Pediatrics Final

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ch 30, 31 and 32

What is the triad management of diabetes?

Well-balanced diet, precise insulin administration, and regular exercise.

What is a sudden increase of a communicable disease in a localized area?

Epidemic

When is growth hormone administered?

At bedtime to simulate the natural timing of hormone release.

Which communicable disease has signs and symptoms of tachycardia, strawberry tongue, pinpoint rash, circumoral pallor, desquamation?

Scarlet fever

In autism, what is the goal of drug therapy?

To reduce behavioral symptoms that interfere with cognitive development and family interactions.

Why should insulin not be injected into an area that has a temporarily increased circulation?

In such areas, a more rapid than expected absorption and effect can trigger hypoglycemia.

Who would be the staff of the modern child guidance clinic?

Psychiatrist, a psychologist, a social worker, a pediatrician, and the nurse.

The symptoms of ADHD as defined by the DSM-IV usually occur before what age?

7 years of age

What is a major goal of education of the child with diabetes?

Self-management to maintain glucose control and to prevent complications

A priority goal in the approach to a child with anorexia nervosa is which of the following: 1. Encourage weight gain 2. Prevent depression 3. Limit exercise 4. Correct malnutrition

4. Correct malnutrition

What is the contagious period for Chickenpox (varicella)?

6 days after appearance of rash

What is a circular reddened area on the skin that is elevated and contains fluid?

Vesicle

Which period is the time between the invasion by the pathogen and the onset of clinical symptoms?

The incubation period

Which test should not be given within 6 weeks of receiving an MMR or varicella immunization, because the results will not be accurate?

A tuberculin test

What is the number one problem of American adolescents?

Substance abuse

Why is exercise important for the patient with diabetes?

Because it causes the body to use sugar and promotes good circulation. It lowers the blood glucose level, and in this respect it acts like more insulin.

Which communicable disease has symptoms of mild fever, cold symptoms precede a rose-colored, maculopapular rash. Glands at ears and back of neck are enlarged?

German measles (rubella)

An important approach to the care for a 7-year-old child diagnosed with attention-deficit/hyperactivity disorder (ADHD) is to encourage which of the following: 1. A diet high in processed foods 2. Regular use of sedatives 3. Strict discipline 4. A structured, one-on-one environment

4. A structured, one-on-one environment

What is the recommended nutritional intake of carbohydrates, fats or proteins for the diabetic patient?

55% carbohydrates (mostly complex carbohydrates), 30% fat, and 15% protein

When is a screening test for hypothyroidism performed?

At Birth (mandatory in US)

The DPT immunization is administered: 1. Orally 2. Subcutaneously 3. Intramuscularly or 4. Intravenously?

3. Intramuscularly

When an adolescent feels hopeless and talks about feeling useless or worthless, how should the nurse respond?

Do not contradict what he or she is saying. Instead listen, indicate your understanding, and encourage the expression of feelings.

What are white spots on the mucous membrane of the oral cavity that occur before a skin rash and are indicative of measles (rubeola) infection.

Koplik spots

What is the street name for Pentobarbital?

Yellow Jackets

What are the signs of an inadequate dosage or noncompliance of hypothyroid medication?

Fatigue, sleepiness, and constipation.

On physical examination, what conditions may be evident with anorexia nervosa?

Dry skin, amenorrhea, lanugo hair over the back and extremities, cold intolerance, low blood pressure, abdominal pain, and constipation.

Red lips and fruity odor to the breath may indicate what in a diabetic child?

A need for insulin

What is Milieu therapy?

The physical and social environment provided for the child.

What is the contagious period for the German measles (rubella)?

Until rash fades (5 days)

What is an Opportunistic Infection?

Caused by organisms normally found in the environment that the immune-suppressed individual cannot resist or fight

Which type of therapy is the reading of stories about children in a situation similar to the child's situation?

Bibliotherapy

Which insulin is cloudy, Regular or NPH?

NPH

What are the initial signs of Diabetes Insipidus?

Polydipsia and polyuria

The two major systems that control and monitor the functions of the body are which?

