Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
If anion gap is less than 12 |
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Definition
no anion gap metabolic acidosis |
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Term
if anion gap is greater than 12 |
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Definition
anion-gap metabolic acidosis loss of bicarbonate due to buffering of endogenous acids |
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Term
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Definition
calculated anion gap - 12 |
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Term
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Definition
indicates the amount of bicarb lost to buffering acids |
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Term
If measured bicarb + excess gap is less than 22 |
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Definition
non-anion gap metabolic acidosis (the bicarb level would still be low even if they didn't buffer the acids) |
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Term
if measured bicarb + excess gap is greater than 26 |
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Definition
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Term
when is using NaHCO3 appropriate in metabolic acidosis? |
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Definition
severe acidemia, renal dysfunction (when kidneys can't regenerate enough bicarb), intoxications |
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Term
when is using NaHCO3 inappropriate for metabolic acidosis |
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Definition
lactic acidosis, ketoacidosis |
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Term
what are the limitations of using NaHCO3 for pts with metabolic acidosis |
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Definition
can't give more than half of the HCO3 deficit (or can cause volume overload, hypernatremia, hyperosmolarity, overshoot alkalemia, hypokalemia) |
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Term
What are the limitations in using NaHCO3 in pts with respiratory acidosis |
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Definition
can generate CO2 and worsen acidemia |
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Term
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Definition
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Term
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Definition
29 days to less than 12 mos. |
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Term
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Definition
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Term
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Definition
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Term
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Definition
age from date of mother's first day of last menstrual period to date of birth |
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Term
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Definition
describes infants born at 38-wks gestation or after? |
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Term
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Definition
describes infants born before 37-wk gestation |
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Term
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Definition
neonates with birth weight below the 10th percentile among neonates of the same GA |
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Term
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Definition
neonates with birth weight above the 90th percentile among neonates of the same GA |
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Term
chronological (post natal) age |
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Definition
age from birth to present measured in days, wks, mos, or yrs |
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Term
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Definition
may be used to describe the age of a premautre child up to 3 yrs of age |
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Term
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Definition
chronological age (mos.) - [(40 - GA in wks at birth)/4 wks] |
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Term
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Definition
Premature infant with birth weight between 1500 and 2500 g |
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Term
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Definition
Premature infant with birth weight 1000 g to less than 1500 g |
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Term
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Definition
Premature infant with birth weight less than 1000 g |
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Term
How do you calculate hourly fluid maintenance requirements in children |
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Definition
first 10 kg = 4ml/kg/hr second 10 kg = 2ml/kg/hr remain kg = 1 ml/kg/hr |
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Term
how do you calculate daily fluid maintenance requirements in children |
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Definition
first 10 kg = 100ml/kg/day second 10 kg = 50 ml/kg/day remain kg = 20 ml/kg/day |
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Term
significant clinical signs of mild dehydration in children |
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Definition
decreased urine output and thirst. no physical changes yet. behavior, HR and BP are normal |
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Term
significant clinical signs of moderate dehydration in children |
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Definition
listlessness, physical changes begin, heart rate increases, BP is normal, markedly decreased UO |
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Term
significant clinical signs of severe dehydration in children |
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Definition
behavioral changes, intense physical changes, BP and HR changes, no urine output |
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Term
what are the percentages of degrees of dehydration in older children |
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Definition
mild = 3% moderate = 6% severe = 9% |
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Term
what are the percentages of dehydration in infnats |
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Definition
mild = 5% moderate = 10% severe = 15% |
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Term
how do you calculate rehydration fluid? |
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Definition
phase I (immediate) = 20ml/kg phase II (8 hours) = 1/2 remaining deficit + 1/3 daily maintenance fluid phase III (16 hours) = 1/2 remaining deficit + 2/3 daily maintenance fluid |
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Term
how do you calculate fluid deficit in children? |
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Definition
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Term
which acid-base disorder is hyperkalemia associated with? |
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Definition
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Term
Which fluid is sodium found in? |
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Definition
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Term
Which fluid is Potassium found in? |
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Definition
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Term
which organs control potassium regulation? |
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Definition
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Term
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Definition
cramps, muscle weakness, polyuria, ECG changes, cardiac arrhythmias |
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Term
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Definition
renal/GI losses, inadequate intake, medications (insulin, diuretics, corticosteroids) |
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Term
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Definition
potassium replacement -check for hypomagnesemia |
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Term
patient with hypokalemia and low phosphate levels, use: |
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Definition
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Term
hypokalemic patient with acidosis |
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Definition
