Briska Exam 3 Sememster 3 PArt 2

Vaccines

• Administration routes mainly include oral, with proper storage needed to maintain potency.
• Potency is sensitive to temperature variations.
• Common side effects include inflammation signs, such as redness, swelling, tenderness, fever (up to 105°F), irritability, shivering, fatigue, headaches, and muscle/joint pain.
• Reportable adverse reactions include:
  • Any fever in infants under 12 weeks
  • Fever over 104°F, lasting more than 3 days, or recurring after 24 hours
  • Widening redness, exceeding 3 inches or accompanied by red streaks
  • Total loss of function, anaphylactic symptoms, or prolonged inconsolable crying.

Normal and Abnormal Side Effects: MMR

• Delayed reactions for MMR and varicella: fever occurring 10-14 days post-vaccine, rash appearing 2-4 days later.

Contraindications

• Children with neomycin allergies should avoid IPV, MMR, Varicella, and certain flu vaccines.
• Egg allergies contraindicate MMR, Varicella, and influenza vaccines.
• Post-injection monitoring for 15-20 minutes with an EpiPen available.

Vaccine Schedules

• Hepatitis B: Given at birth, 1-2 months, and 6-18 months.
• Varicella: Administered at 12-15 months and 4-6 years.
• Respiratory Syncytial Virus: Given at birth - 6 months based on maternal immunity; possible from 8-19 months.
• Pneumococcal (PCV-13): Doses at 2, 4, 6, and 12-15 months, followed by PCV-23 in adulthood.
• Diphtheria, Tetanus, Pertussis: 2, 4, 6, 15-18 months, then again at 4-6 years and Tdap at 11 years, every 10 years thereafter.
• Haemophilus influenzae type b: 2, 4, 6, and 15-18 months.
• Inactivated Poliovirus: Administered at 2, 4, 6-18 months and again at 4-6 years.
• Measles, Mumps, Rubella (MMR): Given at 12-15 months and 4-6 years; may require a booster.
• Influenza: Administered at 6 months, followed by annual vaccinations.
• Rotavirus: Doses at 2, 4, and 6 months.
• Hepatitis A: Given to selected populations at 12 months, with adult booster.
• Meningococcal: Administered at 11 and 16 years.
• Human Papilloma Virus (HPV): Starting after 11 years, requires 2 doses < 5 months apart or 3 doses for those 15-26 years.

Medication Administration

• Pediatric dosages determined by weight (mg/kg) or body surface area charts.
• Administer oral medications using a dropper/syringe; avoid mixing with food.
• Older children should have a choice in medications with water/juice.
• Praise cooperation during administration of medications.

Ear, Eye, and Nose Drops Administration

• Ear Drops: Position appropriately and use correct pulling technique based on age; keep patient on their side post-administration.
• Eye Drops: Same procedure as adults, ensuring proper drop placement.
• Nose Drops: Child should be positioned with neck extended; hold for one minute post-administration.

Vital Signs

• Measurements performed in kg (2.2 lbs = 1 kg); height and weight are essential for medication dosing.
• Pulse, respiratory rate, and blood pressure readings vary by age group, with specific methods for measurement.
• Temperature routes depend on age and should be taken with considerations for proper technique.

Pain Assessment

• Pain is considered the sixth vital sign, with tools like the OUCHER scale and FLACC scale used to assess pain in children based on behavior and age and.
• Assessments should be age-appropriate, using verbalization for school-aged children and facial expressions for younger kids.

SIDS Prevention

• Key risk factors for Sudden Infant Death Syndrome includes prone sleeping position and sleeping with soft surfaces; recommendations advocate for a supine position until 6 months.

Separation Anxiety Stages

• With stages including protest, despair, and detachment, children may experience various emotional responses during hospitalization or loss.

Palliative Care

• Focuses on improving quality of life for children with serious conditions, addressing physical, psychosocial, or spiritual needs, and involves interdisciplinary collaboration.

Recognizing Child Abuse

• Require a thorough examination and detailed documentation of physical signs and observations of child-caregiver interactions.

Adolescent Safety Risks

• Leading causes of death in adolescents arise from risks related to violent behavior, substance use, and risky activities; psychological impacts are significant as well.

Therapeutic Play

• Used to assist children in processing their experiences and feelings regarding medical procedures, hence helping them express fears.

Communication with Families

• Encourage open discussions about feelings and provide reassurance regarding the child’s care and condition, addressing any fears or concerns.

