Pediatrics

Question 1

Pediatric pharmacokinetics

Answer 1

● Absorption
○ Differences in GI pH
○ Larger body surface area
● Metabolism
○ Liver not fully developed until 2 years old
● Excretion
○ Kidney excretion processes mature at different stages

Question 2

Pediatric dosing

Answer 2

● Dosed by weight in kilograms
○ Need to convert any weight from pounds to kilograms:
■ 2.2 lb = 1 kg

Question 3

Routes of Med Admin by Age

Answer 3

● <12 months old
○ IM: Vastus lateralis
○ SC: Fatty tissue over
anterolateral thigh

● 12 months - 2 years
○ IM: Vastus lateralis
○ SC: fatty tissue over upper outer
area of triceps

● ≥ 3 years old
○ IM: deltoid
○ SC: fatty tissue over upper outer
area of triceps

Question 4

Drugs to consider avoiding in pediatrics

Answer 4

● ASA (Reye’s Syndrome)
● Ibuprofen before 6 months old (immature liver)
● Tetracycline (tooth discoloration)
● Oseltamivir (may cause hallucinations)

Question 5

Impetigo

Answer 5

Impetigo is a skin condition caused by group A Streptococcus (GAS; Streptococcus pyogenes) or Staphylococcus aureus. The condition is highly contagious and spreads by contact with the vesicles. The vesicles should remain clean and dry, and swimming is prohibited because it allows for further disease transmission. Children can return to school 24 hours after beginning antimicrobial therapy if the affected area remains covered. Draining lesions should be kept covered. Linens are an effective way to transmit the bacteria, and they should not be shared and laundered daily to prevent reinfection.

✓ Impetigo is a contagious skin condition that is caused by Staphylococcus aureus or Streptococcus pyogenes

✓ This condition is commonly found in young children and typically presents around the face, mouth, and then on the hands, neck, and extremities

✓ The lesions have drainage and then begin to crust

✓ Medical treatment is antibacterial ointments that should be applied via a sterile cotton tip applicator

✓ Nursing care focuses on educating the client on hand hygiene, pain control with warm compresses to the affected area, preventing transmission by not sharing linens, etc.

✓ The individual with impetigo should not go into any pools, hot tubs, or saunas to prevent further transmission

✓ The child may return to school if the vesicles are covered and antibiotic treatment has been started for 24 hours

Question 6

simian crease

Answer 6

It is widely accepted that a finding of a single transverse palmar crease on the palm – often referred to as a simian line or simian crease – is often observed in a wide range of chromosomal defects, including, but not limited to, Down syndrome, congenital limb deficiency, trisomy 13/18/21, 4p, 18q, etc. Although this finding does not in and of itself render a diagnosis of a chromosomal disorder, this finding by the nurse would necessitate the need to alert the newborn’s primary health care provider (HCP), as genetic and chromosomal testing will likely need to be performed.

Question 7

RSV

Answer 7

Frequent monitoring of vital signs, especially respiratory rate and oxygen saturation

✓ Ensuring adequate hydration, possibly through intravenous fluids if necessary

✓ Provide supportive care, such as humidified oxygen and suctioning to clear airway secretions

✓ Educating parents or caregivers on how to care for the child at home, including signs of worsening symptoms and when to seek medical attention