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Final Exam Review: (elaborations) NR602 Primary Care Childbearing And Child Rearing Family (NR602) | Rated A Review| Latest 2022| Chamberlain $12.49   Add to cart

Exam (elaborations)

Final Exam Review: (elaborations) NR602 Primary Care Childbearing And Child Rearing Family (NR602) | Rated A Review| Latest 2022| Chamberlain

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NR602 / NR 602 Primary Care of the Childbearing and Childrearing Family Practicum Final Exam 1. tx of pulmonary atresia - heart cath/balloon valvuloplasty - open heart if severe 2. tetralofy of fallot (TOF) - congenital cyanotic cardiac condition that classically has four anatomi...

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  • June 9, 2022
  • 42
  • 2021/2022
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NR602 / NR 602 Primary Care of the Childbearing and
Childrearing Family Practicum Final Exam

1. tx of pulmonary atresia

- heart cath/balloon valvuloplasty
- open heart if severe


2. tetralofy of fallot (TOF)

- congenital cyanotic cardiac condition that classically has four anatomical defects
in the heart:
- pulm valve stenosis
- RVH
- VSD
- aorta that overrides ventricular septum
- common in downs


3. TOF manifestations

- varying degrees of severity
- cyanosis
- hx poor wt gain
- sternal lift d/t RVH
- hypercyanotic/TET spells w/ feeding/crying/pooping
- harsh systolic ejection murmur @ L mid upper sternal border


4. TOF tx

- severe pulmonary obstruction - ductus arteriosus maintained or reopened w/ pge1
until sx possible
- TET spells - knee chest tripod, o2, morphine SQ, immediate intervention!
- complete sx repair w/ closure of VSD & relief of RVOT in infancy

,5. transposition of great arteries

- aortic and pulm artery switched (aorta gets deox'd blood & takes to body, pulm
artery gets ox'd blood and takes it to pulm circuit)
- may have # of congenital heart defects comorbidly
- males>females


6. manifestations of transposition of great arteries

- cyanosis
- LGA infant w/ G&D retardation after neonatal age
- ? CHF s/s
- loud, single s2


7. mgmt of transposition of great arteries

- immediate referral to peds cardiology care center
- IV PGE1 - delay closure/reopen PDA
- balloon atrial septostomy
- JATENE procedure to switch arteries in first few days of life
- annual echo f/u
- lifetime VTE prophylaxis!


8. coarcation of aorta & manifestations

- narrowing of the descending portion of the aorta, resulting in a limited flow of
blood to the lower part of the body
- males> females
- not always apparent until PDA closes
- HTN, murmur by 3-5 yo
- HA, leg pain w/exercise and mvmt
- severe (1st 6 wks of life): poor feeding, tachypnea, cool LE's


9. physical exam findings of coarc of aorta

, - UE HTN, LE HoTN
- delayed/absent/weak lower body peripheral arterial pulses & bounding upper
body ones
- ? s/s CHF - gallop in infants
- ? systolic ejection murmur
- ? ventricular heave at apex


10. mgmt of coarc of aorta

- neonates: PGE1 for PDA
- sx resection & anastamosis of aorta ( best after age 1)
- older kids - antihypertensives for several mos post op
- 6 mos post op VTE prophylaxis


11. Total anomalous pulmonary venous return (TAPVR)

- Pulmonary veins drain into something other than L ventricle or not attached
normally
- somestimes asymptomatic in infancy/toddlerhood
- cyanosis, tachypnea, freq uri/pna, lethargy, poor feeding, poor growth
- sx: reanastamosis


12. IDA key facts & screening recs

- dietary iron primarily abs in duodenum
- may be comorbid w/lead poisoning
- AAP universally screen at 12 m and freq risk assessments


13. manifestations of IDA in peds

- irritable, anorexia, restlessness (hgb <8)
- pica, ice chewing
- mental & motor devel delays
- cognitive impairment in teens
- behavioral disturbances

, 14. LAB values w/ IDA

- MCV - low/norm
- RBC's - same
- HIGH: TIBC, RDW
- LOW: ferritin
- mentzer index >13


15. mgmt of IDA in peds

- neonates breastfed exclusively: 1 mg/kg/d
- premies: 2 mg/kg/d
- iron supplement 3-6 mg/kg/d in 2-3 doses (takes 6-8 wk to be effective)


16. Sickle cell manifestations in peds

- fatigue
- bacterial infections
- bone infarcts
- abd pain
- pain crises
- aseptic necroses
- eye damage
- LE ulcers
- splenomegaly <5 yo
- growth slows after age 7
- puberty delayed by 3-4 yrs
- arthritis
- cardiopulmonary injury
- swelling of hands & feet


17. SCA carriers manifestations

- benign clinical course of SCA s/s only under stressors

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