Pediatrics

Question 1

Growth and Development
• Growth - ↑ in ____ and development is ↑ in capability or _____
• Development does not always follow growth and ______
• Cephalocaudal development - development that moves from ______ downward thru ____ and towards the _____
• Proximodistal development - development that moves from the ____ of body outward to the _____

Answer 1

• physical size; function
• chronological age
• head downward thru body and towards the feet
• center of body outward to the extremities

Question 2

Play and Toys
• Play is the ____ of children, it’s how they ____ new things, ____, and learn to use ____ skills
• for a child w/ a heart defect, would you give them something to do that will get them excited and ↑ their HR?

Answer 2

• work; learn new things, socialize, use coping skills

* No, b/c that would ↑ workload on the heart, and we NEVER want to ↑ the workload on heart of a client w/ heart disease

Question 3

5 months old baby–most appropriate toy?

1. rattle
2. stuffed animal they can grasp
3. puzzle w/ big pieces
4. nursery rhyme CD

Answer 3

RATTLE – for grasp reflex and hold on to things

Question 4

11 yo boy in hospital–approrpiate activity? (SATA)

1. frequent visits from friends
2. playing video games in the room
3. coin collecting
4. watching TV
5. reading his favorite book

Answer 4

2, 3,4, 5

2. playing video games in the room; 3. coin collecting;
3. watching TV; 5. reading his favorite book
   - -pick the nerdiest adn most -un-fun activity for school-age children!!!

Question 5

General Peds Info
• When does the anterior fontanel close?
• and posterior fontanel?

Answer 5

• anterior close at 12 - 18 months

* posterior close at 2 - 3 months

Question 6

General Peds Info

Why are new foods introduced to infants one at a time?

Answer 6

Allergies and immature GI tract

Question 7

General Peds Info

Teaching for introducing new food to babies

Answer 7

• one food per week
• cut food into little bites
• watch them eat and sit them up in a high chair

Question 8

General Peds Info

Why are peanuts so dangerous when aspirated?

Answer 8

when peanuts are wet, they swell and crumble – DANGEROUS FOR AIRWAYS!!!

Question 9

General Peds Info

FOODS TO AVOID for children <4

Answer 9

hot dogs
carrots
apples
grapes
peanut butter
marshmallows
nuts and seeds
popcorn
hard candy 
chewing gum

Question 10

General Peds Info
When giving IM injections, which muscle is contraindicated in children who have not been walking for at least a year? why?

Answer 10

ventrogluteal muscle; muscle not developed well enough

Question 11

General Peds Info

When viewing the auditory can in the young child, how is the earlobe positioned?

Answer 11

down and back

Question 12

General Peds Info

What is the most common reason for failed toilet training?

Answer 12

they’re not ready

Question 13

General Peds Info

How many cups of milk should 15-month old toddler consume daily?

Answer 13

2 - 3 cups

Question 14

General Peds Info
At what age does the best friend stage occur?
imaginary friends?

Answer 14

9 - 10 years;

3 yo may have imaginary friends

Question 15

General Peds Info

What are the leading causes of death from accidental injury in infants up to 1 yo?

Answer 15

Suffocation, Motor vehicle-related injuries, drowning

–also falls, aspiration, burns, poisoning

Question 16

General Peds Info

Between ages 6 and 12, what’s the major cause of severe accidental injury?

Answer 16

MVAs

Question 17

General Peds Info

What to teach children?

Answer 17

Stranger safety – not talking/texting anyone they don’t know on the internet, social media sites, or phone

Question 18

General Peds Info

What happens to the growth rate between 6 and 12 yo?

Answer 18

decreases

Question 19

General Peds Info

A school-age child requires, on average, how many calories per day?

Answer 19

2,400 calories/day

Question 20

General Peds Info

How much earlier do girls experience onset of adolescence than boys?

