kill me

match the percentage of adult height to the age:

1. fetal

2. infant

3. child

4. pubertal

1. 30%

2. 15%

3. 40%

4. 15%

by adolescence, what percent of adult height is reached?

80-85%

what is the name of the developmental staging method used when you might not know a patients age?

Tanner Staging

average age of growth spurt:

1. female

2. male

1. 12 yo

2. 14 yo

average age of menarche

12 ¼ and 12 ½

what developmental stage are the following age ranges in:

1. 0-2 yrs

2. 2-7 yrs

3. 7-11 yrs

4. 12 yrs +

1. sensory motor

2. preoperational

3. concrete operations

4. formal operations

sensory motor development stage:

1. age range

2. features

3. counseling

1. 0-2 yrs

2. does not connect between self and outside objects

3. not possible

how would you counsel preoperational development stage?

can use symbols and pictures, hand on activities, tell them about the taste of the medication

techniques for counseling a patient in the concrete operations stage

give them time to think and ask questions

explain concepts

include ADE that must be reported to parents

techniques for counseling a patient in the formal operations stage

typically same as adult, but remember they are easily embarrased

when performing a physical assessment on a child, what should be included?

vitals

APGAR

head circumference

height

weight

urine output

stool patterns

which vitals are included in the physical assessment of a pediatric patient? (5)

blood pressure, heart rate, resp rate, temp, pain

height averages: (in cm)

1. at birth

2. 1 yr

3. 3 yrs

4. 4 yrs

5. >4 yrs

1. 50 cm

2. 76 cm

3. 91 cm

4. 102 cm

5. 5/8 cm per year

average birth weight (in kg and lbs)

3.3 kg (7 lbs)

newborns may lose ____ of weight in the first week, but should be regained by 2 weeks old

10%

newborns may lose 10% of weight in the first week, but should be regained by _____

2 weeks old

weight gain averages:

1. 1-4 months old

2. 4 months to 1 yr

3. 2 yrs to puberty

1. 20-30 g/day

2. 15-20 g/day

3. 5 lb/yr

head circumference is also called…

frontal occipital circumference

average head circumference:

1. birth

2. 0-3 months old

3. 3 months to 1 year old

1. 35 cm

2. 2 cm per month

3. 1 cm per month

by age 2 ____ of head growth has occurred

90%

estimating blood pressure:

systolic BP formula for 50th percentile

90 +(age x 2)

estimating blood pressure:

MAP formula for 50th percentile

55 + (age x 1.5)

estimating blood pressure:

MAP formula for 5th percentile

40 + (age x 1.5)

as ped patients age, their HR should ____

a. increase

b. decrease

b

as ped patients age, their ____should decrease (select all that apply)

a. HR

b. BP

c. RR

a and c

as ped patients age, their RR should ____

a. increase

b. decrease

b

as ped patients age, their BP should ____

a. increase

b. decrease

a

as ped patients age, their _____ should increase (select all that apply)

a. HR

b. RR

c. BP

c

neonates peepee within ____of birth

first 24 hrs

neonates peepee ____ times a day

6-8

what is meconium

the first stool of the baby

stool patterns by age (average per day)

1. 0-3 months

2. 6-12 months

3. 1-3 years

4. 3 yrs +

1. 2-3

2. 1.8

3. 1.4

4. 1

what does APGAR stand for?

A: appearance (color)

P: (pulse)

G: Grimace (Reflex irritability)

A: Active motion (muscle tone)

R: respiratory effort

what does the APGAR score look for?

HR

respiratory effort

muscle tone

reflex irritability

color

timing of APGAR scoring

infant is scored at 1 min, 5 min, and 10 min

target APGAR score

>7/10

what pain scale should be used for:

infants < 28 wks - 38 wks in first 28 days of life

Premature Infant Pain Profile (PIPP)

what pain scale should be used for:

Infants (32wks–6 mo)

Crying, Requires O2, Increased vital signs, Expression, Sleepless (CRIES)

what pain scale should be used for:

2 months to 7 yrs

Face, Legs, Activity, Cry, Consolability(FLACC)

what pain scale should be used for:

Children 3 yrs-12 yrs

Oucher

what pain scale should be used for:

Children >3 yrs-< 8 yrs

Wong-baker Faces

what pain scale should be used for:

Children >8 yrs, adolescents, adults

Numeric Pain Intensity Scale or visual analog scale

delete

Visual Analog Scale

what pain scale should be used for:

Adolescents

Adolescent Pediatric Pain Tool (APPT)

Premature Infant Pain Profile (PIPP):

what is the purpose of this assessment tool?

to see if the infant needs pain meds or not

Premature Infant Pain Profile (PIPP)

if the score is _____ then start pain meds or increase dose of current pain med

>6

Premature Infant Pain Profile (PIPP)

if the score is _____ then d/c pain meds or decrease dose of current pain med

<6

the wong baker faces pain scale is best for which age range?

