NUNP 6541 Pediatric Final Exam-Walden U

NUNP 6541 Pediatric Final Exam-Walden U Questions And Answers Verified 2-year-old girl with increased work of breathing had a fever, abdominal pain, post-tussive emesis and no diarrhea. What lab test would be beneficial? - Rapid flu test, respiratory viral panel 3-week-old male infant with projective vomiting and constant feeding: what would be the most likely diagnosis? - Pyloric stenosis 4 year old being treated with chemotherapy; which immunizations should he avoid? - MMR and Varicella because they are live-attenuated vaccines 5 year old has mild leg bowing, what labs would you order? - Vitamin D, Phosphorus 6-month-old with newly diagnosed sickle cell disease, what should you do on the visit of a well-baby visit? - Educate regarding risk of infection due to asplenia and need to seek medical attention promptly for eval of febrile illness. If febrile, immediate referral for blood culture and empiric abx against o and Hib. Prevention is key! Factors that may precipitate events: dehydration, hypoxia, fever, exposure to extreme temps; how to manage pain; how to recognize signs of serious prob. Anticipatory guidance regarding developmental issues such as toilet training, school attendance, delayed growth & development A 11-year-old who presents with weight loss, polyuria, and polydipsia. What do you need to rule out ? - Diabetes A 14-month-old that has lower extremity bowing. Lab values what would be the most likely diagnosis? - Vitamin D, Phosphorus, Calcium A 14-year-old who has not started menstrual cycle - Chromosomal or genetic abnormalities can cause the ovaries to stop functioning normally. Turner syndrome, a condition caused by a partially or completely missing X chromosome, and androgen insensitivity syndrome, often characterized by high levels of testosterone Problems with the hypothalamus or pituitary gland in the brain can cause an imbalance of hormones that can prevent periods from starting A 2-year-old who was brought in with fever, poor feeding, getting worse since yesterday, appears ill, temp 101, tachycardic, x-ray of left hip shows widen joint space but no fractures what would you do at this point? - Oral antibiotics (cephalosporin or clindamycin) and recheck in 2 days A 3 yr old presents with wheezing for past 3 months, what tests would you order? - Spirometry A 5-year-old with acute lymphocytic leukemia. What is he at risk for developing? - Bleeding febrile neutropenia A 5-year-old with encopresis what would your next action be after diagnosis? - Goal is to establish a regular bowel routine. Bowel evacuation using oral PEG solutions (if problem is constipation) If not constipation, establish a structured toileting pattern A 5-year-old with type 1 diabetes and management of the insulin requirement - Children with newly diagnosed type 1 diabetes usually require an initial total daily dose of ∼0.5-1.0 units/kg. In general, younger (and prepubertal) children require lower doses while the presence of ketoacidosis, use of steroids, and the hormonal changes of puberty all dictate higher doses It is common for a newly diagnosed child's diabetes to enter a honeymoon phase with an increase in insulin production within several weeks after the initiation of insulin therapy. During this phase of diabetes, insulin requirements may fall well below the initial dose of 0.5-1.0 units/kg per day needed to maintain blood glucose targets. Children may require only minimal amounts of intermediate- or long-acting insulin, possibly combined with small amounts of rapid- or short-acting insulin. β-cell destruction continues during this honeymoon phase, and with the progressive loss of β-cell function, there is need for increased exogenous insulin to avoid elevated blood glucose levels A 7-month old presents with 1-day cough, yellow sinus drainage and a low grade temp, treatment options? - Tylenol and monitor A 9-year-old who has dyspepsia without occult blood what would your steps be? - Endoscopy A child developed her 2nd perirectal abscess in 6 months. What should she be evaluated for? - Crohn's disease or sexual abuse A child has not received abx for a bacterial respiratory infection, what would you treat them with? - Amoxicillin