking movement, postictal phase= no recollection of what happened Absence seizure: ages 4-12, loss of consciousness for 5-10 sec, looks like daydreaming Myoclonic: brief contraction of muscle Atonic: lose tone and often fall Diagnosis EEG No caffeine before EEG, wash hair Precautions Pad rails O2 and suction ready Place them on there side Loosen restrictive clothes Move furniture out of the way DON’T PUT ANYTHING IN MOUTH Post seizure Take vitals Keep side lying Neuro check NO FOOD OR LIQUIDMeds Antiepileptic meds: valproic acid, carbamazepine, diazepam, and phenotoin Surgical option Focal Surgical resection of brain Vagal nerve simulator inserted Chapter 14 head injury Minor- confusion, pallor, vomiting Sign of ICP= irritability, bulging fontanels, poor feeding, headache, blurred vision late signs= delayed pupil response, posturing decorticate posturing= arms flexed in towards the chest.. issue with cerebral cortex decerebrate posturing= arms flexed out to the sides.. issue with brainstem nursing care stabilize spine ways to decrease ICP HOB 30 degrees Head in midline position Minimize suctioning Avoid coughing or blowing nose Insert foley Give stool softener Meds Corticosteroids= dexamethasone Mannitol= diuretic Antiepileptic Surgery Craniotomy- relieve pressure Complications Epidural hemorrhage Subdural hemorrhage Brain herniation- loss of gag reflex, blinking, pupils not responding Chapter 15 hearing and visual impairment Snellon chart- stand 10 ft away Myopia- nearsightedness Hyperopia- farsightedness Strabismus- inward or outward deviation of one eye.. patch the eye to become strongerHearing Acute otitis media- middle ear infection Common in kids less than 7 years.. Eustachian tube is shorter and more horizontal Administer analgesics, antibiotics Tubes can be put in- myringotomy.. fall out on there own 6-12 months Chapter 16 oxygen therapy SaO2- 95-100% Meter dose inhaler- shake 5-6 times, use spacer, take deep breath and exhale, pressure inhaler and take slow deep breath for 3-5 seconds. Hold breath for 10 sec Chest physiotherapy Percussion, vibration, postural drainage Schedule 1 hr before or 2 hrs after meals Administer bronchodilator before Signs of hypoxemia Tachycardia, restlessness, use of accessory muscles and nasal flaring Oxygen toxicity= Hypoventilation Chapter 17 acute respiratory infections Tonsillitis- sore throat, difficulty swallowing, fever, tonsil inflammation Meds- antibiotics Reoccurred= tonsillectomy Tonsillectomy- keep in side lying position, assess for bleeding: clearing throat and frequent swallowing Administer clear fluids Avoid red color liquids No milk Discourage nose blowing, and throat clearing Warm about blood clots if they throw up Limit activity 2 week recovery bacterial epiglottitis bacterial infection s/s: drooling, hoarseness, difficulty speaking, diff swallowing, high fever DO NOT put anything in there throat Give antibiotics Have intubation supplies ready Influenza Fever, body ache, nasal congestion Antiviral within first 48hrsComplications Pneumothorax, pleural effusion Treatment Chest tube Chapter 18 asthma Triggers: allergens, cold weather, smoking s/s: Wheezing, anxiety, accessory muscles Treatment: bronchodilators- albuterol which can cause tachycardia and tremors Suck on hard candy Corticosteroids- instruct child to rinse mouth after inhaler Use peak flow meter= stand, zero out, lips around device, blow out 3 times, take highest reading Complications: status asthmaticus- intubation kit ready Chapter 19 cystic fibrosis Genetic mutation- both parents Affects lungs, liver, pancreas, small intestine s/s: nonproductive cough, wheezing, dyspnea, mucus plugs, cyanosis, clubbing of fingers and toes, large thick, fatty, smelly stool, sweat and tears are salty sweat chloride test diet- high in calories and protein, take pancreatic enzymes with meals, take vit a,d,e,k albuterol Chapter 20 cardiovascular Congenital heart defects- result in either hypoxemia and HF s/s: tachypnea, dyspnea, tachycardia, peripheral edema, cyanosis, polycythemia (increased RBC) increase pulmonary blood flow ventricular septal defect- creates a harsh murmus, heard at left sternal boarder atrial septal defect patent ductus arteriosus- created bounding pulses, machine hum murmer decreased pulmonary blood flow tricuspid atresia- complete closure of valve, also have to have an ASD tetralogy of fallot- 4 different defects- P= pulmonary stenosis, R= right ventricular hypertrophy, O= overriding aorta, V= ventricular septal defect Obstruct blood flow Pulmonary stenosis- causes systolic ejection murmur Aortic stenosisCoarctation of the aorta- upper body: bonding pulses, high BP… lower body: faint pulses, low BP, cold skinMixed blood flow Transposition of the great arteries- when the aorta is connected to the right ventricle and the pulmonary artery is connected to the left ventricle Requires surgery in the first 2 years of life Can cause major cyanosis Truncus arteriosus- no septum between the right and left ventricle Requires surgery after birth Hypoplastic left heart syndrome- left side of heart is underdeveloped Diagnostic ECG, EKG, echocardiogram, cardiac cath Check for shell fish allergy or iodine NPO for 4-6 hrs Locate pulses on the feet Assess for bleeding Flat laying 4-8 hrs after Provide small frequent meals Keep crying to a minimum Semi fowlers postions Hold at 45 degree angel Feed every 3 hrs Meds Digoxin- contraction of heart ACE inhibitor- provide vasodilation Beta blockers- decrease HR and BP Lasix’s- potassium level Hypoxemia episode Knee to chest position At high risk for bacterial endocarditis- have to take antibiotic before dental procedure Rheumatic fever Causes inflammation of the heart, blood vessels and joints Its is caused by strep Throat culture, ASO titer EKG Jones criteria- patient needs to have two major criteria or 1 major and two minorMajor criteria Carditis- chest pain, muffled heart sounds, friction rub, tachycardia Subcutaneous nodules- nontender Polyarthritis- joint pain Rash- trunk and inner surface Chorea- purposelessness muscle movement Minor criteria Fever Pain in one joint Treatment Antibiotics Kawasaki disease Inflammation of the blood vessels Phases: acute= high fever, irritability, red eyes, red lips, red strawberry tongue, red palms and soles of feet.. subacute= peeling skin on palms and soles.. convalescent= no symptoms altered labs Treatment Gamma globulin- IVGg Aspirin Avoid alive immunizations for 11 months Chapter 21 bleeding disorders Epistaxis- bloody nose Sit upright and lean forward Pinch bridge of nose for 10 min or Put ice on forehead Use cool mist humidifier Iron deficiency anemia Caused by poor diet or drinking a lot of cow milk RBC hgb and hct are all low High iron and protein and vit C diet Iron supplement Give 1 hr before or 2 hrs after consumption of milk or antacids Give with vit c for absorption Take with straw so they don’t discolor teeth IM injection use z track method Stool= tarry green color Iron rich food Dried beans, peanut butter, dark leafy greens, red meat, eggsSickle cell anemia Autosomal recessive disorder Produces abnormal Hgb Primarily affects African Americans Vaso-occlusive crisis- painful, ischemia in tissues Treatment- fluids, pain control, blood Complications: CVA Hemophilia Bleeding time extended due to lack of a factor for clotting Hemophilia A- lack of factor 8 Hemophilia B- lack of factor 9 Joint pain, easy bruising, Labs: prolonged PTT Don’t take rectal temp Avoid skim punctures- IV, IM meds Treatment: replace clotting factors Education: low contact sports, soft bristle toothbrush, wear med wristband, RICE Chapter 22 GI disorders Rotavirus- most common cause of diarrhea in kids s/s: watery diarrhea, vomiting, fever pinworm- causes perianal itching tape test for diagnosis diarrhea foods oral rehydration therapy DO NOT GIVE: fruit juice, gelatin, or carbonated drinks, no broth, don’t give BRAT diet Dehydration Mild- slight thrist, cap refill alittle more