Routine Health Screenings

• Recommended healthcare visits for infants to occur at least six times during the first year for monitoring and preventive care.### Well-Child Visits
• Scheduled at 2 weeks, 2 months, 4 months, 6 months, 9 months, and 12 months.
• Immunizations provided to prevent disease.
• Data collected on growth, development, nutrition, sleep, and caregiver relationships.
• Weight, height, and head circumference documented.
• Emphasis on reinforcing education for first-time caregivers.

Toddler Visits

• Health care provider (HCP) visits at 15 months for immunization boosters; annual visits thereafter.
• Routine physical assessments include growth, development, oral hygiene, and parenting skills.
• Effective information gathering involves family interviews and caregiver-toddler observation.
• Communicating with toddlers requires realistic options at their comprehension level.

Preschool Child Health

• Required immunization boosters for diphtheria-tetanus-pertussis, polio, MMR, and varicella vaccines between ages 4 and 6 years.
• Recommended screenings: urinalysis, hematocrit, lead level, tuberculin skin testing, and Denver Developmental Screening Test.
• Importance placed on vision and hearing assessments.
• Semiannual dental exams recommended.

School-Aged Child Health

• Annual physical examinations required.
• Additional visits for minor illnesses permitted.
• Twice-annual dental visits recommended for cleanings and fluoride applications.
• Immunization requirements enforced for school entry.
• Tdap booster recommended every 10 years; HPV vaccine suggested starting at age 9.

Adolescent Health Care

• Routine physical exams covering developmental milestones, school and behavioral problems, and immunizations.
• Discussion of infection risks related to body piercings and tattoos is essential.
• Dental checkups every 6 months and addressing dental malocclusions.
• Regular pelvic exams, Pap smears, and breast self-exam education for girls.
• Testicular self-examination education for boys is critical.
• Mental health assessments play a key role in overall health evaluations.

Advanced Directives in Pediatrics

• Advance directives can be predetermined by parents/legal guardians for children with terminal illnesses.
• Implementation in emergencies poses challenges if parents are not present.
• Clarity is needed to interpret directives in medical crises.

End-of-Life Care

• Support grieving families by sharing in their sorrow while providing privacy for expression.
• Use comforting language to acknowledge grieving processes.
• Administer pain medication intravenously due to poor absorption when circulation is compromised.
• Maintain cleanliness of mucous membranes and skin to prevent discomfort.
• Family education on changes that occur as death approaches helps manage expectations.

Urine Sample Collection

• U-Bag used for routine urine sampling from toilet-trained infants and toddlers; requires cleanliness and frequent checks.
• For non-toilet-trained children, sterile samples obtained via straight catheterization.

Hydration Importance

• Water constitutes approximately 77% of body weight at birth, reducing to about 60% by age 2.
• Rapid dehydration risks in children necessitate prompt hydration interventions.
• Severe fluid loss can occur from diarrhea, vomiting, or extensive burns.
• Electrolyte balance is vital to maintaining acid-base homeostasis. IV fluids are used when oral hydration isn’t adequate.

Vaccines

• Administration routes mainly include oral, with proper storage needed to maintain potency.
• Potency is sensitive to temperature variations.
• Common side effects include inflammation signs, such as redness, swelling, tenderness, fever (up to 105°F), irritability, shivering, fatigue, headaches, and muscle/joint pain.
• Reportable adverse reactions include:
  • Any fever in infants under 12 weeks
  • Fever over 104°F, lasting more than 3 days, or recurring after 24 hours
  • Widening redness, exceeding 3 inches or accompanied by red streaks
  • Total loss of function, anaphylactic symptoms, or prolonged inconsolable crying.

Normal and Abnormal Side Effects: MMR

• Delayed reactions for MMR and varicella: fever occurring 10-14 days post-vaccine, rash appearing 2-4 days later.

Contraindications

• Children with neomycin allergies should avoid IPV, MMR, Varicella, and certain flu vaccines.
• Egg allergies contraindicate MMR, Varicella, and influenza vaccines.
• Post-injection monitoring for 15-20 minutes with an EpiPen available.

