Vitals
AGE PULSE RR BP systolic
NEWBORN 110-180 35-70 50-70
1-11 mo (infant) 80-140 30-40 70-100
1-3 yr (toddler) 80-130 20-30 70-110
3-6 yr (preschooler) 80-110 20-30 80-110
6-12 yr (school age) 70-100 18-24 80-120
12-18 yr (adolescent) 60-100 14-22 100-120
SKIN Diaper dermatitis
・Raw, moist, weeping macules and papules of skin in contact w/ diaper
・Causes: candida (yeast)
○Use topical antifungal
○Watch for white patches in the mouth (thrush)
○Lay baby on a towel w/o diaper several times a day
Impetigo
・Bacterial infection around mouth, nose, hands, neck, extremities
○Rash → red papules w/ honey colored crusting
・Someone is carrier of bacteria and contagious
○Both parents will need to have nasal swab sent for culture
Folliculitis
・Superficial inflammation of hair follicle → pustules and papules at follicular openings
Cradle cap (Seborrheic dermatitis)
・Recurrent inflammatory condition caused by overgrowth of yeast
・Yellow greasy scales, slight erythema
・1st mo of life, resolves by 6-12 mo
・Occur in face, trunk, neck, diaper area
・Apply shampoo w/ selenium sulfide
・Baby oil or vaseline before washing
・Wash hair daily
・Not contagious
Erythema toxicum neonatorum
・Common, benign rash in NB
・Scattered yellow-white pustules on face, neck, trunk
・Not contagious
・Rash will resolve spontaneously in hours-days
, Eczema
・Lichenification
○Thickening of the skin d/t excessive scratching
○Use hand mittens
Athletes foot (tinea pedi)
・Fungal infection → antifungal ointments
・Keep feet ventilated
・Wear clean socks
CPR ・Infant CPR
○1 rescuer: 30 compression, 2 breaths
○2 rescuers: 15 compressions, 2 breaths
○Check brachial pulse (upper arm)
○Assess breathing & pulse after 5 cycles
Cleft lip ・
Malignant ・Occurs post-op
hyperthermia ○↑BP
○Dark urine (skeletal muscle release of myoglobin)
○Chest erythema
・
Osteomyelitis Infection of the bone caused by bacteria (enter through wound or bloodstream)
・Acute more common in peds
○Bacteremia d/t staphylococcus aureus
・Tenderness over the bone
・Sudden increase in pain of limb
・Erythema (redness)
・Warmth, swelling, presence of wound
・Limited movement
・Fever, irritability, lethargy
Interventions
・IV abx
○PICC line will be placed
○Home infusion therapy
・NSAIDs (pain, swelling)
Scoliosis ・Girl 10-13 yo
○Observe symmetrical shoulder height
・Mild: 10-20 degrees
○Exercise to improve posture and muscle tone
・Moderate scoliosis: 20-40
○Brace
・Severe scoliosis: >40 degrees
○Surgery
Developmental hip ・Pavlik harness
, dysplasia (DDH) ○Worn 24hr / day to correct hip dysplasia
・DO NOT remove for cleaning or diaper changes
○Wear bodysuit under the harness prevent skin breakdown
・Ortolani test
・Assessment
○Asymmetrical gluteal fold
Spina bifida (neural Myelomeningocele
tube defect) ・Most serious form
・Sac present → containsSF, meninges, nerves
・Surgery
○Maintain occlusive dressing on at all times
○Change w/ soiled
Muscle dystrophy Duchenne muscular dystrophy
・Genetic disorder → muscle fiber damage and degeneration
・Muscle weakness and wasting
・↑levels of creatine kinase in blood → inflammation
・Affects skeletal and cardiac muscle
Assessment
・Frequent falls
・Difficulty standing up from lying or sitting
○Gower’s sign → child's legs are too weak to stand w/o using arms for support
・Trouble walking, running, jumping
・Waddling
・Walking on tiptoes
・Muscle pain/stiffness
・Delayed growth
・Enlarged calves or thighs
・Learning disabilities
Teaching
・High-fiber foods to prevent constipation
・Encourage ambulation as tolerated
・Annual flu shot (increased risk of respiratory infections)
・Avoid high-contact sports
Juvenile Rheumatoid ・
arthritis (JRA)
Ewing Sarcoma Cancer in bones of soft tissues surrounding bone → pelvic or long bones
・Common in teens & young adults
・Swelling, bone pain
・Unexplained fatigue
・Fever of unknown origin
・Tx
○Chemotherapy (will require additional tx after chemo)
○Radiation
○Surgery
○Supportive