Answer 20

1 - 2 years
–girls start checking out boys in their trendy outfits whil boys don’t care about anything but food, video games, sports

Question 21

Car Seat Safety

1. Do not place car seats where? why?
2. Place infant <20 lbs (9kg) where? what car seat position? why?
3. In children 12-23 months, what car seat is recommended? which position is it facing?
4. Car seats should be used no matter what age until child weighs how much?
5. Never place ____ under or behind infant/child. Why?
6. Booster seats can be used for children ages _____

Answer 21

1. in front passenger seat b/c of airbags
2. middle of the back seat in a rear-facing, semi-reclined car seat; provides best protection for heavy head and weak neck
3. a convertible car seat; positioned facing forward
4. car seats until child weighs 30 POUNDS (13.6 kg)
5. padding–become compressed and create slackness in the harness = child ejected from car seat
6. booster seat – 4 - 8 years (below 4’9 and weigh 35-80 lbs)

Question 22

Hyperthermia and Car Seat Safety

1. Can occur from what?
2. Develops rapidly why?
3. This has been r/t what?

Answer 22

1. being left in a vehicle in hot weather (>80 F / 26.4 C)
2. b/c infants are NOT ABLE to regulate their body temp
3. busy schedules, distractions (cell phones, mental preoccupations)

Question 23

VS/Assessment
• Observation
• Distraction techniques

Order to obtain VS
• what first?
• ____ before touching/talking to them
• order of VS
• always count RR and HR for how long in infants? why?
• if VS cannot be taken w/o disturbing child, what to do?

Answer 23

• always begin with observation
• cartoon/cute ID badges/pen; talk to the parents before talking to the child

Order to obtain VS
• LEAST INVASIVE
• observe first
• b/c of irregularities d/t immature nervous system regulation
• record behavior w/ measurements

Question 24

VS/Assessment: TEMPERATURE
--Rectal
• considered as most what?
• contraindicated in infants why?
• contraindicated in any child who has what?

• -Axillary: done when?
• -Oral: what ages?
• -Tympanic: for what ages?

Answer 24

-Rectal
• most accurate
• TOO RISKY, may perforate the anus
• diarrhea, rectal lesions, receiving chemo, immunosuppressed, or has no rectum (Imperforate Anus/Anorectal Malformation)

Axillary - done when oral route is impossible
Oral - 5-6 yo (cooperative age)
Tympanic - for ALL ages

Question 25

``` VS/Assessment: Oxygen Saturation • use for? • check what to determine best location for sensor probe? consider child's ____ too • common sites? • should correlate with child's what? ```

Answer 25

* obtain a "picture" of blood oxygen level thru skin * perfusion, skin temp, edema; child's activity * fingers, toes * radial pulse

Question 26

``` Communication: Newborn (birth-1 month) • mode of communication? • express themselves thru what? • they respond to what? • what has a positive effect • nursing strategy? ```

Answer 26

* nonverbal * crying * human voice and presence * touch = + effect * encourage parent to touch infant

Question 27

Communication: Infants (1 month - 12 months) • mode of communication? • begin verbal communication with? starting with? • communicate thru? • attentive to what? • responds to? thru what? • nursing strategies?

Answer 27

* still nonverbal * vocalizations; repeating consonants "da da" * crying, facial expressions * human voice and presence (can't comprehend words) * touch thru patting/rocking/stroking * speak in gentle-toned voice, cuddle, pat, rub to calm, encourage presence of parents

Question 28

Communication: Toddlers and Preschoolers (1 - 5 years) • evolving skills of what? ``` --use of language to express thoughts: • children 3-4 years old form what? called what? • concrete and literal thinking? • vocabulary depends on? • who may ask a lot of questions? ``` * ____ attention span * ____ memory ``` --Cognitive development • egocentric? • magical thinking? • animism? • object permanence? ``` Nonverbal communication • express themselves thru what? • play is the ____ of the child

