AC PNP Pediatric Nurse Practitioner - Acute Care Melnic Questions and ANSWERs 100% Pass

AC PNP Pediatric Nurse Practitioner - Acute Care Melnic Questions and ANSWERs 100% Pass Describe pertussis... course, diagnosis and treatment? - ANSWER -Course, catarrhal phase, paroxysmal phase, convelescent phase. May have co-findings of pneumonia, otits, seizures or encephalitis Diagnosis- Lymphocytosis, Bordetella pertussis, a coccobacillus. Treatment erythromycin Review the signs, symptoms , and etiology of Guillain-Barre vs. Botulism - ANSWER -Guillain-Barre' -- May follow non specific viral infection or commonly, Campylobacter, Landry's ascending. Paralysis. CSF in notable for few white cells and high protein. Botulism- Clostridium botulinum -A gram positive Anaerobe. Rapid descending . Paralysis. CSF is normal. Avoid antibiotics " - ANSWER - What is transient tachypnea of the newborn? - ANSWER -Usually follows uneventful deliveries . May be related to slower absorption of fetal lung fluid resulting. Decreased pulmonary compliance and increased dead space. Usually resolves in approximately 3 days without therapy. Review the criteria for ARDS - ANSWER -Acute onset of symptoms following, precipitating infection of insult, frontal chest xray biliateral infiltrates. No clinical evidence of LA HTN, PsO2 to Fio2 ratio </= 200 What are the radiologic findings for asthma? - ANSWER -Asthma, flattened diaphragm, narrow cardiac silhouette, hyperinflation, narrow cardiac silhouette, peribronchial thickening, subsegmental atelectasis State one major pediatric theorist for each of the following: Psychosocial, cognitive and moral development - ANSWER -Psychosocial: Erickson Cognitive: Piaget Moral: Kohlberg At what age should children first be able to combine words? - ANSWER -18 months Erikson's stage of Industry vs. inferiortiy coincides with which Piaget stage? - ANSWER -Concrete Operations What are the adverse effects of ginkgo biloba? - ANSWER -Bleeding events r/t inhibition of platelet activating factor, subdural hematoma, cerebral hemorrhage, hyphema and post-op bleeding complications, increased CBF may result in increased ICP, may potentiate anticoagulation Describe methods to treat hyperkalemia - ANSWER -Push K into cells- Albuterol, Insulin/glucose, Sodium bicarbonate - Remove K- Kayexalate, dialysis; Stabilize cardiac cell membrane- Ca chloride What is the equation to calculate creatinine clearance in children? - ANSWER -K x ht (cm)/serum creatnine - K equals Preemie 0.33, Term 0.45, 2-21yrs female, 0.55 2-21 yrs male .70 Review the diagnostic criteria, treatment, and followup for urinary tract infection in young children - ANSWER -Diagnostic Criteria- Unexplained fever( 2mos2yrs), + nitrite test, + leukoesterase test, 5 WBC's, Colony coutn > 100,000, Culture of 2 or less organisms; Oral treatment and followup- Amoxicillin, TMP/SMX, Cephalosporin-Treat for 7- 14 days US and VCUG to follow Describe the signs and symptoms, lab findings, and treatment for nephrotic syndrome - ANSWER -Signs and symptoms- edema, especially periorbital, HTN, Anorexia, abd. Pain and or abd distension; Lab findings- Albumin < 2.5, Heavy proteinuria, Cholesterol> 250, hematuria; Treatment-Steroids- DiureticsSodium/fluid restriction, albumin What are some of the clinical findings with systemic lupus erythematosus? - ANSWER -4 or more of the following are diagnostic, Malar rash of the face, discoir rash, photosensitivity, oral ulcers usually painless, arthritis in 2 or more joints, pericarditits or effusion, kidney disease, hemolytic anemia, Leukopenia, Thrombocytopenia, Antiphospholipid antibody, Anti-DNA antibody, false positive for syphillis, Antinuclear antibody " - ANSWER - State the onset, peak, and duration of the following insulins: Humalog, regular, NPH, Glargine - ANSWER -Humalog onset 0.25/hr, peak .5-1.5hr, duration 3-5 hr Regular onset .5-1hr, peak 1-5 hr, duration 3-10hrs NPH onset 1-4hr, peak 4-14hr, duration 10-24hr Glargine, (Lantus) onset 1-2 hrs, peak 2-20hr, duration 20-24hr Describe the differences between the Syndrome of Inappropriate Diuretic Hormone and Diabetes Insipidus - ANSWER -SIADH - Inappropriate ADH secretion, decreased Na with decreased serum osmo, increased urine osmo, Normal kidney function, often follow cerebral illness, or injury esp. spinal surgery, Tx with supp theray and fluid restriction. DI--Inadequate antidiuretic, Hormone effect, Disease of free water, Polyuria/polydipsia, Decreased urine osmo/. even, When serum osmo increased, Increased NA, Central or nephrogenic, Often follows Cerebral illness of injuryTreat with supportive, Therapy and vasopressin List the clinical features of DiGeorge Syndrome - ANSWER - Hypoparathyroidism, hypoplastic thymus, conotruncal heart defects, cleft lip and /or palate, Flattened facies with hypertelorism and low set ears Review the signs, symptoms, and treatment for adrenocortical insufficiency - ANSWER -Signs and symptoms- hypoglycemia, hyponatremia, hyperkalemia, metabolic acidosis, hypotension, gastroenteritis/fever; Treatment- Pretreatment labs:ACTH, plasma renin,Cortisol, DHEAS, 17-OH, aldosterone. Supportive therapy, Hydrocortisone