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Reasons for success in infant mortality rate decline |
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Definition
better identification, prevention, and treatment of diseases during delivery and infancy (i.e. vaccines, antibiotics) |
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caused by use of chloramphenicol: babies are unable to metabolize it, allowing build-up and toxicity |
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caused by Thalidomide or Accutane; causes birth defects that make limbs look like flippers |
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caused by sulfonamides; allows for displacement of bilirubin, causing deposition in the brain, resulting in brain damage |
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<37 weeks gestational age |
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Length of Normal pregnancy |
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Differences in Absorption in GI Tract in Peds |
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Definition
gastric pH is higher in babies causing higher blood concentrations of acid-labile (weak base) drugs i.e. penicillin, ampicillin, nafcillin; Lower blood concentration levels of weak acids (i.e. phenobarbital); Gastric Emptying Rate is slower, increasing absorption; Length of GI tract is shorter, decreasing absorption |
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Altered Intramuscular absorption in Neonates Causes & Results |
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Definition
Causes: differences in muscle mass, poor perfusion, peripheral vasomotor instability, insufficient muscular contraction; Result: decreased absorption |
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Percutaneous Absorption in Neonates |
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Definition
more hydrated skin, less # of skin layers; Result: unpredictable absorption, increased risk of toxic exposure |
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Total Body Fat in Children |
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Definition
significantly decreased; Result: lipophilic meds have a SMALLER Vd |
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Total Body Water in Children |
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Definition
increased; Results: hydrophilic meds have a LARGER Vd |
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Term
Neonates have a decreased blood brain barrier resulting in |
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Definition
increased CNS distribution of drugs |
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Neonates have decreased protein binding during 1st month resulting in: |
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Definition
increased free drug concentrations of highly bound drugs |
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Changes in Metabolism for Children |
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Definition
Decreased liver perfusion; decreased enzyme production; Results: decreased ability to clear drugs, altered pathways, decreased ability to conjugate |
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Changes in Excretion in Neonates |
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Definition
renal excretion altered until maturation occurs between 6 months & 3 yrs; Result: dose renally cleared meds cautiously |
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Term
When calculating dosages for Pediatrics... |
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Definition
NEVER use a percentage of an adult dose or an age range as your SOLE parameter! Use weight-based or body surface area-based |
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Liquid Dosage Forms in Children |
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Definition
work well; keep volumes to manageable amounts --> may have stronger concentration than adult liquids; administer with syringe; AVOID true elixirs that contain alcohol |
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Tablets and Capsules in Children |
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Definition
use Oral Disintegrating Tablet or Chewable tablets; Children CANNOT swallow tabs/caps until about 6 yrs old |
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Definition
caused by increased benzyl alcohol (preservative) in injectables; LIMIT amts of preservative in injectables for children |
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Subcutaneous Injections in Children |
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Definition
increased absorption; inject in abdomen for more predictable absorption |
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Term
Intramuscular Injection in Children |
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Definition
NOT used due to absorption issues |
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Term
Intravenous Administration in Children |
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Definition
IV Bags are too large; Syringe Pumps allow meds to be administered at a specific rate (Dis: left-over drug in tubing); Volumetric Sets: allows set volume of meds into specific volume to creat pt specific conc. (adv: ALL med gets to pt; dis: extra port = risk of infection) |
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Intraosseous Infusions in Children |
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Definition
used when IV cannot be gained; DO NOT USE in pts > 6 yrs old; used "in the field" or emergency rooms |
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Normal Spontaneous Vaginal Delivery |
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predicts how a child should grow based on historical data |
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Definition
a trend on a growth chart that indicates failure to thrive, abuse/neglect, or severe illness |
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Definition
preferred method of temperature taking |
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Definition
start high prior to birth, dips slightly at birth, slowly decreases until 14 when adult normals are reached |
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Term
Respiratory Rate in Children |
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Definition
highest at birth, slowly declines as lungs mature |
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Blood Pressure in Children |
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Definition
Starts low and increases with age |
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Normal Sodium Lab Values in Children |
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Definition
135 - 146 mEq/L, following birth slight alterations are acceptable |
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Term
Potassium Blood Levels in Children |
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Definition
if <10 days old, 3.5-6.0 mEq/L is acceptable; if >10 days old, 3.5-5.0 mEq/L is acceptable |
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Serum Creatinine in Children |
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Definition
first 10 days of life, levels indicative of mother's renal health; levels are dependent on muscle mass |
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Creatinine Clearance in Children |
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Definition
renal system maturation does not occur until 6 months to 3 years of age |
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Bilirubin Levels in Children |
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Definition
T-bili peaks at 3-7 days of life, decreases as liver's ability to conjugate matures; conjugated bilirubin should stay the same |
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Term
Non-Dehydrated Peds Patient Care FEN Plan |
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Definition
Calculation: 100 ml/kg for 1st 10kg + 50 ml/kg for 2nd 10kg + 20 ml/kg for each extra kg; Fluid Choice: for <3 yrs old, D5/0.2 NaCl + 10 mEq KCl; for > or = 3 yrs old, D5/0.45 NaCl + 20 mEq KCl |
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Term
Nelson's Textbook of Pediatrics |
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Definition
widely available general Peds reference; requires some med terminology knowledge; "DiPiro's for Peds" |
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Pediatric Dosage Handbook by Lexi-Comp |
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Definition
excellent drug reference; has nothing on diagnosis or treatment plans |
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Current Concepts in Pediatric Diagnosis & Therapy |
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Definition
up-to-date standards of care; assumes knowledge background on disease states |
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Definition
good sections on diagnosis & testing; some difficulties with drug section |
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Nelson's Essentials of Pediatrics |
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Definition
handbook on common pediatric disease states |
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peds specific compatibility information dealing only with IVs; found very rarely in other resources |
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Definition
limited to medications in neonatal population |
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