NUR 425: Pediatric Exam 1 Review UPDATED ACTUAL Questions and
CORRECT Answers
Why its given: Palivizumab (synagis) Prevents respiratory syncytial virus (RSV)
vaccine
Age recommendation: Palivizumab IM as needed for chronically ill infants and preemies
(synagis) vaccine
Why its given: DTaP vaccine prevents pertussis*, diphtheria, tetanus
Age recommendation: DTaP vaccine 2,4,6,15-18 months
Why its given: H. influenza type B (Hib B) prevent H. influenzae type B (Hib), epiglottitis
vaccine
Age recommendation: H. influenza type B 2,4,6,12-15 months
(Hib B) vaccine
-Decreased gastric acid secretion
-Irregular gastric emptying
Infant physiological differences: absorption
-Increased intestinal motility
-Frequent feedings
-Limited binding of drugs to plasma protein due to low albumin
Infant physiological differences:
-Blood-Brain barrier not fully developed until 1 y/o
distribution
-Infants total body water is 80% compared to adult of 50%
Infant physiological differences: Enzymes in liver to metabolize drugs are immature, drugs cant be broken down
metabolism
-Immature renal function requires smaller doses of drugs primarily excreted by the
Infant physiological differences: excretion kidneys
-Depends on if they are water soluble
Child physiological difference: absorption Gastric pH equal to an adult by 2-3 years
-Plasma protein levels at adult levels by age 1
Child physiological difference: distribution
-Skin and blood-brain barrier more effective
, Child physiological difference: metabolism Decreased BMR after age 2, results in lowered effects of drugs
Child physiological difference: excretion Adult levels of renal function are reached by age 2
Pediatric medication considerations: medication for kids are weight based
medication dosage
-Children (3 years and less)
Pediatric medication considerations: otic
-Pull pinna down/back
administration
-Massage the ear to make sure medication reaches the canal
Adult medication considerations: otic Pull pinna up/back
administration
-Drop in inner canthus when eyes are closed and then massage inner canthus to
Pediatric medication considerations: eye
prevent medicine from entering lacrimal ducts and going into the nasopharynx
administration
-Can prevent unpleasant taste
Pediatric medication considerations: rectal -½ - 1 inch past the sphincter and hold buttocks together for 5-10 minutes
administration -Cut suppository lengthwise if necessary
Pediatric medication considerations: IM -Vastus lateralis up to 2 mL
administration -Deltoids up to 1 mL
-Supine
Pediatric medication considerations: IM
-Side-lying
positioning
-sitting
PO pediatric medication considerations most preferred because it is the least traumatic
benefits
-crushed up meds via syringe on side of the mouth
Pediatric medication considerations: PO
-Stroke cheek afterwards to promote swallowing reflex
administration
-Squeeze cheeks to promote swallowing
Pediatric medication considerations: PO -upright
positioning -feeding position
-Climber cribs
Interventions to prevent falls in the -Vail beds
pediatric population -Infant cribs
*Remember to always have side rails up
-Helps identify children's risk of falling
Humpty Dumpty Scale -Minimum score is a 7
-Score of 12+ is at risk for falls
-Less than 3 years old
-Males more likely to fall
-Containing a neurological diagnosis, alterations in oxygen, psych/behavior
disorders
-Unoriented to own ability
Humpty Dumpty Scale: Increase risk of fall
-History of fall
-Using assistive devices
-In bed are more likely to fall
-Outpatient area
-Sedation within 24-48 hrs
CORRECT Answers
Why its given: Palivizumab (synagis) Prevents respiratory syncytial virus (RSV)
vaccine
Age recommendation: Palivizumab IM as needed for chronically ill infants and preemies
(synagis) vaccine
Why its given: DTaP vaccine prevents pertussis*, diphtheria, tetanus
Age recommendation: DTaP vaccine 2,4,6,15-18 months
Why its given: H. influenza type B (Hib B) prevent H. influenzae type B (Hib), epiglottitis
vaccine
Age recommendation: H. influenza type B 2,4,6,12-15 months
(Hib B) vaccine
-Decreased gastric acid secretion
-Irregular gastric emptying
Infant physiological differences: absorption
-Increased intestinal motility
-Frequent feedings
-Limited binding of drugs to plasma protein due to low albumin
Infant physiological differences:
-Blood-Brain barrier not fully developed until 1 y/o
distribution
-Infants total body water is 80% compared to adult of 50%
Infant physiological differences: Enzymes in liver to metabolize drugs are immature, drugs cant be broken down
metabolism
-Immature renal function requires smaller doses of drugs primarily excreted by the
Infant physiological differences: excretion kidneys
-Depends on if they are water soluble
Child physiological difference: absorption Gastric pH equal to an adult by 2-3 years
-Plasma protein levels at adult levels by age 1
Child physiological difference: distribution
-Skin and blood-brain barrier more effective
, Child physiological difference: metabolism Decreased BMR after age 2, results in lowered effects of drugs
Child physiological difference: excretion Adult levels of renal function are reached by age 2
Pediatric medication considerations: medication for kids are weight based
medication dosage
-Children (3 years and less)
Pediatric medication considerations: otic
-Pull pinna down/back
administration
-Massage the ear to make sure medication reaches the canal
Adult medication considerations: otic Pull pinna up/back
administration
-Drop in inner canthus when eyes are closed and then massage inner canthus to
Pediatric medication considerations: eye
prevent medicine from entering lacrimal ducts and going into the nasopharynx
administration
-Can prevent unpleasant taste
Pediatric medication considerations: rectal -½ - 1 inch past the sphincter and hold buttocks together for 5-10 minutes
administration -Cut suppository lengthwise if necessary
Pediatric medication considerations: IM -Vastus lateralis up to 2 mL
administration -Deltoids up to 1 mL
-Supine
Pediatric medication considerations: IM
-Side-lying
positioning
-sitting
PO pediatric medication considerations most preferred because it is the least traumatic
benefits
-crushed up meds via syringe on side of the mouth
Pediatric medication considerations: PO
-Stroke cheek afterwards to promote swallowing reflex
administration
-Squeeze cheeks to promote swallowing
Pediatric medication considerations: PO -upright
positioning -feeding position
-Climber cribs
Interventions to prevent falls in the -Vail beds
pediatric population -Infant cribs
*Remember to always have side rails up
-Helps identify children's risk of falling
Humpty Dumpty Scale -Minimum score is a 7
-Score of 12+ is at risk for falls
-Less than 3 years old
-Males more likely to fall
-Containing a neurological diagnosis, alterations in oxygen, psych/behavior
disorders
-Unoriented to own ability
Humpty Dumpty Scale: Increase risk of fall
-History of fall
-Using assistive devices
-In bed are more likely to fall
-Outpatient area
-Sedation within 24-48 hrs
