| What is Congenital Heart Disorder (CHD) | An abnormality or anomaly of the heart is present at birth. |
| what are the cardiovascular disorder? | Acquired Heart Disorder, compromises abnormalities occurring after birth that compromises the hearts function. |
| Children with suspected cardiac dysfunction may exhibit what? | cyanosis, pallor, cardiomegaly, pericardial rubs, murmurs and additional heart sound S3 n S4, |
| Environmental factor for CHD includes what? | Intrauterine rubella exposure exposure, maternal alcoholism, DM, advance maternal age and maternal drug ingestion. |
| Genetics risk factor for CHD are. | presence of sibling or parent w/ CHD, chromosomal anomalies, (trisomy G{ trisomy 21, Down Syndrome} Trisomy D { trisomies 13, patau syndrome 14: 15} and monosomy X { turner syndrome} |
| during fetal development the placenta is the source of what? | oxygen and nutrients. |
| at delivery with the first breath the newborns lung expand and fluid within them is absorbed in the? | pulmonary circulation. |
| what are the two types of defects? | CHD - disorder related to symptoms of color ( cyanotic or acyanotic.
Disorders related to the direction of blood flow ( left to right shunt or right to left shunt.) |
| what re the four physiologic characteristics most current CHD categories ? | Increased pulmonary blood flow
decrease pulmonary blood flow
obstruction to systemic blood flow and
mixed blood flow |
| (Patent ductus arteriosus) children with larger defects often exhibits S/S of HF including what? | poor eating, poor growth patterns and fatigue
other S/S typical machine like murmur, widened pulse pressure and bounding pulses |
| (Patent ductus arteriosus) Administration of what medication often has been effective in closing ductus arteriosus in full term and premature newborns? | Indomethacin ( a prostaglandin inhibitor) |
| (Atrial septal defect) smaller defects less than in what diameter are often asymptomatic or do not produce symptoms until later in life? | 5 mm |
| (Atrial septal defect) larger defects produce manifestation consist with what? | Heart Failure |
| palliative procedure for Ventral septal defect is also kwon as? | pulmonary artery banding |
| tetralogy of fallot involves a combination of four defects. | pulmonary stenosis
VSD
right ventricular hypertrophy
overriding aorta |
| fallot sometimes exhibits what? | systolic ejection murmur, clubbing of the nails beds, dyspnea, squatting, poor growth, mental slowness. syncope and stroke |
| Iron deficiency anemia is the most prevalent blood disorder in infancy and early childhood, the incidence peaks is between what ages? | 6 to 24 months in lower income backgrounds |
| full term healthy infants have sufficient iron stores for the first what months? | 4 to 6 months of life |
| breast fed infants should receive adequate amounts of iron from the breast milk for the first at what month? | 6 months of life |
| infants who are not breast fed should receive iron fortified formulas at what age? | first 9 to 12 months |
| how much iron per day that is recommended for allowance in infants between 7 to 12 months? | 11 mg |
| in toddlers how much Iron is recommended? | 7mg/day |
| what is anemia? | defines as decrease in red blood cell volume a decrease in hemoglobin or both |
| infants who drink cow's milk have 50% chance of increased? | fecal loss of blood |
| what is the most common cause of anemia in adolescents? | inadequate intake of dietary iron. |
| what is the clinical S/S of mild to moderate anemia? | hemoglobin values is 6 to 10 g/dl
irritability
weakness
decreased play activity and fatigue |
| if the hemoglobin falls down below 5 g/dl child has | anorexia, skin pallor, pale mucous membranes, glossitis, concave or spoon fingernails etc |
| children w/ chronic long term anemia often exhibit what? | growth retardation and developmental delays |
| it is recommended that infants be screened for iron deficiency and iron deficiency iron anemia between the ages of what? | 9 to 12 months of age |
| pack RBCs are given only to who? | severely anemic children. |
