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Primary Care of Adolescents & Children (NURS 6541) Final Exam Review

John Marsh
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Walden University

Primary Care of Adolescents & Children (NURS 6541)

6541 Final Exam Review

6541 Final Exam Review
1) 7-month-old RSV recommended treatment
a. Supportive treatment; hydration, oxygen
2) Epiglottitis – what decreases the incidence of it?
a. Caused by HIB. Drooling, insp & exp stridor, high fever, aphonia (muffled
voice), shore throat, flaring nares, retractions, tripod position while sitting,
extended neck as to make breathing easier
b. Thumb sign- on lateral neck x-ray, epiglottis are looks like a thumb (google
images has examples)
c. Do not examine the throat
d. Treatment: To surgery for exam w/otolaryngologist to establish airway,
antibiotics, and can be follow by pulmonary edema so watch for that.
e. 25% of cases are less than 1 year old. Otherwise common in 2 – 5 year olds.
f. All household contacts get rifampin if there are unimmunized people that live
3) Antibiotics or not?
a. Asthma – No
b. Epiglottitis – Yes
c. Croup – No
d. Bronchiolitis – No
e. Foreign body aspiration – No. Only if secondary pneumonia develops.
4) 12-year-old female with fever & sore throat – possible differentials
a. Strep, mono, apthous ulcers, peritonsillar abcess, epiglottitis, steven Johnson
syndrome, measles
5) SGA infant – which type of chromosomal analysis?
a. Testing would be chorionic villi sampling, amniocentesis, or fetal free DNA.
b. Lots of detail in this answer, but we will likely need it later. Trisomy 18,
Edwards syndrome. These kids are small, don’t typically live past one year with
lots of issues. Didn’t look up much on this. Wasn’t in the book.
c. Trisomy 13 – Patau Sundrome – 1 in 5,000. Microcephaly, with midline defects
such as cyclopia, cleft lip, cleft palate. Sloping forehead, small easr, anopthalmia
or micropthalmia, micrognathia, and pre-auricular tags. VSD, ASD, TOF and
more hear defects. To test for this one, 17 week ultrasound is the best time to
look for it.
d. Turner syndrome – Short webbed neck, low hairline, posteriorly rotated ears,
ptosis, short legs and 4th & 5th metacarpals, family is generally short in stature, hip
dysplasia, hearing loss. Bicuspid aortic valve, CoA (35%), pulmonic stenosis.
e. Holt-Oram Syndrome – “Heart Hand Syndrome” – Upper limb abnormailities,
such as thumb, thenar and redial bone anomalies. Congenital heart lesions such
as ASD, VSD, and/or conduction issues. Can occur spontaneously but is
autosomal dominant. I have a feeling we are gonna have a question with a weird
arm x-ray and this will be the answer.



Primary Care of Adolescents & Children (NURS 6541) Final Exam Review

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