Vaccine Schedules

• Hepatitis B: Given at birth, 1-2 months, and 6-18 months.
• Varicella: Administered at 12-15 months and 4-6 years.
• Respiratory Syncytial Virus: Given at birth - 6 months based on maternal immunity; possible from 8-19 months.
• Pneumococcal (PCV-13): Doses at 2, 4, 6, and 12-15 months, followed by PCV-23 in adulthood.
• Diphtheria, Tetanus, Pertussis: 2, 4, 6, 15-18 months, then again at 4-6 years and Tdap at 11 years, every 10 years thereafter.
• Haemophilus influenzae type b: 2, 4, 6, and 15-18 months.
• Inactivated Poliovirus: Administered at 2, 4, 6-18 months and again at 4-6 years.
• Measles, Mumps, Rubella (MMR): Given at 12-15 months and 4-6 years; may require a booster.
• Influenza: Administered at 6 months, followed by annual vaccinations.
• Rotavirus: Doses at 2, 4, and 6 months.
• Hepatitis A: Given to selected populations at 12 months, with adult booster.
• Meningococcal: Administered at 11 and 16 years.
• Human Papilloma Virus (HPV): Starting after 11 years, requires 2 doses < 5 months apart or 3 doses for those 15-26 years.

Medication Administration

• Pediatric dosages determined by weight (mg/kg) or body surface area charts.
• Administer oral medications using a dropper/syringe; avoid mixing with food.
• Older children should have a choice in medications with water/juice.
• Praise cooperation during administration of medications.

Ear, Eye, and Nose Drops Administration

• Ear Drops: Position appropriately and use correct pulling technique based on age; keep patient on their side post-administration.
• Eye Drops: Same procedure as adults, ensuring proper drop placement.
• Nose Drops: Child should be positioned with neck extended; hold for one minute post-administration.

Vital Signs

• Measurements performed in kg (2.2 lbs = 1 kg); height and weight are essential for medication dosing.
• Pulse, respiratory rate, and blood pressure readings vary by age group, with specific methods for measurement.
• Temperature routes depend on age and should be taken with considerations for proper technique.

Pain Assessment

• Pain is considered the sixth vital sign, with tools like the OUCHER scale and FLACC scale used to assess pain in children based on behavior and age and.
• Assessments should be age-appropriate, using verbalization for school-aged children and facial expressions for younger kids.

SIDS Prevention

• Key risk factors for Sudden Infant Death Syndrome includes prone sleeping position and sleeping with soft surfaces; recommendations advocate for a supine position until 6 months.

Separation Anxiety Stages

• With stages including protest, despair, and detachment, children may experience various emotional responses during hospitalization or loss.

Palliative Care

• Focuses on improving quality of life for children with serious conditions, addressing physical, psychosocial, or spiritual needs, and involves interdisciplinary collaboration.

Recognizing Child Abuse

• Require a thorough examination and detailed documentation of physical signs and observations of child-caregiver interactions.

Adolescent Safety Risks

• Leading causes of death in adolescents arise from risks related to violent behavior, substance use, and risky activities; psychological impacts are significant as well.

Therapeutic Play

• Used to assist children in processing their experiences and feelings regarding medical procedures, hence helping them express fears.

Communication with Families

• Encourage open discussions about feelings and provide reassurance regarding the child’s care and condition, addressing any fears or concerns.

Routine Health Screenings

• Recommended healthcare visits for infants to occur at least six times during the first year for monitoring and preventive care.### Well-Child Visits
• Scheduled at 2 weeks, 2 months, 4 months, 6 months, 9 months, and 12 months.
• Immunizations provided to prevent disease.
• Data collected on growth, development, nutrition, sleep, and caregiver relationships.
• Weight, height, and head circumference documented.
• Emphasis on reinforcing education for first-time caregivers.

Toddler Visits

• Health care provider (HCP) visits at 15 months for immunization boosters; annual visits thereafter.
• Routine physical assessments include growth, development, oral hygiene, and parenting skills.
• Effective information gathering involves family interviews and caregiver-toddler observation.
• Communicating with toddlers requires realistic options at their comprehension level.

Preschool Child Health

• Required immunization boosters for diphtheria-tetanus-pertussis, polio, MMR, and varicella vaccines between ages 4 and 6 years.
• Recommended screenings: urinalysis, hematocrit, lead level, tuberculin skin testing, and Denver Developmental Screening Test.
• Importance placed on vision and hearing assessments.
• Semiannual dental exams recommended.

School-Aged Child Health

• Annual physical examinations required.
• Additional visits for minor illnesses permitted.
• Twice-annual dental visits recommended for cleanings and fluoride applications.
• Immunization requirements enforced for school entry.
• Tdap booster recommended every 10 years; HPV vaccine suggested starting at age 9.

