Week 1 Content Flashcards
(117 cards)
1
Q
An infant/child can loose > _____ of their blood volume prior to a drop in BP.
A
25%
2
Q
A pediatric peripheral IV must be assessed every ____ hours when it is continuously infusing.
When the PIV is locked must be assessed every ___ hours.
A
A pediatric peripheral IV must be assessed every 1-2 hours when it is continuously infusing.
When the PIV is locked must be assessed every 4 hours.
3
Q
_____ ml/kg of Normal Saline is given to replace fluid loss due to significant dehydration
A
10-20
4
Q
Assessing ___________ history is part of the pain assessment.
A
PCA pump
5
Q
IM injection: infant/toddler - ____ angle
A
90 degree
6
Q
Which muscle is used for IM injection (infant/toddler)
A
Vastus lateralis
7
Q
Infant age range
A
0-12 months
8
Q
Neonate
A
up to 30 days old
9
Q
Infant birth growth doubles by
A
6 months
10
Q
Posterior fontanel closes by
A
1-2 months
10
Q
Infant birth weight triples by
A
12 months
11
Q
Anterior fontanel closes by
A
9-18 months
12
Q
Babies do not need extra water until > ___________
A
6 months
13
Q
Introduce solids at around _____ months (rice, cereal …)
A
4-6
14
Q
Breast feed every _____ hours
A
2-3
15
Q
How should infants sleep?
A
on the back
no extra pillows
16
Q
Never leave infants unattended with
A
pets
17
Q
Pain scale tool used for infants
A
FLACC
[0-2]
4+ = should be treated
Face
Legs
Activity
Cry
Consolability
18
Q
Hospitalized Pediatric Patient - Pneumococcal Pneumonia (PCV13) - precautions?
A
Airborne
19
Q
Chicken pox
Mumps
Measles
Covid
TB
Precautions?
A
Airborne
19
Q
Roto Virus RV (diarrhea) precautions
A
Contact
20
Q
There is no ________ for TB in the US
A
vaccine
21
Q
AIRBORNE can stay aerosolized in INSIDE AIR for up to ______
A
3 hours
22
Q
Doubling the height at 2 years old is predictable of
A
adult height
23
Expect __________ when hospitalized
Regression
24
Toddlers in the hospital
Previously toilet trained may start ___________
* Reassure parents when this happens
bedwetting
25
Give toddler _______ when posible
choices
[which arm should we put the cuff on? which flavor do you want?]
26
Rashes with Fever and ___________
- Coxsackie virus
- Fifths disease
- Strep Throat
- Measles
- Chickenpox
- Bacterial Meningitis
Contagious
27
Coxsackie virus:
No vaccine not dangerous
causes _____________________ disease
Common Childhood illness
High _______
Very ________
Droplet spread plus Contact (contaminated surfaces)
Does NOT lead to severe illness
No vaccine not dangerous
causes hand foot and mouth disease
Common Childhood illness
High fever
Very contagious
Droplet spread plus Contact (contaminated surfaces)
Does NOT lead to severe illness
27
Fifth’s Disease-
_______virus - No vaccine not ___________
“ ___________ Cheeks”
Called Fifth's historically 5th in childhood skin rashes
Fever
Does not Lead to serious illness
Parvovirus - No vaccine not dangerous
“ Slapped Cheeks”
Called Fifth's historically 5th in childhood skin rashes
Fever
Does not Lead to serious illness
28
Strep Throat- no vaccine
Streptococcal – bacterial
Fever
_______ (Scarlet fever: Small raised bumps feels rough like sandpaper)
Spread through droplets and surface contacts
Not contagious ater 24-48 hours of abx tx
If not treated with antibiotic can lead to
* ___________ fever (cardiac)
* ______________ (kidneys)
Strep Throat- no vaccine
Streptococcal – bacterial
Fever
Rash (Scarlet fever: Small raised bumps feels rough like sandpaper)
Spread through droplets and surface contacts
Not contagious ater 24-48 hours of abx tx
If not treated with antibiotic can lead to
* Rheumatic fever (cardiac)
* Glomerulonephritis (kidneys)
29
Is there a vaccine for strep throat?