| serum iron levels usually return in how many months of treatment? | 2 months |
| what is sickle anemia? | genetic disorder characterized by the abnormal form of hemoglobin within erythrocyte |
| sickle anemia is mot common in the? | African American |
| with incidence of how many live birth? | 1-500 |
| sickle anemia is classified as what? | Sickle trait or Active sickle cell disease |
| children with sickle cell trait are carriers of sickle cell anemia, it is estimated in 1 per 13 to what races? | African American |
| the most severe and potentially fatal form of the disorder? | Active Sickle Disease |
| Sickling is an intermittent phenomenon the usual precipitating factors are? | infection
fever
hypoxemia
dehydration
high altitudes, cold and emotional stress |
| children with Sickle cell disease tend to fist experiences what? | pallor
irritability
fatigue
jaundice
growth impairment |
| in older affected children w/ sickle cell disease the joints and surrounding tissue becomes what? | edematous and painful |
| a sickle cell crisis is classified as one of three types.. | vasoocclusive
sequestration
aplastic |
| persistent penile erection (blank) sometimes occurs in response to occluded penile viens. | priapism |
| severe sickling leads to what? | recurrent sickle cell crisis |
| what screening for sickle cell anemia is mandatory in most US so the affected infants can be identified before symptoms accured? | Neonatal Screening |
| The only potential cure for sickle cell disease is what? | Bone marrow or Stem cell transplantation |
| what is Patent ductus arteriosus? | Failure of the ductus arteriosus to close within the first weeks of life allows oxygenated blood to shunt from the high-pressure aorta to the low-pressure pulmonary artery, which causes the blood to become deoxygenated |
| what is Atrial septal defect? | abnormal opening in the atrial septum that enables oxygenated blood to flow from the higher pressure left atrium to the lower pressure right atrium, which causes the blood to become deoxygenated |
| what are the S/S to Atrial Septal Defect? | respiratory infections and difficulty breathing. A characteristic harsh systolic murmur may be heard during auscultation over the third intercostal space. |
| what is VSD? | A ventricular septal defect (VSD) is an abnormal opening in the interventricular septum, resulting in the flow of oxygenated blood from the higher pressure left ventricle to the lower pressure right ventricle, which causes the blood to become deoxygenated. |
| S/S of VSD | such defects may be asymptomatic, but signs of heart failure eventually manifest. Other clinical manifestations include a loud, harsh systolic murmur and a palpable thrill. |
| The most common CHD resulting in decreased pulmonary blood flow is what? | tetralogy of Fallot. |
| what happens in transposition of the great vessels? | the pulmonary artery arises from the left ventricle and the aorta arises from the right ventricle,
Some affected infants are born with associated defects that allow for communication between the two circulations |
| (A) what are the S/S of Transposition of the great vessels? | two circulations have profound cyanosis |
| (A) those who born with associated defect such as patent ductus arteriosus, atrial septal defect, or VSD are sometimes what? | have less cyanosis and experience manifestations of heart failure. Cardiomegaly is usually apparent on x-ray study. |
| (A) what happens in Coarctation of the Aorta? | narrowing of the lumen of the aorta (usually at the site of the ductus arteriosus), resulting in increased pressure proximal to the defect (head and upper extremities) and decreased pressure distal to the defect (body and lower extremities. |
| (A) Clinical Manifestation of Coarctation of the Aorta? | blood pressure in the arms is 20 mm Hg higher than that in the legs (reversal of normal pattern). bounding pulses in the lower extremities, heart failure, leg cramping on exertion in older affected children, and epistaxis. |
| what are the patient education for a child with Hemophilia? | RICE method: Rest, Ice, Compression, and Elevation.
