lOMoARcPSD|44532475
Pediatrics Exam 4 Study Guide
Grief and Loss:
Reactions to Death:
o Toddlers: More affected by change in lifestyle – may go on as if
deceased is still alive
o Pre-School: Believe the deceased is only “sleeping”
o School-Age: Better understanding of death, personify death as a
monster and fear punishment. Fear of the unknown. Asks a lot of
questions. May be curious about what happens to the body.
o Adolescents: Criticize funeral ceremonies, think they are
barbaric.
Hematology and Oncology:
Hemophilia:
o S/S: Prolonged/excessive bleeding, hemarthrosis (bleeding in the
joints, treat with RICE), excessive bruising
o TX: No contact sports (can do swimming/golf/bowling), control
bleeding (RICE for vasoconstriction)
Wilm’s Tumor:
o S/S: Unilateral mass in abdomen, may have HTN. Most common
kidney tumor.
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o TX: Nephrectomy – infection concern, monitor for elevated WBCs
and fever
DO NOT palpate abdomen d/t risk of rupture and spread of
cancer
Monitor BP. Monitor bowel sounds (if absent, notify MD),
observe for distention/vomiting
Neuroblastoma
o S/S: Most common cancer in infants. Firm, irregular mass crosses
midline in abdomen.
Retinoblastoma:
o S/S: Cat’s eye reflex – white glow in pupil when exposed to light.
o TX: Enucleation – surgically implanted sphere keeps shape of eye
to maintain facial symmetry. Face will be swollen/bruised
Iron deficiency anemia
o Give iron-fortified cereal at 6 months
o Breastfed babies will need iron by 4 months
o Give with Vitamin C
o Do not give iron with milk (no cow’s milk until 1 year of age)
o Liquid iron stains teeth-give through straw or syringe
o Black stool is normal
Sickle Cell Crisis
o Types:
Vaso-occlusive – painful
Splenic sequestration – pooling of blood in spleen
Aplastic – decreased production of RBCs
o Can be caused by infection, stress, dehydration
o Oral/IV hydration (have fluids available at all times – enuresis is
possible) Pain management is essential- most commonly with
morphine (if showing signs of opioid overdose, admin naloxone)
o Infection prevention - immunizations
Leukemia
o Decrease infection risk – private room, handwashing, no sick
visitors, no live plants.
Ewing Sarcoma
o Limb more likely to be preserved
o Radiation can lead to skin irritation
Wear loose-fitting clothing over irradiated area
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Pediatrics Exam 4 Study Guide
Grief and Loss:
Reactions to Death:
o Toddlers: More affected by change in lifestyle – may go on as if
deceased is still alive
o Pre-School: Believe the deceased is only “sleeping”
o School-Age: Better understanding of death, personify death as a
monster and fear punishment. Fear of the unknown. Asks a lot of
questions. May be curious about what happens to the body.
o Adolescents: Criticize funeral ceremonies, think they are
barbaric.
Hematology and Oncology:
Hemophilia:
o S/S: Prolonged/excessive bleeding, hemarthrosis (bleeding in the
joints, treat with RICE), excessive bruising
o TX: No contact sports (can do swimming/golf/bowling), control
bleeding (RICE for vasoconstriction)
Wilm’s Tumor:
o S/S: Unilateral mass in abdomen, may have HTN. Most common
kidney tumor.
Downloaded by madiba South Africa stuvia ()
, lOMoARcPSD|44532475
o TX: Nephrectomy – infection concern, monitor for elevated WBCs
and fever
DO NOT palpate abdomen d/t risk of rupture and spread of
cancer
Monitor BP. Monitor bowel sounds (if absent, notify MD),
observe for distention/vomiting
Neuroblastoma
o S/S: Most common cancer in infants. Firm, irregular mass crosses
midline in abdomen.
Retinoblastoma:
o S/S: Cat’s eye reflex – white glow in pupil when exposed to light.
o TX: Enucleation – surgically implanted sphere keeps shape of eye
to maintain facial symmetry. Face will be swollen/bruised
Iron deficiency anemia
o Give iron-fortified cereal at 6 months
o Breastfed babies will need iron by 4 months
o Give with Vitamin C
o Do not give iron with milk (no cow’s milk until 1 year of age)
o Liquid iron stains teeth-give through straw or syringe
o Black stool is normal
Sickle Cell Crisis
o Types:
Vaso-occlusive – painful
Splenic sequestration – pooling of blood in spleen
Aplastic – decreased production of RBCs
o Can be caused by infection, stress, dehydration
o Oral/IV hydration (have fluids available at all times – enuresis is
possible) Pain management is essential- most commonly with
morphine (if showing signs of opioid overdose, admin naloxone)
o Infection prevention - immunizations
Leukemia
o Decrease infection risk – private room, handwashing, no sick
visitors, no live plants.
Ewing Sarcoma
o Limb more likely to be preserved
o Radiation can lead to skin irritation
Wear loose-fitting clothing over irradiated area
Downloaded by madiba South Africa stuvia ()