Nervous system and the endocrine system.

Insulin potency can be decreased if the bottle has been opened for longer than what period of time?

More than 1 month

What meds are used for OCD?

Clomipramine, Fluoxetine and Fluvoxamine.

What manifests with an INCREASED antidiuretic hormone?

SIADH - syndrome of inappropriate antidiuretic hormone secretion

What is a circular reddened area on the skin?

Macule

What are the signs & symptoms for Tuberculosis?

Low-grade fever, malaise, anorexia, weight loss, cough, night sweats, children are often asymptomatic, adenopathy and pneumonia.

What is the most common endocrine disorder of children?

DM type 1

When the person produces his or her own immunity, it is called what?

Active Imminity

Which sugar substitutes should not be given to children and why?

Sorbitol and xylitol because they may contribute to diabetic complications

What are the signs and symptoms for Polio (infantile paralysis; poliomyelitis)?

Fever, headache, stiff neck and stiff back, paralysis.

What is characterized by a developmentally inappropriate degree of gross motor activity, impulsivity, distractibility, and inattention in school or at home?

Attention-deficit/hyperactivity disorder

What is hypotonia?

"ragdoll limpness"

What type of respirations are seen in diabetic children with Ketoacidosis?

Kussmaul's

A child who has diabetes mellitus asks why he cannot take insulin orally instead of by subcutaneous injection. The best response of the nurse would be:

Insulin is destroyed by digestive enzymes

Why are the sides of the fingertips recommended testing sites for blood glucose testing?

Because there are fewer nerve endings and more capillary beds in these areas.

What is the contagious period for Whooping Cough?

Several weeks

The insulin pump should not be removed for longer than what period of time?

1 to 2 hours at a time

What is the contagious period for the Mumps (parotitis)?

Until swelling subsides

What is the fasting blood glucose level criterion in diagnosing diabetes mellitis?

126 mg/dl or higher

Which communicable disease has symptoms of fever, cough, and conjunctivitis are followed by small white (Koplik) spots on inner cheeks (enanthem); maculopapular rash (exanthem) then erupts.

Measles (rubeola)

What is a circular reddened area on the skin that is elevated?

Papule

Which disease is found primarily in the Ashkenazic Jewish population?

Tay-Sachs disease

What is body substance?

Body substance refers to moist secretions of the body that can contain microorganisms.

Which communicable disease has symptoms of child appearing toxic, macules, papules, vesicles, pustules, and scabs appear. Only ONE STAGE of the lesion at a time is present on the body.

Smallpox (variola)

What medication should be available in the unit where vaccines are administered?

Epinephrine

What is a circular reddened area on the skin that is elevated and contains pus?

Postule

Diabetes Insipidus results in a decreased secretion of which hormone?

Antidiuretic hormone.

Regular Insulin takes how long to take effect?

30 minutes to 1 hour for effect

What are the 4 predominant coping patterns of children of alcoholics?

Flight, fight, the perfect child, and the super coper or family savior

What is diuresis?

Increased excretion of urine

What is the treatment for SIADH?

Fluid restriction and hormone antagonists

What are the signs of water intoxication?

Edema, lethargy, nausea, central nervous system signs

What is the contagious period for the Measles (rubeola)?

From 4 days before to 5 days after rash appears

Which finger(s) are best to use for obtaining blood specimens?

The best finger to use is the middle, ring, or little finger on either hand.

In the diabetic patient, WHAT has been shown to reduce blood glucose levels, lower serum cholesterol values, and sometimes reduce insulin requirements. It also appears to slow the rate of absorption of sugar by the digestive tract.

Soluble fiber

What are good sources of soluble fiber?

Raw fruits and vegetables, bran cereals, wheat germ, beans, peas, and lentils.

Which is the most common opiate abused by adolescents?

Heroin

The endocrine system works with which system to regulate metabolic activities?

Nervous system

Which disease involves a deficiency of hexosaminidase, an enzyme necessary for the metabolism of fats?

Tay-Sachs disease

Which type of immunity is not the result of inherited factors but as a result of having the disease or by receiving vaccines or immune serums?

