Test 4 Review

1
Test 4 Review

• Where should I spend
• most of my time?

2
Ground Rules

• This review is not all-inclusive
• You are still responsible for
• Extra notes, comments added in class to clarify a
  concept, etc

3
Test 4 is Cumulative

• Expect 5 questions from Test 3 material
• Usually commonly missed concepts

4
BONUS - Birth Plan

• Be familiar with terms and common issues that
  parents should consider
• Be familiar with the summary statements in the
  circumcision guidelines document
• -anesthesia?
• -UTI?
• -penile cancer?
• -AIDS?
• ...

5
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6
Management of Labor Pain

• Type of pain felt in each stage
• Nulliparous vs. Multiparous
• What determines maternal satisfaction?

7
Nonpharmacological Pain Relief

• Continuous labor support (doula)
• Benefits?
• Warm water baths
• Efficacy? Effect on epidurals?
• Risks? Recommendations?
• Sterile Water Injections
• Position, Touch Massage

8
Natural Birth

• Effect on endorphins, adrenal glands, etc.

9
Pharmacological
10
Terminology of Birth

• Recognition of labor
• retraction
• bloody show
• Hydrostatic dilator
• Mechanisms of birth

11
Stages of Labor What happens? How long does it
last?

12
Retention of Placental Parts

• Symptoms? Clinical signs?
• Management?
• Complications?

13
Complications of Labor

• Polarity - power
• Chiropractic relationship?

14
Primary ( ) inertia vs. Secondary
inertia ( )
15
Abnormal Polarity

• Disordered
• Hypertonic lower pole
• Colicky uterus
• Constriction ring aka ________
• Cervical dystocia

16
Passage

• Pelvis shape
• contracted pelvis
• 2 cm
• Tumor, fibroid, cysts, fracture

17
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19
Puerperium - ?

• ___ weeks
• Lochia rubra
• Lochia serosa
• Lochia alba

20

• Expected changes in tissues
• involution
• How does breastfeeding affect ovulation?
• Considerations related to different types of birth

21
Puerperium Concerns

• Hemorrhage
• Top 3 causes?
• Infection (risk factors? s/s? Tx?)
• Endometritis
• UTI
• Mastitis
• Wounds

22
Puerperium Concerns

• Endocrine (S/S?)
• Postpartum Thyroiditis PPT
• Thyrotoxicosis
• Hypothyroidism
• Postpartum Graves Disease
• Less common

23
Puerperium Concerns

• Psychiatric
• Postpartum Blues
• Postpartum Depression
• Postpartum Psychosis
• S/S? How common? What causes it? Risk factors?

24
Breastfeeding

• How long?
• Benefits? Mom / Baby
• Contraindications?
• Preterm Infant
• Beyond infancy

25
Solids

• When?
• Signs of readiness
• Concerns related to early introduction
• Cows milk after _________
• Fruit juice
• Limit to 2-4 oz/day (with meals)
• Vitamin C increases iron absorption

26
Seriously Ill

• Know red flags
• When assessing a child with a fever consider

27

• ___________ alone is not a sign of serious
  illness
• Dehydration
• signs of dehydration

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Referral Criteria?
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For all childhood diseases know

• AKAs
• Typical symptoms
• Viral/bacterial
• Treatment
• Anything that stands out!

30
Measles

• Rubeola, red measles
• Viral
• Typical vs modified
• 3Cs
• Non-pruritic
• Koplic spots
• Copper-colored desquamation
• Complications?

31
Rubella

• German measles, 3-day measles
• Viral
• Pruritic
• Complications?
• more common in adults
• Congenital rubella
• Deafness
• Microcephaly, cardiac defects, cataracts

32
Fifth Disease

• Erythema Infectiosum
• Parvovirus B-19
• Rash
• Slapped cheek
• Lacy, reticular
• Spares palms and soles of feet
• pruritic
• No longer contagious once the rash appears
• Arthritis

33
Varicella

• Chicken Pox
• Viral
• Pruritic
• Infectious until all lesions have crusted over
• Secondary skin infection
• ???

34
Roseola Infantum

• Exanthum subitum
• Viral
• 6 months 3 years
• Fever 3 days, fever breaks, rash appear
• Rash
• Pink/red rosettes blanches
• A few hours-2 days

35
Scarlet Fever

• Scarlatina
• Strep. (bacterial)
• MC
• Fever, headache, vomiting, sore throat (petechial
  lesions) NO COUGH
• White strawberry tongue
• Rash
• Blanches
• Axilla, groin

36
Hand Foot Mouth

• Enterovirus (fecal-oral)
• Grey vesicles/lesions
• Hands
• Feet
• Mouth
• Diaper area
• Fever, malaise, sore throat, vomiting/diarrhea

37
Mono

• Epstein Barr virus
• Fatigue, fever, pharyngitis, cervical
  lymphadenopathy
• Rare pink rash (older kids)
• Spleen/liver
• Pneumonia/otitis
• Guillain-Barre syndrome

38
Mumps

• Viral
• Saliva, possibly urine
• Parotid glands
• Pain eating
• Orchitis
• Pancreatitis
• Meningitis/encephalitis

39
Diptheria

• Bacterial
• May show no signs of illness until the
• Pseudomembrane
• Grey, fibrinous
• Tonsils, nasopharyx
• Antitoxin antibiotics
• Complications heart neuro
• (dysphagia)

40
Pertussis

• Whooping cough, 100 day cough
• Bacterial
• 3 stages
• Cold symptoms
• Severe cough, whooping
• Convalescent period
• Apnea, pneumonia
• Small meals

41
Tetanus

• Bacterial
• Muscles and nerves
• lock jaw, opisthotonis
• Debridement Antitoxin Antibiotics Reduce
  spasm
• Asphyxia/cyanosis
• Neonatal tetani

42
Polio

• Viral
• Fecal-oral respiratory
• No known wild cases since 1979 (USA)
• Inapparent (no symptoms)
• 90-95
• Abortive
• Nonparalytic
• Paralytic
• 50 recover with no residuals

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