Pediatric Care Flashcards
Gestational Age (GA)
Time from the first day of the last menstrual period until birth
- Typically 2 weeks prior to conception plus pregnancy duration
Neonate
Birth thru 1st month of life
Premature neonate
born less than 38 weeks gestational age
Full-term neonate
born 38 to 42 weeks gestational age
Infant
1 month thru 1 year old
Child
1 year old thru 12 years old
Adolescent
13 years old thru 18 years old
Adult
> 18 years old
NICU
neonatal intensive care unit
What is the PLLR?
Pregnancy and Lactation Labeling Rule
a. New way drugs are categorized for use during pregnancy and lactation
List the FDA Pregnancy Categories.
- Pregnancy
- Lactation
- Female and Male Reproductive Potential
* * A thru D and X are NO longer used **
Where would you find information on drug usage requirements involving pregnancy tests, contraception recommendations and infertility?
Female and Male Reproductive Potential Category of PLLR
Where would you find information on extent, effects and how to minimize exposure of drug for nursing women?
Lactation Category of PLLR
Where would you find a statement on the summary of risks, clinical considerations and information about any existing pregnancy exposure registry for drugs?
Pregnancy Category of PLLR
Pediatric and Neonatal Dosage Handbook contains what kind of information?
- Reliable for Pediatric doses of medications
2. Appendix with help information such as normal and abnormal vital signs and lab values
Which 3 references are suggested for use for most drug-related questions?
- AHFS Drug Info via LexiComp
- Clinical Pharmacology
- UpToDate
Where can you find information to help identify combination drug products and offers comparisons of products available OTC?
Facts and Comparisons
Handbook of Nonprescription Drugs
T/F: You should use Facts and Comparisons to find dosages and pharmacology of drugs
False; Better for combo drug products and less on dosing
What resource is the #1 choice for neonatal drug information?
Neofax
List the normal values for HR and their respective age categories for pediatric patients.
< 2 years old = 120 to 150 bpm
5 to 7 y.o. = ~100 bpm
Adolescents = 85 bpm
List the normal respiratory rate values and their respective age categories for pediatric patients.
< 2 years old = 25 to 30 bpm
3 to 9 y.o. = 20 to 25 bpm
10 to 18 y.o. = 16 to 20 bpm
Give the values for the following:
- Female neonatal blood pressure
- Male neonatal blood pressure
Female = 67/55 mmHg Male = 72/55 mmHg
List the normal ALBUMIN values and their respective age categories for pediatric patients.
<1 y.o. = 2 to 4 g/dL
1 y.o. to 18 y.o. = 3.5 to 5.5 g/dL
Why do normal albumin levels increase as we age?
Neonates and infants have less protein binding than older children and adults
List the normal CREATININE values and their respective age categories for pediatric patients.
< 1 y.o. = ≤ 0.6 mg/dL
1 y.o. to 18 y.o. = 0.5 to 1.5 mg/dL
Why do normal creatinine values increase as we age?
We develop more muscle
List the normal POTASSIUM values and their respective age categories for pediatric patients.
Newborns = 4.5 to 7.2 mEq/L
1 y.o. to 16 y.o. = 3.5 to 5 mEq/L
Why do newborns have higher normal potassium levels than older children and adults?
List the normal BUN values and their respective age categories for pediatric patients.
< 2 y.o. = 4 to 15 mg/dL
2 y.o. to 18 y.o. = 5 to 20 mg/dL
Why do infants and children < 2 years old have a lower normal BUN level?
List the normal Hct (PCV) values and their respective age categories for pediatric patients.
Day of Birth to 3 days old = 45 to 61%
Adolescents - 36 to 47%
Why do neonates have a higher normal Hct level and what are they at risk for developing?
a) Need more RBCs to pick up oxygen since their lungs are underdeveloped
b) Jaundice - Yellowing of skin and eyes due to faster breakdown of RBCs with bilirubin and decreased clearance due to slowly developing liver and kidneys
Neonates and sometimes infants may be fluid restricted or have volume limitations for med admin. What pump is preferred?
IV push or syringe preferred to piggyback
T/F some pediatric dosages may be too small to measure safely, so dilutions may be required
True
while some dosing on OTC products may be based on age for convenience, it is usually preferred to use dosage based on _____ whenever possible
weight
When determining a pediatric dose for a drug normally only given to adults, it is generally after to use ____ than mg/kg. especially for ______
body surface area
chemotherapy
Some neonatal dosage intervals may be quite prolonged because of _______
underdeveloped renal function
penicillin, gentamicin
What is the most reliable neonatal dosing resource?
Neofax
dosage intervals in premies are often based on ___ and ____ and may be odd intervals
GA
weight
Generally children require oral liquid medications until they are ____ years old
6-8
when are oral syringes preferred in pediatrics?
oral liquid admin except large volumes of liquid meds
T/F spoons, medicine cups and even droppers are reliable
false!
usually unreliable unless supplied with medication and only for measuring dose
How to admin oral syringes
slowly into side of mouth rather than inject all at once
T/F for odd dosages of pediatric meds, grind solid dosage and make capsules
true
t/f double check all dosages for peds
true
t/f many medications in pediatrics have pediatric labeling
false!
most do not
check dosage against literature
