NR 602 Final Exam Review Questions and Answers Graded 100% 2023

NR 602 Final Exam Review Questions and Answers Graded 100% 2023. Increased work of breathing, prolonged expiration, grunting, retractions, nasal flaring Croup sx - Answer Low grade fever, URI symptoms, barking cough, inspiratory stridor can occur Croup dx - Answer Made from symptoms Croup tx - Answer Glucocorticoids possibly 0.6mg/kg-1mg/kg humidified air bronchodilators Lead poisoning - Answer Inactivated heme synthesis by inhibiting insertion of iron-leads to microcytic hypochromic anemia Source of lead poisoning - Answer Lead based pain Those at risk for lead poisoning - Answer Children 2-3 y/o summer months Lead poisoning testing - Answer Children with Medicaid need lead level @ 12 months and 24 months-capillary finger stick with venous sample as f/u AAP recommends mo as well as 3-4-5-6 y/o Lead levels - Answer 5 is normal 69 requires chelation Genu varum - Answer Bow legged as a result of uterine position- normal finding up to 3y/o Legg-Calve-Perthes Disease - Answer Avascular necrosis of femoral headepiphyses associated with trauma, synovitis Legg-Calve-Perthes Disease RF - Answer Associated with low birth weight, socioeconomic status, or white race Legg-Calve-Perthes Disease s/s - Answer Onset of painful limp of thigh, knee, or hip worse with activity, not relieved by rest restricted by abduction and rotation of affected hip Legg-Calve-Perthes Disease Tx - Answer Abduction brace or long leg cast Congenital Hip Dysplasia s/s - Answer Thick fold asymmetry, leg length inequality, walking children- painless limp Congenital Hip Dysplasia Dx & Tx - Answer Positive Barlow maneuver, ortolani or Allis sign US for 4 months, X-ray AP of pelvis 4 months Tx: refer to orthopedist, pavlik harness, child should be seen weekly to prevent skin breakdown, necrosis Toxic trait synovitis - Answer Unilateral inflammation arthritis; acute onset; decreased ROM extension and internal rotation; painful hip, crying at night; common in boy 3-6 y/o Toxic trait synovitis Dx and Tx - Answer Dx: WBC with leukocytosis, increased ESR, hip xray normal To: BR, NSAIDs, non WB Impetigo - Answer Superficial layers of the skin Nonbullous or bullous nonbullous= honey-colored crusts on lesions caused by group A streptococcus, S.aerous or MRSA occurs more in summer months, low socioeconomic class Impetigo exam - Answer Lesions on hand, face, neck, extremities or perineium; regional lymphadenopathy Impetigo treatment - Answer Topical antx if superficial, nonbullous or localized to one area bacitracin neomycin polymyxin B Widespread infection again S. Aerous= Augmentin, cephelexin, dicloxacillin, cloxacillin for 7-10 days Cellulitis - Answer In children often periorbital, perivaginal, perinatal, or buccal Cellulitis hx - Answer Recent URI, fever, pain, malaise Cellulitis exam - Answer Buccal cellulitis-blue/purple tinged= enzae Cellulitis Dx - Answer CBC, BCx if child appears toxic, has fever, or is 1 Cellulitis tx - Answer IV antx if streptococcal= PCN, if allergy 3rd generation cephalosporin if staphylococcus=bactrim if child 2 months; doxy if child 8 and 45 kg MRSA suspected= clindamycin H.influenzae=augmentin x 10 days Folliculitis - Answer Infection of hair follicle; s. Aerous most common furnucle - Answer Deeper infection of hair follicle involving the deep dermis Hot tub folliculitis - Answer Pseudomonas aeruginosa Dx of folliculitis & furnucle - Answer Grain stain and cx Management of folliculitis and furnucle - Answer Warm compresses, benzoyl peroxide if superficial- topical antx-erythromycin or clindamycin if severe or widespread- cephalexin or dicloxacillin Paronychia - Answer Infection around fingernail/toenail S.aerous #1 then streptococcus or pseudomonas Paronychia tx - Answer Systemic oral antx if