PEDS final: Fever

Card Set Information

Author:
choward04
ID:
213935
Filename:
PEDS final: Fever
Updated:
2013-04-16 17:52:56
Tags:
Ped
Folders:

Description:
Peds
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user choward04 on FreezingBlue Flashcards. What would you like to do?


  1. Define fever of unknown origin (FUO)
    • -documented fever >2-3weeks with outpatient visits and studies
    • -No etiology after 1 week of eval in hospital
  2. How is heat produced in the body?
    • -With illness, pathogens release endogenous pyrogens that reset the hypothalamic center
    • OR
    • -increased cellular metabolism, involuntary shaking, thermo response, auto response like vasoconstriction, exercise, behavioral responses
  3. When is the body temperature the lowest/highest?
    • lowest--> 2-6AM
    • highest--> 5-6pm

    -mild increase of 1-1.5 degrees F can be caused by exercise, excess clothing, hot bath, weather, hot car
  4. When is an oral temp appropriate in kids?
    3-4yo
  5. Every increase in degree of temp causes what increase in HR and RR?
    • -HR 10-15 beats/min
    • -RR 3-5 breaths/min
  6. What are the 2 most common bacterial cause of fever in <2mo?
    • 1. GBS
    • 2. E. coli
  7. What bacteria are most common sources of fever in >2mo? KNOW
    • 1. S. pneumoniae
    • 2. GBS
    • 3. N. meningitidis
    • 4. H. Flu
  8. List 5 acceptable sources of fever.
    • 1. Croup (known viral w/ high fever, barky cough)
    • 2. Roseola (viral <18mo, low temp & papular rash)
    • 3. Stomatitis (certain seasons- coxsackie pharyngitis)
    • 4. Otitis media (although not all have fever)
  9. What should you consider with "prolonged" fever?
    • -Unusual infectious disease (kawasaki)
    • -Collagen vascular disease
    • -malignancies
    • -munchausen dx
  10. What determines a toxic appearing child?
    • -lethargy
    • -pale
    • -rash (petechia over several surfaces)
    • -Increased RR
    • -irratible
  11. What are the 6 parts of the Acute Illness Observation Scale?
    • 1. Quality of cry
    • 2. Responsiveness to cuddling
    • 3. Alertness
    • 4. Interactive for age
    • 5. Color
    • 6. Hydration
  12. What is the most common serious bacterial infection seen in febrile infants?
    UTI
  13. T or F.  All febrile (T-100.4) children <28 days should be admitted to the hospital.
    True
  14. T or F.  Infants 4-8 weeks with bronchiolitis/influenza who are well-appearing should undergo limited lab eval.
    True: if CBC/UA are benign and culture pending
  15. What are the parts of a full sepsis workup? (4)
    • 1. CBC, blood cx
    • 2. UA, urine cx
    • 3. CSF cx
    • 4. Empiric antibiotic therapy
  16. T or F.  Most febrile infants 4-8 weeks "who present to the ER" warranta  full eval for SBI.
    T because cannot ensure adequate f/u and threshold for LP should be low
  17. What are the criteria for observing a child 8-12weeks with no treatment? (5)
    • 1. WBC 5-15,000
    • 2. Bands <20%
    • 3. ANC >1000
    • 4. U/A <5 WBC
    • 5. Stool <5 WBC (if diarrhea present)
  18. What is the ceftriaxone dose for kids 8-12weeks with sepsis?
    • -50mg/kg
    • --> meningitic dose is 100mg/kg
  19. What should you consider in a kid 8-12 weeks with a fever, source?
    • -UTI
    • -Pneumonia
    • -bone or joint
  20. T or F.  No lab test or antibx if fever w/out a source is < 102.2 in infants 3-36ml
    True, prescribe antipyretics and return if fever persists >48hrs
  21. In kids 3-36mo with T>102.2 (39C), what should you consider?
    • -occult bacteremia
    • -occult UTI
    • -occult pneumonia
  22. T or F.  All childen <1 year should be evaluated for occult UTI if T >102.2 between 3 to 36mo?
    • FALSE--> all children < 6mo
    • -Uncircumcised boys < 1yo
    • -Girls <24 mo if 1 or more risk factors (fever >2days, <12mo, white, no alternative source)
  23. What is Brudzinski's sign?
    -Supine--> head is lifted toward sternum and (+) if patients resist head lift or flex hips/kneeds
  24. What is Kernig's sign?
    -(+) if pain and reflex contraction in hamstring muscles when attempting to extend leg after flexin the thigh upon the body
  25. When should a child with fever be seen immediately?
    • -Child <3mo
    • ->104
    • -crying inconsolably
    • -cries when moved or touched
    • -difficult to awaken
    • -stiff neck
    • -petechia on skin
    • -difficulty breathing
    • -drooling and unable to swallow
    • -seizure has occured
    • -child acts or looks sick
  26. What is the tylenol and motrin dose for fever?
    Tylenol--> 10-15mg/kg dose q 4-6hr if >102 or pain

    Motrin--> 5-10mg/kg dose q 6-8hr

    **can also add sponging w/ luke warm water & increase fluid intake

What would you like to do?

Home > Flashcards > Print Preview