fon tom 31
care of child w/ physical disorder
Terms
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- Anemia defined
- decrease in RBC volume, a decrease in hemoglobin....or both......this can result in HYPOXIA
- Idiopathic Thrombocytopenia Purpura ITP
- characterized by marked decrease in the amt. of circulating platelets w/ resulting bleeding beneath the skin 2-5 yr old group...the cause is unknown
- Upper Respiratory Tract Infections (pharyngitis)a
- 4-12 yr old....child increasingly exposed to infections outside the home u
- what clinical manifestations would suggest a hydrocephalus in a neonate?
- Bulging fontanelle, dilated scalp veins
- CRUOP
- acute viral disease of kids, marked by resonant BARKING COUGH, suffocative and difficult breathing an laryngeal spasm
- Hydrocephalus
- excess of fluid w/in the cranial vault, subarachnoid space or both....skull becomes markedly enlarged....S/S widening and bulging of fontanelles, separation of cranial sutures, dilation of scalp veins, thin and shiny scalp
- Myopia
- nearsighted
- Candidiasis (thrush)
- caused by fungus...white patches of CANDIDA are found in moist tissues, because they cannot grow on skin....
- ITP how can you check it? (children outgrow this disorder)
- blood pressure cuff on for 5 min at 100...if more than 15 petechiae are present
- Metabolic acidosis
- results from a gain of hydrogen ions or a loss of bicarbonate.....in other words....retaining too ,many acids (H+ ions) or loosing too many bases (HCO-3)....the EFFECT is hyperventialtion, by blowing off carbon dioxide to lower the PCO2 level.......administration of sodium bicarbonate is usual treatment for acidosis
- Ketoacidosis
- when insulin is absent, glucose is not avail. for cellular metabolism and the body chooses alternate sources for energy, mainly fat....the keton bodies are now used for energy,...the resp. system attempt to eliminate the excess cargon dioxide by increased depth and rate....KUSSMAUL'S RESPIRATIONS.....the hyperventilation characteristic of METABOLIC ACIDOSIS
- LTB
- laryngotracheobronchitis...3 mo to 3 yrs...upper resp. infection that descends to lower resp tract..gradual progressive onset.....the will snow S/S of hoarseness, inspiratory strider, nasal flaring, the chest retractions (3) and the barking cough
- Hemophilia
- serious lifelong bleed disoprder inherited as an X-linked recessive disorder...transmitted by female carriers and affects male offspring. Classic hemophilia (typeA) is caused by deficiency of factor VIII (8)...which is necessary component of blood coagulation
- what is the most common form of meningitis?
- bacterial meningitis
- Hirschprung's disease
- there is an absence of innervation to a segment of bowel....no peristaltic waves in affected protion
- Hodgkin's Disease
- malignant lymphoma distinguished by painless, progressive enlargement if lymohoid tissue...etiology not known, more common in males, rare in children under 5 & peaks between 15 & 19 yr old
- Acquired Heart disease is when?
- those disorders that occur after birth
- cyanotic
- the blood doesnt have enough oxygen...condition of blue
- amblyopia
- lazy eye
- Luekemia characteristics
- is uncontrollable proliferation of blast cells(immature WBC's) which accumulate in the bone marrow, causing crowding and depression of other healthy cells.....the blasts can invade the bones causing pain, limping, and joint pain w/ edema....fracture can be a problem...a LUMBAR PUNCTURE may be done to see if infiltration of the CNS has occured
- what is the most prevalent blood disorder in infancy and early childhood?
- Iron defiency anemia...it occurs between 6-24 months in lower income children....infants are at risk because of their reduced fetal iron supply, adolescents are at risk because of their rapid growth rate combined w/ poor diet....iron is essential for the HEMOGLOBIN synthesis
- How are Congenital heart defects classes?
- acyanotic and cyanotic
- what intervention should be done when a child is having a seizure?
- describe & record the seizure activity observed
- Intussusception
- is result of the telescoping of one portion of intestine into another...common site ileocecal valve....CURRANT JELLY stools (feces mixed w/ blood and mucus from the intestinal mucosa? an hallmark of this...S/S sudden onset of severe abdominal pain in previously sell child
- ITP what are 1st signs?
- Ecchymoses and a pinpoint PETECHIAL rash...and over boy prominences....bleeding gums, epitaxis (nosebleed) ..hematuria, subarachnoid bleed, melena (black tarry stool) hematemesis( blood in vomit)
- Back to Sleep Campaign
- suggest that letting a baby sleep Prone (on stomach) may let the baby re-breath their own carbon dioxide and fall deeper into sleep (impaired arosal from active and quiet sleep) and quietly suffocate. they suggest having baby sleep in back (SUPINE) to avoid this problem///side lying and prone positions are no longer recommended
- what are the most common facial malformations?
