Chapter 54: Pediatric Conditions Flashcards

1
Q

When must an infant age < 3 months old seek urgent care

A

Temp of 100.4 F/38 C (rectal)

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2
Q

When must an infant age 3-6 months old seek urgent care

A

Temp of 101 F/38.3 C (rectal)

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3
Q

When must an infant age < 6 months old seek urgent care

A

Temp of 103 F/39.4 C (rectal)

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4
Q

A newborn’s general condition is assessed with what scoring tool

A

Apgar score

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5
Q

An infant with a lower Apgar score requires

A

more medical care

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6
Q

Which medication is a standard med given at birth to prevent bleeding

A

IM Vitamin K

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7
Q

What can be used in newborn children for jaundice

A

Light therapy

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8
Q

Low Apgar scores in pre-term infants are usually due to

A

immature lung and heart development

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9
Q

The ductus arteriosis should close naturally in a newborn after birth. If it does not, it remains open (patent). What medication class & specific medications can be given within 14 days to close the duct

A

NSAIDs (IV indomethacin or ibuprofen)

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10
Q

Respiratory distress syndrome (RDS) is caused by:

A

a deficiency of surfactant production in lungs that are not fully developed

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11
Q

Most babies born < ____ weeks gestation will receive surfactant immediately after birth for RDS

A

35 weeks

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12
Q

Do not recommend ASA or salicylates for pts < ___ years old

A

16 (risk of Reye’s syndrome in children recovering from viral infections)

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13
Q

Acetaminophen infant drops and children’s suspension are the same _____

A

concentration (to help reduce dosing errors)

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14
Q

Avoid ibuprofen in children < ___ months for pain/fever d/t risk of nephrotoxicity

A

6

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15
Q

T/F: Ibuprofen products are supplied in different dosage strengths for infants and children

A

true

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16
Q

Which OTC gas product can be used for mild relief of gas

A

simethicone drops

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17
Q

The FDA does not recommend OTC cough and cold medications in children < ___ years old

A

2

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18
Q

Oral _____ is recommended for treatment of intermittent constipation

A

PEG 3350 (MiraLax)

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19
Q

OTC pediatric-size _____ are commonly used for quick relief of constipation in an uncomfortable baby

A

glycerin suppositories

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20
Q

What oral rehydration solutions can be used in infants

A

Pedialyte and Enfamil Enfalyte

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21
Q

What is the dosing for acetaminophen in children and infants

A

10-15 mg/kg/dose every 4-6 hours

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22
Q

What is the dosing for ibuprofen in infants

A

5-10 mg/kg/dose every 6-8 hrs

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23
Q

A definitive diagnosis of bacterial meningitis can be made with

A

a lumbar puncture

24
Q

Common symptom of bacterial meningitis in infants

A

nuchal rigidity

25
Q

Empiric treatment of bacterial meningitis in neonates

A

ampicillin + either cefotaxime or gentamicin

26
Q

Ceftriaxone, which is used in adult bacterial meningitis, is generally avoided in neonates for what reason

A

It displaces bilirubin from albumin, which can cause bilirubin-induced brain damage. Ceftriaxone and calcium-containing solutions can precipitate, causing an embolus and death

27
Q

RSV is a common cause of

A

bronchiolitis (swelling & mucus build up in the bronchioles)

28
Q

Treatment of RSV

A

supportive (oxygen, IV fluids, suctioning of secretions)

29
Q

Treatment for severe lower respiratory tract RSV infections with an underlying compromising condition

A

inhaled ribavirin (Virazole)

30
Q

Prevention of serious lower respiratory tract disease caused by RSV in children at high risk

A

Palivizumab (Synagis)

31
Q

When is RSV ppx recommended

A

During RSV season (late fall, winter, early spring)

32
Q

Who should receive Palivizumab (Synagis) for RSV ppx

A
  • Premature infants born at < 29 weeks gestation
  • Premature infants born < 32 weeks gestation with chronic lung disease who are < 12 months of age
  • Infants < 12 months of age with certain heart conditions
33
Q

How often is Palivizumab (Synagis) dosed for RSV

A

IM monthly

34
Q

In neonates and infants, where is the IM injection site

A

anterolateral thigh muscle

35
Q

What is the max monthly doses an infant can receive of Palivizumab (Synagis) during the RSV season

A

no more than 5 monthly doses

36
Q

Croup is a viral infection which causes inflammation of

A

the upper airway

37
Q

Hallmark signs of croup

A

inspiratory stridor (high-pitched breathing sound), barking cough and hoarseness

38
Q

Mainstay of croup treatment for mild, moderate and severe cases

A

Systemic steroids (usually dexamethasone)

39
Q

Moderate - severe croup cases will usually be given a systemic steroid and then

A

nebulized racemic epinephrine

40
Q

Nebulized racemic epinephrine is a 1:1 mixture of dextro (D) isomers and levo (L) isomers. Which isomer is the active component

A

L isomer

41
Q

Non-drug treatment for nocturnal enuresis

A

Positive reinforcement, normal daytime voiding pattern, normal hydration patterns, alarm therapy

42
Q

Drug treatment for nocturnal enuresis

A

Desmopressin tablet

43
Q

How is desmopressin dosed

A

QHS

44
Q

Desmopressin CI

A

hyponatremia

45
Q

Codeine is CI in all patients age < ___ years

A

12

46
Q

Codeine is CI in patients age < 18 years after the most common childhood surgeries, such as

A

tonsillectomy/adenoidecomy

47
Q

FDA recently changed its labeling for all prescription cough and cold medications that contain codeine or hydrocodone to no longer be indicated in patients < ___ years

A

18

48
Q

Promethazine is CI in children < __ years

A

2

49
Q

Quinolones are not recommended in pediatric patients due to the possibility of

A

adverse effects on the cartilage, bone and muscle

50
Q

Tetracyclines are not recommended in patients < 8 years of age b/c

A

they stain teeth and deposit into mineralizing bone and cartilage

51
Q

What is the one exception to using tetracyclines in children & which tetracycline is the most effective

A

tick-borne Rickettsial diseases

Doxycycline

52
Q

T/F: benzocaine is safe to use for teething infants

A

false - can cause methemoglobinemia & FDA recommends against its use in children < 2 yrs

53
Q

Two common culprits of accidental overdose in children

A

Iron and APAP

54
Q

Classic symptoms of measles

A

Koplik spots (white spots on the inside of cheeks), maculopapular rash

55
Q

Measles transmission

A

airborne