no
30
Strepthroat is caused by
bacteria (streptococcal)
31
Measles Virus : Koplick Spots
Red spots ( sometimes with blue centers)
Measles can be dangerous
High fever EXTREMELY ______________
Airborne isolation
Rash
Immunize with ______, ______ months
____________ Injection
Measles Virus : Koplick Spots
Red spots ( sometimes with blue centers)
Measles can be dangerous
High fever EXTREMELY contagious
Airborne isolation
Rash
Immunize with MMR 12-15 months
Subcutaneous Injection
32
Chickenpox virus – can get secondary bacterial infections of skin lesions
Very dangerous for immunocompromised and older persons
Fever and Rash
Highly Contagious
__________ isolation
Immunize at ______ months, ______ inj.
Chickenpox virus – can get secondary bacterial infections of skin lesions
Very dangerous for immunocompromised and older persons
Fever and Rash
Highly Contagious
Airborne isolation
Immunize at 12-15 months SQ
33
Bacterial Meningitis: bacteria life threatening
Purpuric Rash Purpura is ________________________
This is technically not a rash
unlike rashes it does not ______ when you press on it.
Purpuric Rash Purpura is bleeding under the skin
This is technically not a rash
unlike rashes it does not blanch when you press on it.
34
Bacterial Meningitis
Newborns: Group B Streptococcus, S. pneumoniae, L. monocytogenes, E. coli
Babies and young children: S. pneumoniae, N. meningitidis, H. influenzae, group B Streptococcus, M. tuberculosis
Teens and young adults: N. meningitidis, S.
pneumoniae
Older adults: S. pneumoniae, N. meningitidis, H.
influenzae, group B Streptococcus, L. monocytogenes
Immunize pre teens, adolescents, older adults
Droplet and Contact
Not contagious after 24 hours on abx
Newborns: Group B Streptococcus, S. pneumoniae, L. monocytogenes, E. coli
Babies and young children: S. pneumoniae, N. meningitidis, H. influenzae, group B Streptococcus, M. tuberculosis
Teens and young adults: N. meningitidis, S.
pneumoniae
Older adults: S. pneumoniae, N. meningitidis, H.
influenzae, group B Streptococcus, L. monocytogenes
Immunize pre teens, adolescents, older adults
Droplet and Contact
Not contagious after 24 hours on abx
35
Rashes Contagious: no _______
common to get at day care
-Impetigo
-Cold Sores
Fever
36
Impetigo- bacteria
Caused usually by ______, Sometimes strep
Very _________
Not serious
Common to get at daycare
Treat with topical or oral __________
Teach to prevent spreading at home
Caused usually by Staph, Sometimes strep
Very Contagious
Not serious
Common to get at daycare
Treat with topical or oral antibiotics
Teach to prevent spreading at home
37
Cold Sores- _______ virus
Highly _________
Common to get at daycare
Can be __________ for newborn babies & immunocompromised
Contagious as long as blisters _______
Cover blister with dressing or mask
Cold Sores- herpes virus
Highly contagious
Common to get at daycare
Can be serious for newborn babies & immunocompromised
Contagious as long as blisters weep
Cover blister with dressing or mask
38
Rashes no fever and _______________
- Eczema
- Diaper rash
- Cradle Cap
- Hives
not contagious
39
Eczema: Atopic dermatitis
Can Start in ________ and Continue into Adulthood
Effects daily life extremely ______!
Eczema: Atopic dermatitis
Can Start in infancy and Continue into Adulthood
Effects daily life extremely itchy!
40
Eczema – Atopic __________
- __________ of skin
- Immune system reacts to small irritants and stimulants
- Strong family history of ________
- Dry , _____ skin.
- Red bumps and scaly, leathery patches of skin.
- Crusting skin.
- Worse in ____________ seasons
- Better in humid climates
- Inflammation of skin
- Immune system reacts to small irritants and stimulants
- Strong family history of allergies
- Dry , itchy skin.
- Red bumps and scaly, leathery patches of skin.
- Crusting skin.