- cleft lip and palate....usually involves nutritional, dental, & speech alterations and requires a multidisciplinary approach to treatment
- Bronchial Asthma
- is reversible resp. disorder...frequent cause is allergic hypersesitivity to environmental factors S/S shortness of breath, expiratory weezing, tachypnea, dyspnea, course breath sounds, restless, anxiety, dry and hacking to productive ...and fatigue.......Doc will do PULMONARY FUNCTION TEST
- Respiratory Distress Syndrome RDS...way to correct?
- Exogenous surfactant is admin. via the endotracheal tube directly into the infant's trachea and lungs shorty after birth....NEVER suction regularly....regualr can lead to pneumothorax (collection of air or gas in pleural space, causing lung to collapse
- what are the "general features" of Nephrotic Syndrome include?
- Albuminuria, edema, puffiness of face
- intussusception
- prolapse of the one part of the intestine into the lumen of adjoining part (intus = within; suscipiens = to take up)
- what kind of an effect can acne have on an adolescent?
- may have a psychological effect
- predisposes
- make susceptible
- what is associated w/ severe infantile diarrhea?
- Metabolic acidosis
- Dehydration (in children)
- Mild 5%, moderate 10%, severe 15%
- Talipes
- clubfoot..can be lateral or bilateral.....inherited or environmental disorder
- Tonsillitis
- masses of lymphoid tissue located in pharyngeal cavity believed to protect respiratory and alimentary tracts form invasion by pathogens
- Hirschsprung's Disease
- Hirschsprung's Disease is a rare congenital (present at birth) abnormality that results in obstruction because the intestines do not work normally. It is most often found in males. It is commonly found in Down Syndrome children. It can be life-threatening or a chronic disorder. The inadequate motility is a result of an aganglionic (without nerve tissue) section of the intestines resulting in megacolon (dilated section of colon). The FIRST sign of this is the babies inability to pass it's first poop (Meconium)
- children w/ long term anemia may exhibit what?
- growth retardation & developmental delays
- DM
- diabetes caused by a relative or absolute deficiency of insulin and characterized by polyuria......resulting in alterations in protein, carbohydrate, and fat metabolism IDDM Type 1 is more frequent in children
- in children how is HIV passed to them?
- semen, vaginal secretions, breast milk, tears, saliva, and UR
- what best describes Hirschsprung's disease?
- absence of parasympathetic ganglion cells in a segment of the colon
- Cleft Lip
- abnormal dev. of external nose, nasal cartilages, and nasal septum...it is due to failure of the palatal shelves to fuse...surgery to repair....may need to use special "cleft-palate" nipples for feeding...usually will have speech impairment...recurrent otitus media w/ scarring of tympanic membrane...which leads to hearing impairment.
- Hypertrophic pyloric stenosis is recognized by what?
- projectile vomit, malnutrition, dehydration, and a palpable mass in the epigastrium...and is re leaved by a pyloromyotomy
- what describes acute glomerulonephritis?
- it occurs after an antecedent steptococcal infection
- SCOLIOSIS
- the most common skeletal deformity of adolescence ...lateral curvature of spine
- Hernia
- protrusion of organs or portions of organ thru a structural defect of weakend muscel wall...protruding organ is called strangulated hernia
- what factor predisposes the urinary tract to infection?
- a short urethra in young females
- SIDS
- sudden unexpected death of infant under 1 yr old, dramatic decrease is from Back to Sleep Campaign,....leading cause of death in infants...more in males...cause unknown...
- Osteomyelitis
- infection w/in the bone
- Spina Bifida Myelomeningocele
- terms describes a variety of congenital defects...neural tube (tube formed from the fusion of the neural folds from which the brain and spinal cord arise).....infant may have tuft of hair, cleft, small, fatty mass over the defect
- Sickle Cell Anemia
- Red blood cells are bent and is usually seen with people with the African descent.....genetic disorder characterized by abnormal form of hemoglobin w/in the erythrocyte (RBC) there are 2 classes...sickle cell trait or active sickle cell disease.....active is the worse and is potentially fatal
- Luekemia
- name given to group of malignant diseases of the bone marrow and lymphatic system....it is the most common malignancy of childhood and is more common in males 2-6 yr old
- Pneumonia
- acute inflammation of the pulmonary tissue..small airways, and alveoli...the cause is bacterial, via, mycoplasmal, or foreign body aspriation...VIRAL is more commone
- strabism
- cross-eyed
- Respiratory Distress Syndrome RDS
- Ifdiopathic Respiratory Distress Syndrome (IRDS) & Hyaline M... is major cause of mortality and morbidity in neonatal period......W/O sufficient production of surfactant, infant unable to keep the lungs inflated and alveoli collapse at end of espiration results in hypoxia, atelectasis, and RESPIRATORY ACIDOSIS...can cause death, treat very fast.....S/S nasal flaring, expiratory grunting, intercostal, subcostal, or substernal retractions, tachypnea....those who survive may show improvement by 4th day
- Diabetes mellitus is characterized by ?
