NURS 5434 Family III Comprehensive Resource To Help You Ace 2026-2027 Exams Includes
Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!! Current Update!!
every year in children 3 and older
BP screening in children every visit in children 3 and older with risk factors (obesity,
renal disease, diabetes, etc)
Elevated BP - lifestyle recommendations and then BP
recheck in 6 months, then 6 months later
Stage 1 HTN - if pt is asymptomatic, lifestyle mods and
initial management of HTN in children
recheck in 1-2 weeks, then 3 months later
Stage 2 HTN - check upper and lower extremity pressure
and recheck in 1 week, refer to specialist within 1 week
auscultatory BP is over 95th percentile on 3 separate visits,
diagnosing pediatric HTN
to confirm - ambulatory BP monitoring
elevated BP - >/= 90-95th percentile OR 120/80-95th per-
centile
HTN in age < 13 yo Stage 1 - >/= 95th percentile to <90th + 12mmHg OR
130/80 to 139/89
Stage 2 - >/= 95th percentile + 12mmHg OR >/= 140/90
Elevated - 120/<80 to 129/<80
HTN in age >13 yo Stage 1 - 130/80-139/89
Stage 2 - >/= 140/90
cutt should be 40% of arm circumference and bladder
determining cutt size in peds
80-100% of arm circumference
ACEIs
ARBs
approved meds for pediatric HTN
CCBs
Thiazide diuretics
symptomatic HTN
when is an echo needed in pediatric HTN? stage 2 HTN with modifiable risk factor (like obesity)
LVH
, HTN with CKD or DM
persistent HTN despite lifestyle modifications
adolescents primary cause: obesity
most common cause of HTN in adolescents and <13 yo younger primary cause: secondary causes, often renal
disease
renal parenchymal disease
rheumatologic disorder
renal artery stenosis
obstructive sleep apnea
secondary causes of HTN in pediatrics mineralocorticoid excess
hyperthyroidism
coarctation of aorta
cushings disease
drugs (steroids, cocaine, meth, OCPs, catteine, diet pills)
all patients:
- urinalysis
- chemistry panel (electrolytes, BUN, Cr)
- lipid profile
- renal ultrasound in <6 yo or with abnormal urinalysis or
renal function
obese pts:
diagnostic tests for pediatric HTN pts - HbgA1c
- renal function tests
- fasting lipid panel
optional:
- sleep study
- drug screen
- fasting glucose
- TSH
Treatment of Pediatric HTN
,1. lifestyle modifications - 30-60 min moderate to vigorous
activity 3-5 days/week, DASH diet, stress reduction, sleep
intervention, family based intervention
2. pharmacologic - ACEI or ARB first may be best, CCBs
or HCTZ for females at risk of pregnancy, start low and
titrate q2-4 weeks, may add a 2nd med if goal not achieved
@max dose of monotherapy
stage 2 HTN without known cause or when symptomatic
stage 1 HTN that persists after 6 months of lifestyle mod-
when to start meds in pediatric HTN ifications
Any HTN with diabetes, CKD, or TOD (LVH on echo, retinal
changes, microalbuminuria)
Stage 2 HTN at diagnosis
Evidence of target organ damage (LVH, retinopathy, pro-
teinuria)
when to refer pediatric HTN to specialist
Age <6 years with HTN (high chance secondary)
No improvement on 2-3 meds
Suspected secondary cause
Excessive anxiety & worry about multiple events or activi-
ties for 6e months, diflcult to control
Associated with 3e (only 1 needed for kids):
Restlessness
diagnostic criteria for anxiety
Easily fatigued
Diflculty concentrating
Irritability
Muscle tension
Sleep disturbance
diagnostic criteria for depression
, 5 or more of the following symptoms including depressed
mood OR loss of interest/pleasure (anhedonia)
- depressed mood
- anhedonia
- weight/appetite change
- sleep disturbance, insomnia, hypersomnia
- psychomotor changes
- fatigue/loss of energy
- poor concentration
- feelings of worthlessness or guilt
- suicidal thoughts
"SIG E CAPS"
sleep, interest, guilt, energy, concentration, appetite, psy-
chomotor sx, suicidal
Recurrent, unexpected panic attacks (abrupt surge of in-
tense fear / discomfort peaking within minutes), plus 4e
symptoms:
Palpitations, sweating, trembling, SOB, choking, chest
pain, nausea, dizzy, chills/hot, paresthesia, derealization,
diagnostic criteria for panic disorder
fear of losing control or dying.
