ABNORMAL PEDIATRICS : Increased ICP, Seizure
Meningitis, Head Trauma, PDA, Septal Defects, C
of Aorta, Tetralogy of Fallot, ToGA, Rheumatic He
Kawasaki Disease, Heart Failure, Cleft Lip, Cleft P
GERD, Pyloric Stenosis, Celiac Disease, Hirschsp
Disease, Intussusception, Croup, Cystic Fibrosis,
Subject PEDIATRICS
NEUROLOGIC DISORDERS
INCREASED INTRACRANIAL PRESSURE (ICP) 4. PSYCHOMOTOR
normal : 5-15 mmHg common : geria
→ > 15 mmHg : increased ICP mental clouding & intoxication
→ > 20 mmHg : life-threatening 5. FEBRILE
CUSHING’S TRIAD common : pedia
hypertension under 5 : immature hypothalamus → h
bradycardia (38.5 → 39 → 40 C)
bradypnea 6. STATUS EPILEPTICUS
widened pulse pressure (SBP — DBP) 30 minutes : on & off / tuloy-tuloy
normal : 30-40 mmHg EMERGENCY! → brain damage could
narrow : shock mgt :
sx : primary tx : medication
bulging fontanels : aggravated by crying hydantoins : PHENYTOIN “primary drug”
anterior → diamond ; closes 12-18 mos WOF :
posterior → triangular ; closes 2-3 mos gingival hyperplasia → soft-bristled to
care
high-pitched cry / shrill cry : early sign
pinkish red urine → inform significant
universal language of infant : crying
BENZODIAZEPINES : “-pam / -lam”
early sign of increased ICP / age group
minimizes seizure episodes
infant : high-pitched cry
iminostilbenes : CARBAMAZEPINES
child : irritability & agitation
refractory seizures (pabalik-balik na s
adult : restlessness
prevent seizure reoccurence
geria : confusion
valproates : VALPROIC ACID “last resort m
increased head circumference
SE : hepatotoxicity → pedia, immature
at bedside : tape measure → to measure q shift / 8 hours
never given in pregnancy → NTD’s (ne
headache : initial sign (first sx)
last resort : surgery
projectile vomiting : compression of medulla → CTZ
NEURECTOMY → surgical resection of th
chemoreceptor trigger zone : vomiting center seizure
trigger by : cerebral edema
still functional cranial nerve, may part
diplopia (double vision)
, → increased fluid = increased pressure nuchal rigidity : stiff neck
coughing & sneezing is avoided seizures
limit fluid intake to 1200 - 1500 ml/day opisthotonus : arching of the back
pharmacotherapy : position : side-lying
DIURETICS : potassium wasting → monitor : hypokalemia mgt :
LASIX : loop → loop of henle (localized) ANTIBIOTICS
MANNITOL : osmotic → osmosis : pulling pressure (generalized) there is no specific antibiotic → it dep
DECADRON (DEXAMETHASONE) : prevents cerebral edema RN responsibility : finish the duration
ANTACIDS : neutralize acidity
→ stress levels HEAD TRAUMA
→ use of decadron → due to poor sense of balance
magnesium : diarrhea “Mg TAE” CONCUSSION : jarring of the brain → sud
rigid skull
aluminum : constipation “Alang TAE”
transient loss of consciousness
ANTI-COAGULANTS : prevent clumping of blood
CONTUSION (bruising) : structural alterat
heparin : IV / SQ → PTT (partial thromboplastin time)
mgt :
warfarin : oral → PT (prothrombin time)
priority : SAFETY
*** REMEMBER : opiates & sedatives are CI in increased ICP (CNS
depressants) bike helmet
cushing’s triad → respiratory & cardiac depression seat belts
safe driving of parent
SEIZURE DISORDER / EPILEPSY infant care seat
→ erratic transmission of electrical impulses < 3 y/o : rear facing → protect the
types : > 3 y/o : front / forward facing boo
1. GRAND MAL : generalized assess for cerebral functioning : GCS / PE
tonic (mild) - clonic (severe) : “during” → dyspnea, salivation, most important prognostic indicator :
urination
assess cervical neck injury
position : flat / supine → protect head
(+) : do not move the px (immobilize)
post-ictal (exhaustion) : “after”
(-) : head of bed elevated (30 degree
position : side-lying / recovery (gravity)
2. PETITE MAL / ABSENT
blank facial expression
automatisms → repeated unilateral facial movement
lip smacking
3. JACKSONIAN
tonic clonic of a group of muscles → progress to grand mal
CARDIOVASCULAR DISORDERS
layers of the heart :
1. endocardium : innermost
2. myocardium : muscle → contraction → cardiac output
CO → amount of blood ejected by the heart in 1 full minute
