Pre-placement

Question 1

How are children categorised?

Answer 1

• Neonate: birth to 1 month
• Infant: 1 month to 2 years
• Young child: 2-6yrs
• Child: 6-12yrs
• Adolescent: 12-18yrs

Question 2

What is the immunisation schedule for children?

Answer 2

• 2 months: ‘6 in 1’ (diptheria, tetanus, whooping cough, polio/Hib (Haemophilus Infleunza Type B), Hep B), rotavirus, pneumococcal (PCV), Men B
• 3 months: ‘6 in 1’, oral rotavirus vaccine, PCV
• 4 months: 6 in 1, Men B
• 1yr: Hib/Men C, PCV, Men B, MMR
• Pre-school (3-5yrs): 4-in-1 pre-school booster (DTP/polio) (DTP = diphtheria, tetanus toxoids and pertussis - wooping cough), MMR
• Girls 12-13yrs: HPV
• Teens: 3 in 1 teenage booster (DT/polio), Men ACWY

Question 3

What is the developmental progress for age 2 months?

Answer 3

• Coos and gurgling sounds
• Turns head towards sound
• Begins to smile at people
• Tries to look at parents
• Sucks on hand to sooth
• Begins to follow things with eyes
• Begins to act bored

Question 4

What is the developmental progress for age 8 months?

Answer 4

• Understands no
• Mama/dada sounds
• Stranger awareness
• Has favourite toy
• Transfers from one hand to another
• Picks up cereal between thumb and index finger
• Plays peek a boo

Question 5

What is the developmental progress for age 18 months?

Answer 5

• Says 10 words
• Says no and shakes head
• Temper tantrums
• Points to show something interesting
• Follows 1 step verbal command
• Scribbles on own

Question 6

What is the developmental progress for age 3 years?

Answer 6

• Understands words such as in/on/under
• Carries on a conversation using 2-3 sentences
• Copies adults and friends
• Takes turns in games
• Shows concern for friend crying
• Does jigsaw 3-4 pieces
• Copies a circle with a pencil

Question 7

What are growth charts like for babies?

Answer 7

• Use a gender appropriate chart; choose a close monitoring chart for premature infants
• Always plot birth data for babies born between 37-42 completed weeks at 40 weeks
• For preterm babies draw a line back the number of weeks and mark with an arrow
• On the close monitoring chart complete the date boxes for accurate plotting and quick gestation calculation

Question 8

What is the calculation for routine maintenance for paediatrics?

Answer 8

Calculated by weight - Holliday-Segar Formula:
- 100ml/kg for first 10kg of weight
- 50ml/kg for next 10kg of weight
- 20ml/kg for weight >20kg
This is the total volume needed in ml over 24 hours. To find the rate of infusion (ml/hr) it is the total amount in ml/24.

Question 9

How do you calculate fluid replacement in paediatrics?

Answer 9

• May need to add potassium here too - monitoring of levels should be completed every 24hrs.
• To calculate fluid deficit (ml) and therefore what needs to be replaced - %dehydration x weight (kg) x 10
• % deyhdration = (well weight - current weight)/(well weight x 100)

Question 10

What is the total fluid requirement for paediatrics?

Answer 10

• Total fluid in mls 24hrs = routine maintenance (ml) + fluid deficit/replacement (ml)
• Rate of infusion (ml/hr) = total amount in ml/24
• Duration (mins) = total amount ml/rate x 60

Question 11

What is given for resuscitation in paediatrics?

Answer 11

• Needed if child is in shock e.g. hypovolaemic shock, sepsis, anaphylaxis
• Bolus (ml) = 20ml/kg given over <10 mins
• Rate written as STAT, duration is 10 mins
• 0.9% NaCl