Pediatric Self Care

True or False: a fever is a normal physiologic response to infection and often resolves without complications

true

What is a fever?

body temp of at least 38 degrees Celsius or 100.4 degrees Fahrenheit (rectal)

What is the clinical presentation of a fever in pediatrics?

• elevated body temperature

• irritability

• fatigue

• decreased appetite

• flushed skin

• sleep disturbances

• increased fussiness

When is self care appropriate for a fever in a pediatric patient?

a child with a mild fever who otherwise appear well

When should a child with a fever be referred to a provider?

• infant < 3 months with a fever of at least 38 degrees

• fever lasting more than 3 days

• signs of dehydration

• severe lethargy or irritability

• difficulty breathing

• seizures of persistent vomiting

What are the nonpharmacological strategies for a fever?

• ensuring adequate fluid intake

• allowing the child to rest

• dressing the child in light clothing

• avoiding excess bundling

True or False: cold baths and alcohol rubs are recommended for children with fevers

false

What is the age range for ibuprofen?

greater than 6 months of age

What are the two main medications for fever management in pediatrics?

acetaminophen and ibuprofen

What should caregivers be counseled on regarding antipyretics?

• dose medications based on weight rather than age

• use a standardized measuring device

• avoid duplicate therapy from combo products

Why should aspirin be avoided in children?

risk of Reye Syndrome

What information should be assessed when evaluating pediatric pain?

• location of the pain

• severity and duration

• associated symptoms (fever, swelling, vomiting)

• possible cause

• previous treatments attempted

What is the criteria for self-care related to pain?

mild pain caused by a minor injury, headache, sore throat, or musculoskeletal discomfort

What are exclusions to self-care for pain in pediatrics?

• pain that is severe, persistent or worsening

• pain associated with significant trauma

• unexplained swelling, redness, or deformity

• pain accompanied by high fever or neurologic symptoms

• headache associated with vision changes if persistent vomiting

• pain lasting longer than several days despite treatment

What are nonpharmacological interventions to reduce discomfort/pain in pediatrics?

• rest and activity modification

• cold or warm compress

• hydration and adequate sleep

• comfort measures

• distractions

What is the RICE approach?

rest, ice, compression, and elevation; used for minor musculoskeletal injuries

What is the OTC medication that is helpful for musculoskeletal pain or inflammatory conditions?

ibuprofen

What is teething?

a normal developmental process that occurs as primary teeth erupt through the gums

When do infants begin teething?

4 and 7 months of age

What is the clinical presentation of teething?

• gum irritation or swelling

• increased drooling

• desire to chew on objects

• mild irritability or fussiness

• decreased appetite

What would be symptoms that would need a referral and not related to teething?

• high fever

• significant diarrhea

• vomiting

• severe illness

What are non-pharmacological interventions for teething?

• firm rubber teething rings

• cool (not frozen) teething ring

• massaging the gums

True or False: in most cases, pharmacologic therapy is not necessary for teething discomfort

true

Why should topical anesthetic products be avoided in infants and young children?

methemoglobinemia

What is methemoglobinemia?

a rare but potentially life-threatening condition in which the blood’s ability to carry oxygen is reduced

What are the common causes of respiratory infections?

rhinovirus, coronavirus, and respiratory syncytial virus

How long does it take for symptoms of a common cold to resolve?

7-10 days (cough can last longer)

What is the clinical presentation of a cold and cough in pediatrics?

• nasal congestion

• runny nose

• cough

• sore throat

• sneezing

• mild fever

• decreased appetite or irritability

What signs and symptoms of a cold and cough would warrant a referral?

• difficulty breathing or rapid breathing

• persistent high fever

• symptoms lasting longer than 10-14 days

• severe ear pain or suspected ear infection

• signs of dehydration

• persistent vomiting

• cough accompanied by wheezing or cyanosis

What are the nonpharmacological interventions for cough and cough?

• ensuring adequate fluid intake

• allowing the child to rest

• using a cool-mist humidifier to help relieve nasal congestion

• performing saline nasal irrigation or nasal drops to loosen mucus

• using a bulb syringe to removal nasal secretions in infants

What is the age that pediatrics can safely have honey?

older than 1

Why is honey not safe for infants younger than 1 year old?

the risk of infant botulism

What age can children begin to use combination cold and cough products?

4 years old

What is the most appropriate recommendation for pediatric colds and coughs?

nonpharmacologic management

What is the risk of combination cold and cough products?

excessive sedation, agitation, cardiac effects, and respiratory depression