3 yrs to 8 yrs

which labs are included:

electrolyte panel

Na

K

Cl

CO2

which labs are included:

BMP

electrolyte panel +

glucose

creatinine

BUN

Ca

which labs are included:

CMP

BMP +

total albumin

ALP

ALT

AST

total bilirubin

which labs are included:

Hepatic Panel

total albumin

ALP

AST

ALT

total bilirubin

direct bilirubin

which labs are included:

renal panel

BMP

Phos

total albumin

which labs are included:

sepsis panel

absolute neutrophil count

total neutrophil ratio

the absolute neutrophil count is the…

part of the WBC count consisting of neutrophils

what is the formula for absolute neutrophil count?

ANC = (WBC (%Neut/100))*1000

I:T ratio is the

ratio of immature to total neutrophil count

I:T ratio of >0.2 indicates _____ in neonates

left shift

I:T ratio of _____ indicates left shift in neonates

>0.2

what are the immature neutrophils

bands, myelocytes, metamyelocytes, and promyelocytes

total bilirubin is _____

direct (conjugated) + indirect (unconjugated)

normal conjugated bilirubin in neonates

<0.6

normal conjugated bilirubin in infants and children

<0.2

indirect (unconjugated) bilirubin is the…

(lowkey idk about this)

maximum rate of bilirubin increase for normal infants with nonhemolytic hyperbilirubinemia

define neonate

day of birth - 1 month old

define pre term

born 37 weeks gestational or less

define term

born between 38 and 42 weeks gestational

define infant

1 month to 1 year

define child

1 yr to 11 yrs old

define toddler

1 year to 3 years old

define adolescent

12 yrs to 16 yrs old

define gestational age

age from conception to birth

define postnatal (chronological age)

age from birth to now

define post conceptional (post menstrual) age

gestational age + postnatal (chronological) age

ceftriaxone is CI in which age range and why?

neonates (1 -28 days old)

displaced albumin and bilirubin

codeine is CI in which age range and why?

<12 yrs old

increased risk of resp depression

promethazine is CI in which age range and why?

< 2 yrs old

increased risk of resp depression

tramadol is CI in which age range?

< 12 yrs old

which two medications mentioned in the slides are CI in pts under 12 yrs old?

codeine

tramadol

which medication mentioned in the slides is CI in pts under 2 yrs old?

promethazine

which mediation mentioned in the slides is CI in neonates (1-28 days old)?

ceftriaxone

aspirin is generally not rec for which age range?

children and teens

tetracyclines are generally not rec for which age range?

< 8 yrs old

benzocaine is generally not rec for which age range?

less than 2 yrs old

OTC cough and cold medications are generally not rec for which age range?

less than 2 years

children and teens are generally recommended to NOT take…

ASA

children under 8 are generally NOT recommended…

a. ASA

b. quinolones

c. tetracyclines

d. benzocaine

e. codeine

c

children under 2 are generally NOT recommended… (select all that apply)

a. ASA

b. quinolones

c. tetracyclines

d. benzocaine

e. codeine

f. OTC cough and cold preparations

d and f

ratio and proportion trough only vancomycin formula

(current dose / current trough) = (new dose / target trough)

dosing interval change formula for trough only vancomycin

new dosing interval = [(current trough / target trough) / current dosing interval]

what formula is used to estimate a new target trough after selecting a standard dosing interval? (vanc dosing)

target trough = [current trough (current interval / new interval)]

requirements for flagging pediatric syringes

do not obstruct any graduated markings

label should be readable

Css old stands for

current trough

Css new stands for…

target trough

TAU new stands for…

new dosing interval

TAU old stands for…

current dosing interval

Congenital heart disease etiology is multifactorial, name some of those causes

genetics

maternal factors

environmental factors

what maternal factors can lead to congenital heart defects (4)

smoking (even 2nd hand)

binge drinking

obesity

pregestational diabetes

name some environmental factors that can lead to CHD

air pollution exposure in the 1st trimester

associated defects

paternal exposure