Adolescent Health Care

• Routine physical exams covering developmental milestones, school and behavioral problems, and immunizations.
• Discussion of infection risks related to body piercings and tattoos is essential.
• Dental checkups every 6 months and addressing dental malocclusions.
• Regular pelvic exams, Pap smears, and breast self-exam education for girls.
• Testicular self-examination education for boys is critical.
• Mental health assessments play a key role in overall health evaluations.

Advanced Directives in Pediatrics

• Advance directives can be predetermined by parents/legal guardians for children with terminal illnesses.
• Implementation in emergencies poses challenges if parents are not present.
• Clarity is needed to interpret directives in medical crises.

End-of-Life Care

• Support grieving families by sharing in their sorrow while providing privacy for expression.
• Use comforting language to acknowledge grieving processes.
• Administer pain medication intravenously due to poor absorption when circulation is compromised.
• Maintain cleanliness of mucous membranes and skin to prevent discomfort.
• Family education on changes that occur as death approaches helps manage expectations.

Urine Sample Collection

• U-Bag used for routine urine sampling from toilet-trained infants and toddlers; requires cleanliness and frequent checks.
• For non-toilet-trained children, sterile samples obtained via straight catheterization.

Hydration Importance

• Water constitutes approximately 77% of body weight at birth, reducing to about 60% by age 2.
• Rapid dehydration risks in children necessitate prompt hydration interventions.
• Severe fluid loss can occur from diarrhea, vomiting, or extensive burns.
• Electrolyte balance is vital to maintaining acid-base homeostasis. IV fluids are used when oral hydration isn’t adequate.

Vaccines

• Administration routes mainly include oral, with proper storage needed to maintain potency.
• Potency is sensitive to temperature variations.
• Common side effects include inflammation signs, such as redness, swelling, tenderness, fever (up to 105°F), irritability, shivering, fatigue, headaches, and muscle/joint pain.
• Reportable adverse reactions include:
  • Any fever in infants under 12 weeks
  • Fever over 104°F, lasting more than 3 days, or recurring after 24 hours
  • Widening redness, exceeding 3 inches or accompanied by red streaks
  • Total loss of function, anaphylactic symptoms, or prolonged inconsolable crying.

Normal and Abnormal Side Effects: MMR

• Delayed reactions for MMR and varicella: fever occurring 10-14 days post-vaccine, rash appearing 2-4 days later.

Contraindications

• Children with neomycin allergies should avoid IPV, MMR, Varicella, and certain flu vaccines.
• Egg allergies contraindicate MMR, Varicella, and influenza vaccines.
• Post-injection monitoring for 15-20 minutes with an EpiPen available.

Vaccine Schedules

• Hepatitis B: Given at birth, 1-2 months, and 6-18 months.
• Varicella: Administered at 12-15 months and 4-6 years.
• Respiratory Syncytial Virus: Given at birth - 6 months based on maternal immunity; possible from 8-19 months.
• Pneumococcal (PCV-13): Doses at 2, 4, 6, and 12-15 months, followed by PCV-23 in adulthood.
• Diphtheria, Tetanus, Pertussis: 2, 4, 6, 15-18 months, then again at 4-6 years and Tdap at 11 years, every 10 years thereafter.
• Haemophilus influenzae type b: 2, 4, 6, and 15-18 months.
• Inactivated Poliovirus: Administered at 2, 4, 6-18 months and again at 4-6 years.
• Measles, Mumps, Rubella (MMR): Given at 12-15 months and 4-6 years; may require a booster.
• Influenza: Administered at 6 months, followed by annual vaccinations.
• Rotavirus: Doses at 2, 4, and 6 months.
• Hepatitis A: Given to selected populations at 12 months, with adult booster.
• Meningococcal: Administered at 11 and 16 years.
• Human Papilloma Virus (HPV): Starting after 11 years, requires 2 doses < 5 months apart or 3 doses for those 15-26 years.

Medication Administration

• Pediatric dosages determined by weight (mg/kg) or body surface area charts.
• Administer oral medications using a dropper/syringe; avoid mixing with food.
• Older children should have a choice in medications with water/juice.
• Praise cooperation during administration of medications.

Ear, Eye, and Nose Drops Administration

• Ear Drops: Position appropriately and use correct pulling technique based on age; keep patient on their side post-administration.
• Eye Drops: Same procedure as adults, ensuring proper drop placement.
• Nose Drops: Child should be positioned with neck extended; hold for one minute post-administration.