avoid injury and control bleeding |
| what medication administer for JIA (Juvenile Idiopathic Arthritis) | Nonsteroidal anti-inflammatory drugs (NSAIDs), which include naproxen (Naprosyn) and ibuprofen (Motrin) |
| S/S in JIA? | joints may be stiff and warm to the touch, fever and rash, may reveal swelling in the spleen, liver, and lymph nodes. Changes in vision include red eyes and photosensitivity. |
| at what age the condition manifest with JIA? | 6 months of age |
| in most affected children it is diagnosed by what age? | 16 years. |
| how does the infant or child get affected of HIV? | by their mother while in utero, during delivery, or through breastfeeding. |
| The greatest threat to an HIV-infected infant younger than 1 year is what? | Pneumocystis jiroveci (formerly Pneumocystis carinii) Pneumonia |
| what is RDS? | Respiratory distress syndrome severe lung disorder that is the major cause of morbidity and mortality in the neonatal period. |
| RDS is caused by what? | deficiency of surfactant and occurs almost exclusively in preterm infants of low birth weight. |
| what does the surfactant do? | reduces the surface tension of fluids that line the alveoli. |
| what happens when the production of surfactant is not sufficient? | infant is unable to keep the lungs inflated and the alveoli collapse at the end of expiration, resulting in hypoxia, atelectasis, and respiratory acidosis. |
| what are the S/S of RDS? | nasal flaring; expiratory grunting; intercostal, subcostal, or substernal retractions; dusky color involving the skin, nail beds, and mucous membranes; tachypnea (up to 80 to 120 breaths/minute) initially and dyspnea; and low body temperature. apnea, flaccidity, absence of spontaneous movement, unresponsiveness, and mottling. |
| in severe cases of RDS what happens to the infant? | die within hours of the onset of signs and symptoms |
| Pneumonia is classified according to what causative agents? | Bacterial
Viral
mycoplasmal or Foreign body aspiration |
| what is the difference between bacterial and viral pneumonia? | Viral pneumonias are more common than bacterial pneumonias. Respiratory syncytial virus (RSV) accounts for the largest percentage of infections in infants and young children. Bacterial pneumonias most common in infants and children are caused by streptococci, staphylococci. |
| S/S Pneumonia in Children are? | abdominal pain
anorexia
chest pain
cough
fever |
| diagnostic for pneumonia are? | Radiographic examination
Peripheral blood tests
culture and Gram stain of respiratory secretions and the blood |
| ( T or F ) if no bacterial microorganism is identified the pneumonia is considered to be viral? | true |
| what diagnostic tests for leukemia? | physical examination
CBC
Lumbar puncture |
| how to assist the parents post SIDS death for infant? | Ensure that the parents last moments with their infant are quite and peace. |
| How to care the infant after death? | Clean the infant, wrap the infant in a sheet or blanket and tidy the room where the family able to spend time with the infant. |
| what is the viral disease of childhood marked by a resonant barking cough, suffocative and difficult breathing and laryngeal spasm? | Croup |
| patient teaching for patient had tonsillectomy. | avoid food that are irritating or highly seasoned
avoid the use of gargle or vigorous brushing of the teeth.
try avoid coughing and clearing throat
do not use aspirin
use ice collar for pain |
| Hemorrhaging after tonsillectomy is possible how many days after surgery? | 5 to 10 days |
| what is LTB? | laryngotracheobronchitis is the most common for of croup |
| at what age group in the children does it affect most having LTB? | 3 months to 3 years old |
| Immediate treatment for child with Acute epiglottis? | establishing artificial airway
humidification
gentle oral suctioning and constant observation |
| what is Acute epiglottis? | is a severe, potentially life-threatening bacterial infection of the epiglottis in older children and is usually caused by H. influenzae type B. |
| what can happen suddenly in acute epiglottis? | inflamed epiglottis becomes cherry-red and edematous, which has the potential to lead to total airway obstruction. |
| S/S of having LTB? | hoarseness; inspiratory stridor; tachypnea; nasal flaring; suprasternal, substernal, and intercostal retractions; and characteristic barking cough |
| S/S of having Acute epiglottis? | cutely ill with high fever, muffled voice, drooling, progressive respiratory distress, anxiety, and fear. |
| is acute epiglottis life threatening? | YES its potentially life-threatening |
| what is the most common type of pneumonia? | Viral |
| what is the most common involves with CHD | Increased pulmonary blood flow |
| what is cystic fibrosis? | genetic disorder that a child inherits from both parents |
| what is cystic fibrosis? | disorder of the exocrine (mucus-producing) glands, with the characteristic presence of excessive thick mucus that obstructs the lungs and the gastrointestinal (GI) system. |
| cystic fibrosis is a multi-organ disease, but death is usually caused by what? | pulmonary failure |
| is cystic fibrosis genetic disorder that inherits form both parents? ( T or F ) | True |
| S/S of Cystic Fibrosis | steatorrhea (bulky, foul-smelling, fatty stools), growth failure, protuberant abdomen, and thin, wasted extremities. |
| what is the most ingle important therapy for Cystic fibrosis? | Pulmonary therapy |
| Nursing intervention for post cleft palate surgery? | kept on NPO status until the effects of the anesthesia have disappeared,
avoiding contact with the suture line
Breastfeeding is usually contraindicated immediately after surgery. |
| S/S of congenital hypothyroidism | cool, mottled skin
dyspnea
hypothermia
lethargy
poor appetite
poor sucking reflex
prolonged jaundice |
| S/S o acquired hypothyroidism | constipation
dry skin
growth delay
lethargy
mental slowness
puffy eyes |
| S/S of hyperthyroidism | accelerated growth
advance bone age
excessive appetite
hypertension
hyperactivity |
| (A) what disorder is sex linked that inherited disorder, gradual progressive skeletal music wasting and weakness.
