ch 54 special populations: pediatrics

neonate

0-28 days

when to seek medical care for fever if < 3 months old?

≥ 100.4º F

when to seek medical care for fever if ≥ 3 months old?

≥ 104º F or ≥ 100.4º F for ≥ 2 days

meds given shortly after birth

IM vitamin K

ophthalmic erythromycin ointment

hepatitis B vaccine (first dose)

patent ductus arteriosus treatment

NSAIDs: IV indomethacin or ibuprofen

what drug class can cause peristent pulmonary hypertension of the newborn if taken by the mother during pregnancy?

SSRIs

sepsis evaluation for neonates

blood and urine cultures

lumbar puncture —> meningitis

chest X-ray

lab tests

what is meningitis typically caused by in neonates?

group B strep (GBS)

rarely listeria

common cause of bacteremia in neonates?

e coli

how do we prevent GBS transmission from mother to child?

universal GBS screening during pregnancy

-positive GBS screening: abx prophylaxis (PCN G aqueous) during labor

empiric tx in neonates with fever

ampicillin + ceftazidime, cefepime, or gentamicin

why do we avoid ceftriaxone in neonates?

displaces bilirubin which can cause kernicterus (brain damage)

ceftriaxone can precipitate with ____ containing solutions

calcium

_____ is the cause of most bronchiolitis cases

RSV

how to treat bronchiolitis?

supportive care

when do we give Abrysvo to pregnant patients?

32-36 weeks

when do we give RSV prophylaxis to baby?

if mom not vaccinated during pregnancy

if mom vaccinated but gave birth within 2 weeks of receiving

give prophylaxis during RSV season

RSV prophylaxis for babies

nirsevimab (Beyfortus)

palivizumab (Synagis)

sx of croup

inspiratory stridor

barking cough

tx of croup

dexamethasone

racemic epinephrine (nebulized)

drug tx for nocturnal enuresis (bed-wetting)

desmopressin

OTC cough and cold products are not recommended for children ____

< 2 years old

why is aspirin not recommended in patients ≤ 18 years old?

REYE’S syndrome

-can happen when recovering from viral infection

APAP dosing for children

10-15 mg/kg/dose Q4-6H

ibuprofen dosing for children ≥ 6 months old

5-10 mg/kg/dose Q6-8H

APAP oral liquid concentration

160 mg/5 mL

intestinal gas tx

simethicone drops

constipation tx for < 6 months old

glycerin suppositories

constipation tx for ≥ 6 months old

miralax

constipation tx for ≥ 2 years old

OTC rectal enemas

diarrhea/dehydration tx

pedialyte

enfamil enfalyte

Reye’s syndrome presentation

confusion and seizures

swelling in brain or liver

why is promethazine CI < 2 years old?

respiratory depression

why are OTC products containing benzocaine CI in < 2 years old?

methemoglobinemia

when are codeine and tramadol CI?

< 12 years old

< 18 years old post tonsillectomy/adenoidectomy

why are tetracyclines not recommended in children < 8 years old?

stain teeth

slow bone growth

BUT still use doxy for ticks

why are FQs generally not recommended in pediatrics?

cartilage, bone, and muscle adverse effects

classic sx of measles

Koplik spots

maculopapular rash

classic sx of mumps

swollen salivary glands