Chapter 54: Pediatric Conditions

Question 1

What temperature must an infant age < 3 months old seek urgent care

Answer 1

Temp of 100.4 F/38 C (rectal)

Question 2

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

Answer 2

Temp of 101 F/38.3 C (rectal)

Question 3

What temperature 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

What medications should be given for patent ductus arteriosus

within how long of birth?

Answer 9

NSAIDs (IV indomethacin or ibuprofen)
(meant to close naturally, avoid NSAIDs in 3rd trimester to avoid early closure)

14 days

Question 10

Persistent pulmonary hypertension of a newborn may be linked with exposure to ___

Answer 10

in utero SSRIs

Question 11

Respiratory distress syndrome (RDS) is caused by:

Answer 11

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

Question 12

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

Answer 12

35 weeks

Question 13

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

Answer 13

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

Question 14

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

Answer 14

concentration (to help reduce dosing errors)

Question 15

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

Answer 15

6

Question 16

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

Answer 16

true

Question 17

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

Answer 17

simethicone drops

drug not absorbed

Question 18

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

Answer 18

2

Question 19

Oral _____ is recommended for treatment of intermittent constipation in pediatrics

Answer 19

PEG 3350 (MiraLax)

Question 20

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

Answer 20

glycerin suppositories

Question 21

What oral rehydration solutions can be used in infants

Answer 21

Pedialyte and Enfamil Enfalyte

used in children with diarrhea

Question 22

What is the dosing for acetaminophen in children and infants

Answer 22

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

Question 23

What is the dosing for ibuprofen in infants

Answer 23

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

infant must be ≥ 6 months

Question 24

A definitive diagnosis of bacterial meningitis can be made with

Answer 24

a lumbar puncture

Question 25

Common symptom of bacterial meningitis in infants

Answer 25

nuchal rigidity

Question 26

Empiric treatment of bacterial meningitis in neonates (< 1 month)

Answer 26

ampicillin + either cefotaxime or gentamicin

Question 27

bacterial meningitis treatment 1-23 months

Answer 27

vanco + (ceftriaxone or cefotaxime)

Question 28

bacterial meningitis treatment 2 +

Answer 28

vanco + (ceftriaxone or cefotaxime)

Question 29

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

Answer 29

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 30

RSV is a common cause of

Answer 30

bronchiolitis (swelling & mucus build up in the bronchioles)

Question 31

Treatment of RSV

Answer 31

supportive (oxygen, IV fluids, suctioning of secretions)

Question 32

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

Answer 32

inhaled ribavirin (Virazole)

Question 33

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

Answer 33

Palivizumab (Synagis)

Question 34

When is RSV ppx recommended

Answer 34

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

Question 35

Who should receive Palivizumab (Synagis) for RSV ppx

Answer 35

- 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 36

How often is Palivizumab (Synagis) dosed for RSV

Answer 36

IM monthly

Question 37

In neonates and infants, where is the IM injection site

Answer 37

anterolateral thigh muscle

Question 38

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

Answer 38

no more than 5 monthly doses

Question 39

Croup is a viral infection which causes inflammation of

Answer 39

the upper airway

Question 40

Hallmark signs of croup

Answer 40

inspiratory stridor (high-pitched breathing sound), barking cough and hoarseness | usually < 6 years old

Question 41

Mainstay of croup treatment for mild, moderate and severe cases

Answer 41

Systemic steroids (usually dexamethasone)

Question 42

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

Answer 42

nebulized racemic epinephrine

Question 43

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

Answer 43

L isomer

Question 44

Non-drug treatment for nocturnal enuresis

Answer 44

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

Question 45

Drug treatment for nocturnal enuresis

Answer 45

Desmopressin tablet

Question 46

How is desmopressin dosed | administration?

Answer 46

QHS | tablets, nasal spray, injection; tablets used for enuresis

Question 47

Desmopressin CI

Answer 47

hyponatremia

Question 48

Codeine is CI in all patients age < ___ years and < ___ after ___

Answer 48

<12 and < 18 after tonsillectomy/adenoidectomy

Question 49

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 49

<18

Question 50

Promethazine is CI in children < __ years

Answer 50

<2 | due to potentially fatal respiratory depression

Question 51

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

Answer 51

adverse effects on the cartilage, bone and muscle

Question 52

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

Answer 52

they stain teeth and deposit into mineralizing bone and cartilage

Question 53

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

Answer 53

tick-borne Rickettsial diseases | Doxycycline

Question 54

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

Answer 54

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

Question 55

Two common culprits of accidental overdose in children

Answer 55

Iron and APAP

Question 56

name the list of vaccine preventable childhood disease

Answer 56

measles mumps rubella polio pertussis rotavirus chickenpox

Question 57

Classic symptoms of measles

Answer 57

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

Question 58

Measles transmission

Answer 58

airborne

Question 59

mumps has what symptoms

Answer 59

swollen salivary glands