Hospital pediatrics

Question 1

what are the 3 most common pathogens associated with empyema

Answer 1

1. GAS- strep pyogenes
2. Strep pneumonia** most common
3. Staph aureus

Question 2

what imaging should be done for a complicated pneumonia

Answer 2

1. CXR

2. U/S to characterize empyema

Question 3

what antibiotics would you consider for a complicated pneumonia

Answer 3

ampicillin or cefotaxime/ceftriaxone
only add Vanco for MRSA
typically treat for 3-4 weeks

Question 4

what are 3 procedural options for complicated empyema

Answer 4

VATS
early thoracotomy
small-bore percutaneous chest tube placement with instillation of fibrinolytics (CTWF)

Question 5

what are some advantages of breastfeeding (baby and mom)

Answer 5

Decreased infectious diseases
Bacterial meningitis, diarrhea, bacteremia, respiratory infections, AOM, UTI
Reduced hospital admissions
Reduces SIDS
Enhanced neurocognitive development
Reduced breast and ovarian cancer in mom
Greater postpartum weight loss for mom
economical

Question 6

exclusive breastfeeding is recommended for how long?

Answer 6

6 months

then with complimentary food for up to 2 years and beyond

Question 7

what is the goal of the baby friendly initiative (3)

Answer 7

protect
promote
and support breastfeeding

Question 8

what are 10 steps to successful breastfeeding

Answer 8

Step 1: Have a written breastfeeding policy

Step 2: Ensure all health care providers have the knowledge and skills necessary to implement the breastfeeding policy.

Step 3: Inform pregnant women and their families about the importance of breastfeeding.

Step 4: Place babies in uninterrupted skin-to-skin contact with their mothers immediately following birth for at least an hour or until completion of the first feeding or as long as the mother wishes

Step 5: Assist mothers to breastfeed and maintain lactation

Step 6: Support mothers to exclusively breastfeed for the first six months, unless supplements are medically indicated.

Step 7: Facilitate 24-hour rooming-in for all mother-infant dyads: mothers and infants remain together.

Step 8: Encourage baby-led breastfeeding. Encourage sustained breastfeeding beyond six months with appropriate introduction of complementary foods.

Step 9: Support mothers to feed and care for their breastfeeding babies without the use of artificial teats or pacifiers (dummies or soothers).

Step 10: Provide a seamless transition among the services provided by the hospital, community health services and peer support programs. Apply principles of primary health care and population health to support the continuum of care, and implement strategies that affect the broad determinations that will improve breastfeeding outcomes.