AGE PULSE RR BP systolic
NEWBORN 110-180 35-70 50-70
1-11 mo (infant) 80-140 30-40 70-100
1-3 yr (toddler) 80-130 20-30 70-110
3-6 yr (preschooler) 80-110 20-30 80-110
6-12 yr (school age) 70-100 18-24 80-120
12-18 yr (adolescent) 60-100 14-22 100-120
SKIN Diaper dermatitis
・Raw, moist, weeping macules and papules of skin in contact w/ diaper
・Causes: candida (yeast)
○Use topical antifungal
○Watch for white patches in the mouth (thrush)
○Lay baby on a towel w/o diaper several times a day
Impetigo
・Bacterial infection around mouth, nose, hands, neck, extremities
○Rash → red papules w/ honey colored crusting
・Someone is carrier of bacteria and contagious
○Both parents will need to have nasal swab sent for culture
Folliculitis
・Superficial inflammation of hair follicle → pustules and papules at follicular openings
Cradle cap (Seborrheic dermatitis)
・Recurrent inflammatory condition caused by overgrowth of yeast
・Yellow greasy scales, slight erythema
・1st mo of life, resolves by 6-12 mo
・Occur in face, trunk, neck, diaper area
・Apply shampoo w/ selenium sulfide
・Baby oil or vaseline before washing
・Wash hair daily
・Not contagious
Erythema toxicum neonatorum
・Common, benign rash in NB
・Scattered yellow-white pustules on face, neck, trunk
・Not contagious
・Rash will resolve spontaneously in hours-days
, Eczema
・Lichenification
○Thickening of the skin d/t excessive scratching
○Use hand mittens
Athletes foot (tinea pedi)
・Fungal infection → antifungal ointments
・Keep feet ventilated
・Wear clean socks
CPR ・Infant CPR
○1 rescuer: 30 compression, 2 breaths
○2 rescuers: 15 compressions, 2 breaths
○Check brachial pulse (upper arm)
○Assess breathing & pulse after 5 cycles
Cleft lip ・
Malignant ・Occurs post-op
hyperthermia ○↑BP
○Dark urine (skeletal muscle release of myoglobin)
○Chest erythema
・
Osteomyelitis Infection of the bone caused by bacteria (enter through wound or bloodstream)
・Acute more common in peds
○Bacteremia d/t staphylococcus aureus
・Tenderness over the bone
・Sudden increase in pain of limb
・Erythema (redness)
・Warmth, swelling, presence of wound
・Limited movement
・Fever, irritability, lethargy
Interventions
・IV abx
○PICC line will be placed
○Home infusion therapy
・NSAIDs (pain, swelling)
Scoliosis ・Girl 10-13 yo
○Observe symmetrical shoulder height
・Mild: 10-20 degrees
○Exercise to improve posture and muscle tone
・Moderate scoliosis: 20-40
○Brace
・Severe scoliosis: >40 degrees
○Surgery
Developmental hip ・Pavlik harness
, dysplasia (DDH) ○Worn 24hr / day to correct hip dysplasia
・DO NOT remove for cleaning or diaper changes
○Wear bodysuit under the harness prevent skin breakdown
・Ortolani test
・Assessment
○Asymmetrical gluteal fold
Spina bifida (neural Myelomeningocele
tube defect) ・Most serious form
・Sac present → containsSF, meninges, nerves
・Surgery
○Maintain occlusive dressing on at all times
○Change w/ soiled
Muscle dystrophy Duchenne muscular dystrophy
・Genetic disorder → muscle fiber damage and degeneration
・Muscle weakness and wasting
・↑levels of creatine kinase in blood → inflammation
・Affects skeletal and cardiac muscle
Assessment
・Frequent falls
・Difficulty standing up from lying or sitting
○Gower’s sign → child's legs are too weak to stand w/o using arms for support
・Trouble walking, running, jumping
・Waddling
・Walking on tiptoes
・Muscle pain/stiffness
・Delayed growth
・Enlarged calves or thighs
・Learning disabilities
Teaching
・High-fiber foods to prevent constipation
・Encourage ambulation as tolerated
・Annual flu shot (increased risk of respiratory infections)
・Avoid high-contact sports
Juvenile Rheumatoid ・
arthritis (JRA)
Ewing Sarcoma Cancer in bones of soft tissues surrounding bone → pelvic or long bones
・Common in teens & young adults
・Swelling, bone pain
・Unexplained fatigue
・Fever of unknown origin
・Tx
○Chemotherapy (will require additional tx after chemo)
○Radiation
○Surgery
○Supportive