- Worse in fall and winter seasons
- Better in humid climates
41
Treatment of Eczema : Atopic Dermatitis
- Humidify, moisturize with cream or ointments every __________
- NO _________ - only short Luke warm baths
- Very _____ hypoallergenic soaps
- Steroid creams
- Antihistamines
- Avoid synthetic clothing materials ________ is best
- Keep __________
- Topical immunomodulators
- Light therapy decreases inflammation
- Humidify, moisturize with cream or ointments every diaper change
- NO hot water- only short Luke warm baths
- Very mild hypoallergenic soaps
- Steroid creams
- Antihistamines
- Avoid synthetic clothing materials COTTON is best
- Keep hydrated
- Topical immunomodulators
- Light therapy decreases inflammation
42
Eczema and Food Allergies
The connection between eczema and food allergies is _________.
Common allergies associated with eczema - peanuts, dairy, eggs, sugar, alcohol and gluten.
Teach parents to monitor their child’s eczema flares ups after certain __________________
Children with Eczema are sensitive to __________________ > skin breakdown
Eczema and Food Allergies
The connection between eczema and food allergies is unclear.
Common allergies associated with eczema - peanuts, dairy, eggs, sugar, alcohol and gluten.
Teach parents to monitor their child’s eczema flares ups after certain foods are eaten.
Children with Eczema are sensitive to tape and adhesives > skin breakdown
43
Diaper Rash: Diaper Dermatitis- prolonged exposure to urine or stool can be caused by yeast or bacteria.
[not on test]
44
Cradle Cap:
Seborrheic Dermatitis
No Pain
No Itch
Wash daily mild soap
Helps to loosen scales
Don’t remove scales vigorously
For persistent can use a medicated shampoo
[not on test]
45
Contact Dermatitis- Many triggers
-Painful itchy rash
-Rash caused by contact with something person is
sensitive too
-Poison Oak/Ivy
-Harsh soaps or laundry detergents
[not on test]
46
Hives: __________ ___________ reaction
AKA _________: Most common medication that causes this is antibiotics
also caused by ingestion of ______ individual is sensitive too
Can be associated with dangerous _________
Symptoms occur due to high level of ___________ release
Hives: systemic allergic reaction
Urticaria : Most common medication that causes this is antibiotics
also caused by ingestion of foods individual is sensitive too
Can be associated with dangerous anaphylaxis
Symptoms occur due to high level of histamine release
47
Treatment for Anaphylaxis : Acute allergic reaction
-_________ Medication or Blood
-Assess ___________ Status (Airway can be closing due to edema and bronchial constriction)
-IM ____________ (or Epi pen if at home) first line of treatment
-Steroids
-Antihistamines
Treatment for Anaphylaxis : Acute allergic reaction
-Discontinue Medication or Blood
-Assess Respiratory Status (Airway can be closing due to edema and bronchial constriction)
-IM epinephrine (or Epi pen if at home) first line of treatment
-Steroids
-Antihistamines
48
Reasons for Vaccine Hesitancy
* Low disease burden resulting in low disease __________
* More attention paid to vaccine _______ than benefits
* Low tolerance for vaccine risks
* Complicated Immunization ___________
* Low disease burden resulting in low disease awareness
* More attention paid to vaccine risks than benefits
* Low tolerance for vaccine risks
* Complicated Immunization schedule
49
Infants have a greater percentage of fluid in the extracellular compartments compared to adults leading to _________________________
greater and more rapid fluid loss with illnesses.
50
Causes of Fluid Loss
- Fever
- Diarrhea
- Vomiting
- Sweating
- Burns
- Increased __________________
- Tissue death causes cellular breakdown and leakage with fluid shifts from intracellular to extracellular
- Fever
- Diarrhea
- Vomiting
- Sweating
- Burns
- Increased Respiratory Rate
- Tissue death causes cellular breakdown and leakage with fluid shifts from intracellular to extracellular
51
Infants have 5x body ___________ of adults causes as increase metabolic and therefore fluid requirements
surface area
52
Normal temperature for an infant is ______________
37.5° C (99.5° F).
53
Fever increases fluid needs by ____% for every 1° C rise in temperature.
