Chapter 54: Pediatric Conditions

Question 1

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

Answer 1

Temp of 100.4 F/38 C (rectal)

Question 2

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

Answer 2

Temp of 101 F/38.3 C (rectal)

Question 3

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

Answer 3

Temp of 103 F/39.4 C (rectal)

Question 4

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

Answer 4

Apgar score

Question 5

An infant with a lower Apgar score requires

Answer 5

more medical care

Question 6

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

Answer 6

IM Vitamin K

Question 7

What can be used in newborn children for jaundice

Answer 7

Light therapy

Question 8

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

Answer 8

immature lung and heart development

Question 9

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

Answer 9

NSAIDs (IV indomethacin or ibuprofen)

Question 10

Respiratory distress syndrome (RDS) is caused by:

Answer 10

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

Question 11

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

Answer 11

35 weeks

Question 12

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

Answer 12

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

Question 13

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

Answer 13

concentration (to help reduce dosing errors)

Question 14

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

Answer 14

6

Question 15

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

Answer 15

true

Question 16

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

Answer 16

simethicone drops

Question 17

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

Answer 17

2

Question 18

Oral _____ is recommended for treatment of intermittent constipation

Answer 18

PEG 3350 (MiraLax)

Question 19

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

Answer 19

glycerin suppositories

Question 20

What oral rehydration solutions can be used in infants

Answer 20

Pedialyte and Enfamil Enfalyte

Question 21

What is the dosing for acetaminophen in children and infants

Answer 21

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

Question 22

What is the dosing for ibuprofen in infants

Answer 22

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

Question 23

A definitive diagnosis of bacterial meningitis can be made with

Answer 23

a lumbar puncture

Question 24

Common symptom of bacterial meningitis in infants

Answer 24

nuchal rigidity

Question 25

Empiric treatment of bacterial meningitis in neonates

Answer 25

ampicillin + either cefotaxime or gentamicin

Question 26

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

Answer 26

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

Question 27

RSV is a common cause of

Answer 27

bronchiolitis (swelling & mucus build up in the bronchioles)

Question 28

Treatment of RSV

Answer 28

supportive (oxygen, IV fluids, suctioning of secretions)

Question 29

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

Answer 29

inhaled ribavirin (Virazole)

Question 30

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

Answer 30

Palivizumab (Synagis)

Question 31

When is RSV ppx recommended

Answer 31

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

Question 32

Who should receive Palivizumab (Synagis) for RSV ppx

Answer 32

- 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

Question 33

How often is Palivizumab (Synagis) dosed for RSV

Answer 33

IM monthly

Question 34

In neonates and infants, where is the IM injection site

Answer 34

anterolateral thigh muscle

Question 35

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

Answer 35

no more than 5 monthly doses

Question 36

Croup is a viral infection which causes inflammation of

Answer 36

the upper airway

Question 37

Hallmark signs of croup

Answer 37

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

Question 38

Mainstay of croup treatment for mild, moderate and severe cases

Answer 38

Systemic steroids (usually dexamethasone)

Question 39

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

Answer 39

nebulized racemic epinephrine

Question 40

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

Answer 40

L isomer

Question 41

Non-drug treatment for nocturnal enuresis

Answer 41

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

Question 42

Drug treatment for nocturnal enuresis

Answer 42

Desmopressin tablet

Question 43

How is desmopressin dosed

Answer 43

QHS

Question 44

Desmopressin CI

Answer 44

hyponatremia

Question 45

Codeine is CI in all patients age < ___ years

Answer 45

12

Question 46

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

Answer 46

tonsillectomy/adenoidecomy

Question 47

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

Answer 47

18

Question 48

Promethazine is CI in children < __ years

Answer 48

2

Question 49

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

Answer 49

adverse effects on the cartilage, bone and muscle

Question 50

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

Answer 50

they stain teeth and deposit into mineralizing bone and cartilage

Question 51

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

Answer 51

tick-borne Rickettsial diseases | Doxycycline

Question 52

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

Answer 52

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

Question 53

Two common culprits of accidental overdose in children

Answer 53

Iron and APAP

Question 54

Classic symptoms of measles

Answer 54

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

Question 55

Measles transmission

Answer 55

airborne