Pediatric Medication, Immunizations, and Blood Pressure Management

Increased risk of medication toxicity in children

Immature liver and kidney function affects metabolism and excretion

Preferred IM injection site for infants

Vastus lateralis

Reason for avoiding dorsogluteal site in young children

Risk of sciatic nerve injury and poor muscle development

Most accurate method to calculate pediatric medication dosages

Weight-based dosing in kilograms

Proper way to give oral meds to infants

Slowly with syringe toward side of cheek to avoid aspiration

Otic medication positioning for children < 3 years

Pinna down & back

Otic medication positioning for children > 3 years

Pinna up & back

Safety teaching for liquid iron

Use straw or syringe and brush teeth after to prevent staining

Reason not to mix meds in a full bottle of formula

If not finished → incorrect dose received

Ways to minimize pain during IM injections

Comfort positioning, distraction, sucrose for infants

Reason for frequent medication dosing adjustments in infants

Rapid growth changes volume of distribution and metabolism

Vaccine preventing epiglottitis caused by Haemophilus influenzae type b

Hib vaccine

Reason for strong influenza vaccination recommendation for children with asthma

Respiratory infections can trigger severe asthma exacerbations

Vaccine that decreases incidence of pneumonia and otitis media

Pneumococcal vaccine (PCV13)

Importance of immunizations for children with cystic fibrosis

Lower risk of respiratory infections that worsen lung disease

Who qualifies for RSV prophylaxis (palivizumab)

High-risk infants (premature, congenital heart disease)

How DTaP prevents respiratory complications

Protects against pertussis (whooping cough)

Fever care after immunization

Use acetaminophen; avoid aspirin (Reye's syndrome risk)

Reason to avoid live vaccines in immunocompromised children

Live vaccines can cause infection if immunity is low

Reason MMR/Varicella is required before school entry

Reduces respiratory outbreak illnesses in group settings

Importance of vaccination in daycare children

Close contact = rapid spread of respiratory infections

Definition of an 'easy' temperament

Adaptable, predictable routines, generally positive mood

Response of 'slow-to-warm-up' temperament to hospitalization

Withdrawn at first → needs gradual introduction to people/situations

Coping mechanism of 'difficult' temperament in hospitalization

Irregular routines, intense reactions, harder to comfort and adapt

Normal BP range for a newborn (full-term)

64/41

Normal BP range for an infant (1-12 months)

85/50

Normal BP range for a toddler (1-2 years)

91/46

Normal BP range for a preschooler (3-5 years)

98/40

Normal BP range for a school-age child (6-12 years)

106/55

Normal BP range for an adolescent (13-18 years)

Less than 120 / less than 80

BP indicating hypertension in a toddler

Above 103/56

BP indicating hypertension in a preschooler

Above 104/58

Systolic/diastolic ranges indicating hypertension in school-age children

Systolic 114-123 or Diastolic 74-81

Reason to compare BP to age-based thresholds

Children's heart size and vascular resistance change as they grow

Correct BP cuff size determination

Cuff width = 40% of arm circumference (bladder 80-100% arm)

Reason to avoid taking BP on an arm with an IV

Can alter reading and affect IV flow

Effect of crying/anxiety on BP reading

Can falsely elevate BP

Why BP is a late indicator of shock in children

Children maintain BP until they suddenly decompensate

Primary long-term concern of untreated hypertension in children

Progresses to persistent HTN into school-age/adolescence

Reason to repeat BP before diagnosing HTN

Emotional state (crying/anxiety) can cause false elevation

Initial lifestyle recommendation for pediatric HTN

Monitoring BP and adjusting based on age-appropriate ranges

Importance of cuff accuracy in diagnosing hypertension

Incorrect cuff size can create a false HTN reading

Reason to monitor hydration status when evaluating BP

Dehydration lowers BP → may mask real hypertension

Age group most commonly screened for HTN

≥ 3 years at all healthcare visits

Reason hospitalized children must continue routine BP tracking

Detect acute changes in cardiac or fluid status

Factors that elevate BP temporarily

Pain, crying, stress, fever, caffeine

Importance of accurate BP in respiratory conditions

Respiratory distress can progress to shock → BP drop late sign

Priority teaching for families about childhood hypertension

Know your child's normal values and compare against age standards