Pediatric Care

Question 1

Gestational Age (GA)

Answer 1

Time from the first day of the last menstrual period until birth
- Typically 2 weeks prior to conception plus pregnancy duration

Question 2

Neonate

Answer 2

Birth thru 1st month of life

Question 3

Premature neonate

Answer 3

born less than 38 weeks gestational age

Question 4

Full-term neonate

Answer 4

born 38 to 42 weeks gestational age

Question 5

Infant

Answer 5

1 month thru 1 year old

Question 6

Child

Answer 6

1 year old thru 12 years old

Question 7

Adolescent

Answer 7

13 years old thru 18 years old

Question 8

Adult

Answer 8

> 18 years old

Question 9

NICU

Answer 9

neonatal intensive care unit

Question 10

What is the PLLR?

Answer 10

Pregnancy and Lactation Labeling Rule

a. New way drugs are categorized for use during pregnancy and lactation

Question 11

List the FDA Pregnancy Categories.

Answer 11

1. Pregnancy
2. Lactation
3. Female and Male Reproductive Potential
   * * A thru D and X are NO longer used **

Question 12

Where would you find information on drug usage requirements involving pregnancy tests, contraception recommendations and infertility?

Answer 12

Female and Male Reproductive Potential Category of PLLR

Question 13

Where would you find information on extent, effects and how to minimize exposure of drug for nursing women?

Answer 13

Lactation Category of PLLR

Question 14

Where would you find a statement on the summary of risks, clinical considerations and information about any existing pregnancy exposure registry for drugs?

Answer 14

Pregnancy Category of PLLR

Question 15

Pediatric and Neonatal Dosage Handbook contains what kind of information?

Answer 15

1. Reliable for Pediatric doses of medications

2. Appendix with help information such as normal and abnormal vital signs and lab values

Question 16

Which 3 references are suggested for use for most drug-related questions?

Answer 16

1. AHFS Drug Info via LexiComp
2. Clinical Pharmacology
3. UpToDate

Question 17

Where can you find information to help identify combination drug products and offers comparisons of products available OTC?

Answer 17

Facts and Comparisons

Handbook of Nonprescription Drugs

Question 18

T/F: You should use Facts and Comparisons to find dosages and pharmacology of drugs

Answer 18

False; Better for combo drug products and less on dosing

Question 19

What resource is the #1 choice for neonatal drug information?

Answer 19

Neofax

Question 20

List the normal values for HR and their respective age categories for pediatric patients.

Answer 20

< 2 years old = 120 to 150 bpm
5 to 7 y.o. = ~100 bpm
Adolescents = 85 bpm

Question 21

List the normal respiratory rate values and their respective age categories for pediatric patients.

Answer 21

< 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

Question 22

Give the values for the following:

1. Female neonatal blood pressure
2. Male neonatal blood pressure

Answer 22

Female = 67/55 mmHg
Male = 72/55 mmHg

Question 23

List the normal ALBUMIN values and their respective age categories for pediatric patients.

Answer 23

<1 y.o. = 2 to 4 g/dL

1 y.o. to 18 y.o. = 3.5 to 5.5 g/dL

Question 24

Why do normal albumin levels increase as we age?

Answer 24

Neonates and infants have less protein binding than older children and adults

Question 25

List the normal CREATININE values and their respective age categories for pediatric patients.

Answer 25

< 1 y.o. = ≤ 0.6 mg/dL | 1 y.o. to 18 y.o. = 0.5 to 1.5 mg/dL

Question 26

Why do normal creatinine values increase as we age?

Answer 26

We develop more muscle

Question 27

List the normal POTASSIUM values and their respective age categories for pediatric patients.

Answer 27

Newborns = 4.5 to 7.2 mEq/L | 1 y.o. to 16 y.o. = 3.5 to 5 mEq/L

Question 28

Why do newborns have higher normal potassium levels than older children and adults?

Answer 28

*****

Question 29

List the normal BUN values and their respective age categories for pediatric patients.

Answer 29

< 2 y.o. = 4 to 15 mg/dL | 2 y.o. to 18 y.o. = 5 to 20 mg/dL

Question 30

Why do infants and children < 2 years old have a lower normal BUN level?

Answer 30

****

Question 31

List the normal Hct (PCV) values and their respective age categories for pediatric patients.

Answer 31

Day of Birth to 3 days old = 45 to 61% | Adolescents - 36 to 47%

Question 32

Why do neonates have a higher normal Hct level and what are they at risk for developing?

Answer 32

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

Question 33

Neonates and sometimes infants may be fluid restricted or have volume limitations for med admin. What pump is preferred?

Answer 33

IV push or syringe preferred to piggyback

Question 34

T/F some pediatric dosages may be too small to measure safely, so dilutions may be required

Answer 34

True

Question 35

while some dosing on OTC products may be based on age for convenience, it is usually preferred to use dosage based on _____ whenever possible

Answer 35

weight

Question 36

When determining a pediatric dose for a drug normally only given to adults, it is generally after to use ____ than mg/kg. especially for ______

Answer 36

body surface area | chemotherapy

Question 37

Some neonatal dosage intervals may be quite prolonged because of _______

Answer 37

underdeveloped renal function | penicillin, gentamicin

Question 38

What is the most reliable neonatal dosing resource?

Answer 38

Neofax

Question 39

dosage intervals in premies are often based on ___ and ____ and may be odd intervals

Answer 39

GA | weight

Question 40

Generally children require oral liquid medications until they are ____ years old

Answer 40

6-8

Question 41

when are oral syringes preferred in pediatrics?

Answer 41

oral liquid admin except large volumes of liquid meds

Question 42

T/F spoons, medicine cups and even droppers are reliable

Answer 42

false! | usually unreliable unless supplied with medication and only for measuring dose

Question 43

How to admin oral syringes

Answer 43

slowly into side of mouth rather than inject all at once

Question 44

T/F for odd dosages of pediatric meds, grind solid dosage and make capsules

Answer 44

true

Question 45

t/f double check all dosages for peds

Answer 45

true

Question 46

t/f many medications in pediatrics have pediatric labeling

Answer 46

false! most do not check dosage against literature