CMN568 FINAL EXAM LATEST WITH ACTUAL
QUESTIONS AND CORRECT VERIFIED ANSWERS
ALREADY GRADED A+ 100% GUARANTEED PASS
Incidence of Fever - (answers)One of most common reasons for parents to seek medical care.
Preschoolers have an average 6-8 febrile illnesses a year.
Definition of fever - (answers)Rectal temperature ≥ 100.4°F
Tympanic temperature - (answers)Not accurate in infants under 3 months
Fever Causes - (answers)Most common Benign viral illness, can also caused by bacterial or
fungal infections, drug reactions including immunizations, malignancies, autoimmune or
metabolic disorders, CNS disorders, excessive environmental temperatures.
Factors that increase likelihood of serious bacterial illness - (answers)Age under 3 months,
history of prematurity, chronic medical conditions such as immunosupression or aspenia,
previous hospitalizations, daycare. Toxic appearance
Non-Toxic appearance - (answers)Strong cry
Consolable
Alert and easy to arouse
Pink skin tones
Good hydration; good turgor, tears, moist mucous membranes
Smiles, responsive to environment
Toxic appearance - (answers)Weak or high pitched cry
Inconsolable
,Difficult to arouse
Pale, ashen, cyanotic, or mottled skin tones
Poor hydration; poor turgor, dry mucous membranes, no tears
No smile, listless, dull, infant won't alert to environment
Signs of serious illness - (answers)Fever greater than 40 (105)
Nuchal rigidity
Petechial skin rash
Seizure activity
Stridor or increased WOB
Physical exam signs of serious infection: Skin - (answers)Petechiae, rashes
Physical exam signs of serious infection: head/neck - (answers)Sunken or bulging fontanelles,
nuchal rigidity
Physical exam signs of serious infection: ears - (answers)Bulging TM, AOM, mastoiditis
Physical exam signs of serious infection: Chest - (answers)Tachypnea, wheezing, rales, rhonchi
Physical exam signs of serious infection: Heart - (answers)Murmurs
Physical exam signs of serious infection: Abdomen - (answers)Tenderness, distension
Physical exam signs of serious infection: Musculoskeletal - (answers)Refusal to bear weight or
use an extremity, erythema/warmth over joint
,Diagnostic tests for fever in infant and young child - (answers)CBC w/ Diff (WBC > 15,000
may indicate SBI. Child with overwhelming sepsis my have WBC <5,000)
UA/ C&S: R/O UTI
CXR: R/O Pneumonia
Lumbar Puncture: R/O meningitis
Blood cultures: R/O Bacteremia
Stools for C&S: R/O Infectious diarrhea
Management of fever in infant < 4 weeks - (answers)Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
Management of fever in infant 4 weeks - 3Mo - (answers)Toxic appearance:
Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
Non-Toxic appearance/No risk factors for SBI:
Full septic workup
Specific treatment for any diagnosed conditions
Empiric antibiotics after cultures: Rocephin 50mg/kg/day (up to 1 gm max)
Must have reliable caregiver with phone and transportation
Close followup in 24 hours
, Management of fever in 3Mo to Preschool - (answers)Toxic appearance:
Septic work up
Consider hospitalization and IV antibiotics, especially if no focal source of fever can be
identified
Non-Toxic appearance:
Lab work up guided by H&P
CBC with Diff
CXR if cough or dyspnea
Stool C&S if diarrhea
UA: all girls under 2yo, all males under 6Mo, uncircumcised males under 12Mo
Non-Toxic appearance:
Fever <39 (102) no obvious source: Antipyretics, close followup by visit or phone
Fever >39 (102) antipyretics, consider empiric antibiotics, close followup by visit or phone
Antipyretic - (answers)Acetaminophen: 10-15mg/kg Q 4-6 Hrs (Max 5 doses in 24 hours)
Ibuprofen: 5-10mg/kg Q 6-8hrs (max 40mg/kg/day)
Never use aspirin
Educate parents on risk of overdosing and review concentration information.
Fever-Home Care - (answers)Increased fluids to maintain hydration
Light clothing/blankets to help reduce fever
Tepid sponge baths if fever unresponsive to antipyretics
No alcohol or cold water baths
Parents should check every 4 hours for: Temp, activity level, fluid intake and report any change
in condition to medical provider
QUESTIONS AND CORRECT VERIFIED ANSWERS
ALREADY GRADED A+ 100% GUARANTEED PASS
Incidence of Fever - (answers)One of most common reasons for parents to seek medical care.