12
54
_________ – most common cause of fluid and electrolyte imbalance in Pediatrics
- Infectious, Bacterial , Viral, parasitic
- Malabsorption problems
- Inflammatory diseases
- Dietary factors
Diarrhea
55
Hydration Status Assessment
- Irritability to lethargy
- Poor skin __________
- Absence of ______
- Dry sticky mucous membranes
- Wt loss : ______%
- __________ anterior fontanel
- Decreased urine output
- Increased ____________ time
- Irritability to lethargy
- Poor skin turgor/tenting
- Absence of tears
- Dry sticky mucous membranes
- Wt loss : 5-15%
- Depressed anterior fontanel
- Decreased urine output
- Increased capillary refill time
56
Degrees of Dehydration
Severe dehydration is characterized by a ___ or greater loss of weight.
10%
10-15%?
57
Heart Rate Ranges per age
Table; awake, sleeping
Under 28 days old 100–205 bpm 90–160 bpm
1–12 months old 100–190 bpm 90–160 bpm
1–2 years old 98–140 bpm 80–120 bpm
3–5 years old 80–120 bpm 65–100 bpm
6–11 years old 75–118 bpm 58–90 bpm
12–15 years old 60–100 bpm 50–90 bpm
58
Respiratory Rate Range per age
1–12 months old 30–60
1–3 years old 24–40
3–6 years old 22–34
6–12 years old 18–30
12–18 years old 12–16
59
Blood Pressure Range per age
Newborn (under 1,000 grams [g]) 39–59 16–36
Newborn (over 1,000 g) 60–76 31–45
0–1 month old 67–84 35–53
1–12 months old 72–104 37–56
1–2 years old 86–106 42–63
3–5 years old 89–112 46–72
6–9 years old 97–115 57–76
10–11 years old 102–120 61–80
12–15 years old 110–131 64–83
60
Dehydration- Vital Signs
- HR _______
- Temp might be _________
- BP- stays normal until it’s not !
-NOTE: a pediatric difference: Cardiac output is the product of heart rate and stroke volume. Unlike adults, neonates and infants possess a limited ability to Increase cardiac output by increasing _____________. Instead cardiac output Is significantly dependent on heart rate, indicating they have less preload reserve.
- HR elevated
- Temp might be elevated
- BP- stays normal until it’s not !
-NOTE: a pediatric difference: Cardiac output is the product of heart rate and stroke volume. Unlike adults, neonates and infants possess a limited ability to Increase cardiac output by increasing stroke volume. Instead cardiac output Is significantly dependent on heart rate, indicating they have less preload reserve.
61
Dehydration- Vital Signs
-Hypotension is a late and ominous sign—pediatric patients can lose up to ___% of their blood volume before a fall in blood pressure is observed.
25
62
Dehydration Lab
- Elevated __________ - IS A VERY IMPORTANT Electrolyte when assessing hydration
- Note W/ chronic/ severe diarrhea can lose sodium.
- Elevated _____
- Elevated _____
- Elevated SODIUM NOTE SODIUM IS A VERY IMPORTANT Electrolyte when assessing hydration
- Note W/ chronic/ severe diarrhea can lose sodium.
- Elevated Hct
- Elevated BUN
63
Treatment OF DEHYDRATION
- Rehydration
___________ plus ___________
- Determine _______
- Isolation precautions (which one?)
- Antibiotics maybe
- NO ANTI DIARRHEAL Meds.
- Rehydration
Maintenance plus replacement
- Determine causes
- Isolation precautions (which one?)
- Antibiotics
- NO ANTI DIARRHEAL Meds.
64
IV Fluids: Replacement + Maintenance
-Replacement : Normal Saline ___mg/kg IV (how fast do you give?)
PALS : reassess and repeat up to a total of x3
-Maintenance: D5.NS- (maintenance calculated at 100%)
-Electrolytes are replaced based on Lab values and dosed per kilogram and “Y”d into side port .