than 2 sec Moderate- cap refill 2-4 sec, thirst, irritability, mucus membranes dry Severe- cap refill >4, tachycardia, extreme thirst, not tearing, tented skin, sunken eyes Chapter 23 Cleft lip and palate Cleft lip- visible separation from the upper lip towards the nose Repaired around 2-3 months of age Use wide base nipple for bottle feeding Apply elbow restraints Cleft palate- visible opening of the palate inside the mouth, connecting the mouth to the nasal cavity Repaired 6-12 months of ageUse specialized bottle with one way valve Prone position Postop Avoid use of pacifier or nipple Complications Hearing loss and ear infections Speech and language impairment Dental problems GERD Self resolves by 1 year s/s: excessive spitting up, arching of back, irritability, heartburn give small frequent meals thick formula with rice cereal avoid caffeine, fried foods elevate head 30 degrees for atleast 1 hr after eating meds: ranitidine surgical: nico fundoplication- wrapping the fundas around the distal esophagus Pyloric stenosis Cause obstruction Projectile vomiting Dehydration and hunger Olive shaped mass seen in right upper quadrant of abdomen Surgery- pyloromyotomy Hirschsprung disease Lack of ganglionic cells in segments of the colon.. mechanical obstruction s/s: ribbon like stool, vomiting bile, abdominal distention risk: baby doesn’t pass meconium in first 24-48hrs of life high calorie, protein, low fiber diet child may need colostomy Intussusception One part of the intestine telescopes into another part s/s: red jelly like stool, sausage shaped abdominal mass therapeutic procedure- air enema Appendicitis Average age:10 years old s/s: RLQ pain, fever, absent bowel sounds CT scan Avoid applying heat to abdomen Give fluid and antibioticsChapter 24 Genital urinary disorders Enuresis: uncontrolled or unintentional urination after the age of 5 Restrict fluids in the evening Primary: child has never had control of there bladder Secondary: They have had control of there bladder in the past an now they are wetting the bed. Occurs when the child is regressing due to trauma or stress UTI s/s: frequent urination, foul smelling urine, fever, pallor, poor app., swelling of the face diagnosis: urinalysis.. looking for nitrates and leukocytes elevated education: wipe front to back, wear cotton underwear, avoid bubble baths, void frequently don’t hold it in, avoid constipation Chapter 25 structural disorders of GU tract Bladder exstrophy where the bladder or urethra or urinal orphan orifice is coming through the super pubic area. It’s a medical emergency requires surgery Put sterile gauze over the area hypospadias medius of the meatal opening of the penis is in the wrong spot. It is on the underneath part of the penis don’t get circumcision phimosis where it is difficult or impossible to retract the foreskin of the penis testicular torsion medical emergency s/s: enlargement of the affected testicle, severe sudden onset of pain chapter 26 renal disorders acute glomerular nephritis ***associated with strep infection s/s: cloudy tea colored urine, decreased urine output, periorbital edema, fashial edema in morning, mild to severe hypertension protein and blood in urine labs: elevated BUN, creatinine diagnosis: ASO titer for strep infection strict fluid and sodium meds: diuretics, antihypertensives, antibiotics nephrotic syndromealteration in the glomerular membrane that allows proteins especially albumin to pass into the urine which results in decreased serum osmotic pressure s/s: facial and perorbital edema, decreased frothy urine, BP in normal range, protein greater than 2+, low albumin, hyperlipidemia daily weight monitor edema measure abdominal girth restrict fluids and sodium meds: prednisone, diuretic, albumin 25% Chapter 27 fractures Open or compound: bone outside skin Closed or simple Apply ice, stabilize joint, neurovascular check Neurovascular check Sensation: no numbness or tingling Skin temp: warm Skin color: no pallor Cap refill: <3 