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Term
hypokalemic patient with alkalosis |
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Definition
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Term
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Definition
muscle weakness, hypotension, ECG changes, cardiac arrhythmias, decreased pH |
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Term
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Definition
increased intake (salt substitutes, IV, potassium sparing diuretics), decreased excretion (renal failure, Addison's disease), potassium release from ICF (tissue breakdown, blood transfusions, metabolic acidosis) |
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Term
treatments of hyperkalemia |
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Definition
D/C potassium-sparing diuretics, salt substitutes, potassium supplements antagonize proarrhythmic effects (IV calcium) drive potassium into ICF (dextrose, insulin, beta agonists) lower total potassium content (sodium polysterene sulfonate, loop diuretics, hemodialysis) |
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Term
cause of high anion gap metabolic acidosis |
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Definition
lactic acidosis, ketoacidosis, renal failure |
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Term
cause of normal anion gap metabolic acidosis |
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Definition
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Term
causes of metabolic alkalosis |
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Definition
loss of acid, prevention of excretion (hypovolemia), drugs (bicarb, corticosteroids) |
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Term
respiratory acidosis causes |
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Definition
respiratory failure (NM and pulmonary disease), impaired CNS control of respiration |
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Term
cause of respiratory alkalosis |
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Definition
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Term
cause of hypertonic hyponatremia |
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Definition
hyperglycemia (inc in TBW) |
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Term
causes of hypotonic hypervolemic hyponatremia |
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Definition
CHF, cirrhosis, nephrotic syndrome |
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Term
causes of hypotonic euvolemic hyponatremia |
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Definition
SIADH, hypothyroidism, kidney failure, mineralocorticoid deficiency |
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Term
causes of hypotonic hypovolemic hyponatremia |
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Definition
diuretics, sweating, wound drainage, GI losses |
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Term
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Definition
loss of water, decrease in intake, diuresis, DI |
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Term
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Definition
losses: GI, renal Inadequate intake alkalosis meds: insulin, loop diuretics |
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Term
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Definition
increased intake decreased excretion:renal failure, addison's movement into the ECF: tissue breakdown, blood transfusions, metabolic acidosis |
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Term
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Definition
inadequate intake
losses:hypoparathyroidism, renal failure, alkalosis, pancreatitis, blood product infusion, vitamin D deficiency |
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Term
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Definition
hyperparathyroidism, hyperthyroidism, malignancy, addison's, bony fractures, immobilization, acidosis |
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Term
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Definition
decreased absorption: starvation, antacids, vitamin D deficiency, diarrhea increased renal loss: diuretics, ketoacidosis inc distribution to ICF:hyperglycemia, insulin, malnourishment |
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Term
causes of hyperphosphatemia |
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Definition
increased intake: enemas, laxatives decreased excretion: renal failure movement into ECF |
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Term
causes of hypomagnesemia: |
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Definition
inadequate intake: losses: GI, urinary |
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Term
causes of hypermagnesemia: |
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Definition
increased intake: meds decreased loss: renal failure |
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Term
treatment of hypertonic hyponatremia: |
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Definition
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Term
hypotonic hypervolemic hyponatremia treatment: |
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Definition
sodium and fluid restriction treat underlying cause (CHF, cirrhosis, nephrotic syndrome) |
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Term
hypotonic euvolemic hyponatremia treatment: |
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Definition
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Term
treatment of hypotonic hypovolemic hyponatremia |
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Definition
water and salt replacement (isotonic) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
rehydration diuresis bisphosphonates in renal insufficient pts |
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Term
hypophosphatemia treatment |
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Definition
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Term
hyperphosphatemia treatment |
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Definition
dietary restriction phosphate binder IV calcium |
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Term
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Definition
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Term
hypermagnesemia treatment |
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Definition
D/C meds with mag normal saline infusion furosemide IV calcium |
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Term
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Definition
ECF replacement, TBW depletion |
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Term
use for half normal saline |
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Definition
treatment for hypertonic patients (they lost ECF) |
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Term
use for hypertonic saline |
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Definition
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Term
what is use for ringer's lactate |
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Definition
replace ECF, buffer acids |
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Term
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Definition
severe hypernatremia, KVO |
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Term
a patient with elevated anion gap tells us |
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Definition
they have metabolic acidosis due to acids present |
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Term
a non-elevated anion gap metabolic acidosis tells us |
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Definition
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Term
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Definition
isotonic, but acts as hypotonic |
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Term
infant's absorption in stomach |
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Definition
slower gastric emptying, so increased absorption in stomach |
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Term
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Definition
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Term
volume of distribution in babies |
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Definition
larger for w/s drugs, lower for lipophilic drugs |
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Term
protein binding in babies |
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Definition
smaller albumin stores > less protein binding |
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Term
