kupdf.net_pediatrics-notes2.pdf - Peds Rotations Questions from Chris H NORMAL LITTLE BUGGER STUFF PROTECTING THE LITTLE BUGGERS 1 Sleep a When is a

kupdf.net_pediatrics-notes2.pdf - Peds Rotations Questions...

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Peds RotationsQuestionsfrom Chris H_ NORMAL LITTLE BUGGER STUFF1.Sleepa.When is a baby going to sleep all night? 6 months1)total sleep =14 hrs2)longest sleep period 10-11 hrs3)# of naps = 24)no longer need to be fed @ nightb.Sleep position? “Back to Sleep” prevents SIDS2.Feedinga.Don’t give solid food until > 4 mo (need good head support)3.Crying:a.Colic1)Periods of unexplained crying and irritability2)10-20% of children3)“Rule of 3’s”a)3 hours of crying (@ same time of day; usu afternoon orevening)b)3 days a weekc)begins in 1st3 weeks of lifed)improves by 3 mo of ageb.Normal crying1)@ 2 wk 1 _ hrs / d2)@ 6 wk 2 _ hrs / d3)@ 8 wk PEAKS4)@ 12 wk 1 hr / dc.Differentials1)Idiopathic2)Colic3)Heat / cold4)Lying position5)Illness4.Temper Tantrumsa.Ignore themb.Separate from situation or other children5.Short staturea.Constitutional short stature1)NOT A DISEASE! Normal variation…2)Characteristics:a)Fhx of delayed pubertyb)Delayed dentition in ptc)Delayed bone age c normal growth rated)Most will have catch-up growth nl final height3)W/u:a)Plot on growth curveb)Look @ parentsc)Bone age studyb.Familial short stature1)Height below nl on growth chart2)Bone age accurate6.Development_ PROTECTING THE LITTLE BUGGERS7.Vaccinesa.Contraindications & Precautions1)Contraindic to Live: Allergy, ImmSupp, Uterine Preg2)Contraindic to Inactiv: ALlergy, Encephalitis)3)Precaution to either: Illnessb.ImmComp pts:1)NO - OPV, VZV2)OK – DPT, MMR?c.Pertussis contraindications: Previous vaccine T>103º F,adverse rxn, collapse synd, encephalopathy after 1st7 days, seizure1)zIf fever < 103 DaPT8.Abusea.Si/Sx of Shaken Baby Syndrome:1)retinal hemorrhage2)subdural hematoma3)burns: donut butt, stocking & gloves, cigsb.Ecchymosis DDx1)Over buttocksa)Henoch-Schonlein purpura (Anaphylactoid purpura)(i)Peaks in winter months(ii)May follow viral / bacterial infection9.Safetya.Carseat1)Face back of car (since infant head control is weak & head islarge for body)2)1 yo or > 20 lbsFace forward3)4 yo or 40 lbs Booster seat4)6 yo Booster seat5)8 yo legally don’t need booster seat10.Poisoninga.Most common lethal ingestion1)Fe (#1 cause of OD death)2)TCA3)Cardiac medsb.Ipecac1)Use with large pills2)DO NOT use with3)May be used @ home w/in 1 hour of ingestion4)Causes emesis in 20 min5)30% of toxin remain in gut even if given w/in _ hr of ingestion6)Dosea)6 mo 5 mLb)1 y 15 mLc)> 1 y 30 mLc.Gastric Lavaged.Activated charcoal1)1 gm per kg2)does not work for Fe, Lithium, CN, etoh, acids and alkalie.Radiopaque substances on KUB – “CHIPPED”1)Chloral hydrate, Ca++ carbonate2)Heavy metals
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  • CHRIS H

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