PEDs Exam 2A

What is a major risk factor for ADHD?

Family history

What are two common suicide precautions that are implemented?

Paper gowns, finger foods

When are ADHD meds given?

in the morning

What should be avoided when taking ADHD meds?

Caffeine

What are major SE of ADHD meds?

Insomnia, anorexia, nervousness, HTN. tachycardia

What are examples of stimulant ADHD meds?

Amphetamine and dextroamphetamine

What are examples of no stimulant ADHD meds?

atomoxetine and guanfacine

What is the action of ADHD meds?

Increase norepinephrine and dopamine in the CNS

Contraindications for aphetamine/dextroamphetamine?

Alcohol use

cardiac disease,

DBM

Tourette’s

What time is the last dose of methylphenidate given?

4pm

What is a secondary use of lisdexamfetamine?

Binge eating disorder

What are major SE of atomoxetine?

Suicidal thoughts
Hepatotoxicity

What is St Johns wort potentially used for?

Depression

What is Kava used for?

Insomnia, anxiety

What is lavender used for?

Anxiety, insomnia, depression

What is chamomile used for?

Anxiety

What is the definition of borderline personality disorder?

Feeling as though bordering sanity and psychosis

What is the main characteristic of BPD?

Manipulating behaviors

What two meds are primarily used in pediatric BPD?

Fluoxetine and sertraline

How long do antidepressants like Fluoxetine and sertraline take to work?

2-6 weeks

Risk factors for depression?

Family history, prior episode of depression, lack of social support, stress, substance abuse

What TCA is used for bed wetting?

Imipramine

When stopping antidepressants, what actions should be taken?

Taper off

Therapeutic levels of lithium?

0.6-1.2

AE of SSRI?

Serotonin syndrome, weight gain, decreased libido

What herbal supplement should be avoided with antidepressants?

St John’s Wort

S/S of serotonin syndrome?

Fever, tremors, confusion, increased HR and BP

What are early signs of lithium toxicity?

Fine tremor, polyuria, weight gain, hyponatremia, GI upset

Advanced signs of lithium toxicity

Coarse tremors, sedation, N/V/D

Severe signs of lithium toxicity? (2.0-2.5 mEq/L)

Extreme polyuria
Tinnitus
Seizures
Involuntary extremity movements

Severe Hypotension

What is the most common psychiatric disorder in children?

GAD

What 2nd generation antipsychotics may be given for aggressive bipolar?

Olanzapine

Risperidone

Aripiprazole

What meds may be given for anxiety?

Fluoxetine
Diphenhydramine
Hydroxyzine
Buspirone

What is the treatment for OCD?

Fluoxetine

S/S of panic disorder?

Intense fearfulness

Dizziness/ lightheadedness

Diaphoresis

SOB
Trembling

What is the antidote for benzos?

Flumazenil

What class are chlordiazepoxide and clorazepate?

Benzos

What meds treat PTSD?

Fluoxetine, sertraline, propranolol

What meds are given for conduct disorders?

Risperidone
Haloperidol

Lithium
Divalproex sodium

Amitriptyline

What is the key intervention for oppositional defiant disorder?

Consistent consequences

What does MacDonald’s triad consist of?

Enuresis
Cruelty to animals

Pyromania

What do children with autism greatly benefit from for success?

Consistent routines

What is the main characteristic of anorexia nervosa?

Distorted body image

What causes anorexia nervosa?

unkown etiology - possible genetics, sociocultural, psycho developmental factors

Pharmacologic interventions for anorexia?

SSRIs, provigil (stimulate appetite)

Main characteristics of bulimia?

Binge eating commonly followed by purging behaviors

S/S of anorexia nervosa?

Lanugo, amenorrhea, bradycardia, hypotension, dry skin

What is Russel’s sign?

Teeth marks on the knuckles

What are major concerns with bullimia nervosa?

Hyponatremia
Hypokalemia

Depressoin

What is Munchauser syndrome?

Caregiver attempts to make the child appear ill

Mnemonic for airborne precautions?

MTV is Cool (Measles, TB, Varicella, Covid)

What diseases require droplet precautions?

Meningitis

Rubella

Mumps

Influenza
Pneumonia
Pertussis
Strep

What diseases is hand sanitizer not effective against?

