Pedi test 3

• aceptic
• septic
• TB

viral or secondary to leukemia, brain ases

bacteria or microorganism gets in blood crosses the BBB-trigers inflamatory respons

<1yr

high risk   birth -6mo

Af Am esp boys

<7yrs

have vaccine if w/im 4hr of exposure

usually give combo therapy

• many types
• mumps, androvirus

symptoms

college students requires to get meningococcal vaccine

• hemopholus influenza
• mengingioccus
• neumococis

• sudden onset dev
• septosemia
• facial lesions
• can die w/in 2hr

• invades meningies
• dircet contact
• droplet
• throat discharge

• indirect method-travels to blood stream
•   -ex infection in sinus andtravel
• -dev sepsis-once get in blood it will get septic
• direct method-area closest to brain
•  (ear, skull, scalp infection -untreated)

• 2 blood cultures from differant sites
• liver puncture for meningitis

• bacterial meningits
• perulant form can lead to hydrocephalus

b/w 6-12 mo

strict isolation

• weak cry
• poor muscle tone
• hypo or hyper thermia
• apnea

seizures

sepsis

sepsis

• bulging fontanel
• DTC

• poor feeding
• irritable
• vomit
• bulging fontanel
• lathargic
• seizures
• abn cry
• high pitch cry

• ncal(neck) rigidity
• sever headach
• + cernigs side-can't fully extend leg
• +Brusinky sign-neck flextion

• when move one side the other side moves
• photphobia esp w/
• v/d -go w/increased intercrania pressure

• seizures
• ecamosis
• fever
• joint/muscle fever
• very drowsy
•  hard to arrouse

lumbar puncture

• need to be on side w/ knee/ chest postition
• watch airway carefully
• check CSF
• check glucose will be <45 
•             increase intercranial pressure
• color initially clear->cloudy-> perulant (pus)

tramadic spinal tap not rare

• lymph 5cells
• protein 14-15 mg/dL
• glucose 3

• WBC # too numberous to count
• elevated protein
• decreased glucose

• Iv antibiotics for 10days (even before culture)
• broad spectrum
• strict droplet isolation at least 24 hr after start antibiotics
• still strict isol w/ antibiotic-usually 3rd or 4th cep
• sephotoxine-combo of ampicilin and getamizcin if can't afford other

• 60%
• fluid restriction hydroceph
• phebitis
• nosocomial suberal effusion
• DIC
• pericaritus

• Vaccine
• Hep A & B

start Hep B-<18mo

strict isolation precausion


prevent further brain insult

put in protective cav in crib b/c higher risk of seizure

• avoid startling them
• place them on side
• frequent vs monitor
• up to date w/ immunization

• recent Hx of URI b/c precurser view drop in blood pressure & rise in pulse
• look for seizure activities & immos of joints-pain- many need to give O2

i & O

• accumulation of fluid in scrotum are
• very common esp in  
• usually self resolving if doesn't go down

hydrocephely-small insicion & drain

undesended testicles in term newborns

testies stay in abd can be bi or unilateral

30%

body temp

temp of body too hot cand destroy sperm-becomes sterile

• can be exposure to injury
• high incidences for angler hernia
• not affect 2ndary sex characteristics

• can desend on own
• can give HCS hormone -can bring down testicles and be used for Dx purposes
• surgery
• sometimes need to do orcodectomy-remove testical b/c problem w/ CA or injury

• surgery usually done b/w 2-3 yr
• can lower possibility of sterility
• testierin  band around testicle

• have no outward symptoms of any disease
• seem otherwise healthy
• happens in sleep
• refered to as crib death

higher in males

leading cause of death in norm term newborn

unknown

• Theory
•  defect in brain stem
• possibly to hypersensetivity to cow's milk
• over wrapping-cause more stress
• -some recomend not wrap babies over armpit
• abn gene-affects
• -SCN 5 A gene isolated in some studies

• low social economic level-crowded living
• mom>20yr, multipregnancy
• multi birth w/o rest period twin triplet
• male infants esp w/ low birthweight

• Native Am
• Af Am
• Hisp
• Caucasions

Asians

• cardiac dysrhythmia
• family history-esp neuro problems
• abn breathing while baby sleeping/stops breathing

all unproven

precaustion

dealing w/ grieving parents

don't survive

• child fails to gain weight
• weigh falls below 5th% of age group
• usually <2yrs

• organic
• nonorganic

• emotional deprevation
• basic needs met but w/o touch
• often from neglect

can go in and treat

• interaction b/w parent & infant
• lack of food-

• b/c don't have touch/interaction they stop eating
• sometimes too lathargic to eat b/c don't have that interaction
• care very irregular/inconsistant usually absent

infant doesn't learn to trust / interlectually delayed

• not respond to affection
• listless
• apathetic
• no direct eye contact
• no fear of strangers
• no interest in toys or playig
• no nurturing/teaching

• goal - make sure they have adequate nutrition
• if possible try to keep baby w/ family
• teaching very important
• you are role model
• teaching of nutritional needs
• family counseling

if parent only points out neg of kids

• support mother /father
• observe them
• encourage parernting classes
• have consistant caregiver
• -observe infant response from mom look at parent affect

give parent info about baby

• immediatly
• after about 1 yr
• sometimes these baby parents don't attach

• give them special diet
• teaching to parent
• CPS is called

• uncertain-worry esp of very young
• if malnurished-intellectually affected

child abuse/neglect

• battering hitting
• get phys abused

• bend
• only break under direct impact
• can get splintered

• lots of old fractures
• have Hx of old/unhealed Fx

2.4 mil (known)