Answer 28

• evolving verbal skills * 3-4 word sentences, telegraphic speech * may interpret phrases * development, family's use * preschooler ask a lot of "why" questions to everything * short attention span * limited memory * think the world revolves around them * believe that their thoughts can cause events to actually happen * think nonliving things behave just like humans * an awareness that an object still exists even when it's not in front of them * dramatic play and drawing * work

Question 29

``` Communication: School-Age Children (6 - 12 years) --Cognitive development • able to use what? • begin to understand ____ and ______ • developing an understanding of? ``` --Verbal communication • ____ vocabulary • ____ and ____ language is more balanced • Misinterpretation of phrases is _________ --Nonverbal communication • can interpret what? • expression of?

Answer 29

* use logic * others point of view; cause and effect * body functions * big vocabulary * receptive and expressive language * still common * nonverbal messages * thoughts and feelings

Question 30

Communication: Adolescents (13 - 18 years) • abstract thinking but without what? • interpretation of medical terminology is ____ • strive for _____ • what 2 things build rapport? • need for ____ • nursing strategies?

Answer 30

* without adult comprehension * limited * strive INDEPENDENCE * Trust and Understanding * need PRIVACY * straightforward approach; talk in private area; have a part of interview w/o parent present

Question 31

Communication: Children w/ Physical and/or Developmental Disabilities • if unable to communicate, they may feel what? • who else may feel this way? • Nursing strategies?

Answer 31

* may feel helplessness, fear, anxiety * family may feel fear and anxiety * use gestures, picture boards, writing tablets; use ehad nods, eye blinks

Question 32

Respiratory Distress • what are observable signs of respiratory distress in children? • what causes it? • what illnesses causes it? • the amount of resp distress depends on what?

Answer 32

* Signs - Use of accessory muscles, Nasal flaring, Sternal retractions, Grunting w/ respirations * any illness that affects the lungs ability to get O2 in and CO2 out * pneumonia, atelectasis, pneumothorax, pleural effusion * depends on degree of airway disease

Question 33

Pneumonia

Answer 33

infection that inflames the air sacs in one or both lungs

Question 34

Atelectasis

Answer 34

partial or complete collapse of a lung

Question 35

Pneumothorax

Answer 35

air enters chest and lung collapses

Question 36

Pleural effusion

Answer 36

fluid buildup between the lungs and chest

Question 37

* What's Laryngotracheobronchitis/Croup? aka? * s/sx? * viral organisms that causes it? * they sound like what?

Answer 37

* viral infection * - slight to severe dyspnea, barking/brassy cough, ↑ temp * Parainfluenza, Adneovirus, RSV * barking seal!

Question 38

Laryngotracheobronchitis/Croup Treatment • if mild: • if sx worsens or no improvement?

Answer 38

* (at home) -- steam from hot showers; cool temp therapy (constrict swollen blood vessels in trachea that are causing swelling) * Nebulized epinephrine or corticosteroids

Question 39

``` Laryngotracheobronchitis/Croup Treatment: Nebulized epinephrine • onset? • improvement? • always watch for a ```

Answer 39

* has rapid onset * improvement in 10-15 mins * relapse and return of sx when epi wears off

Question 40

Epiglottitis • what is it? s/sx? • primary organism cause? • prevention? * can lead to what? * considered as? * the less noise they make = the _____ the airway obstructive * never try to visualize throat/tongue with what?

Answer 40

* serious obstructive inflammatory process -- absence of a cough, presence of DYSPHAGIA, DROOLING, rapid progression to severe respiratory distress * H-Flu * Hib vaccine * partial/full occlusion of airway * MEDICAL EMERGENCY * the WORSE the airway obstructive * tongue depressor

Question 41

RSV • what is it? caused by? • can be _____ in infants • Risk factors? --how to prevent RSV? • S/Sx? --know the onset of s/sx b/c RSV become worse at days ____ and can progress to life-threatening resp distress • Treatment - -mild? - -severe?

