Fluids/burns
What is the total daily maintenance fluid for a child weighing 15kg?
1250mL
Chronic renal failure - which direction does the sodium go?
Down; Hyponatremia
It is diluted by the extra volume
Elevated CPK, AST/ALT with initial diagnosis
Duchenne Muscular Dystrophy (DMD)
Patient c/o hip/knee pain, patient is obese.
Slipped capital femoral epiphysis.
What is the treatment for slipped capital femoral epiphysis?
NWB, if needed surgical pinning (femoral head has slid down off the growth plate - risk for avascular necrosis)
What type of burn do we clean with soap and water, and can apply bacitracin or silvadene?
Minor burn (1st & 2nd degree)
UA - +leukocyte esterase, + casts, +rbcs, +nitrites
UTI
Increased WBC, high blast count
Leukemia
What is the treatment for nephrotic syndrome?
Steroids, immunosuppressants
remove metal jewelry, run under cool water/cool cloths, remove clothing
Stop the burning process
UA +ketones + glycosuria
DM/DKA
Renal Failure
What age is the DTAP given?
2, 4, 6, 15 months
TDAP is for Teens - starts at 11-12yrs
What treatments are appropriate for sickle cell anemia?
rest, hydration, pain mgmt (morphine or hydromorphone), warm compresses
A patient with diarrhea is at risk for which electrolyte imbalance
Hypokalemia
High reticulocyte count
Sickle cell crisis
What is the most common cause of death for patients with DMD?
muscle weakness leads to respiratory and cardiac compromise (they need/are muscles)
facial muscle weakness with repeated use/stress, difficulty swallowing. Can have extremity weakness. What test diagnoses this disease?
Tensilon test - give edrophonium, physostigmine, neostigmine - if S&S improve it is Myasthenia Gravis
What is the treatment for hemophilia with a severe bleed?
If they lose too much blood - give blood
Replace clotting factors (VIII vs IX)
DDAVP will not work - only for mild (increases activity of factor VIII).
What is the hourly fluid rate for a child weighing 24kg?
66mL/hr
UA + protein, dark, frothy
Blood - hyperlipidemia, hypoalbuminemia, increased BUN/Creatinine
Nephrotic Syndrome
A 6 year old is diagnosed with GB. His VS are: temp 99.1, HR 80, RR 12, BP 85/55, spo2 - 93. He is pale and breathing is shallow - what is the priority?
Breathing!!!!!!
A patient who has had which neuromuscular disease before should not receive a flu vaccine?
Guillan Barre
What medications are used to treat hyperthyroidism?
PTU, Methimazole
Beta Blockers to manage symptoms