20
65
Oral Rehydration for Diarrhea
- Pedialyte
- NO ______ or __________ (TOO much sugar, hyperosmolar)
- Might hold dairy
- Pedialyte
- NO JUICES or Gatoraide (TOO much sugar, hyperosmolar)
- Might hold dairy
66
Infant theories
Erikson & Piaget
Erikson- trust v mistrust
Piaget- sensory motor
67
Progression of social behaviors
infants will smile before
playing peekaboo
68
Know the progression of physical development
Infants have head control before they can
roll over from stomach to back
69
Vaccinations given at 2, 4, 6 month mark
Rotavirus (RV)
DTaP
Hib
Pneumococcal conjugate
Inactivated Poliovirus (IPV)
2nd dose Hep B
69
Toddlier theories
Erikson & Piaget
Erikson: Autonomy v shame
Piaget: Pre-operational thought/ pre-conceptual
70
Note: toddlers are at increase risk of ____________________: due to parental knowledge deficits
choking with solids foods
make sure to cut food into small pieces
71
What immunizations are given at the 12 month well child visit?
HIB 3d or 4th dose
Pneumococcal conjugate (PCV15, PCV20) 4th dose
Hep A 2 dose series
72
What pediatric disease causes teratogenic effects on a fetus?
What immunization prevents this disease?
Rubella
MMR
73
What disease if contacted by a newborn (from an un-vaxed sibling) causes prolonged coughing and crowing and can be DEADLY?
What immunization prevents this disease?
Pertussis/ Whooping cough
DTaP
74
Fluid Maintenance calculation:
75
Expected Urine Output – Infant
____ ml/kg per hour
_____ wet diapers/day
1-2 ml/kg per hour
5-6 or more wet diapers a day
76
NOTE: PIV or IO preferred for fast fluid replacement vs ________ line.
Central
77
_______ in a child is one of the most common clinical symptom managed by pediatricians and other health care providers
Fever
78
Most parents need to be educated about fevers:
Maintaining a normal temperature is not the goal.
There is _____________ that fever worsens the outcome of an illness.
Most parents need to be educated about fevers:
Maintaining a normal temperature is not the goal.
There is NO evidence that fever worsens the outcome of an illness.
79
Fever: __________ Care – “Outside the Hospital”
Primary
80
______: Cause of Parental Concerns
High fevers if left untreated will lead to seizures, brain damage and death.
There is no evidence that __________ a fever leads to decreased morbidity and mortality in healthy children. (exceptions for chronically or critically ill children when fever causes increase
metabolic demands)
Myth: Cause of Parental Concerns
High fevers if left untreated will lead to seizures, brain damage and death.
There is no evidence that lowering a fever leads to decreased morbidity and mortality in healthy children. (exceptions for chronically or critically ill children when fever causes increase
metabolic demands)
81
FACT: Fever can __________
Fever’s physiologic mechanism in fighting infection is slowing the growth and reproduction of _______________________. Fevers also enhances neutrophil production and T-lymphocyte proliferation.
FACT: Fever can Benefit
Fever’s physiologic mechanism in fighting infection is slowing the growth and reproduction of bacteria and viruses. Fevers also enhances neutrophil production and T-lymphocyte proliferation.
82
______________________________ is the most common single ingredient implicated in emergency department visits for medication overdoses among children
In 2011 study: of 78.414 ED admissions for ____________ ingestions 13% were a result of unsupervised ingestions by children less than 6 years.
15.7% were a result of caregiver accidental overdosing
Tylenol/ Acetaminophen is the most common single ingredient implicated in emergency department visits for medication overdoses among children
In 2011 study: of 78.414 ED admissions for Tylenol ingestions 13% were a result of unsupervised ingestions by children less than 6 years.
15.7% were a result of caregiver accidental overdosing
83
Reye’s Syndrome: sudden seizures, coma, brain and liver damage and death.
* NO ________
Do not give aspirin to infants and children with a _____________ —can lead to a potentially fatal condition called Reye's syndrome.
Associated with illnesses caused by influenza (the flu) or chickenpox, but we avoid aspirin entirely
Reye’s Syndrome: sudden seizures, coma, brain and liver damage and death.
* NO Aspirin
Do not give aspirin to infants and children with a viral illness —can lead to a potentially fatal condition called Reye's syndrome.
Associated with illnesses caused by influenza (the flu) or chickenpox, but we avoid aspirin entirely
84
Reye's syndrome can occur if _______ is given to children while they have a fever/ viral illness
aspirin
85
Measuring a child’s temperature at home
* _________ Temperature – Gold Standard for neonate < 30 days .
* Refer to Pediatrician for best way to measure temp for older infants.