Preschoolers have an average 6-8 febrile illnesses a year.
Definition of fever - (answers)Rectal temperature ≥ 100.4°F
Tympanic temperature - (answers)Not accurate in infants under 3 months
Fever Causes - (answers)Most common Benign viral illness, can also caused by bacterial or
fungal infections, drug reactions including immunizations, malignancies, autoimmune or
metabolic disorders, CNS disorders, excessive environmental temperatures.
Factors that increase likelihood of serious bacterial illness - (answers)Age under 3 months,
history of prematurity, chronic medical conditions such as immunosupression or aspenia,
previous hospitalizations, daycare. Toxic appearance
Non-Toxic appearance - (answers)Strong cry
Consolable
Alert and easy to arouse
Pink skin tones
Good hydration; good turgor, tears, moist mucous membranes
Smiles, responsive to environment
Toxic appearance - (answers)Weak or high pitched cry
Inconsolable
,Difficult to arouse
Pale, ashen, cyanotic, or mottled skin tones
Poor hydration; poor turgor, dry mucous membranes, no tears
No smile, listless, dull, infant won't alert to environment
Signs of serious illness - (answers)Fever greater than 40 (105)
Nuchal rigidity
Petechial skin rash
Seizure activity
Stridor or increased WOB
Physical exam signs of serious infection: Skin - (answers)Petechiae, rashes
Physical exam signs of serious infection: head/neck - (answers)Sunken or bulging fontanelles,
nuchal rigidity
Physical exam signs of serious infection: ears - (answers)Bulging TM, AOM, mastoiditis
Physical exam signs of serious infection: Chest - (answers)Tachypnea, wheezing, rales, rhonchi
Physical exam signs of serious infection: Heart - (answers)Murmurs
Physical exam signs of serious infection: Abdomen - (answers)Tenderness, distension
Physical exam signs of serious infection: Musculoskeletal - (answers)Refusal to bear weight or
use an extremity, erythema/warmth over joint
,Diagnostic tests for fever in infant and young child - (answers)CBC w/ Diff (WBC > 15,000
may indicate SBI. Child with overwhelming sepsis my have WBC <5,000)
UA/ C&S: R/O UTI
CXR: R/O Pneumonia
Lumbar Puncture: R/O meningitis
Blood cultures: R/O Bacteremia
Stools for C&S: R/O Infectious diarrhea
Management of fever in infant < 4 weeks - (answers)Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
Management of fever in infant 4 weeks - 3Mo - (answers)Toxic appearance:
Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
Non-Toxic appearance/No risk factors for SBI:
Full septic workup
Specific treatment for any diagnosed conditions
Empiric antibiotics after cultures: Rocephin 50mg/kg/day (up to 1 gm max)
Must have reliable caregiver with phone and transportation
Close followup in 24 hours
, Management of fever in 3Mo to Preschool - (answers)Toxic appearance:
Septic work up
Consider hospitalization and IV antibiotics, especially if no focal source of fever can be
identified
Non-Toxic appearance:
Lab work up guided by H&P
CBC with Diff
CXR if cough or dyspnea
Stool C&S if diarrhea
UA: all girls under 2yo, all males under 6Mo, uncircumcised males under 12Mo
Non-Toxic appearance:
Fever <39 (102) no obvious source: Antipyretics, close followup by visit or phone
Fever >39 (102) antipyretics, consider empiric antibiotics, close followup by visit or phone
Antipyretic - (answers)Acetaminophen: 10-15mg/kg Q 4-6 Hrs (Max 5 doses in 24 hours)
Ibuprofen: 5-10mg/kg Q 6-8hrs (max 40mg/kg/day)
Never use aspirin
Educate parents on risk of overdosing and review concentration information.
Fever-Home Care - (answers)Increased fluids to maintain hydration
Light clothing/blankets to help reduce fever
Tepid sponge baths if fever unresponsive to antipyretics
No alcohol or cold water baths
Parents should check every 4 hours for: Temp, activity level, fluid intake and report any change
in condition to medical provider