sec Pulses: palpable Movement Casting Elevate cast above heart for 24-48 hrs Apply ice for first 24hrs Turn and position patients q2hrs for drying, no hairdryer Assess for hot spot on cast- infection Plaster cast use palms of hands Don’t put anything into cast Traction care Maintain body alignment Address pain and muscle spasms Neuro checks Assess pin site Make sure weights hang freely Do not lift or remove weights Halo traction- make sure wrench is attached to vest for CPR Compartment syndrome Compression of the nerves, blood vessels and muscle in a space.. tissue necrosis can occur s/s: intense pain, numbness, pulselessness, pallor fasciotomyosteomyelitis seen more in compound fracture infection of the bone s/s: fever, tachycardia, edema, pain bone biopsy antibiotics Chapter 28 musculoskeletal disorders and congenital disorders Club foot Deformity of foot and ankle Serial casting Legg calve parthes disease Necrosis of the femoral head s/s: painless limp, hip stiffness, shortening of affected leg, limited ROM bracing, casting or traction.. Possible replacement of the hip Developmental dysplasia of the hip s/s: infant- asymmetry of gluteal and thigh folds, limited hip abduction. Kid- One leg shorter than the other, positive trendalburg sign, limp Tests: positive ortolani test, positive barlow test Treatment: infant pavlik harness, child- Bryant traction or hip spica cast Complications: issue with bowel and bladder elimination Osteogenesis imperfect Heterogeneous autosomal dominate of the bones s/s: bone fractures, blue sclera, early hearing loss no cure treatment: pamidronate- increase bone density.. brings electrolytes down low impact exercise’s scoliosis lateral curvature of the spine causes rib asymmetry treatment: bracing or spinal fusion with rods Chapter 30 skin infections Impetigo: red macular- vascular lesions around nose Spreads through direct contact Antibiotic ointment Use burow’s solution Cellulitis Inflammation and infection of the soft tissue s/s: firm swollen red area of skin, fever, malaise antibioticsTinea infections Fungal infections s/s: red round scale like bumps topical antifungal treat infected pets Lyme disease Tick transmission s/s: chills, fever, stiff neck, bulls eye rash antibiotics scabies s/s: itchness, rash, thin pencil line marks 5% permethrin cream over whole body pediculosis lice s/s: intense itching, nits of hair shaft 1% permethrin shampoo remove nits with comb Chapter 31 dermatitis and acne Diaper dermatitis: diaper rash Wash area with warm water and mild soap Expose area to air Encourage use of disposable diapers Encourage frequent changes Zinc oxide repels moisture. NO TALCUM powder Contact dermatitis- poison plant Treat with alcohol followed by water Apply burrow solution Topical gel Seborrheic dermatitis Thick flakes on head Not an infection Gently scrub scalp Use fine tooth comb Keep nails trimmed short to prevent itching Atopic dermatitis Intense itching Encourage cotton clothing Avoid excessive heatAvoid irritants- no bubble baths Acne Healthy diet Mild cleanser Tretinoin- increased risk of sunburn Chapter 32 burns Thermal Chemical Electrical 1st – superficial, skin intact, epidermis effects 2nd – superficial partial thickness, damage to epidermis and part of dermis, blisters 3rd – full thickness, damage to epidermis and dermis and subcutaneous 4th – deep full thickness, throw all layers, down to muscle, bone or tendon, no pain rule of nine head: 18 total truck: 36 total arms: 9 total leg: 13.4 total interventions maintain airway IV access with large bore cath Check DTap vaccine Advise lotion on burns Fluids: <30kg maintain 1-2mL per kg per hr 30mL per hr for 66lbs or over lactated ringers nutrition: increase protein and calories, vit a, c and zinc maintain ROM meds silver sulfadiazine- causes transient neutropenia morphine Chapter 33 diabetes Foot care: inspect feet daily, dry feet completely, foot powder, cut nails straight across, avoid open toe shoes, leather shoes, cotton or