* __________ is ok with toddler/child
Measuring a child’s temperature at home
* Rectal Temperature – Gold Standard for neonate < 30 days .
* Refer to Pediatrician for best way to measure temp for older infants.
* Axillary is ok with toddler/child
86
Measuring a child’s temperature In hospital:
Never do a rectal temp on a child with immunosuppression or cancer
99.9 % of time OK to do _________ on pediatric ward.
Neonates/ Infants with new temperatures in ED – ________ required
Never do a rectal temp on a child with immunosuppression or cancer
99.9 % of time OK to do axillary on pediatric ward.
Neonates/ Infants with new temperatures in ED – Rectal required
87
Concerns for fevers in healthy infants > 6 months of age and children
* Increase in insensible __________
* Decrease desire to _____________
_____________
Concerns for fevers in healthy infants > 6 months of age and children
* Increase in insensible water loss
* Decrease desire to eat and drink
Dehydration
88
General Instructions to Parents for fevers in infants and children > 6 months of age.
* Most fevers resolve _____________
* Most fevers are caused by ______ illness, usually last 2-3 days
* Children prone to fevers as ___________ systems not developed
* Children tend to develop _______ fevers than adults
* Most fevers resolve without intervention
* Most fevers are caused by viral illness, usually last 2-3 days
* Children prone to fevers as immune systems not developed
* Children tend to develop higher fevers than adults
89
Infant younger than 6 months of age , contact _________________ for any fever.
your health care provider
90
Fever: 0 to 6 months of age
Take a _______ temperature after ensuring warm clothing or over bundling is not the cause for the increase in temperature
Take a rectal temperature after ensuring warm clothing or over bundling is not the cause for the increase in temperature
91
Baby 6-24 months call pediatrician for Temp > _____ F (38.9C) for greater than 1 day OR any fever baby seems sick (lethargic)
Baby 6-24 months call pediatrician for Temp >102 F (38.9C) for greater than 1 day OR any fever baby seems sick (lethargic)
92
Any child > 24 months old call pediatrician for fever > ___ days
3
93
In general when the pediatrician is consulted regarding a fever in a child older than 6 months they will ask about feeding and behavior after _________
Tylenol
94
Treatment of Fever
* To improve the infant/child’s comfort- helps to improve the oral intake of ____________________________
* Treatment with ____________ can also be reassuring to the parent/physician. Child should “Perk up”, be interested in surrounding and taking fluids.
* How high a temperature is not the point, a child with a low temperature that is lethargic is an EMERGENCY
* To improve the infant/child’s comfort- helps to improve the oral intake of fluids to remain hydrated.
* Treatment with antipyretics can also be reassuring to the parent/physician. Child should “Perk up”, be interested in surrounding and taking fluids.
* How high a temperature is not the point, a child with a low temperature that is lethargic is an EMERGENCY
95
* How high a temperature is not the point, a child with a low temperature that is __________ is an EMERGENCY
lethargic
96
Antipyretics :Dosing and Administration
* Acetaminophen ______ mg/kg every 4-6 hours
-Know that there is a ____ hours ceiling for Tylenol.
Antipyretics :Dosing and Administration
* Acetaminophen 10-15 mg/kg every 4-6 hours
-Know that there is a 24 hours ceiling for Tylenol.
97
Antipyretics :Dosing and Administration
* Avoid aspirin (< ___ years) and ibuprofen (< __ months)
* Avoid aspirin (< 19 years) and ibuprofen (< 6 months)
98
Ibuprofen
* Do not give until ___months old or older
* Ibuprofen ___ mg/kg every 6-8 hours
Ibuprofen
* Do not give until 6 months old or older
* Ibuprofen 10 mg/kg every 6-8 hours
99
Downside of FEVERs-
* Neonate has high risk for _________
* Poor oral intake and insensible fluid losses effect hydration status and can lead to severe _________ (especially when fever occurs with vomiting and diarrhea)
* Parents CAN be freaked out by fevers (our goal is to educate)
* Parents can misunderstand Tylenol and Ibuprofen ________ leading to potential over and under dosing.
