Exam (elaborations)
NR602 MIDTERM TOPIC REVIEW 2024/2025
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NR602 MIDTERM TOPIC REVIEW 2024/2025
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NR602 MIDTERM TOPIC REVIEW 2024/2025When should infant have first hearing screen
All infants should receive hearing screening before 1 month of age
Evoked otoacoustic emission (EOAE) testing is the method of
hearing screening used for universal newborn screening
What are recommendations for screening retinoblastoma
● The US Preventive Services Task Force (USPSTF)
recommendations for vision screening for children six
months to 5 years of age
● The American Association of Ophthalmic
Oncologist and Pathologists (AAOOP)
screening recommendations for children at
risk for retinoblastoma all infants and children
should have a red reflex exam before
discharge from the newborn nursery and after
that at every health maintenance visit
Education for preventing eye injuries
● Using safety gates and cushions/pads at sharp corners,
storing sharp utensils/tools out of reach of children, and
storing chemicals securely
● Restraining children properly in the car
(seatbelt), not allowing children under 12 years
of age to sit in the front seat
● Limiting/supervising the use of laser pointers, BB
guns, air rifles, paintball devices, darts, and
fireworks
Scabies diagnosis and treatment
● Key finding: Itching, worse at night, initially mild but
progressively more intense
○ Fitful sleep, crankiness, or rubbing of hands
and feet (infants) lesions include curving S-
shaped burrows, especially on webs of fingers
and sides of hands, folds of wrists and
armpits, forearms, elbows, belt line, buttocks,
genitalia, or proximal half of foot and heel.
● Diagnostics: Microscopic examination of scrapings
from an unscratched burrow in saline or mineral oil
can reveal an eight-legged mite, eggs, or feces. Do
not use KOH because it dissolves the mites, eggs,
and feces. Burrows and fresh papules are best for
specimen collection
, ● Treat with permethrin 5%, repeated in 1 week;
use an antihistamine, hydrocortisone, or
nonsteroidal anti- inflammatory drugs (NSAIDs)
for itching; simultaneously treat family members
(even if asymptomatic), friends, and
school/daycare contacts
● At the time of treatment, linens and any clothing worn
during the past 48 hours should be washed with hot
water, put into a hot dryer for 20 minutes, or dry-
cleaned. The house should be vacuumed
● Educate the family about the course of the
disease. Rash and itching persist for up to 3
weeks following treatment
● The child should not be infectious 24 hours after
treatment and may return to school or daycare.
Immunizations- recommendations, teaching, promoting
Hypothyroidism/ adrenal insufficiency
● Labs: Free T4 and TSH- levels will be high
● Infants: slowing of growth rate indicate
hypothyroidism Kawasaki disease (~2-3 questions)
presents as an acute febrile illness and is the leading
cause of acquired heart disease. The disease is
triphasic.
● characterized by an acute generalized systemic small and
medium vessel vasculitis occurring throughout the body
○ the rash resembles an erythroderma
○ begins weeks after the fevers and can be seen
months or years later
● Outbreaks in late winter and early spring
● At risk for cardiac
involvement Characteristics
● persistent fever for at least 5 days plus four of the
following: bilateral conjunctival injection, changes of
the lips and oral cavity, cervical lymphadenopathy,
polymorphous exanthema, and changes in the
peripheral extremities (swelling of the hands or feet) or
perineal area
Diagnosis of exclusion. The six components that need to be
present in a patient with suspected KD but an incomplete
diagnosis include:
(1) albumin ≤3.0
g/dL (2) urine ≥10
WBC/HPF
(3) platelet count ≥450,000 after 7 days of fever;
, (4)anemia consistent with age values
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