Chapter 54: Pediatric Conditions Flashcards
What temperature must an infant age < 3 months old seek urgent care
Temp of 100.4 F/38 C (rectal)
What temperature must an infant age 3-6 months old seek urgent care
Temp of 101 F/38.3 C (rectal)
What temperature must an infant age < 6 months old seek urgent care
Temp of 103 F/39.4 C (rectal)
A newborn’s general condition is assessed with what scoring tool
Apgar score
An infant with a lower Apgar score requires
more medical care
Which medication is a standard med given at birth to prevent bleeding
IM Vitamin K
What can be used in newborn children for jaundice
Light therapy
Low Apgar scores in pre-term infants are usually due to
immature lung and heart development
What medications should be given for patent ductus arteriosus
within how long of birth?
NSAIDs (IV indomethacin or ibuprofen)
(meant to close naturally, avoid NSAIDs in 3rd trimester to avoid early closure)
14 days
Persistent pulmonary hypertension of a newborn may be linked with exposure to ___
in utero SSRIs
Respiratory distress syndrome (RDS) is caused by:
a deficiency of surfactant production in lungs that are not fully developed
Most babies born < ____ weeks gestation will receive surfactant immediately after birth for RDS
35 weeks
Do not recommend ASA or salicylates for pts < ___ years old
16 (risk of Reye’s syndrome in children recovering from viral infections)
Acetaminophen infant drops and children’s suspension are the same _____
concentration (to help reduce dosing errors)
Avoid ibuprofen in children < ___ months for pain/fever d/t risk of nephrotoxicity
6
T/F: Ibuprofen products are supplied in different dosage strengths for infants and children
true
Which OTC gas product can be used for mild relief of gas
simethicone drops
drug not absorbed
The FDA does not recommend OTC cough and cold medications in children < ___ years old
2
Oral _____ is recommended for treatment of intermittent constipation in pediatrics
PEG 3350 (MiraLax)
OTC pediatric-size _____ are commonly used for quick relief of constipation in an uncomfortable baby
glycerin suppositories
What oral rehydration solutions can be used in infants
Pedialyte and Enfamil Enfalyte
used in children with diarrhea
What is the dosing for acetaminophen in children and infants
10-15 mg/kg/dose every 4-6 hours
What is the dosing for ibuprofen in infants
5-10 mg/kg/dose every 6-8 hrs
infant must be ≥ 6 months
A definitive diagnosis of bacterial meningitis can be made with
a lumbar puncture
Common symptom of bacterial meningitis in infants
nuchal rigidity
Empiric treatment of bacterial meningitis in neonates (< 1 month)
ampicillin + either cefotaxime or gentamicin
bacterial meningitis treatment 1-23 months
vanco + (ceftriaxone or cefotaxime)
bacterial meningitis treatment 2 +
vanco + (ceftriaxone or cefotaxime)
Ceftriaxone, which is used in adult bacterial meningitis, is generally avoided in neonates for what reason
It displaces bilirubin from albumin, which can cause bilirubin-induced brain damage. Ceftriaxone and calcium-containing solutions can precipitate, causing an embolus and death
RSV is a common cause of
bronchiolitis (swelling & mucus build up in the bronchioles)
Treatment of RSV
supportive (oxygen, IV fluids, suctioning of secretions)
Treatment for severe lower respiratory tract RSV infections with an underlying compromising condition
inhaled ribavirin (Virazole)
Prevention of serious lower respiratory tract disease caused by RSV in children at high risk
Palivizumab (Synagis)
When is RSV ppx recommended
During RSV season (late fall, winter, early spring)
Who should receive Palivizumab (Synagis) for RSV ppx
- 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
How often is Palivizumab (Synagis) dosed for RSV
IM monthly
In neonates and infants, where is the IM injection site
anterolateral thigh muscle
What is the max monthly doses an infant can receive of Palivizumab (Synagis) during the RSV season
no more than 5 monthly doses
Croup is a viral infection which causes inflammation of
the upper airway
Hallmark signs of croup
inspiratory stridor (high-pitched breathing sound), barking cough and hoarseness
usually < 6 years old
Mainstay of croup treatment for mild, moderate and severe cases
Systemic steroids (usually dexamethasone)
Moderate - severe croup cases with difficulty breathing will usually be given a systemic steroid and then
nebulized racemic epinephrine
Nebulized racemic epinephrine is a 1:1 mixture of dextro (D) isomers and levo (L) isomers. Which isomer is the active component
L isomer
Non-drug treatment for nocturnal enuresis
Positive reinforcement, normal daytime voiding pattern, normal hydration patterns, alarm therapy
Drug treatment for nocturnal enuresis
Desmopressin tablet
How is desmopressin dosed
administration?
QHS
tablets, nasal spray, injection; tablets used for enuresis
Desmopressin CI
hyponatremia
Codeine is CI in all patients age < ___ years and < ___ after ___
<12
and < 18 after tonsillectomy/adenoidectomy
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
<18
Promethazine is CI in children < __ years
<2
due to potentially fatal respiratory depression
Quinolones are not recommended in pediatric patients due to the possibility of
adverse effects on the cartilage, bone and muscle
Tetracyclines are not recommended in patients < 8 years of age b/c
they stain teeth and deposit into mineralizing bone and cartilage
What is the one exception to using tetracyclines in children & which tetracycline is the most effective
tick-borne Rickettsial diseases
Doxycycline
T/F: benzocaine is safe to use for teething infants
false - can cause methemoglobinemia & FDA recommends against its use in children < 2 yrs
Two common culprits of accidental overdose in children
Iron and APAP
name the list of vaccine preventable childhood disease
measles
mumps
rubella
polio
pertussis
rotavirus
chickenpox
Classic symptoms of measles
Koplik spots (white spots on the inside of cheeks), maculopapular rash
Measles transmission
airborne
mumps has what symptoms
swollen salivary glands
