Peds Nursing (ATI) Flashcards

Terms Definitions
reed-sternberg cells characterize which disease?
hodgkins disease
what virus has been shown to sometimes play a role in hodgkins lymphoma?
epstein-barr virus
overproduction of which cytokine is characteristic of hodgkins lymphoma?
interleukin 13
what is the major S&S that characterizes hodgkin's disease?
painless swelling of the neck (enlarged lymph glands), sometimes in the axilla, chest, and groin.
T/F. Boys diagnosed with hodgkin's disease may become infertile in the future.
what's the most common form of anemia in kids?
iron-deficient anemia
how is hemophilia inherited?
x-linked recessive
what clotting factors do pts with Hemophilia A lack?
they lack factor VIII
What is the other name for Hemophilia B? and what clotting factors do pts with Hemophilia B lack?
Hemophilia B = Christmas Disease

they lack factor IX
what is the cardinal sign of hemophilia?
hemarthrosis (bleeding in the joints)
T/F. PT and PTT are both prolonged in hemophilia.
PT is normal while PTT is prolonged in pts with hemophilia.
what is the primary method of treatment for hemophilia?
replacement of the missing clotting factor
what is DDAVP used to treat?
for MILD hemophilia A
(not for hemophilia B)
T/F. swollen lymph glands is a common finding in children with leukemia.
what are the two most typical sanctuary sites for leukemia?
CNS and testicles
radiation therapy is generally reserved for what kind of leukemia pts?
those with CNS involvment
T/F. kids who undergo bone marrow transplant for leukemia can go home 2 days post-procedure.
THey typically stay for several weeks following the transplant.
what kinda of isolation is prescribed for a post-marrow transplant child?
reverse isolation until transplanted cells start to produce enough WBCs
4 side effects of biological therapy for kids with leukemia:
- rashes
- swelling
- flu-like symptoms
- anemia
surgery for cleft lip is usually performed at what age?
3 months of age
surgery to close cleft palate is usually performed at what age?
1 year of age
what are two meds that treat pin worm infestations?
Vermox and Antiminth
what's the definition of failure to thrive?
consistently below the 3rd percentile, or falls >2 major percentiles down the growth chart
What's wilm's tumor?
nephroblastoma, the most common kidney tumor that occurs most commonly in children younger than age 5
4 characteristics of the lump seen in Wilm's tumor:
- firm
- nontender
- unilateral
- deep within the flank
what's the most severe complication of Wilm's tumor?
metastasis to the lungs, liver, bone, or brain
besides metastasis, what are 2 other common complications of Wilm's Tumor?
- kidney damage
T/F. During examination, always palpate the child's abdomen in order to locate Wilm's tumor.
Never palpate the tumor to avoid metastasis.
when can a baby sit on his own for long periods of time w/o using hands to prop himself up?
by 8-9 months
when can a baby fix his eyes on and follow an object?
by 2 months
when does the posterior fontanel close?
2-3 months of age
the infant doubles his weight at what age? triples at what age?
doubles weight by 1/2 year, triples by 1 year of age
baby can hold head up at what age?
3-4 months
baby can roll over by what age?
5-6 months
baby can stand alone w/o holding on to something by what age?
1 year of age
baby can eat finger foods by what age?
by 6 months (1/2 year)
baby can nest an object inside another by what age?
12 months
baby can use thumb and finger to grasp items by what age?
9 months
baby obtains object permanence by what age?
by 9-10 months
how fast do kids grow between ages 6-10?
2 inches per year
bone development is completely developed by what age range?
the 20's
when does teething begin?
6 months
do lower or upper incisors appear first?
lower incisors first
solid foods can be introduced at what age?
5-6 months, when the infant doubles birthweight
what immunization is recommended at birth?
hep B
what 5 immunizations are recommended for at 2 months and 4months of age?
- HiB
- Rotavirus
- DTaP
- PCV (pneumococcal)
- IPV (polio)
when are MMR and varicella vaccinations first recommended?
at 1 year of age
T/F. Infants 6-12 months old should receive the yearly influenza vaccine.
how should you clean the infant's teeth?
with wet cloth
toddlers engage in what kind of play?
T/F. Toddlers are picky eaters.
when are Hep A vaccinations given?
2 doses during toddlerhood, at least 6 months apart
hypospadias is most common in which race?
what procedure is contraindicated in the case of hypospadias?
why should you avoid, as much as possible, crushing meds and mixing with apple sauce, jello, etc., to facilitate med administration for small kids?
they might later associate nutritious foods, like apple sauce, with bad taste from meds.
how do you pull the ears of a kid <3 years old when administering ear drops? how about for older kids?
- back and down for kids <3
- up and back for older kids
which solid food should be introduced first?
iron fortified rice cereal
why should cow's milk be limited for toddlers and preschoolers?
to avoid iron-deficiency anemia
pulse should be taken for how long for all children?
1 whole minute
respiratory rate should be counted for how long for all children?
1 whole minute
to ensure accuracy by preventing discomfort and tantrums in kids, which vital sign should be the last one measured?
blood pressure
why does hypotension require immediate intervention in kids?
hypotension is a late sign for inadequate circulation in kids
cold stress can cause which blood gas imbalance in newborns?
metabolic acidosis
taking temperature via which route is recommended for kids 3 and younger?
if the axillary temperature for a 2 year old is 99F (37.2C) or higher, what's the next step?
take temperature again rectally
by what age are oral thermometers an option for taking temperatures?
by age 4
most croup is caused by what agent?
4 things used to treat croup in the hospital:
- epinephrine
- corticosteroids
- IV fluids
- O2 in cool mist tent
normal pulse range for infants:
120-160 bpm