Answer 41

* Respiratory Syncytial Virus; leading cause of lower resp tract illness in children <2yo; caused by acute viral infection that affects bronchioles * life-threatening! • prematurity; congenital disorders (like heart defects); smoke ---avoiding sick contacts and RSV immunizations (Synagis, RespiGam) • simple URI; nasal discharge, mild fever, wheezing, nonproductive paroxysmal cough (violent attack), tachypnea w/ flaring nares; dyspnea and retractions ---worse at 2-3 days * mild -- supportive care (hydration, antipyretics, nebulizers) * severe -- IVFs, Albuterol sulfate (Proventil), antipyretics, suction, O2 (may need intubation and mechanical ventilation)

Question 42

``` Pneumonia • what is it? causes? • s/sx • treatment • teaching ```

Answer 42

• inflammation of lungs; causes -- bacterial, viral, fungal, aspiration of foreign substance s/sx • FINE CRACKLES or RHONCHI w/ COUGH (productive/nonproductive); ↓/absent breath sounds over affected lung fields; chest pain; back/abdominal pain; HIGH fever tx • ABCs, O2, fluids, abx if bacterial, supportive care for viral (hydration, antipyretics, nebulizers) teaching • have children vaccinated!!!!

Question 43

Cleft Lip/Cleft Palate • defects occur when? • what is it? Treatment --Pre-op • to prevent aspiration: infants fed with? where in mouth? • what to do frequently because they swallow lots of air? because lots of air causes what? be at risk for what? • if born with both, which one is corrected first? why? --Post-op • goal? • position after cleft lip repair? • w/ cleft palate: what to avoid? why? what diet until well healed? • when is the best time for a cleft palate repair to be done?

Answer 43

* during fetal development * orofacial defect that affects the oropharynx and ↑ risk of malnutrition and aspiration tx --Pre-op • elongated nipple, medicine dropper -- down the side of mouth • BURP frequently; causes abdominal distention; at risk for vomiting and aspiration • CLEFT LIP; assists w/ feeding and promotes parental bonding --Post-op • protect suture line • SUPINE or SIDE-LYING --- DO NOT put in PRONE POSITION!!!! • avoid putting hard/rough foods or utensils in child's mouth; disrupts suture line --- SOFT DIET • before speech develops (between 1-2 years old)

Question 44

Gastroesophageal Reflux (GERD) • what is it? • at risk of? lead to? tx/positioning • position? • reflux precautions? • can we alter feeding to help w/ reflux? what's better tolerated?

Answer 44

* backwash or reflux of gastric contents into esophagus * aspiration of gastric contents into lungs = lead to PNEUMONIA * UPRIGHT position during feeding and 30 mins after * UPRIGHT position w/ frequent burping during feedings * YES --- thickened formula ( 1 tbsp of rice per 1 oz of formula/breast milk)

Question 45

``` Pyloric Stenosis • what is it? • s/sx • diagnosis • treatment ```

Answer 45

• disorder results in PROJECTILE VOMITING during/after a feeding s/sx • feel OLIVE-shaped mass in epigastric region near umbilicus (enlarged pylorus; PROJECTILE VOMITING b/c of pressure behind the vomitus dx • abdominal ultrasound ``` tx • hydration and electrolyte replacement; I and O; Monitor urine specific gravity; Daily weights Surgery ```

Question 46

Intussusception • what is it? • s/sx * what can be done to push out the telescoped area? * what should you be monitoring closely? * after an enema or surgery, they still keep them in the hospital for several days, why?