wool socks, no heating pads to warm feet A1C <7 When youre sick: monitor blood glucose every 3 hrs, take insulin, test urine for ketones q3hrs, rest, call health care if glucose is more than 240Type of insulin Rapid- Humalog Short acting- humulin Never mix anything lantus- long acting, no peak time Clear before cloudy (short before regular) Chapter 34 growth hormone deficiency Will cause short stature Somatropin- given till growth plate closes Chapter 35 immunizations Contraindications Influenza = eggs Varicella = steroids IPV = neomycin MMR = gelatin, neomycin Dtap= encephalopathy or seizures Chapter 36 communicable diseases Risks: Lack of vaccination Poor sanitation and nutrition Crowded living spaces- dorms Conjunctitivits- pink eye Bacterial or viral Direct contact Fifths disease Spread through droplet Red rash across the cheek Hand foot mouth disease Rashes, painful sores in mouth Mononucleosis Spread through saliva Swollen lymph glands, enlarged spleen and liver No contact sports Measles or rubiola Droplet Coplic spots in mouthMumps Droplet Painful swollen salivary glands Deafness can occur Pertussius Cold symptoms, rapid cough Droplet Rubella Droplet Red rash on face to rest of body Varicella Airborn Rash, fever Nursing care No aspirin Calamine lotion Nails clean and short Gargle with warm water Benadryl can be given Antiviral may be given for mono Chapter 38 HIV/AIDS Affects T lymphocytes Labs: CD4+ = <500 s/s: enlarged spleen and liver, dermatitis, inflammation of salivary glands, kaposi’s sarcoma, pneumonia, muscle wasting syndrome standard precautions high protein and calorie diet medications: antiretroviral Chapter 39 cancer Wilms tumor- occurs in kidneys or abdomen. Usually unilateral Occurs around age 3 Metastasis is rare s/s: abdominal swelling, nontender diagnosis: abdominal ultrasound, CT, bone marrow aspiration DO NOT PALPATE ABDOMEN Surgical removal, chemo, radiation Neuroblastoma Malignancy of adrenal glandToddler years Metastasis in half the cases at time of diagnosis s/s: none specific diagnostic: CT, bone marrow aspiration Surgical removal, chemo, radiation Chapter 40 leukemia Production of immature white blood cells Most common cancer in children Causes anemia, thrombocytopenia, neutropenia Diagnosis: bone marrow biopsy, CSF analysis through lumbar puncture Lay flat 4-8hrs after Chapter 42 pediatric emergencies Respiratory distress s/s: restlessness, tachypnea, tachycardia, wheezing, grunting, nasal flaring Obstructed airway: use back blows and chest thrusts in infants In children: abdominal thrusts Never preform a blind finger sweep No don’t induce vomiting in case of poisoning Drowning: Lock toilets Do not leave kid in bath tub alone Pools have fence Life jackets when boating SIDS Risks: smoking, co-sleeping, prone sleeping, low birth weight or premie Remove all pillows Encourage breast feeding Chapter 43 psychosocial issues ADHD S/s: inattentiveness, hyperactivity, impulsiveness, easily distracted Meds: methylphenidate, dextroamphetamine Can cause insomnia- administer before 1800 Autism s/s: distress when routine is changed, delayed language, withdrawn, no eye contact decrease stimulation change routine slowlyMaltreatment/abuse Physical: Multiple fractures at different stages of healing Bruising Inconsistent stories Interview parent and child apart Repeat injuries Emotion: Failure to thrive Eating disorders Fear of parents Neglect Sexual: Difficulty walking or standing Shaken baby syndrome UTI Risks Single parents Low income portents Young parents Drug use
Connected book
- 2005
- 9780976006329
- Unknown
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- Miami Dade College Medical Campus
- Module
- ATI pediatrics
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- December 7, 2021
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- 2021/2022
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ati pediatrics
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chapter 1 parenting styles
