1. car crashes
2. fires
3. drowning
4. homicide

1. poverty
2. stress
3. family structure
4. school & child care
5. community
6. culture

1. frequent resp illnesses
2. frequent GI illnesses
3. increased risk for injury
4. long term (HTN, stroke, heart attack)

chickenpox (varicella)

-transmission

-nursing

• airborne, direct contact
• isolation

Coxsackievirus (herpangina; hand, foot & mouth disease)

-transmission

-nursing

- fecal-oral & resp

-isolation, topical lotions, cool drinks

Erythema infectiosum (fifth disease)

-transmission

-nursing

- resp secretions and blood

- isolation, fever control, soothing baths (oatmeal)

haemophilus influenzae type B

-transmission

-nursing

- direct contact or droplet

- isolation, prophylaxis for contact, antipyretics

Measles (Rubeola)

-transmission

-nursing

- airborne, droplet and contact

- isolation, antitussives, antipyretics and monitor resp status

Mononucleosis

-transmission

-nursing

- direct contact with secretions

- antipyretics, bedrest during acute phase

Pertussis (whooping cough)

- transmission

- more severe at ?

- nursing

- resp droplets, direct contact with secretions

- night

- isolation, monitor resp status and dehydration

Rotavirus

- season

- transmission

- nursing

- jan to march

fecal to oral route

- hand hygiene and monitor I&O

• loss of Na and water equal
• serum sodium is normal

• more sodium is lost than water
• serum sodium is low

• more water is lost than sodium
• serum sodium is high

1. asthma
2. resp failure

1. hyperventilation
2. anxiety
3. pain
4. fever
5. aspirin toxicity
6. sepsis
7. mechanical overventilation

Causes of metabolic acidosis (2)

1. DKA
2. severe anorexia

1. prolonged vomiting
2. excess suctioning

Conjunctivitis ("pink eye")

-tx

1. bacterial: ATB
2. viral: comfort measures
3. allergen: anithistamines, mast-cell stabliziers

• infection of eyelid and surrounding tissues
• usually bacterial
• tx: IV ATB

• retina normally vascularizes around 8 mo
• impairment to complete vision loss
• laser therapy or surgical procedures
• minimize light exposure and titrate O2 closely

•  9-11; boys 11-15

• inflammation with or without infection in middle ear
• neraly all children by 7 YOA
• peak incidence 2 YOA
• cause: eustachian tube dysfunction
• ATB tx

• inflammation of soft tissues and skin of ear
• "Swimmer's ear"
• irritated canal easily infected
• tx: clean, ATB gtts, steriod gtts

• 2/100 affected
• tx: early detection, cochlear implants, hearing aids
• SOME FORMS UNTREATABLE!

• infection of pharynx and tonsils
• rare under 1 YOA; common 4-7 YOA
• 80% viral; 20% bacterial
• tx: bacterial- ATB, viral- comfort care

• infection and hypertrophy of the palatine tonsils
• tx: viral- comfort, bacterial- ATB

• infection can be acute or chronic
• bacterial or viral
• nasal issues
• tx: surgical removable

• obligatory nose breather
• nasal patency is critical
• suck, swallow and breath to grow

• alveoli change size and shape, increase in number
• smooth muscles of bronchi and bronchioles
• intercoastal muscles immature
• ribs are primarily cartiladge

• foreign body aspiration
• croup syndrome
• epiglottitis
• viral and bacterial resp infection

• obstructive sleep apnea
• asthma
• cystic fibrosis
• bronchopulmonary dysplasias

• restlessness
• tachypnea
• tachycardia
• diaphoresis

• nasal flaring
• retractions
• grunting, wheezing
• anxiety, irritability, mood changes, confusion
• HTN

• dyspnea
• bradycardia
• cyanosis
• stupor, coma

• food, toys, coins, latex balloons common
• right lung most common d/t straighter tube to right lung
• no other s/sx of illness
• may be asymptomatic after coughing 15-30 min then resp distress

• broad term for upper airway illness
• 3 mo- 3 yrs
• NO ATB
• needs cool air and humidity
• abrupt onset normally at night
• barky cough
• hoarse voice

• potentially life threatening
• usually caused by hib
• 2-8 yrs
• fever, drooling, difficulty swallowing, tripod positioning

• usually viral
• dry hacking cough
• worse at night
• ribs/chest hurt

• RSV and other virus main cause
• dyspnea, retractions, dehydration, trouble swallowing, wheezing, cough and fever

• viral, mycoplasmal and bacterial
• fever, abnormal BrSo
• bacterial is more severe and septic

• systemic vascular resistance increases
• foramen ovale closes
• ductus arteriosus constricts; closes within 10-15 hrs after birth
• left ventricle enlarges d/t increased pressure

• persistant fetal circulation
• very common in preterm
• can be closed with meds, devices or surgery
• prognosis good

• opening in atrial septum left to irght shunting
• opening may be small or large
• very common heart defect
• closure is spontaneous, devices or surgery
• prognosis good if closed

• opening in venticular septum, left to right septum
• most common defect
• may close spontaneously or surgery
• prognosis is high risk if repair needed in first few months of life

• ASD, VSD, tricuspid and mitral valve defects
• affects down syndrome babies
• repair: surgical
• Prognosis: mitral valve insufficient and arrhythmias

• PDA
• ASD
• VSD
• AV Canal

• PS
• TOF
• pulmonary or tricuspid atresia

• narrowing of pulmonary valve
• second most common defect
• repair: dilate with balloon or surgical valvotomy
• prognosis good with repair

• four defects: PS, right ventricular hypertrophy, VSD and overriding aorta
• elevated right heart pressure, right to left shunt
• repair: surgical
• prognosis: improved quality of life

• right side of heart not developed
• repair: surgical (E1 prostaglandin)
• Prognosis: right ventricular dysfunction is common

• AS
• COA
• HLHS

• group A beta-hemolytic strep
• clinical manifestations: heart, joints, brain, skin
• tx: ATB, steriods and aspirin

• fever, hyperemia, lymph node enlargement, cracking skin and coronary artery aneurisms
• tx: IV IGG
• aspirin for anti inflammatory and antiplatelet