Chapter 10, 11, 42

Question 1

Premature infants are less than ____ weeks

Answer 1

less than 36 weeks gestational age

Question 2

Full-term infants are ___ weeks

Answer 2

between 36-40 weeks

Question 3

Neonates: ____ weeks

Answer 3

first 4 postnatal weeks

Question 4

Infants: weeks _____

Answer 4

5-52 postnatal

Question 5

children: _____ years

Answer 5

1-12 years old

Question 6

Adolescents: ___ years

Answer 6

12-16 years old

Question 7

___ of drugs used in pediatrics have never been tested in children

Answer 7

2/3

Question 8

of drugs studied:
___ ineffective in children
___ unanticipated side effects
___ required dosage adjustments

Answer 8

20%
30%
20%

Question 9

Why are very young children highly sensitive to drugs?

Answer 9

BC of organ system immaturity

Question 10

In neonate and young infants, drug responses are usually ___ and ___

Answer 10

intense and prolonged

Question 11

absorption of IM drugs in neonates is ___ than in adults

Answer 11

slower

Question 12

Absorption of IM drugs in infants is ___ than in adults

Answer 12

more rapid

Question 13

Infants metabolize drugs faster than adults until age ___ when rates start to decline

Answer 13

2 years

Question 14

___ stain children’s teeth and should be avoided bc they are a teratogen

Answer 14

Tetracyclines

Question 15

__ causes growth suppression in kids but once stopped they will catch back up.

Answer 15

Steroids

Question 16

The elderly are __ of population and __ of nation’s prescribed drugs

Answer 16

12%

31%

Question 17

The elderly often have complications to drugs bc:

4

Answer 17

1. organ system degernation
2. multiple and severe illnesses
3. Multidrug Therapy
4. Poor Adherence

Question 18

The __ of drug absorption changes in older adults

Answer 18

rate

Question 19

reduced liver function may ___ drug effects

Answer 19

prolong

Question 20

___ ____ ___ with resultant drug accumulation is the most important cause of adverse drug reactions in older adults.

Answer 20

Reduced renal function

Question 21

The lab value that you should always pay attention to in older adults is the: ___

Answer 21

creatinine levels
(kidney function)

Question 22

ADR’s are __ more common in elderly

Answer 22

7x

Question 23

Elderly ADR’s account for __ of hospital admission and ___ of all medication related deaths

Answer 23

16%

50%

Question 24

__ to ___ of elderly do not take meds as prescribed

Answer 24

26%-59%

Question 25

Described in terms of sodium content of plasma:

Answer 25

osmolality

Question 26

Normal Sodium (Na) : ___ to ___ mEq/L

Answer 26

135-145mEq/L

this is in the blood, not cellular levels

Question 27

Osmolality : ___ to __-

Answer 27

280-300

Question 28

Fewer particles extracellularly than intracellularly

Fluid moves into the cell

Answer 28

Hypotonic solution

- cell swells

Question 29

more substance extracellularly than intracellularly. Fluid moves out of cell

Answer 29

Hypertonic solution

- cell shrinks

Question 30

Isotonic volume contractions are caused by:

treatment:

Answer 30

vomiting, diarrhea, kidney disease, diuretics

replaced with isotonic solution (0.9%) NaCl

Question 31

Hypertonic Volume Contractions are caused by:

treatment:

Answer 31

exc sweating, osmotic diuresis, lose more water than sodium

- replace hypotonic fluids (.11% NaCl, sterile water)

Question 32

Hypotonic Volume Contractions are caused by:

treatment:

Answer 32

diuretics, CRI, lack of aldosterone
isotonic or hypertonic replacement
** can be detrimental to pt***

Question 33

Volume expansion is caused by:

treatment:

Answer 33

overdose w/fluids, heart failure, nephrotic syndrome, cirrhosis of liver
treatment: diuretics

Question 34

Potassium is important for ________

Answer 34

conducting nerve impulses, electrical excitability of muscle (including cardiac)

Question 35

normal levels of potassium

Answer 35

3.5-4.5 K+

Question 36

a deficiency of potassium in the blood

Answer 36

Hypokalemia

Question 37

what causes hypokalemia, what are its effects, how do you treat it?

Answer 37

causes: diuretics, poor intake, excessive insulin, alkalosis, urinary loss, vomiting, diarrhea, laxatives, sweat

Effects: weakness, paralysis of skeletal muscle, dysrhyhtmias, slowing of gut, digoxin toxicity

Treatment: IV replacement, potassium chloride tablets

Question 38

You should NEVER give __ as an IV push. it will kill them

Answer 38

Potassium

Question 39

You would treat respiratory or metabolic acidosis with __ ___

Answer 39

sodium bicarbonate

Question 40

What causes Hyperkalemia?

Answer 40

tissue trauma, Addison’s disease, acidosis, K+ sparing diuretics

Question 41

Hyperkalamia can cause:

Answer 41

lethal cardiac electrical abnormalities

Question 42

To treat Hyperkalemia, you should:

Answer 42

begin by withdrawing potassium containing foods and drugs that promote potassium accumulation

• infuse calcium salt to offset cardiac effects
• infuse glucose and insulin to promote K+ uptake by cells
• infuse sodium bicarbonate if acidosis is present

Question 43

__ is needed for enzymes & RNA activity, neurochemical transmission and muscle excitability

Answer 43

Magnesium

Question 44

Hypomagnesemia is caused by:

Answer 44

diarrhea, dialysis, kidney disease, IV feedings, chronic alcoholism, DM, pancreatitis

Question 45

Treatment fo Hypomagnesemia:

Answer 45

IM or IV magnesium sulfate or oral magensium

Question 46

Hypermagnesemia causes:

Answer 46

muscle weakness, hypotension, confusion, sedation, EKC changes, respiratory paralysis