acute infection present candida-nystatin if purulant-loosen cuticle with blade Candiasis - Answer Tx: thrush-oral nystatin QID if resistant to tx: oral fluconazole skin diaper rash-nystatin, ketonazole Tinea captitis - Answer ringworm of the scalp diffuse fine scale without obvious hair loss discrete area of hair loss with broken hairs (black dot ringworm) trichophyton tonsurans and microsporum canis-most common organisms African American boys most common tx of tinea capitis - Answer griseofulvin ultramicrosize once or twice daily for 6-8 weeks, take with fatty food to increase absorption shampoo with econazole or ketonazole in addition tinea corporis - Answer ringworm found on non hairy part of body tx for tinea corporis - Answer topical antifungals miconazole or clotrimazole 1-4 weeks BID Tinea cruris - Answer jock itch 4-6week of antifungals tinea pedis - Answer 3-6 weeks of antifungals onychomycosis - Answer fungal infection of the nail typically with T.rubrum or candida exam= opaque, white, silvery nail that becomes thick/yellow seldom symmetrical tx: oral terbinafine, fluconazole, itraconazole tinea versicolor - Answer a fungal infection that causes painless, discolored areas on the skin occurs on the trunk more in adolescents, warm weather, immunocompromised exam= hypopigmented or hyper (salmon colored to brown) with raindrop or guttate appearance Tx: selenium sulfide lotion or shampoo for 2-4 weeks older adolescents can use ketonazole herpex simplex - Answer HSV type 1-oral mucosa, pharynx, lips caused by herpes labialis-cold sore/fever blister HSV-2 neonatal Herpes simplex exam - Answer HSV-1= gingivostomatitis- grouped vesicle that ulcerate and form white plaques on mucosa, gingiva, tongue, chin, labial folds halitosis present herpes labialis-cluster of small clear vesicle with erythematous base usually only on one side of the mouth HSV-2= grouped vesicopustules and ulceration with edema, primary lesions on vaginal mucosa, labia, perineum, penile shaft Herpes simplex dx & tx - Answer Dx: viral cx= gold standard for diagnosis Tx: acyclovir 20-40mg/kg/dose 5x daily for 5 days Herpes zoster - Answer shingles more common in adolescents exam- 2-3 clustered groups of macules and papules-progress to vesicle on the a red based, vesicles become pustular, rupture, and crust Tx: antivirals not usually recommended unless immunocompromised. Molluscum contagiosum - Answer small firm, pink, papules 1-6mm, itchy occurs on face, axillae, antecubital area, trunk tx: usually disappear on own if pain occurring curettage, salicylic acid Warts - Answer caused by HPV virus most common on extremities but can occur on face, scalp, and genitalia verruca vulgans-common wart verucca plantaris-plantar warm condylomata acuminata- on genital mucosa-cauliflower appearance TX: watchful waiting, no treatment if asymptomatic pediculosis - Answer head lice Tx: OTC permethrin 1% 1st step- apply permethrin or pyrethrin 2nd step- remove nits, comb hair 3rd step-cleanse environment Scabies - Answer itching that is worse at night-S shaped burrows webs of fingers, fold of wrist, arm pits, forearm TX: permethrin 5%, repeat in 1 week Drug eruption - Answer exanthematous reaction-morbilliform measles like rash Most common drugs: PCN, cephalosporin, sulfonamide antx, NSAIDS, antifungals, typical onset 1-2 week of starting new med Tx: D/c drug, antihistamines Erythema multiforme - Answer skin disorder resulting from a generalized allergic reaction to an illness, infection, or medication Pityriasis Rosea - Answer Presents with a herald patch, Christmas-tree pattern. Psoriasis - Answer chronic skin condition producing red lesions covered with silvery scales Psoriasis treatment - Answer ■ Topical STEROIDS ■ Topical RETINOIDS (TAZOROTENE) ■ TAR preparations (PSORALEN drug class).