3. pericardium : outermost
Meningitis, Head Trauma, PDA, Septal Defects, C
of Aorta, Tetralogy of Fallot, ToGA, Rheumatic He
Kawasaki Disease, Heart Failure, Cleft Lip, Cleft P
GERD, Pyloric Stenosis, Celiac Disease, Hirschsp
Disease, Intussusception, Croup, Cystic Fibrosis,
Subject PEDIATRICS
NEUROLOGIC DISORDERS
INCREASED INTRACRANIAL PRESSURE (ICP) 4. PSYCHOMOTOR
normal : 5-15 mmHg common : geria
→ > 15 mmHg : increased ICP mental clouding & intoxication
→ > 20 mmHg : life-threatening 5. FEBRILE
CUSHING’S TRIAD common : pedia
hypertension under 5 : immature hypothalamus → h
bradycardia (38.5 → 39 → 40 C)
bradypnea 6. STATUS EPILEPTICUS
widened pulse pressure (SBP — DBP) 30 minutes : on & off / tuloy-tuloy
normal : 30-40 mmHg EMERGENCY! → brain damage could
narrow : shock mgt :
sx : primary tx : medication
bulging fontanels : aggravated by crying hydantoins : PHENYTOIN “primary drug”
anterior → diamond ; closes 12-18 mos WOF :
posterior → triangular ; closes 2-3 mos gingival hyperplasia → soft-bristled to
care
high-pitched cry / shrill cry : early sign
pinkish red urine → inform significant
universal language of infant : crying
BENZODIAZEPINES : “-pam / -lam”
early sign of increased ICP / age group
minimizes seizure episodes
infant : high-pitched cry
iminostilbenes : CARBAMAZEPINES
child : irritability & agitation
refractory seizures (pabalik-balik na s
adult : restlessness
prevent seizure reoccurence
geria : confusion
valproates : VALPROIC ACID “last resort m
increased head circumference
SE : hepatotoxicity → pedia, immature
at bedside : tape measure → to measure q shift / 8 hours
never given in pregnancy → NTD’s (ne
headache : initial sign (first sx)
last resort : surgery
projectile vomiting : compression of medulla → CTZ
NEURECTOMY → surgical resection of th
chemoreceptor trigger zone : vomiting center seizure
trigger by : cerebral edema
still functional cranial nerve, may part
diplopia (double vision)
, → increased fluid = increased pressure nuchal rigidity : stiff neck
coughing & sneezing is avoided seizures
limit fluid intake to 1200 - 1500 ml/day opisthotonus : arching of the back
pharmacotherapy : position : side-lying
DIURETICS : potassium wasting → monitor : hypokalemia mgt :
LASIX : loop → loop of henle (localized) ANTIBIOTICS
MANNITOL : osmotic → osmosis : pulling pressure (generalized) there is no specific antibiotic → it dep
DECADRON (DEXAMETHASONE) : prevents cerebral edema RN responsibility : finish the duration
ANTACIDS : neutralize acidity
→ stress levels HEAD TRAUMA
→ use of decadron → due to poor sense of balance
magnesium : diarrhea “Mg TAE” CONCUSSION : jarring of the brain → sud
rigid skull
aluminum : constipation “Alang TAE”
transient loss of consciousness
ANTI-COAGULANTS : prevent clumping of blood
CONTUSION (bruising) : structural alterat
heparin : IV / SQ → PTT (partial thromboplastin time)
mgt :
warfarin : oral → PT (prothrombin time)
priority : SAFETY
*** REMEMBER : opiates & sedatives are CI in increased ICP (CNS
depressants) bike helmet
cushing’s triad → respiratory & cardiac depression seat belts
safe driving of parent
SEIZURE DISORDER / EPILEPSY infant care seat
→ erratic transmission of electrical impulses < 3 y/o : rear facing → protect the
types : > 3 y/o : front / forward facing boo
1. GRAND MAL : generalized assess for cerebral functioning : GCS / PE
tonic (mild) - clonic (severe) : “during” → dyspnea, salivation, most important prognostic indicator :
urination
assess cervical neck injury
position : flat / supine → protect head
(+) : do not move the px (immobilize)
post-ictal (exhaustion) : “after”
(-) : head of bed elevated (30 degree
position : side-lying / recovery (gravity)
2. PETITE MAL / ABSENT
blank facial expression
automatisms → repeated unilateral facial movement
lip smacking
3. JACKSONIAN
tonic clonic of a group of muscles → progress to grand mal
CARDIOVASCULAR DISORDERS
layers of the heart :
1. endocardium : innermost
2. myocardium : muscle → contraction → cardiac output
CO → amount of blood ejected by the heart in 1 full minute
3. pericardium : outermost
