Section 2 Peds Review Guide

South Louisiana Community College HNUR 2055 Section 2 Peds Review Guide 1. Adolescent mental health disorders Refer to Ppt. 27-38 adolescent mental disorders** Slide 13-35 2. Freud’s stages (know preschool, school age, and adolescent) Preschool: Phallic phase finds sexual identity by exploring the genitalia and masturbating. School age: Sexual latency (a time when sexual desires are lessened; sexual drives are dormant or hidden(latent) while school-aged child focuses attention on schoolwork, etc.) Adolescent: Genital stage (erogenous zone), engage in masturbation and sexual relations. 3. Anticipatory guidance for adolescent Prevent injuries, disease and illness -Most causes of death are due to injuries, self-harm and high-risk behaviors. Dental health, hearing, posture, prevent motor vehicle accidents, tanning/sun exposure, and social isolation. 4. Erikson’s developmental stages (know preschool, school age, and adolescent) Preschool: Initiative vs guilt; Child must master the process of initiating activities that are independent and self-directed. lack of opportunity may make the child reluctant to try new processes. Support the child in the attempts; frequent blame or negativity during skill exploration can cause feelings of guilt and decreased feelings of worth School age: Industry vs inferiority Adolescent: Identity vs role confusion; Develops confidence and selfesteem. 5. Celiac disease Is a Gluten Intolerance - the inability to tolerate or fully digest foods that contain rye, wheat, oat, and barley glutens; causes atrophy of small intestine villi (decrease intestinal absorption). S/S: Fowl smelling stool, wt. loss and increased gas. Tx: Diet modifications 6. Types of play (preschooler vs school age) Play – Preschooler: Associative play, cheating to win School age: family games, competitive play, same-sex teams 7. Neurovascular checks in r/t fractures- normal vs abnormal Normal: Abnormal: 8. Health promotion for the preschooler 9. Conjunctivitis Inflammation of the conjunctiva- highly contagious, Tx: Abx eye drops if bacterial, ointment. 10. Box 20.1- review this box There are Three components of pre conceptual thinking: * Artificialism: The preschooler believes that everything is made by humans * Animism: The preschooler believes that inanimate objects are alive * Imminent justice: A belief that everything has a determined universal code of law and order 11. Rheumatic fever Systemic disease involving the joints, heart, CNS, skin and subq. Tissues; Affects ages 6-12 (autoimmune); Cause due to untreated group A strep throat. 12. Immunizations for the preschool, school age, and adolescent- these are located in colored boxes in each chapter Preschool- Varicella zoster, MMR, Dtap (diphtheria, tetanus, pertussis) and IPV (inactivated poliovirus) School age- Tetanus, Tdap, measles, mumps, rubella (MMR), Gardasil (HPV), Meningococcal group B, and influenza. Adolescent- Tetanus toxoid, reduced diphtheria toxoid, acellular pertussis, tetravalent meningococcal polysaccharide (MPSV4), HPV, Hep A and B, influenza. 13. Ringworm treatment and signs and symptoms Tx: local application of antifungal of clotrimazole for 2-4 weeks. S/S: athletes’ foot, fingernail or toenail infection, Jock itch, fungal infection in the groin etc, darker and lighter varied patches on back or chest. 14. Fractures Transverse – Line crosses shaft at 90-degree angle. Spiral- diagonal line coils around the bone, caused by twisting force. Oblique- diagonal line across bone. Greenstick- Bone is bent but not broken; common in children Comminuted- 3 or more fracture fragments. Compression- bone becomes wider and flatter; usually seen in spine. 15. Normal growth and development for preschool, school age, and adolescent ***Refer to ppts. 16. Egocentrism- define Inability to differentiate form self and others; Inability to see any perspective other than one’s own. 17. Precocious puberty- define The appearance of secondary sex characteristics before 8 yeas in girls and 9 in boys. The cause of this condition may be premature secretion of sex hormones not caused by pituitary or hypothalamic action. 18. Nephrotic syndrome Development of pores along final filtration membrane of kidney and loss of serum proteins; Cause unknown. 19. School-age child preferred peer groups Social groups 20. Epilepsy Recurrent seizures 21. Traumatic brain injury Occur across the lifespan; Increased ICP and cerebral edema; Those who participate in contact sports; Types: Concussion (most common), contusion. 