Exam 3 Total Review
Hypertrophic Pyloric Stenosis (HPS) correct answers obstruction
non-bilious emesis 30-60 mins after feeding, crying after feeds, failure to thrive, olive
mass
Intussuseption correct answers Telescoped bowel
-Bilious emesis, sudden intermittent pain with currant jelly stools, sausage mass
-dx and tx with air enema or surgery
Appendicitis correct answers RLQ pain, N/V, frequent small stools, mcburneys point
tenderness
NONPERFORATED: appy or ABX alone
PERFORATED: appy and ABX, inverval appy and ABX or ABX ALONE
GER correct answers burping, pain with feeding, failure to thrive, posturing is sandifer
syndrome
TX: small frequent feeds, upright for 45 min after, thickened, H2 blockers, PPI,
prokinetics, nissen fundopilcation
H2 blockers correct answers decrease acidity
Cimetidine
Ranitidine
Famotidine
Nizatidine
PPIs correct answers decrease acid production
prazole
Hirschsprung Disease correct answers no ganglionic cells in bowel- poor motility, abd
dis/pain, V, failure to thrive
RF: not passing meconium in 24hrs/male
DX: biopsy of cells
TX: resection/reanastomosis
Celiac correct answers autoimmune; NO gluten
NO wheat, rye, barley, oats
-malnourished, iron deficient/resistent anemic, steatorrhea, abd dis. , no muscle
Respiratory Distress Syndrome correct answers newborn respiratory distress bc of
poor lung maturity and lack of surfactant
RF: preterm, maternal DM
, S/S: grunt, nasal flare, atelectasis, cyanosis
TX: support/PEEP, give surfactant, vent
*BETAMETHASOME in utero prevents RDS
Mechanical Ventilation can cause correct answers bronchopulmonary dysplasia and
retinopathy
Meconium Aspiration Syndrome correct answers inhalation of mecium fluid
RF: post term, maternal DM, prolonged labor, breech, assistive device, drug use
S/S: tachypnea, stained amniotic fluid, grunt, cyanosis, uneven pulm ventilation
TX: assess amniotic fluid, hyperoxygenation, vent, vasodilators, surfactant
Hyper ischemic encephalopathy (HIE) correct answers inability to transtition; acidosis
RF: birth trauma, asphyxia, mas, sepsis, malformation, shock from mom trauma
TX: resuscitate- dry, warm, suction, resuscitate
Comps: cerebral palsy, retardation, speech issue, impairments
FAS correct answers maternal alcohol abuse, causes growth restriction, craniofacial
malformations and CNS dysfunction
-microcephaly, small eyes, thin upp lip, missing philtrum, narrow head, FGR,
retardation, cardiac issue, poor coordination
tobacco in pregnancy causes correct answers impaired oxygenation, SGA/growth
restriction, preterm, SIDS, chronic resp illness
marijuanna in pregnancy causes correct answers fetal growth restriction/SGA, preterm,
sleep issues, hyperirritability, tremulousness, high pitch cry
cocaine in pregnncy correct answers CNS simulated, inc VS, hypoxia, abruption,
preterm, anomalies, piercing cry, poor feeds, poor sleep, irritable, sensitivity, dec
responsiveness
NAS correct answers NAS appears 48 hrs after birth, screening done when awake after
feedings, CNS irritability, over reactivity, GI issues
newborn hypoglycemia correct answers lethergy, weak cry, poor feeding, apnea,
tremor, cyanosis, hypothermia!
Prevent: early feeds, thermoregulation
TX: feeds, iv glucose if severe
hyperbilirubinemia (jaundice) correct answers need age of newborn in hours to
determine if its worsening- bilirubin comes from RBC hemolysis
RF: delay in meconium excretion
*Unconjugated: toxic, cannot excrete
*Conjugated: soluble, excreted
Physiologic: slow onset, not serious