• 3mo-3yr
• adolescent
• elders

• younger kids
• major cause-parent temper
• should never disciplin child angrey

by law to report and follow through on child abuse

• physical
• social
• sexual
• societal
• emotional

societal-whole society doing same abuse

• abuser & person being abused-
• abuser was often abused

anoxia of brain during delivery

• chronic disease
• no cure
• nonprogressive

one of most crippling toddler conditions

• motor & nerve cortex
• basal ganglia
• cerebellum

• some damage to brain that controls movement
• damage can occur at differant points prenatal

• Rh/ABO incompatability-cause severe jaundice
• diabetes
• genetics

• anoxia
• intacranial bleeding
• no Oxygen
• intracranial hemeraging
• preme high risk

• head trauma
• infection
• neoplasm
• stroke

2000

• primitive reflexes don't go away as should
• ave decayed gross motor movement
• lack mildstones-don't go through all
• difficult to control movement
• ataxia-toe walk4behavior prob

• r/o usually not till ~2mo
• eeg
• ct & MRI
• electrolyte/BMP

• most common
• affects cortex of brain

• poor purposeful movement
• hyperactive contractions-common
• contstant contractions

• constant movement
• dysarthria-poor speach
• slow writhing muscle contracions
• drooling

aquard gait/lak coordination

rigid movement, hard to move at all


mixture onf morte than one

• fam teaching lots
• feeding-may need special eating utencils
• phys therapy- to maintain what have
• good skin care
• nutritional supp
• allow rest times-need lots naps

main thing-make most of their assets

• Greenstick-splinter, one side bent
• spiral-twisting-oftenassos w/ abuse
• oblique

1wk for every year of life up to age 10

• covers lower part of body
• maintains legs in froglike position
• usually haave a bar b/w legs to help support cast

increasing pressure w/in muscle compartment causes decreased circu

monitor neurovadc status frequent

• Pain
• Pulse
• Paresthesia-diminished/absent sensation/numb/tingling
• paralysis

• pullin force applied
• can realign bone
• w/ weights--need to make sure weights hanging freely
• reduce/elim muscle spasm
• reduces contractures of muscles
• used to align/aleviate problems of spine, large bones, can be applied to skin or bone

• body provides countertraction to wts
• short term immobilization use
• to correct contractures & bone deformities

more effective than Bucks in olde kids

• sometimes used for fractures of humerous or elbow
• either skel or skin

• often used for Tx of fractured femur in kids <2
• often transverese or spiral fractures
• hip should not rest on bed in tration

• some risk of compromised circulaton-may result in contractures of foot/lower leg
• s/s extreme pain

• uses pins
• need special skin care at pin site q8h
• for severe fracture or to lengthen extremity

• toddler/young kids-fall /abuse
• school-age &teen- bicycling,skating, mva

• watch for @ least 6 hr for LOC& vomit
• awakened q1-2 hr in sleep to see LOC,
• q4h for 48h check pupils for reaction to light

• cerbral edema
• increased intratracranial pressure
• cranial hemorrhage

• gain5-10bs/yr
• 3in/yr

• 1st yr 12-14hr
• by 3yr 10-12

• 3-5lb/yr
• 2.5in/yr

legs & ft

• DTP booster
• pollio
• MMR
• varcella (b/w 4-6yr)

• bed wetting
• involuntary urination beyond the age when control of urination is commonly acquired

b/w 5-7

• sleep to soundly-don't get signal
• UTI
• small baldder capacity

• lipoid nephrosis
• idiopathic nephrotic cyndrome

edma proteinuria,

<9

2-6yrs

1st around eyes & ankles

• lbecomse geralized w/ a pendulous abdomen full of fluid
• anorexi
• irritability
• loss of appetite
• malnutiron

• labs
• -marked proteinuria-esp albumil
• larg # of hyaline & granular casts in urine
• hfew blood cells
• reduced blood serum protein
• increase in cholesteral

• corticosteroids
• -prednisone-most used

• daily urine testing for protein
• immunosuppressant therapy-reduce s/s
• -cytoxan most often used
• frequent small meals

• edema
• wt
• abd measurements

• relieve edema
• improve nutritional status
• maintain skin integrity
• covserving energy
• prevent infection

• monitor fluid i/o
• --wt pt same time every day
• -measure abd daily
• -test urine regularly for albumin& spec grav
• improve nutrional intake
• promot skin integrity
• promot energy conservation-bed rest
• prevent infection
• family support/teaching

• anadenosarcoma in kidney region
• one of most common abd neoplasms of early kid

from bits of embryonic tissue remaining after birth

rarely before big enough to palpate through abd wall

abd palpation

• surgical removal ASAP
• radiation/chemo

best in kids < 2yr

• collection of peritoneal fluid accumulates in scrotum
• -from nonclosure of processus vaginalis

corrective surgery > 1 yr

• non descent of testes
• often self correcting by 1yr
• -if not need orchiopexy-surg bring testies
• --usually b/w 1-2yrs

• clavicle
• femur
• tibia
• humerus
• wrist
• fingers

acute inflammation of epiglottis

Haemophilus influenza type B

2-7yr

epiglottis inflamed /swollen w/ edema-edmadecreasesability to move->blockage of airway

• sore throat
• dysphagia-drooling
• fever 102.2-104
• breath-sitting up leaning foward w/ mouth open& tongue out-tripod position

• endotracheal intubation/trach-if too swollen
• moist air-reduce inflammation
• pulse ox
• antibiot-IV
• antibiot-10days

• gastric lavage
• activated charcoal
• sodium bicarbonate-combat acidosis

• gastric lavage
• acetylcysteine (mucomsyt)-diluted

• activated charcoal
• observe for/Tx Gi bleed

deferoxamine-chelating agent

• alkali corrosives-initially w/ lots water
• -diluted fruit juice or vindger
• ACID corrosives Tx w/
• alkaline  drinks-milk, olive oil, mineral oil/ss