Summary Peds HESI exit - PEDS HESI EXIT STUDY GUIDE
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Course
PEDS HESI
Institution
PEDS HESI
Vitals
AGE PULSE RR BP systolic
NEWBORN -70
1-11 mo (infant) -100
1-3 yr (toddler) -110
3-6 yr (preschooler) -110
6-12 yr (school age) -120
12-18 yr (adolescent) -120
SKIN Diaper dermatitis
・ Raw, moist, weeping macules and papules of skin in contact w/ diaper
・ Causes: candida (yeast...
SKIN Diaper dermatitis
・ Raw, moist, weeping macules and papules of skin in contact w/ diaper
・ Causes: candida (yeast)
○ Use topical antifungal
○ Watch for white patches in the mouth (thrush)
○ Lay baby on a towel w/o diaper several times a day
Impetigo
・ Bacterial infection around mouth, nose, hands, neck, extremities
○ Rash → red papules w/ honey colored crusting
・ Someone is carrier of bacteria and contagious
○ Both parents will need to have nasal swab sent for culture
Folliculitis
・ Superficial inflammation of hair follicle → pustules and papules at follicular openings
Cradle cap (Seborrheic dermatitis)
・ Recurrent inflammatory condition caused by overgrowth of yeast
・ Yellow greasy scales, slight erythema
・ 1st mo of life, resolves by 6-12 mo
・ Occur in face, trunk, neck, diaper area
・ Apply shampoo w/ selenium sulfide
・ Baby oil or vaseline before washing
・ Wash hair daily
・ Not contagious
Erythema toxicum neonatorum
・ Common, benign rash in NB
・ Scattered yellow-white pustules on face, neck, trunk
・ Not contagious
・ Rash will resolve spontaneously in hours-days
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Eczema
・ Lichenification
○ Thickening of the skin d/t excessive scratching
○ Use hand mittens
Malignant ・ Occurs post-op
hyperthermia ○ ↑BP
○ Dark urine (skeletal muscle release of myoglobin)
○ Chest erythema
・
Osteomyelitis Infection of the bone caused by bacteria (enter through wound or bloodstream)
・ Acute more common in peds
○ Bacteremia d/t staphylococcus aureus
・ Tenderness over the bone
・ Sudden increase in pain of limb
・ Erythema (redness)
・ Warmth, swelling, presence of wound
・ Limited movement
・ Fever, irritability, lethargy
Interventions
・ IV abx
○ PICC line will be placed
○ Home infusion therapy
・ NSAIDs (pain, swelling)
Scoliosis ・ Girl 10-13 yo
○ Observe symmetrical shoulder height
・ Mild: 10-20 degrees
○ Exercise to improve posture and muscle tone
・ Moderate scoliosis: 20-40
○ Brace
・ Severe scoliosis: >40 degrees
○ Surgery
Developmental hip ・ Pavlik harness
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dysplasia (DDH) ○ Worn 24hr / day to correct hip dysplasia
・ DO NOT remove for cleaning or diaper changes
○ Wear bodysuit under the harness prevent skin breakdown
・ Ortolani test
・ Assessment
○ Asymmetrical gluteal fold
Spina bifida (neural Myelomeningocele
tube defect) ・ Most serious form
・ Sac present → containsSF, meninges, nerves
・ Surgery
○ Maintain occlusive dressing on at all times
○ Change w/ soiled
Muscle dystrophy Duchenne muscular dystrophy
・ Genetic disorder → muscle fiber damage and degeneration
・ Muscle weakness and wasting
・ ↑levels of creatine kinase in blood → inflammation
・ Affects skeletal and cardiac muscle
Assessment
・ Frequent falls
・ Difficulty standing up from lying or sitting
○ Gower’s sign → child's legs are too weak to stand w/o using arms for support
・ Trouble walking, running, jumping
・ Waddling
・ Walking on tiptoes
・ Muscle pain/stiffness
・ Delayed growth
・ Enlarged calves or thighs
・ Learning disabilities
Teaching
・ High-fiber foods to prevent constipation
・ Encourage ambulation as tolerated
・ Annual flu shot (increased risk of respiratory infections)
・ Avoid high-contact sports
Juvenile Rheumatoid ・
arthritis (JRA)
Ewing Sarcoma Cancer in bones of soft tissues surrounding bone → pelvic or long bones
・ Common in teens & young adults
・ Swelling, bone pain
・ Unexplained fatigue
・ Fever of unknown origin
・ Tx
○ Chemotherapy (will require additional tx after chemo)
○ Radiation
○ Surgery
○ Supportive
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