Answer 46

• a piece of bowel telescopes in on itself forming an obstruction • s/sx sudden onset (smiling → suddenly scream in pain) cramping and abdominal pain drawing up of knees inconsolability episodes of pain (HURT then becomes okay) CURRANT JELLY STOOLS (maroon color) • air-contrast, barium, ultrasound-guided saline enema ---the pressure of enema push out the telescoped area * monitor STOOLS * it might reoccur

Question 47

``` Hirschsprung's Disease • what is it? • usually affects what colon? • s/sx • treatment ```

Answer 47

* a congenital anomaly; aka aganglionic mega colon, results in MECHANICAL OBSTRUCTION * sigmoid colon (swollen/enlarged w/ narrowed rectum) s/sx • CONSTIPATION • abdominal distention • RIBBON-like stools w/ FOUL smell tx • surgery -- remove portion of bowel that's diseased

Question 48

``` Head Lice • what is it? • can lice spread to other parts of body beside the head? • spread how? • treatment ```

Answer 48

* scalp itching * yes, can go anywhere in the body * DIRECT CONTACT * antiparasitic meds -- often need re-treatment

Question 49

``` Pin Worms • sx? manifested by? • how are they spread? • whole family should be ____ • how do you collect a specimen for dx? • Treatment • teaching ```

Answer 49

* INTENSE RECTAL ITCHING --- general irritability, restlessness, poor sleep, bedwetting, distractibility, short attention span * hand to mouth * treated * TAPE TEST -- clear tape in rectum early AM before bm * mebendazole (Vermox) * good handwashing; keep fingernails SHORT; wash sheets and clean bathroom

Question 50

``` Infectious Mononucleosis • commonly known as? • s/sx • virus that causes it? • how is it spread? • treatment --if spleen's enlarged, limit what? why? ```

Answer 50

* "the kissing disease" * sore throat, fatigue, SWOLLEN LYMPH NODES, LIVER and/or SPLEEN ENLARGEMENT * Eipstein-Barr virus * Direct intimate contact --- kids can get it from drinking from water fountain tx • rest, analgesics, ↑ fluids, good nutrition • limit participation in CONTACT SPORTS to prevent injury

Question 51

Tonsillectomy and Adenoidectomy • surgical procedure for children w/ recurrent what? • position after tonsillectomy? prevent what? • why are brown and red fluids not given post-op? * what would indicate hemorrhaging is occurring? * how may days postop is the client at risk for hemorrhage? why? avoid what? * common complaints postop? * low grade temp is ____ * bad breath is sign of? caused by? tx?

Answer 51

* upper resp infections or obstructive sleep issues * place on side w/ elevated HOB or Prone position; prevent ASPIRATION * be confused with BLOOD * frequent SWALLOWING * 10 days --- scabs on surgical sites will begin to slough off 7-10 days --- no chips or rough foods for several days! * sore throat, slight ear pain * normal (↑ = infection) * foreign body in nose --- caused from infection in the area --- remove foreign body

Question 52

Otitis Media • what is it? preceded by? ``` treatment • use • avoid ___; need ____ foods • teach parent that? • avoid ____ of any kind • may require what? uses? if they have it in ears, what to wear when in bathtub or swimming? ``` ``` prevention • position for feedings • no ____ propping • gentle nose ____ • play _____ games • avoid ____ of any kind ```

Answer 52

• middle ear infection; BULGING, BRIGHT RED, TYMPANIC MEMBRANE; upper resp infection treatment • use ANTIBIOTICS • avoid CHEWING; need SOFT foods • teach parent -- child may not be able to hear them well • avoid SMOKE of any kind • TYMPANOSTOMY TUBES or PE (pressure equalizing) TUBES -- keep middle ear drained (temporary and it's ok when it falls out) --- wear earplugs when in bathtub or swimming ``` prevention • SITTING UP • no BOTTLE propping • gentle nose BLOWING • play "BLOWING" games (blow balloon, pinwheel) • avoid SMOKE of any kind ```

Question 53

Cystic Fibrosis (CF) • what is it? involves what? • what's given to help improve digestion w/ every meal and snack? take within how many mins of eating? beads should not be ____ • diet? why? s/sx • what's commonly seen? • have trouble absorbing what? what to take? • diagnostic test for CF? • earliest sign in newborn? • w/ CF, mucous secretion are ____ and ____ • what kind of disorder is this?

