chapter 32
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Defects involving what kind of blood flow are the most common congenital heart defects | Increased pulmonary blood flow |
Tetralogy of fallot involves a combination of four defects | 1. pulmonary stenosis 2. VSD 3. right ventricular hypertrophy 4. overriding aorta |
In transportation of the great vessels, the pulmonary artery arises form the left ventricle and the aorta arises from the | Right ventricle |
Palliative procedures to provide mixing, either by enlarging an atrial septal defect that is already present or by creating one by | Pulling a balloon catheter through the atrial septum |
Clinical manifestations of coarctation of the aorta, the blood pressure in the arms is | 20mm Hg higher than that in the legs |
Iron deficiency anemia is the most prevalent disorder in | Infancy and early childhood |
The incidence of iron deficiency anemia peaks between ages | 6-24 months in children from lower-income backgrounds |
Recommended daily allowance of iron for infants between the ages of 7 and 12 months is | 11mg of iron per day |
Hypoproliferative is | Defective production of erythrocytes |
When the hemoglobin falls below 5g/dl the child has | Anorexia, skin pallor, pale mucous membranes |
With sickle cell anemia, the erythrocyte changed from its characteristic round shape to | An elongated crescent shape (sickled cell) |
As sickle cells clump, circulation slows, resulting in | Obstruction with severe tissue hypoxia and necrosis ‘ |
Sickling is an intermittent phenomenon, the usual precipitating factors are | Infection, fever, hypoxemia, dehydration, high attitudes, cold, or emotional stress |
Two diagnostic tests for sickle cell anemia are | SICKLEDEX for screening purposes, and hemoglobin electrophoresis to determine whether the patient has sickle cell trait or sickle cell disease |
With hemophilia factors what are deficient or absent | 8 and 9 (VIII and IX) |
Diagnostic tests for hemophilia are | Abnormal prolonged partial thromboplastin time (PTT) |
Regular injection of what hormone helps in preventing bleeding from occurring | Desmopressin (DDVAP) |
RICE method is used for hemophilia when external bleeding occurs | R: rest I: ice C: compression E: elevation |
Idiopathic thrombocytopenia purpura (ITP) is characterized by | A marked decrease in the number of circulating platelets |
ITP clinical manifestations | Ecchymosis, pinpoint petechial rash are usually the first signs |
Leukemia medical management: prophylactic treatment is given through what route | Intrathecal (where the drug is injected directly into the spinal fluid) |
Hodgkin’s lymphoma is distinguished by | Painless enlargement of lymphoid tissue, fever, night sweats and weight loss |
The most common sites for hodgkin’s lymphoma to develop are | Chest, neck, underarms, and groin |
Primary immunodeficiency disorders result from | Genetic or congenital abnormalities |
Secondary immunodeficiency disorders (most common form) are disorders acquired in | Association with certain drug therapies such as corticosteroids |
HIV targets the | CD4+ molecules, especially the T helper lymphocytes |
Two tests for HIV | ELISA and western blot |
Juvenile idiopathic arthritis may manifest as early as | 6 months of age |
RDS occurs almost exclusively in | Preterm infants of low birth weight |
RDF occurs more frequently in | Boys delivered by caesarean section |
RDF: without sufficient production of surfactant, the infant is unable to keep the lungs inflated and the alveoli collapse at the end of expiration, resulting in | Hypoxia, atelectasis, and respiratory acidosis |
RDF clinical manifestations | Nasal flaring, expiratory grunting |
Bronchopulmonary dysplasia is a disorder that develops in | Premature infants |
BPD arises in association with mechanism aspiration, RDS, high concentrations of o2, positive pressure ventilation and | Endotracheal intubation |
BPD clinical manifestations | Respiratory distress (wheezing, retracting, nasal flaring, irritability, abundant secretions, and cyanosis when stressed) |
Pneumonia is classified according to the causative agent: | Bacterial, viral, myocoplasmal, or foreign body aspirations |
Viral pneumonia’s are more common than | Bacterial pneumonia’s |
Croup: laryngotracheobronchitis and acute epiglottitis is marked by | Resonant barking cough, suffocating and difficult breathing, and laryngeal spasm |
Croup pathophysiology: the inflamed epiglottis becomes | Cherry-red and edematous, which has the potential to lead to total airway obstruction |
Medical management of croup focuses on | Maintaining patency of the airway |
Cystic fibrosis is a disorder of the exocrine (mucus-producing) glands, with the characteristic presence of | Thick mucus that obstructs the lungs and the gastrointestinal (GI) system |
A combination of cleft lip and palate is more common than | An isolated occurrence of either |
Nursing interventions for cleft palate | Promote bonding between the parents and the infant |
“currant jelly” stools | Feces mixed with blood and mucus from the intestinal mucosa |
Clinical manifestations of hirschsprung’s disease | Failure to pass meconium stool within 48 hours and ribbon-like foul smelling stools |
Types of hernias | Diaphragmatic: abdominal organs hiatal: stomach through esophagus inguinal: loop of intestine umbilical: protrusion of intestine |
Kernig’s sign | Resistance to knee extension in supine position with hips and knees flexed against torso |
Brudzinski’s sign | Flexion of the knees and hips when neck is flexed rapidly onto the chest |
Chelation therapy | The use of a compound to bind to a toxic substance and render it nonactive and thus nontoxic |
Down syndrome clinical manifestations | Low-set ears and a simian crease of the palmar side of the hand |
Patent ductus arteriosus: failure of the ductus arteriosus to close within the first weeks of life allows oxygenated blood to shunt from the high pressure aorta to | The low pressure pulmonary artery |
Atrial septal defect: an abnormal opening in the atrial septum that enables oxygenated blood to flow from the high pressure left atrium to the | Lower pressure right atrium |
Ventricular septal defect: an abnormal opening in the interventricular septum, resulting in the flow of oxygenated blood from the higher pressure left ventricle to the | Lower pressure right ventricle |
Tetralogy of fallot: | 1. pulmonary stenosis 2. VSD 3. right ventricular hypertrophy 4. overriding aorta |