C. Diff

Rotavirus

At what age can ibuprofen be given?

6 months

Normal vaccination reactions?

Pain/tenderness at site

Redness, mild swelling

Low grade fever

What can occur if a child/teen takes aspirin with a viral infection?

Reye’s syndrome

Contraindications for receiving immunizations?

Severe allergic reaction
Live vaccine for immunocompromised
Severe febrile illness >100.4

If the mother is HBsAG + what is given?

Hep B vaccine, HBIG within 12 hours

If mother is HBsAG unknown what is given?

Hep B vaccination
If less than 2000g HBIG within 12 hours
if >2000g, and if HBsAG+, HBIG within 7 days

What age is DTaP given?

birth to 7 years

What age is TDaP given?

7 years and older

What can Hib type B cause?

Bacteria may cause epiglotitis, meningitis, pneumonia, sepsis

What type of precautions does rotavirus require?

Contact

What immunizations are given at 2 months?

Hep B, IPV, PCV, RV, DTaP

What immunizations are given at 4 months?

IPV, PCV, RV, DTaP

What immunizations are given at 6 months?

Hep B, IPV, PCV, RV, DTaP

What vaccines are given at 12-15 months and 4-6 years old?

MMR and varicella

What vaccines are given at 4-6 years old? Mnemonic?

IPV, DTaP, MMR, Varicella
I did my vaccines

What vaccines are given at 11-12 years old?

HPV, meningococcal, TDaP, Influenza

What type of precautions does Pertussis require?

Droplet

S/S of pertussis?

Cough for 1-2 weeks lasting up to 4-6

Cyanotic cheeks

Protruding tongue

What are the three stages of pertussis?

Catarrhal - fever runny, nose, congestion, cough
Paroxysmal - severe spasmodic cough
Convalescent - several months decreasing in frequency

What precautions does strep throat/scarlet fever require?

Droplet

What is strep throat with a rash called?

Scarlet fever

What is strep treated wit ? What needs to be monitored during tx?

Amoxicillin. Monitor for yeast infection (tx with fluconazole)

S/S of Scarlet fever?

Acute pharyngitis, fever, sore throat
Papular rash that feels like sandpaper

Strawberry tongue
Pale palms and soles

What type of precautions does conjunctivitis require?

Contact

How is enterobius vermicularis (Pinworm) transmitted?

fecal-oral

How is enterobius vermicularis (Pinworm) diagnosed?

Tape test with tongue depressor to perianal area in the AM

What is a major consideration when treating pinworm?

Treat the whole family at once ( very contagious)

How is Giardiasis transmitted?

Contact

Tx of Giardiasis? What is a major AE of this medication?

Metronidazole. No alcohol use

How long is erythema infectiosum (Fifth disease) contagious?

Until the rash appears

S/S of erythema infectiosum (Fifth disease)

Rash on face
Lacey rash on upper and lower extremities
Progression proximal to distal areas

What precautions are required for erythema infectiosum (Fifth disease)?

Droplet

When can erythema infectiosum (Fifth disease) be especially dangerous?

During pregnancy

S/S of hand-foot-mouth disease?

Painful sores on the mouth, hands, and feet

Precautions for mononucleosis? How is it spread?

Standard, saliva

S/S of mononucleosis?

Fever, sore throat, splenomegaly, swollen lymph nodes

TX of mononucleosis?

Pain meds, salt water gargle, ice packs to neck

Complications of mononucleosis?

Ruptured spleen/splenomegaly

Avoid physical activity for 6-8 weeks
If amoxicillin given, maculopapular rash may appear

S/S of Roseola (Exanthem subitum)

High fever for 3-7 days
Fever suddenly subsides and rash appears that starts on trunk and spreads to face and extremities

How long is Roseola contagious?

24 hours fever free

How is zika virus transmitted? What is a major AE it can cause?

Mosquitos, pregnant defects

Precautions required for HIV

Standard

Most common sign of bed bugs?

3 bites seen in the morning

S/S of RSV?

Copius secretions, cough, fever

Precautions for Measles (rubeola)

Airborne

3 C’s of Measles?

Cough
Coryza (inflamed runny nose)

Conjunctivitis

What supplement can be given for measles (rubeola)

Vitamin A