Answer 53

* genetic/inherited disease involves sx r/t exocrine glands -- involves GI system and Respiratory system * PANCREATIC ENZYMES; take within 30 MINUTES of eating; NOT CRUSHED/CHEWED * HIGH FAT, HIGH CALORIE --- usually underweight ``` s/sx • STEATORRHEA (fatty, frothy stools) • fat-soluble vitamins---do not absorb fat well; take Water-miscible forms of fat-soluble vitamins (in multi-vitamin form) to improve absorption "ADEKs" • Sweat Chloride test • meconium ileus (cannot pass meconium) • THICK and STICKY ``` • Autosomal Recessive Disorder --MUST get the gene from both parents

Question 54

Fat-Soluble Vitamins

Answer 54

A, D, E, K

Question 55

Down Syndrome • most common what? a.k.a.? • what type of infections are they most prone to? why? • most common type of physical defect associated with DS? • Risk factor? Genetic counseling is use for?

Answer 55

* birth defect; Trisomy 21 * Respiratory infections d/t POOR IMMUNE SYSTEM * Congenital heart defects * Advanced maternal age; To inform parents of their RISK

Question 56

Celiac Disease • what is it? treatment • teach? • cannot have BROW? • can have RCS?

Answer 56

• genetic disorder causing malabsorption d/t intestinal INTOLERANCE TO GLUTEN * teach it's a lifelong disorder so NO FOOD W/ GLUTEN (vegetable proteins) * Barley, Rye, Oats, Wheat * Rice, Corn, Soy

