NR 602 Final Exam Questions And Answers 100% Verified

NR 602 Final Exam Questions And Answers 100% Verified Step 1 Asthma approach-Intermittent - answersymptoms 2x or less per week asymptomatic and normal PED requires SABA 2 days/week no interference with normal activities brief exacerbations nighttime symptoms 2x or less a month lung fx- FEV>80% predicted Step 2 Asthma Approach-Mild persistent - answerSymptoms >2 x a week, less than once per day requires SABA more than 2days/week, no more than once a day exacerbations may affect activity nighttime symptoms 3-4x a month FEV> 80% predicted Step 3 Asthma Approach-Moderate Persistant - answerdaily symptoms daily use of SABA some limitations 2x or more per week exacerbations nighttime symptoms more than 1x per week, not nightly FEV >60% but <80% Step 4 Asthma Approach-Severe Persistent - answercontinual symptoms requires SABA multiple x a day extremely limited activity nighttime symptoms 7x a week FEV <60% Tx of asthma - answerStepwise approach step 1: SABA PRN step 2: low dose ICS Step 3: low dose ICS+ LABA or medium dose ICS step 4: Medium dose ICS+LABA Step 5: high dose ICS+ LABA Step 6: High dose ICS+LABA + corticosteroid Step 6 Asthma Approach - answer Bulbar/palpebral conjunctival infection - answerMay be unilateral or bilateral Leukocoria - answerabnormal appearance of a white film in the pupil; immediate referral to pediatric ophthalmologist warranted Causes: retinal detachment, cataract, retinal dysplasia, newborn retinoblastoma Visual screening in children - answerAt least once between ages 3-5 y/o according to USPSTF AOM - answerRF: genetics, males, Native American, siblings, low economic status, ages 6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke S/S of AOM - answererythema, otalgia, bulging TM, absent cone of light Dx of AOM - answerAudiometry, tympanometry, possible lateral neck xray to r/o mass TX of AOM - answeruncomplicated: supportive with tylenol/ibuprofen; watchful waiting 48- 72 in 6m-2y/o; <5 benzocaine otic drops 1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days if allergy to PCN- augmentin, cefuroxime Bacterial rhinosinusitis - answerPreceded by URI-typically worsens after 5-7 days- not resolved in 2 weeks Sx of bacterial rhinosinusitis - answerPurulant nasal congestion, drainage, facial pain, headache, fever No imaging required- if no improvement refer to ENT Bronchiolitis - answerUsually caused by RSV wheezing present <2 y/o other causes; influenza, adenovirus, rhinovirus S/s of bronchiolitis - answerIncreased work of breathing, prolonged expiration, grunting, retractions, nasal flaring Croup sx - answerLow grade fever, URI symptoms, barking cough, inspiratory stridor can occur Croup dx - answerMade from symptoms Croup tx - answerGlucocorticoids possibly 0.6mg/kg-1mg/kg humidified air bronchodilators Lead poisoning - answerInactivated heme synthesis by inhibiting insertion of iron-leads to microcytic hypochromic anemia Source of lead poisoning - answerLead based pain Those at risk for lead poisoning - answerChildren 2-3 y/o summer months Lead poisoning testing - answerChildren with Medicaid need lead level @ 12 months and 24 months-capillary finger stick with venous sample as f/u AAP recommends mo as well as 3-4-5-6 y/o Lead levels - answer<5 is normal >69 requires chelation Genu varum - answerBow legged as a result of uterine position- normal finding up to 3y/o Legg-Calve-Perthes Disease - answerAvascular necrosis of femoral head- epiphyses associated with trauma, synovitis Legg-Calve-Perthes Disease RF - answerAssociated with low birth weight, socioeconomic status, or white race