Acquired immunity

What occurs when blood glucose levels are lowered to a point at which the body's counterregulatory hormones (epinephrine, cortisol, glucagon) are released. Glucose is released from muscle and liver cells, which precipitates a rapid rise in blood glucose levels.

The Somogyi phenomenon (rebound hyperglycemia)

What is the treatment for Diabetes Isipidus?

Vasopressin by injection or nasal spray DDAVP (desmopressin acetate) and provide adequate fluids

What is the dawn phenomenon?

Early morning elevations of blood glucose occur without preceding hypoglycemia but may be a response to growth hormone secretion that occurs in the early morning hours.

Which type of immunity acts immediately but does not last as long as immunity actively produced by the body. This immunity provides the antibody but does not stimulate the system to produce its own antibodies.

Passive Immunity

What is the time period for hypothyroidism medication to achieve its full therapeutic effect?

1 to 3 weeks

Which period refers to the initial stage of a disease: the interval between the earliest symptoms and the appearance of a typical rash or fever. Children are often contagious during this time.

The prodromal period

What are the signs and symptoms for the infant with hypothyroidism?

Sluggish, sleeps a lot, tongue becomes enlarged, causing noisy respiration, skin is dry, there is no perspiration, and the hands and feet are cold. The infant feels floppy when handled (hypotonia)

What is an eating disorder that involves bingeing and purging and can result in deterioration of teeth and electrolyte imbalance?

Bulimia

During puberty, what may be implicated as contributing to development of diabetes?

Rapid growth, increased emotional stress, and insulin antagonism of sex hormones

Varicella vaccine, if not given on the same day as MMR, must be given no less than HOW MANY days later?

no less than 28 days later

What is a worldwide high incidence of a communicable disease?

A pandemic

What is any inanimate material that absorbs and transmits infection?

A fomite

In general, do the symptoms of HIV infection develop more rapidly or slower in infants?

More rapidly and this may be attributed to the infant's immature immune system.

Polydipsia and polyuria are the initial signs of which metabolic disorder?

Diabetes Insipidus

What is the third leading cause of death in adolescents after accidents and homicide?

Suicide

Why are immunizations not routinely given until 2 months of age, unless a high risk of infection exists?

In newborn infants, the presence of passively acquired immunity from the mother may inhibit the infant's natural immune response to vaccines.

What is acanthosis nigricans?

A dark pigmentation in the flexor creases of the skin which may be a cutaneous marker for patients with type 2 DM.

Which type of precautions are techniques recommended by the CDC to prevent the transmission of communicable diseases?

Standard precautions

What is the basic essential factor to prevent the transmission of infection?

Proper hand hygiene

What are the signs of hypothyroid medication overdose?

Rapid pulse rate, dyspnea, irritability, weight loss, and sweating.

The term refers to the dysfunctions of the body that seem to have an emotional or a mental basis?

Psychosomatic

What is the street name for Dimethyltryptamine (DMT) or phencyclidine hydrochloride (PCP) sprinkled over parsley or tobacco

Angel Dust

The thyroid gland controls the rate of metabolism in the body by producing what?

Thyroxine (T4) and triiodothyronine (T3)

What is characterized by inattention, hyperactivity, impulsivity, and distractibility?

ADHD

Diabetes insipidus is the consequence of hypofunction in the anterior or posterior pituitary?

Posterior

What meds may be used for ADHD?

Methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) may be prescribed but may interfere with alertness and cognitive ability.

What are some of the complications with anorexia nervosa?

Gastritis, cardiac arrhythmias, inflammation of the intestine, and kidney problems.

At what age do symptoms of Tay Sachs disease start to manifest?

At about age 5 to 6 months, when physical development begins to slow. There may be head lag or an inability to sit.

True or False: Medication for hypothyroidism is for a period of 1 year.

False. Medication is not to be discontinued because the replacement for hypothyroidism is lifelong.

The manifestation of the infant crying and preferring water to milk formula. Loss of weight, growth failure, and dehydration are signs of which disorder?

Diabetes Isipidus

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