(lowest resting HR can be 90 bpm)
normal respiration range for infants:
30-60 breaths per min
normal oral temperature for older children and adolescents:
36 - 38C
(96.8 - 100.4F)
normal pulse range for children ages 3-6:
75-120 bpm
normal pulse range for adolescents:
60-90 bpm
normal respiratory rate for older children ages 3-6:
20-30 breaths per min
an erect head posture is expected in infants after what age?
4 months
infants should be able to turn from their abdomens to their backs at what age:
5 months
infants should be able to turn from their backs to their abdomens at what age?
6 months
babies can grasp for objects at what age:
5 months
babies can pull their feet into their mouths at what age:
6 months
what's the normal respiratory rate for toddlers?
25-35 per min
during a pRBC transfusion for a kid, what indicates that the infusion is too rapid?
wet lung sounds
rheumatic fever occurs as a reaction to what kind of infection?
Group A beta-hemolytic strep infection of the throat
what tissues does rheumatic fever affect?
connective tissues (of the heart, joints, CNS, skin, and subcutaneous tissue)
rheumatic fever can lead to chorea. Describe chorea:
involuntary muscle movements and labile emotions
Diagnosis of rheumatic fever is based on 1 major and 2 minor criteria. What are the major and minor criteria?
- carditis
- polyarthritis
- chorea
- subcutaneous nodules
- rash