Vital Signs

• Measurements performed in kg (2.2 lbs = 1 kg); height and weight are essential for medication dosing.
• Pulse, respiratory rate, and blood pressure readings vary by age group, with specific methods for measurement.
• Temperature routes depend on age and should be taken with considerations for proper technique.

Pain Assessment

• Pain is considered the sixth vital sign, with tools like the OUCHER scale and FLACC scale used to assess pain in children based on behavior and age and.
• Assessments should be age-appropriate, using verbalization for school-aged children and facial expressions for younger kids.

SIDS Prevention

• Key risk factors for Sudden Infant Death Syndrome includes prone sleeping position and sleeping with soft surfaces; recommendations advocate for a supine position until 6 months.

Separation Anxiety Stages

• With stages including protest, despair, and detachment, children may experience various emotional responses during hospitalization or loss.

Palliative Care

• Focuses on improving quality of life for children with serious conditions, addressing physical, psychosocial, or spiritual needs, and involves interdisciplinary collaboration.

Recognizing Child Abuse

• Require a thorough examination and detailed documentation of physical signs and observations of child-caregiver interactions.

Adolescent Safety Risks

• Leading causes of death in adolescents arise from risks related to violent behavior, substance use, and risky activities; psychological impacts are significant as well.

Therapeutic Play

• Used to assist children in processing their experiences and feelings regarding medical procedures, hence helping them express fears.

Communication with Families

• Encourage open discussions about feelings and provide reassurance regarding the child’s care and condition, addressing any fears or concerns.

Routine Health Screenings

• Recommended healthcare visits for infants to occur at least six times during the first year for monitoring and preventive care.### Well-Child Visits
• Scheduled at 2 weeks, 2 months, 4 months, 6 months, 9 months, and 12 months.
• Immunizations provided to prevent disease.
• Data collected on growth, development, nutrition, sleep, and caregiver relationships.
• Weight, height, and head circumference documented.
• Emphasis on reinforcing education for first-time caregivers.

Toddler Visits

• Health care provider (HCP) visits at 15 months for immunization boosters; annual visits thereafter.
• Routine physical assessments include growth, development, oral hygiene, and parenting skills.
• Effective information gathering involves family interviews and caregiver-toddler observation.
• Communicating with toddlers requires realistic options at their comprehension level.

Preschool Child Health

• Required immunization boosters for diphtheria-tetanus-pertussis, polio, MMR, and varicella vaccines between ages 4 and 6 years.
• Recommended screenings: urinalysis, hematocrit, lead level, tuberculin skin testing, and Denver Developmental Screening Test.
• Importance placed on vision and hearing assessments.
• Semiannual dental exams recommended.

School-Aged Child Health

• Annual physical examinations required.
• Additional visits for minor illnesses permitted.
• Twice-annual dental visits recommended for cleanings and fluoride applications.
• Immunization requirements enforced for school entry.
• Tdap booster recommended every 10 years; HPV vaccine suggested starting at age 9.

Adolescent Health Care

• Routine physical exams covering developmental milestones, school and behavioral problems, and immunizations.
• Discussion of infection risks related to body piercings and tattoos is essential.
• Dental checkups every 6 months and addressing dental malocclusions.
• Regular pelvic exams, Pap smears, and breast self-exam education for girls.
• Testicular self-examination education for boys is critical.
• Mental health assessments play a key role in overall health evaluations.

Advanced Directives in Pediatrics

• Advance directives can be predetermined by parents/legal guardians for children with terminal illnesses.
• Implementation in emergencies poses challenges if parents are not present.
• Clarity is needed to interpret directives in medical crises.

End-of-Life Care

• Support grieving families by sharing in their sorrow while providing privacy for expression.
• Use comforting language to acknowledge grieving processes.
• Administer pain medication intravenously due to poor absorption when circulation is compromised.
• Maintain cleanliness of mucous membranes and skin to prevent discomfort.
• Family education on changes that occur as death approaches helps manage expectations.

Urine Sample Collection

• U-Bag used for routine urine sampling from toilet-trained infants and toddlers; requires cleanliness and frequent checks.
• For non-toilet-trained children, sterile samples obtained via straight catheterization.

Hydration Importance

• Water constitutes approximately 77% of body weight at birth, reducing to about 60% by age 2.
• Rapid dehydration risks in children necessitate prompt hydration interventions.
• Severe fluid loss can occur from diarrhea, vomiting, or extensive burns.
• Electrolyte balance is vital to maintaining acid-base homeostasis. IV fluids are used when oral hydration isn’t adequate.