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Unit 2 68 > Immunizations, antibiotic therapy selection, additional pediatric questions > Flashcards

Immunizations, antibiotic therapy selection, additional pediatric questions Flashcards

1
Q

T of F: The CDC did NOT recommend use of LAIV for 2015-2017

A

Answer: True; concerned that it wasn’t effective in preventing flu past 2 years

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2
Q

T or F: The CDC still does not recommend use of LAIV for 2019-2020 season

A

Answer: False; this year, they have resumed recommending LAIV as a suitable option in age-appropriate patients.

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3
Q

What patient can receive the LAIV4 vaccine?

A

Answer: 2yr-49yr old patients without contraindications (CANNOT BE GIVEN: <2 yr old, pregnancy, 18yr old on aspirin therapy, healthcare personnel, person in close contact w/high risk groups, asthma, 50yr or older (they receive IIV3), immunocompromised, use of antiviral med in past 48hr (Tamiflu)

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4
Q

What patient can receive the IIV4 vaccine?

A

Answer: 6 mo and older (inactivated virus; includes healthcare workers)

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5
Q

What patient can receive the IIV3 vaccine?

A

Answer: >65 yr (inactivated virus at higher dose)

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6
Q

What patient can receive RIV4 (recombinant) vaccine

A

Answer: 18 yr and older, reactions to egg or who required epi or another emergency medical intervention

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7
Q

ANTIBIOTIC THERAPY SELECTION

A

According to guidelines:
1. Don’t test for or initiate abx therapy in bronchitis (unless pneumonia is suspected)
2. Test patient with symptoms suggesting group-A strep by rapid antigen test or culture; treat with abx ONLY with confirmed strep pharyngitis
3. Acute rhinosinusitis should only receive abx if symptoms persist >10 days, high fever and purulent nasal drainage + face pain >3
days; worsening symptoms lasting 5 days
4. Don’t give abx for common cold

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8
Q

Aspiration of a FB can mimic the symptoms of what condition?

A

Answer: Croup

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9
Q

When treating a health 3 yr. old patient for PNA, the NP realizes that the MOST likely cause is?

A

Answer: Respiratory virus

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10
Q

Which abx effectively treats atypical pathogens in pneumonia?

A

Answer: Clarithromycin

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11
Q

Which virus causes the “summer cold”?

A

Answer: Enterovirus

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12
Q

What is the most common cause of croup?

A

Answer: Parainfluenza

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13
Q

What are the 1st line tx for bronchiolitis in children?

A

Answer: Supportive measures

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14
Q

What age group is usually affected by croup?

A

Answer: 6mo-5yr

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15
Q

Croup is usually preceded by a ______________?

A

Answer: URI

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16
Q

Croup is usually cause by what?

A

Answer: Virus

17
Q

A patient present with mild symptoms of croup. How should the NP proceed with treatment?

A

Answer: oral hydration, minimal handling, dexamethasone (0.15mg/kg IM), can d/c from ED if symptoms improve in <3hr

18
Q

If patient’s croup signs and symptoms are moderate to severe. How should the NP proceed with treatment?

A

Answer: humidified O2, dexamethasone IM x1, nebulized racemic epi; s/s should improve in 10-30min; if not – admit to hospital

19
Q

What is epiglottitis?

A

Answer: Severe form of croup

20
Q

Epiglottitis is usually caused by what organism?

A

Answer: H. influenza B (HiB)

21
Q

____________ is the most common cause of bronchiolitis?

A

Answer: RSV

22
Q

Bronchiolitis usually affects what age group?

A

Answer: <2years old

23
Q

How is RSV identified?

A

Answer: Viral nasal swab

24
Q

According to the 2015 AAP, the following ARE NOT recommended for treatment of bronchiolitis.

A

Answer: routine RSV testing, CXR, albuterol, corticosteroids, ABXs, Ribavirin

25
Q

What causes Pertussis?

A

Answer: Bordetella pertussis

26
Q

How is pertussis diagnosed?

A

Answer: Rapid antigen (PCR) by nasal swab or nasal aspirate (best if done in 1st 3wks of cough)

27
Q

Most common cause of CAP in children is?

A

Answer: RSV

28
Q

T of F: Bacterial PNA is MORE common in kids?

A

Answer: False

29
Q

If in fact a bacterium is the cause of pneumonia in a child, what is the likely organism?

A

Answer: S. pneumoniae

30
Q

A 2 mo old is diagnosed with CAP. What treatment plan should the NP institute?

A

Answer: Admit to hospital

Unit 2 68 (32 decks)

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