- fever
- arthralgia
what treatment is prescribed for rheumatic fever?
antibiotics such as penicilliln
what is used to treat the inflammation associated with rheumatic fever in kids?
aspirin (but watch for Reyes)
what is the most definitive diagnostic test for rheumatic fever?
serum antistreptolysin-O titer
(an ASO titer)
- it should be elevated
what are 2 contraindications for getting DTaP?
- febrile illness
- seizures w/in 3 days
what are 2 points of education regarding oral hygiene to give to a kid with hemophilia?
- use soft toothbrush
- avoid high sugar content
signs that tell you your infant has cerebral palsy:
- floppiness
- swallowing and sucking problems
- baby can stiffen like a board
- delayed development
T/F. All kids with cerebral palsy have mental retardation.
Although some may have mental disabilities, many are normal or above normal.
Is cerebral palsy curable?
what is the most common method to correct club foot?
ponsetti method: serial casts for several weeks after birth
how do you test a child with cerebral palsy for ataxia?
hold a toy in front of them and ask them to touch it on the first try. Kids with ataxia cannot.
what's the most common type of cerebral palsy?
spastic cerebral palsy.
symptoms of pain, swollen joints, and dactylitis indicate:
vaso-occlusive crisis
what is done to confirm the diagnosis of pyloric stenosis?
what should you find during a physical exam for a kid with pyloric stenosis:
- peristaltic waves across abd
- olive-sized palpable mass in LUQ
T/F. A low grade fever is a contraindication for getting vaccinated.
Low grade fevers are OK for vaccination.
a low grade fever in leukemia is a result of:
an infectious process caused by neutropenia, a dysfunction of the bone marrow
the most common sites for childhood eczema are:
antecubital and popliteal fossae, wrists, ankles, and feet.
by what time can a baby transfer objects from one hand to another?
by 7 months
what should diabetic kids check for in their urine when they're ill?
ketones (for DKA)
what is the typical early manifestation of pertussis?
dry hacking cough
if a kid comes in who has just ingested an unknown substance, list 4 steps in order of priority.
- vital signs
- check mouth for substance
- call poison control
- give activated charcoal if prescribed
how long is incubation period for rubeola (measles)?
10-20 days (followed by fever)
describe blood chemistry for nephrotic syndrome:
- serum lipids & cholesterol
- BUN & Cr
- Na+
- Hgb, Hct & plts

Decreased albumin
what solution is used for impetigo?
1:20 Burrow's soln
what's a major symptom during a blood transfusion that alerts you of a hemolytic reaction?
flank pain
which IM injection site should be avoided in a 2 year old kid?
dorsogluteal muscle
(not sufficiently developed yet)
by what age can a baby sit while leaning on hands?
6-7 months
screening for lead poisoning should start at what age? repeat screenings at what age?
18 months
then at 24, 30, and 36 months
babies at high risk for iron def anemia should be screened starting at what age?
6 months
regular dental visits should begin at what age?
2 years of age
what condition typically seen in Down's kids put them at risk for respiratory infections?
hypotonicity of chest muscles
is sodium bicarbonate used to treat hyponatremia?
No, it can be used to treat hyperkalemia in kids (it promotes movement of potassium into the intracellular spaces)
T/F. Scoliosis is more common in teenage boys.
It's more common in girls and peak age is between ages 8-15.
what's the most common initial finding for genital herpes?
Burning and tingling genital discomfort (then advances to vesicular lesions rupturing into ulcerations, which then dry into a crusty erosion
An infant with a surgically repaired cleft lip must be fed with what to prevent sucking or suture trauma?
a rubber dropper
Breck feeder
what is characterized by a barking cough?
what characteristics of bacterial meningitis is not present for viral meningitis?
- petechial, purplish rash
- hypothermia in infants <3 y.o.
4 Common signs and symptoms of viral meningitis include:
- nuchal rigidity
- fever
- irritability
- phtophobia
which 4 vaccinations should a 2 month old baby get if he/she has never gotten any?
- Hep B
- IPV (polio)
by what age do most children have an adult concept of death?
by age 9-10
rattles and blocks are appropriate toys for what age?
4-8 months
push toys are appropriate for what age?
around 10 months of age
mobiles are appropriate for what age?
up to 4 months of age
erratic eating habits and strong taste/food preferences develop around what developmental period?
T/F. HTN is a late sign of acute renal failure in kids.
The majority of children don't achieve balancing on each foot for 6 seconds until about what age?
5.5 y.o.
T/F. the majority of children are able to correctly copy a square by age 4.
T/F. A 4 y.o. can prepare his own cereal w/o help.
T/F. School-aged kids understand that death is a universal process
It starts with adolescent years.
Stranger anxiety normally peaks at what age?
8 months
T/F. Cystic fibrosis does not delay the onset of puberty.
T/F. Cystic fibrosis pts have a higher risk for diabetes.
T/F. Cystic fibrosis pts should be able to decrease the frequency of respiratory treatment when they get older.
Frequency of respiratory treatment usually increases with age.
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