22. Adolescent sex education Protection from pregnancy and sti’s. 23. Appendicitis complications and signs/symptoms Complications: Rupture/perforation = risk for sepsis and peritonitis (inflammation of the lining of the belly or abd.) S/S: Lower right quad. Pain, n/v, chills, fever, elevated WBC, positive u/s. 24. ASD- autism spectrum disorder -A pervasive developmental disorder; Includes condition like: Rett’s syndrome (brain, communication, motor, and growth disorder), Asperger’s syn (milder form). -No known cause but exist from birth. - accompanied by repetitive and restrictive behaviors called “echolalia”. 25. Impetigo Infectious disease of skin caused by staph or group A strep; break in skin; TX: Antibiotics/topical ointments like “Bactroban.” 26. Sickle cell anemia -Abnormal sickle-shaped hemoglobin S, causing pain and fatigue; Crises or episodes (Life threatening); Sickledex screen for it; -TX: Pain control, hydration, O2, rest and antibiotics if febrile or to prevent infection. 27. Drownings/near drownings Toddler period and later adolescence. Drowning – child dies within 24hrs after submersion Near drowning – if child lives beyond the 24hr and recovers or dies. 28. ADHD Neurobehavioral psychiatric disorder Must exhibit 6 out of 9 s/s and present at least 6 months, 2 settings and be present before 12th bday. 29. Anorexia vs bulimia Anorexia: Unknown cause; Voluntarily refuses to maintain a normal body wt.; Fear of gaining wt., females may experience amenorrhea. Bulimia: An excessive appetite and insatiable eating; recurrent episodes of binging followed by guilt; self-induced vomiting, dieting and excessive. 30. Soft tissue injuries- treatment R- rest, I- ice, C- compress, and E- elevate 31. SBE- subacute bacterial endocarditis An infection in the lining of the heart. Cause: Turbulent blood flow or other factors that damage lining of heart. TX: if early caught – penicillin S/S: Fever, fatigue, sweats, chills, loss of appetite, joint pain, confusion, HA, malaise and cough; May have + history of IV drug use. 32. Type 1 DM vs Type 2 DM and signs & symptoms Type 1 DM: Body produces no insulin; Often 1st presents with DKA; Chronis metabolic disorder marked by hyperglycemia. S/S: Polyphagia (excessive hunger), Polydipsia (excessive thirst), polyuria (excessive urination) – HbA1c Type 2 DM: Insulin resistance; Interventions: exercise/wt. loss, oral hypoglycemic and insulin. S/S: Hyperglycemia, acanthosis (darkened, thickened skin pigmentation) 33. Osteogenesis imperfecta An autosomal dominant, heterogenous disease where the child suffers from fractures and skeletal deformity or “brittle bone disease”; Defect in genes and require special handing. 34. Legg-Calve-Perthes Disease -Blood supply to epiphysis (end of bone) is disrupted, tissue death and affects development of head of femur. -In children 2-12 - Onset of limb/hip pain TX: decreased activity, bed rest and NSAIDs 35. Ulcerative colitis vs Crohn’s -Ulcerative colitis: disease of the large intestine w/ continuous lesions involving the superficial mucosa. (peak age 15-20) *S/S: Frequent stool, wt. loss, anemia; Tx; meds, diet modification -Crohn’s: ulcerations along the mucosal lining of the bowel but can affect any part of the alimentary tract, child’s mouth to anus. *S/S: Diarrhea w/ frank or occult blood, abd. Pain and cramping, abscess formation; Tx: meds, surgery 36. UTI signs and symptoms S/S: Urinary frequency or pain, odor of urine, color and clarity of urine, fever, dehydration, hematuria, lethargy/poor feeding, pain and h/o previous UTI. 37. Hemophilia Lack of clotting factors which impairs clotting ability; several types genetic; medical alert worn; No contact sports; Normal blood clots in 3-6 mind where as hemo. Is greater or = to 1 hr. 38. Neutropenic precautions (see Leukemia) **Box 38.7 pg. 720 -Assess for fever; blood cultures should be drawn as ordered - Assess regularly for any signs and sympt. Of infection of erythema at central line catheter insertions sites and infections at wounds - Maintain a meticulous environment to reduce infection possibility. - Prevent nosocomial infections by keeping the child in his/her hospital room - To reduce chances of bleeding and infections don’t use rectal thermometers, no rectal exams, and no rectal suppositories. - Perform meticulous hygiene - Teach family about neutropenia 39. Tonsillitis and tonsillectomy Inflammation of tonsils caused by bacteria (most common) or virus. - Tonsillectomy- removal of tonsils (post- op hemorrhage signs = frequent swallowing or throat clearing.; earache and low grade temp. common 2-3 days post op.