* Neonate has high risk for meningitis
* Poor oral intake and insensible fluid losses effect hydration status and can lead to severe hypovolemia (especially when fever occurs with vomiting and diarrhea)
* Parents CAN be freaked out by fevers (our goal is to educate)
* Parents can misunderstand Tylenol and Ibuprofen dosing leading to potential over and under dosing.
100
FEVER CONCERNS: Neonate
Neonates: increased risk of __________
* Premature babies and neonates are increased risk!
* All neonates must be seen by a pediatrician for rule out
* Full ________ work up including blood cultures and Lumbar puncture for Cerebral Spinal Fluid analysis for all neonates without a fever source.
Neonates: increased risk of meningitis
* Premature babies and neonates are increased risk!
* All neonates must be seen by a pediatrician for rule out
* Full septic work up including blood cultures and Lumbar puncture for Cerebral Spinal Fluid analysis for all neonates without a fever source.
101
Temperatures in Hospitalized Child; Big Concern When:
* Child receiving ______ transfusion
* Child has vascular access device /and or other invasive devices
* Child receiving _______ (immunocompromised)
* Child with a _________ (immunocompromised)
* Other children that are immunosuppressed
* Post operatively (if happens early might be due to atelectasis)
* Child receiving blood transfusion
* Child has vascular access device /and or other invasive devices
* Child receiving chemo (immunocompromised)
* Child with a transplant (immunocompromised)
* Other children that are immunosuppressed
* Post operatively (if happens early might be due to atelectasis)
102
What do we consider a Temperature in the hospitalized patient?
* Immunocompromised Child Axillary/Oral temp > 38.0 C (_____ F)
* Non Immunocompromised Child > 38.5 (______ F)
* If receiving a blood transfusion- 1.0 degree C above baseline.
* Immunocompromised Child Axillary/Oral temp > 38.0 C (100.4 F)
* Non Immunocompromised Child > 38.5 (101.3 F)
* If receiving a blood transfusion- 1.0 degree C above baseline.
103
Febrile Seizures
* Young age. Most febrile seizures occur in children between _____________________, with the greatest risk between 12 and 18 months of age.
* __________ history. Some children inherit a family's tendency to have seizures with a fever. Additionally, researchers have linked several genes to a susceptibility to febrile seizures.
* Most occur during the _______ rise of the temperature. Many parents don’t know the child has a fever until the seizure occurs
* Parents should bring child to ED for evaluation-
* Young age. Most febrile seizures occur in children between 6 months and 5 years of age, with the greatest risk between 12 and 18 months of age.
* Family history. Some children inherit a family's tendency to have seizures with a fever. Additionally, researchers have linked several genes to a susceptibility to febrile seizures.
* Most occur during the initial rise of the temperature. Many parents don’t know the child has a fever until the seizure occurs
* Parents should bring child to ED for evaluation-
104
Febrile Seizure cont
* Most febrile seizures produce no lasting _______.
* Simple febrile seizures don't cause brain damage, intellectual disability or learning disabilities
* There is no more serious underlying disorder
* Usually does not occur again during the same illness
* Some kids do have a tendency and can have another with a future temp.
* Most febrile seizures produce no lasting effects.
* Simple febrile seizures don't cause brain damage, intellectual disability or learning disabilities
* There is no more serious underlying disorder
* Usually does not occur again during the same illness
* Some kids do have a tendency and can have another with a future temp.
105
Mnemonic for Vaccines
2 mo = B Dr. Hip
4 mo = Dr. Hip
6 mo = B Dr. Hip InC
106
FEVER CONCERNS: Neonate
increased risk of meningitis
107
Neonate with any fever : _________________
call pediatrician.
108
Acetaminophen ______ mg/kg every 4-6 hours
10-15
109
Do not give ________ to infants and children with a viral illness —can lead to a potentially fatal condition called Reye's syndrome.
aspirin
110
Ibuprofen
* Do not give until ________ old or older
6 months
111
Dehydration- Vital Signs
HR elevated
Temp might be elevated
BP- stays normal until it’s not [late and ominous sign]
112
_________________ is characterized by a 10% or greater loss of weight.
Severe dehydration
113
Know what diseases are airborne
Pneumococcal Pneumonia (PCV13)
Chicken Pox (Varicella)
Mumps (MMR)
Measles (MMR)
COVID AND TB