- deficiency of insulin, resulting in alterations in protein, carbohydrate, & fat metabolism
- Cerebral Palsy (CP)
- most common permanent physical disability of childhood
- Diaper Dermatitis
- one of the most common skin disoprder in infancy.....is a form of contact dermatitis and usually caused by external irritant.....prolonged exposure to UR or feces, inadequate cleaning of the diaper area, detergents, fabric softeners....too much ointments of powders
- who is at greatest risk w/ sickle cell?
- children under 5 yr old....they can die of overwhelming infection
- telescoping of one segment of bowel w/in another is called?
- intussusception
- CROUP describes a group of S/S of varied origins....what is it characterized by?
- obstruction or edema in region of the larynx, producing a respiratory strider hoarseness, and a cough described as BARKING
- Albuminuria
- the presence of excessive protein (chiefly albumin but also globulin) in the urine.....usually isysmtom a kidney disorder
- area of pain for hemophilia?
- internal bleeding occurs w/in the joints (hemarthrosis) and muscles...pain intensifies as bleeding continues to fill teh joint, limiting movement ...gets to the point where child refuses to use the affected joint
- as sicled cells clump, (these are cells that changed from round shape to elongated shape) circulation slows, resulting in what?
- obstructions w/ severe tissue hypoxia and necrosis...Cardiomegaly and heart failure develope in response to hypoxia and decrease cardiac output....in older child the joints are surrounded by tissue that can become edematous and painful......severe sickling can lead to SICKLE CELL CRISIS ...an acutely painful period that can occur off and on through out child's life
- pyloromyotomy
- cutting the muscle at the end of the stomach...the pyloric muscle
- what are spiral fractures a sign of?
- often signs of abuse
- acyanotic
- lacking a blue appearance of the skin and mucous membranes
- JRA juvenile RA
- is chronic inflammatory, autoimmune disease of connective tissue...more girls have it.....erosion, destruction, and fibrosis of articular cartilage....edema results from joint effusion and synovial thickening
- 6 month old is suspected to have cystic figbrosis. the dx test commonly used for this is?
- Sweat test
- what i the most common form of Neoplasm in childhood?
- acute lymphoblastic leukemia
- what is true regarding Wilms' tumor?
- th tumor manifests as a firm, non tender intraabdominal mass
- Hyperopia
- farsightedness
- Otitus Media
- infection of middle ear, cause is accumulation of bacteria in nasopharynx....S/S pulling, tugging, fussy, dec. appetite, rolling head from side to side.
- CHD
- Coronary heart disease
- 5 yr old is admitted to peds. w/ sickle cell crisis...what to do for her?
- admin. IV fluids to improve circulation, administer analgesics as ordered, admin. of oxygen as ordered
- wha tare most common skin disorders of infant & childhood?
- diaper dermatitis, atopic dermatitis, seborrheic cermatitis
- when should oral preparations of IRON be given? (these kids have iron deficiency anemia)
- should be given between meals w/ citrus fruits or juices to enhance absorption
- Aplastic Anemia
- is due to the failure of the cell generating capacity of the bone marrow, all formed elements of the blood are defective, underdeveloped or absent, resulting in severe anemia, leukopenia and thromcytopenia
- Encephalitis
- inflammation of CNS, namely, the brain tissue and spinal cord...resembles meningitis....treatment is similar
- glomerulonephritis
- nephritis marked by inflammation of the glomeruli of the kidney ....characterized by the decrease of production of UR and the presence of blood and protein in the UR and by edema
- acute lymphoblastic leukemia
- acute leukemia characterized by proliferation of immature lymphoblast-like cells in bone marrow, lymph nodes, spleen, and blood....MOST common in children
- newborn with cleft lip and palate, Doc says expects good results, mother refuses to hold baby....what therapeutic approach to the mother should be?
- Encourage her to express her feelings