(B) what age is the onset symptoms typically occurs? | (A) Duchenne muscular dystrophy
(B) 2 to 4 years |
| what is the primary cause of hypothyroidism? | deficient production of thyroid hormone by the thyroid gland. |
| what is the primary cause of hyperthyroidism? | autoimmune process that results in the production of immunoglobulins that have thyroid-stimulating properties. |
| hydrocephalus can be develop at what age? | during infancy ( as congenital lesion) throughout life. |
| What disorder that has clinical manifestation of arching of the back, feeding difficulties, hypertonic muscles, involuntary movements, development disabilities and also its a common permanent disability in childhood? | Cerebral palsy |
| what are the Clinical manifestation of Hydrocephalus? | widening and bulging of the fontanelles,
separation of the cranial sutures, dilation of scalp veins,
thin and shiny scalp, and rapidly increasing head circumference. |
| What are the treatment for cerebral palsy? | occupational, physical, and speech and hearing therapists, and surgery braces. |
| what are the Antenatal factors in development of cerebral palsy? | maternal infections, maternal drug ingestion, hypoxia in utero, and blood incompatibilities. |
| The term seizure refers to what? | sudden, excessive, disorderly discharge of abnormal electrical impulses by the brain's neurons, causing a temporary alteration in CNS function. |
| what medication is administered to control seizure? | Anticonvulsants ( carbamazepine (Tegretol), phenytoin (Dilantin), fosphenytoin (Cerebyx), and valproic acid (Depakote or Depakene). |
| what are the two major categories of seizure? | partial and generalized. |
| what test to detect neuro tube defects? | prenatally,
Uterine ultrasonography and
elevated levels of maternal alpha-fetoprotein (antigen present in the human fetus that helps in evaluating fetal development) |
| what congenital defects that shows many infants have a tuft of hair, a cleft, or a small, fatty mass over the defect. | Spina bifida |
| What spinal function absent below defect in spina bifida? | the spinal cord most commonly ends at the defect therefore all motor and sensory function below the defect is absent. |
| Its skin inflammatory process of the skin | Acne Vulgaris |
| what patient teaching for teenage who is sexually active that uses Isotretinoin (Accutane) for acne? | Must use a effective contraceptive method during treatment and for 1 month after treatment |
| What is the most significant side effects of this drug? (Isotretinoin) | Teratogenic - Cause developmental abnormalities in the fetus ( it is absolutely contraindicated in pregnant women) |
| patients receiving isotretinoin also must be monitored for what? | Elevated cholesterol and triglyceride levels |
| Thrush is infection common disorder in fants younger than 6 months and it is transmitted by what? | Contaminated hands
nipples and pacifiers
it can also transmitted by mothers infected vagina at birth. |
| S/S of BPD? | respiratory distress
wheezing, retracting, nasal flaring, irritability, abundant secretions and cyanosis |
| what re the medical management and nursing intervention for parasitic infection? | lindane (kwell)1% lotion, cream or shampoo
occlusive treatment petroleum jelly
cleansing of the contaminated clothes and linens
hydroxyzine and benadryl for pruritus |
| IQ below 25 indicates | Severe |
| what congenital chormosomal that has square head, raised eyebrows and slanted eyes? | Down Syndrome |
| what cognitive impairment that includes extra chormosome? | Down syndrome |
| what is the most common cause of vague physical symptoms in school age? | School avoidance |
| When does the School avoidance occurs? | When a physically healthy child repeatedly stays home from school or sent home from school. |
| Its an infectious parasitic disorder caused by a mite. | Scabies |
| ADHD disorder appears to be genetic basis. ( T or F ) | True |
| what are the two types of brace that is used for scoliosis? | Milwaukee brace and TLSO (thoracolumbosacral) |
| (blank) has the incidence peaks between 6 an 24 months in children lower income background. | Iron deficiency anemia |
| Decreased number of circulating platelets with resultant bleeding beneath the skin, and it is most frequently among children age 2 to 10 years old. | Idiopathic thrombocytopenia |
| what medication administered for Otitis Media? | Antibiotics for 10 days
Acetaminophen for fever and discomfort |