describe metabolism as you age |
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Definition
depressed at birth, then exceeds adult. at 12, starts to level off |
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Term
phase II metabolism in infants |
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Definition
glucoronidation is decreased sulfation is increased acetylation is decreased |
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Term
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Definition
depressed, bc of low GFR, renal blood flow, and tubular secretion |
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Term
what is the normal urine output in infants |
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Definition
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Term
how to estimate creatinine clearance in babes |
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Definition
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Term
effect of reduced metabolism and clearance on dosing in peds |
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Definition
longer half-lives >>> extended dosing intervals |
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Term
what is appropriate for fluid boluses? |
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Definition
isotonic (NS, lactate ringer) |
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Term
how are GI fluid losses replaced in children? |
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Definition
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Term
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Definition
(desired Na - measured Na)x.6 x wt |
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Term
formulation of pancreatic enzymes |
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Definition
eneteric-coated microspheres |
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Term
monitoring parameters of pancreatic enzymes in CF |
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Definition
stool output, steatorrhea, abdominal symptoms, weight gain, nutritional status |
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Term
antibiotics used in CF outpatients-pseudomonas |
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Definition
oral fluoroquinalones with tobramycin |
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Term
inpatient therapy for CF, antibiotics: |
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Definition
antipseudomonal beta-lactam (cephaloasporins) plus aminoglycoside (tobramycin) |
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Term
volume of distribution in CF |
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Definition
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Term
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Definition
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Term
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Definition
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Term
dose of aminoglycosdies in pts with CF |
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Definition
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Term
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Definition
inhaled med for CF that improves respiratory system, FEV, and reduces productive cough |
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Term
how is pulmonary system measured/evaluated in CF |
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Definition
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Term
use of azithromycin in CF |
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Definition
antiinflammatory, improves lung function |
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Term
side effect of taking supplemental iron when pregnanct |
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Definition
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Term
purpose of taking folic acid while pregnancy |
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Definition
prevents neural tube defects |
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Term
effect of pregnancy on absorption |
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Definition
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Term
effect of pregnancy on distribution |
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Definition
increased Vd, decreased protein binding |
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Term
effect of pregnancy on metabolism |
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Definition
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Term
effect of pregnancy on renal elimination and dosing |
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Definition
increases clearance, so drugs need to be dosed more frequently |
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Term
first line therapy for n/v |
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Definition
promethazine, prochlorperazine, or pyridoxine/doxylamine |
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Term
first line treatment constipation |
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Definition
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Term
first line therapy for hemorrhoids |
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Definition
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Term
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Definition
antacids (avoid aluminum products), all other OTC meds are fine |
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Term
management of pain in pregnancy |
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Definition
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Term
cough and congestion treatment during preg |
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Definition
DM, gauifenacin, pseudofed (in 2 and 3 trimester) |
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Term
treatment for allergies during preg |
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Definition
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Term
what can and can't you give for bacteriuria in pregn? |
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Definition
give amox, ceph, and nitrofurantoin don't give bactrim or fluroquinalones |
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Term
how to treat bacterial vaginosis in pregn |
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Definition
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Term
how to treat bacterial vaginosis during lactation |
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Definition
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Term
treatment for vulvovaginal candidiasis |
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Definition
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Term
treatment for chlamydia during preg? |
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Definition
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Term
treatment of chlamydia during lactation |
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Definition
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Term
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Definition
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Term
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Definition
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Term
treatment of syphillis during preg |
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Definition
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Term
treatment of syphillis during lactation |
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Definition
erythromycin or doxycycline |
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Term
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Definition
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Term
treatment for preterm labor |
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Definition
antenatal corticosteroids tocolytic agents (CCB) antibiotics |
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Term
treatment for group B strep |
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Definition
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Term
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Definition
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Term
nipple candidiasis treatment |
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Definition
topical antifungal and nystatin to baby |
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Term
lactation enhancement therapy |
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Definition
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