Followed by 1e month of:
Persistent worry about more attacks or consequences
Maladaptive behavior changes (avoiding exercise, unfa-
miliar situations)
SSRIs (sertraline, escitalopram, fluoxetine); also SNRIs
first line treatment for depression
(venlafaxine, duloxetine)
SSRIs (escitalopram, paroxetine), SNRIs (venlafaxine XR);
first line treatment for anxiety
buspirone sometimes used
Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!! Current Update!!
every year in children 3 and older
BP screening in children every visit in children 3 and older with risk factors (obesity,
renal disease, diabetes, etc)
Elevated BP - lifestyle recommendations and then BP
recheck in 6 months, then 6 months later
Stage 1 HTN - if pt is asymptomatic, lifestyle mods and
initial management of HTN in children
recheck in 1-2 weeks, then 3 months later
Stage 2 HTN - check upper and lower extremity pressure
and recheck in 1 week, refer to specialist within 1 week
auscultatory BP is over 95th percentile on 3 separate visits,
diagnosing pediatric HTN
to confirm - ambulatory BP monitoring
elevated BP - >/= 90-95th percentile OR 120/80-95th per-
centile
HTN in age < 13 yo Stage 1 - >/= 95th percentile to <90th + 12mmHg OR
130/80 to 139/89
Stage 2 - >/= 95th percentile + 12mmHg OR >/= 140/90
Elevated - 120/<80 to 129/<80
HTN in age >13 yo Stage 1 - 130/80-139/89
Stage 2 - >/= 140/90
cutt should be 40% of arm circumference and bladder
determining cutt size in peds
80-100% of arm circumference
ACEIs
ARBs
approved meds for pediatric HTN
CCBs
Thiazide diuretics
symptomatic HTN
when is an echo needed in pediatric HTN? stage 2 HTN with modifiable risk factor (like obesity)
LVH
, HTN with CKD or DM
persistent HTN despite lifestyle modifications
adolescents primary cause: obesity
most common cause of HTN in adolescents and <13 yo younger primary cause: secondary causes, often renal
disease
renal parenchymal disease
rheumatologic disorder
renal artery stenosis
obstructive sleep apnea
secondary causes of HTN in pediatrics mineralocorticoid excess
hyperthyroidism
coarctation of aorta
cushings disease
drugs (steroids, cocaine, meth, OCPs, catteine, diet pills)
all patients:
- urinalysis
- chemistry panel (electrolytes, BUN, Cr)
- lipid profile
- renal ultrasound in <6 yo or with abnormal urinalysis or
renal function
obese pts:
diagnostic tests for pediatric HTN pts - HbgA1c
- renal function tests
- fasting lipid panel
optional:
- sleep study
- drug screen
- fasting glucose
- TSH
Treatment of Pediatric HTN
,1. lifestyle modifications - 30-60 min moderate to vigorous
activity 3-5 days/week, DASH diet, stress reduction, sleep
intervention, family based intervention
2. pharmacologic - ACEI or ARB first may be best, CCBs
or HCTZ for females at risk of pregnancy, start low and
titrate q2-4 weeks, may add a 2nd med if goal not achieved
@max dose of monotherapy
stage 2 HTN without known cause or when symptomatic
stage 1 HTN that persists after 6 months of lifestyle mod-
when to start meds in pediatric HTN ifications
Any HTN with diabetes, CKD, or TOD (LVH on echo, retinal
changes, microalbuminuria)
Stage 2 HTN at diagnosis
Evidence of target organ damage (LVH, retinopathy, pro-
teinuria)
when to refer pediatric HTN to specialist
Age <6 years with HTN (high chance secondary)
No improvement on 2-3 meds
Suspected secondary cause
Excessive anxiety & worry about multiple events or activi-
ties for 6e months, diflcult to control
Associated with 3e (only 1 needed for kids):
Restlessness
diagnostic criteria for anxiety
Easily fatigued
Diflculty concentrating
Irritability
Muscle tension
Sleep disturbance
diagnostic criteria for depression
, 5 or more of the following symptoms including depressed
mood OR loss of interest/pleasure (anhedonia)
- depressed mood
- anhedonia
- weight/appetite change
- sleep disturbance, insomnia, hypersomnia
- psychomotor changes
- fatigue/loss of energy
- poor concentration
- feelings of worthlessness or guilt
- suicidal thoughts
"SIG E CAPS"
sleep, interest, guilt, energy, concentration, appetite, psy-
chomotor sx, suicidal
Recurrent, unexpected panic attacks (abrupt surge of in-
tense fear / discomfort peaking within minutes), plus 4e
symptoms:
Palpitations, sweating, trembling, SOB, choking, chest
pain, nausea, dizzy, chills/hot, paresthesia, derealization,
diagnostic criteria for panic disorder
fear of losing control or dying.
Followed by 1e month of:
Persistent worry about more attacks or consequences
Maladaptive behavior changes (avoiding exercise, unfa-
miliar situations)
SSRIs (sertraline, escitalopram, fluoxetine); also SNRIs
first line treatment for depression
(venlafaxine, duloxetine)
SSRIs (escitalopram, paroxetine), SNRIs (venlafaxine XR);
first line treatment for anxiety
buspirone sometimes used