Question 57

``` Sickle Cell Disease • what is it? • s/sx • ____ Blood Flow → ____ Oxygen → PAIN • treatment ```

Answer 57

• hereditary form of anemia --- normal Hgb is partly/completely replaced by abnormal Hgb and sickle-shaped RBCs s/sx • PAIN in areas of involvement; Anorexia (loss of apetite); Exercise intolerance; Fatigue, malaise • ↓ Blood Flow → ↓ Oxygen → PAIN treatment • bed rest, HYDRATION, analgesics, abx, blood transfusion or packed RBCs (temporary fix), O2 (if hypoxic), Hydroxyurea (chemo med--reduce painful episodes)

Question 58

Duchenne's Muscular Dystrophy • what is it? • common in what gender? why? onset? ages what? • s/sx • treatment --how to maintain optimum muscle function? --prevent what? --what help improve muscle strength and respiratory function? --as disease progresses?

Answer 58

* most common and severe muscular dystrophy; inherited as X-linked recessive trait * Male children; it's a X-linked recessive trait; early childhood 3-5 yo ``` s/sx • LORDOSIS (curvature of lower spine) • WADDLING gait • frequent falls: muscle weakness • TOE WALKING • GOWER'S SIGN (classic sign of DMD) -- climbing or walking up oneself in an effort to standing up position ``` ``` tx • physical therapy • prevent contractures • Steroids • support groups and palliative care ```

Question 59

Tet Spells • what is it? seen in children with what? • caused by? treatment? • position? • monitor what? ``` prevention • ____ play • minimize ____ • respond to ____ quickly • _____ in infants and small children is usually d/t Congenital heart defects ``` • What's Congenital heart defects?

Answer 59

* "hypercyanotic" spells; childrent w/ congenital heart defect of TETRALOGY OF FALLOT * insufficient blood flow to lungs tx • 100% O2, Morphine for sedation • position -- KNEE-CHEST POSITION --- ↓ venous return from lower extremities and ↑ systemic resistance = diverts blood to pulmonary artery for oxygenation ``` prevention • QUIET play • minimize STRESS • respond to CRYING quickly • heart failure ``` • Structural defect of heart or great vessels that's present at birth

Question 60

Urinary Tract Infections (UTIs) • what is it? occurs most often in children ages what? greater risk in? s/sx <2 yo • if left untreated? • tendency for infections to ____ causes? • ____ anomalies • why are girls more prone to UTIs than boys? s/sx over 2 yo • classic s/sx diagnosis • requires? • most accurate method? treatment? ``` prevention? • proper wiping technique • no _____ • what type of underwear? • limit what kind of drink? ```

Answer 60

• very common but potentially serious infection in urinary tract --- 2-6 yo ---- females s/sx <2 yo • failure to thrive; Feeding problems, V/D • if left untreated = DESTROYED RENAL TISSUE AND SCARRING = KIDNEY FAILURE • re-occur --- family teaching is important! causes? • RENAL anomalies; • Constipation, Bubble baths, Poor hygiene, Pin worms, Sexual activity (sexual abuse) • female urethra is 1 ½ in (maturity), ¾ in young females -- ready pathway for microorganisms to invade s/sx over 2 yo • frequency, dysuria, fever, FLANK pain, hematuria, foul smelling urine diagnosis • properly collected urine specimen • CATHETERIZATION treatment • abx PO or IV ``` prevention • FRONT to BACK wiping technique • no BUBBLE BATHS • wear COTTON undies • limit CARBONATED DRINKS -- reduces acidity of urine and bacteria like ALKALINE in urinary tract ```

Question 61

Hydrocephalus • what is it? what builds up? causes what? ``` s/sx • bulging ____ w/ _____ enlargement • ____ scalp veins • eyes? • LOC? • cry? • _____ _____ Sign? what is it? ``` Diagnosis Head circumference measure how often? Surgical treatment • insertion of? --postop care measure what? assess for? monitor? what position? Hydrocephalus is frequently associated with a ______ • when infant is born w/ this type of spina bifida, protect what? and do not let it _____ • position? • cover sack with a what? why? • need special services and referrals for?

Answer 61

• disturbance of ventricular circulation of CSF; CSF builds up = ↑ ICP ``` s/sx • bulging FONTANELS w/ HEAD enlargement • DILATED scalp veins • DEPRESSED/SUNKEN eyes • IRRITABILITY and changes in LOC • HIGH-PITCHED cry • SETTING SUN Sign ---- can see the white all around the iris ``` Diagnosis Head circumference measure every well-child check-ups until 3 YEARS OLD Surgical treatment • insertion of VP SHUNT (ventriculoperitoneal shunt) --postop care • measure HEAD CIRCUMFERENCE • assess BULGING FONTANELS and widening cranial suture lines • monitor TEMP • SUPINE position Hydrocephalus is frequently associated with a MYELOMENINGOCELE • when infant is born w/ this type of spina bifida, protect SAC and do not let it RUPTURE • position PRONE • cover sack with a STERILE MOISTENED DRESSING ---- so it won't DRY OUT while waiting for surgery • mobility and developmental delays

Question 62

``` Scoliosis • what is it? • can be ____ or _____ • contributing factors? • Treatment (3 O's)? ```

Answer 62

* musculoskeletal disorder --- lateral curvature and rotation of spine * idiopathic (no cause) or congenital * heavy backpacks/suitcases; Bags; Carrying children on hips tx • Observation • Orthosis (supports and braces) • Operation (spinal fusion w/ rods)

Question 63

``` Chicken Pox • what is it? • how to not get it? • primary focus is to prevent what? • home remedies to relieve itching? • is it contagious? • what virus causes chicken pox? ```

Answer 63

* childhood communicable disease; the same virus that causes Shingles as a person gets older * vaccines recommended by CDC * prevent infection of lesions * oatmeal bath and baking soda w/ water * YES! VERY CONTAGIOUS * Varicella zoster

Question 64

Parenting Style: Authoritarian

Answer 64

highly controlling, expects to be obeyed, inflexible rules

Question 65

Parenting Style: Authoritative

Answer 65

the GOOD ONE! | sets reasonable limits on behavior, encourages growing autonomy of child, open communication

Question 66

Parenting Style: Permissive

Answer 66

few/no restraints, unconditional love, much freedom, little guidance, no limit setting

Question 67

Parenting Style: Indifferent

Answer 67

no limit setting, lacks affection for the child, focused on own life