Child With a Physical and Mental Disorder (CH 32)
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302 questions
| 🇬🇧 | 🇬🇧 |
| List some environmental factors contributing to congenital heart defects | Intrauterine rubella exposure Maternal alcoholism Diabetes Advanced maternal age Maternal drug ingestion |
| List some genetic factors contributing to the development of congenital heart defects: | Sibling or parent with CHD Chromosomal anomalies Other noncardiac congenital anomalies |
| Oxygenated blood enters the fetal heart via the: | Inferior vena cava |
| The four CHD categories are related to: | Increased pulmonary blood flow Decreased pulmonary blood flow Obstruction to systemic blood flow Mixed blood flow |
| Administration of ________ is effective in closing the ductus arteriosus in full-term and premature newborns | Indomethacin |
| Which palliative procedure can be performed in infants with symptomatic VSD's? | Pulmonary artery banding |
| What is the most common CHD resulting in decreased pulmonary blood flow? | Tetralogy of Fallot |
| Tetralogy of Fallot involves four defects: | 1. Pulmonary stenosis 2. VSD 3. Right ventricular hypertrophy 4. Overriding aorta |
| In coarctation of the aorta, blood pressure in the arm is _____ higher than that in the legs | 20 mm Hg |
| Iron-deficiency anemia peaks in children between which ages? | 6 and 24 months |
| List 3 iron-rich foods: | Red meat Legumes Iron-fortified cereals |
| How is anemia defined? | A decrease in red blood cells, hemoglobin, or both |
| What are the two classifications of anemia? | Hypoproliferative (defective production of erythrocytes) Hemolytic (premature destruction of erythrocytes) |
| What are signs of mild to moderate anemia? | Irritability Weakness Decreased play activity Fatigue |
| Hemoglobin values of 6 to 10 g/dL is considered: | Mild to moderate anemia |
| What are the clinical signs of a hemoglobin below 5 g/dL? | Anorexia Skin pallor Pale mucous membranes Glossitis Spoon fingernails Inability to concentrate Tachycardia Systolic murmurs |
| Why are adolescents at risk for iron-deficiency anemia? | Rapid growth rate Poor eating habits |
| Health care provider usually prescribe ________ until the hemoglobin value returns to normal | Oral iron supplementation (ferrous sulfate) |
| What should be taken with iron supplements? | Citrus fruits or juices |
| Packed RBC's are given only to which children? | Severely anemic |
| What will the stool look like while receiving iron therapy? | Dark, tarry, green |
| What are some precipitating factors causing the sickling of erythrocytes? | Infection Fever Hypoxemia Dehydration High altitudes Cold Emotional stress |
| Name the three types of sickle cell crisis: | 1. Vasoocclusive 2. Sequestration 3. Aplastic |
| What happens to the red bone marrow in aplastic anemia? | Becomes yellow and fatty |
| What is used to determine whether a patient has sickle cell trait or sickle cell disease? | Hemoglobin electrophoresis |
| What is the only potential cure for sickle cell disease? | Bone marrow or stem cell transplantation |
| Which gender is the carrier of hemophilia? | Transmitted by female carriers |
| How many male births are affected by hemophilia? | 1 in 5000 male births |
| In hemophilia, where does bleeding most frequently occur? | Within the joints and muscles |
| What is the purpose of the infusion of the hormone desmopressin? | Prevent bleeding from occurring |
| What does RICE stand for? | Rest Ice Compression Elevation |
| The onset of ITP is seen in children of which ages? | 2 to 10 years |
| What is the most serious complication of ITP? | Intracranial hemorrhage |
| What are usually the first signs of ITP? | Ecchymosis and petechial rash (usually over bony prominences) |
| A splenectomy eliminates the site of ________ ________ production | Platelet antibody |
| What is the leading cause of disease in children past infancy? | Neoplastic disease (cancer) |
| What is the most common form of leukemia in children? | Acute lymphoid leukemia (ALL) |
| In leukemia, there is an overproduction of _______ which accumulate in the marrow. | Blast cells (immature WBC's) |
| Which three problems develop as a result of the overproduction and accumulation of immature WBC's? | 1. Decrease in RBC production 2. Neutropenia leads to infection 3. Decrease in platelets, causing bleeding |
| What is often the first symptom of leukemia? | Anemia with pallor and fatigue |
| What is the route of choice for CNS prophylaxis? | Intrathecally (directly into cerebrospinal fluid) |
| What is the drug of choice for CNS prophylaxis? | Methotrexate |
| Which ages are considered to be high-risk when diagnosed with acute lymphoid leukemia (ALL)? | Younger than 1 and older than 10 |
| What is the main diagnostic feature of Hodgkin's lymphoma? | Reed-Sternberg cells |
| What is the common indicator in all immunodeficiency disorders? | Unusual or recurrent, severe infections |
| Why does HIV target T helper lymphocytes? | They have more CD4+ receptors on their surface than any other cell |
| What is the greatest threat to an HIV infected infant younger than one year? | Pneumocystis jiroveci pneumonia |
| Juvenile idiopathic arthritis is more common in which gender? | Affects GIRLS twice as much as boys |
| How is JIA characterized? | Chronic inflammation of the synovium with joint effusion |
| What is the disadvantage of using DMARD's? | Increased chance of infection |
| What do TNF blockers do? | Reduce pain, morning stiffness, and joint swelling |
| What are the disadvantages of TNF blockers? | Increased risk of infection Increased chance of lymphoma or other cancer |
| What are two examples of TNF blockers? | Etanercept (Enbrel) adalimumab (Humira) |
| What is respiratory distress caused by? | A deficiency of surfactant |
| What kind of feedings are contraindicated in an infant with RDS? | Nipple and gavage |
| How is exogenous pulmonary surfactant administered? | Endotracheal tube directly into the lungs |
| How should the infant with RDS be positioned? | On the side with head in alignment |
| Frequent suctioning increases the risk for: | Bronchospasm Infection Pneumothorax Hypoxia Increased intracranial pressure |
| What is the most effective preventative measure for RDS? | Prevention of premature delivery |
| Infants who survive Bronchopulmonaary dysplasia are at risk for: | Chronic lung disease |
| Bacterial pneumonias are most common in _____ and ______. | Infants and children |
| What is the most common viral pneumonia in infants and children? | Respiratory syncytial virus (RSV) |
| What kind of pneumonias typically run a longer course? | Staphylococcal |
| How many infants die of SIDS? | 2 out of every 1000 |
| SIDS is often associated with which factors? | Premature birth Low birth weight Multiple births CNS and respiratory dysfunctions |
| What does postmortem examination reveal in an infant with SIDS? | Pulmonary edema and intrathoracic hemorrhages |