Term
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Definition
found in more than 600 products
pain relievers, fever reducers, sleep aids, cough, cold, and allergy medications
may appear on package as: acetaminophen, acetam, APAP
liquid tylenol concentration:
now 160mg/5mL or 32mg/mL
old concentration was 80mg/0.8mL (100mg/mL)
recommended maximum dose:
now 3,000 mg/day
old max dose was 4,000 mg/day
dose:
10-15 mg/kg every 4-6 hours
packaged label gives dosing based on either weight or years (weight is preferred) |
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Term
| symptoms of tylenol overdose |
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Definition
abdominal pain
upset stomach
nausea/vomiting
diarrhea
convulsions
coma
jaundice |
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Term
| tylenol patient counseling points |
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Definition
dose and administration
dosing changes and new maximum daily dose
signs and symptoms of overdose |
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Term
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Definition
life threatening allergic reactions - anaphylaxis
severe swelling, breathing difficulties, or loss of blood pressure
EpiPen auto-injector - yellow cap
contains 0.3 mg of epinephrine
intended for those > or equal to 30 kg (66lbs)
EpiPen Jr auto-injector - green cap
contains 0.15 mg of epinephrine
intended for those 15-30 kg (33-66 lbs) |
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Term
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Definition
1. flip off the yellow or green cap of the auto injector
2. remove the EpiPen from the carrier tube
3. grasp the auto-injector with the orange tip pointing down and form a fist around it
4. pull off blue safety cap
5. hold orange tip near outer thigh
6. swing and firmly push against outer thigh at a 90 degree angle until it clicks
7. hold firmly against thigh for 10 seconds
8. remove auto-injector from thigh and massage for 10 seconds
9. call 911
10. take auto-injector with you to ER |
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Term
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Definition
fast, irregular heartbeat
sweating
nausea/vomiting
breathing problems
paleness
dizziness
weakness
headache
feeling of nervousness or anxiety |
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Term
| what you should avoid with EpiPen |
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Definition
never put thumb or fingers over the orange tip
never press orange tip with thumb or fingers - may result in loss of blood flow to fingers or hands
do not inject into buttocks
do not inject into a vein
do not drop the auto-injector carrier
do not use if solution in clear window is discolored or contains solid particles |
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Term
| other counseling points for EpiPen |
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Definition
storage - do not expose to extreme heat or cold
keep nearby and ready for use at all times
periodically check the expiration date and refill before expires
examine the contents in the clear window of the auto-injector periodically and before administration
solution should be clear and free from particles
once used, about 85% of the liquid stays in the auto-injector and cannot be reused
inform patient that they are receiving the correct dose if: orange needle tip is extended and window is obscured |
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Term
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Definition
gel formulation of diazepam for use in patients 2 years of age and older with refractory epilepsy or status epilepticus
dose based on age and weight
[image] |
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Term
| how to correctly set the Diastat AcuDial dial |
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Definition
[image]
1. HOLD
remove a Diastat AcuDial from case; hold barrel as shown; DO NOT REMOVE CAP!
2. ADJUST
grasp cap firmly with other hand and turn to adjust dose
3. LOCK
CONFIRM prescribed dose shwon in window; now grasp locking ring and push upward to lock both sides of ring
4. REPEAT
repeat steps 1-3 for second Diastat AcuDial; return both to case
available in 2.5 mg, 10 mg, and 20 mg |
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Term
| administration of Diastat AcuDial |
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Definition
after patient seizes for 5 minutes:
roll person to their side facing you
push up with thumb and pull to remove cap; be sure seal pin is removed too
lubricate rectal tip with lubricating jelly
bend upper leg forward to expose rectum
separate buttocks to expose rectum
gently insert syringe tip into rectum
slowly count to 3 while gently pushing plunger
slowly count to 3 before removing syringe
hold buttocks together for 3 seconds |
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Term
| Diastat AcuDial proper disposal |
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Definition
2.5 mg syringe:
discard all used materials in the garbage in a safe place away from children and pets
do not reuse
10 mg syringe:
pull on plunger until it is completely removed from the syringe
point tip of syringe over the sink or toilet
replace plunger into syringe and push plunger down until it stops
rinse sink or flush toilet until gel is no longer visible
discard all used materials
do not reuse |
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Term
| cough and cold medications - 4 different medication classes |
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Definition
antitussives:
dextromethorphan or DM
cough expectorants:
guanifenesin
nasal decongestants:
pseudoephedrine
phenylephrine
antihistamines:
brompheniramine
chlorpheniramine maleate
diphenhydramine |
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Term
| cough and cold supportive measures |
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Definition
use acetaminophen or ibuprofen for fevers
ibuprofen only for those > 6 months of age
consider honey for coughs or sore throat for kids > 1 year of age
saline drops or saline nasal irrigation to clear thick mucus
increase liquids to increase hydration and help thin mucus
place a humidifier in the child's room to add moisture
to ease congestion, elevate the child's head when resting |
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Term
| cough and cold medications patient counseling |
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Definition
DON'T RECOMMEND FOR THOSE < 4 YEARS OF AGE
never give adult cough and cold medication to children
make sure patient isn't begin administered an active ingredient in several different medications
patient should see a doctor if symptoms worsen or don't improve within a few days
proper administration |
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Term
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Definition
egg -> nymph -> adult
eggs can either be:
live
empty eggs or nits (does not necessarily indicate active infection; if close to scalp and treatment has not been given, it is most likely an active infection) |
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Term
| who should be treated for lice? |
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Definition
those with an active infection
check other household members and close contacts
only treat if they also have an active infection |
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Term
| what if a patient has been treated previously for lice? |
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Definition
if no dead lice are found and lice seem as active post treatment, the medicine may not be working
speak with healthcare professional before retreating |
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Term
OTC options for lice
pyrethrins (RID) - shampoo |
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Definition
work by disrupting Na channels in the CNS
100% pediculicidal activity
70-80% ovicidal activity
indications:
approved for those > 2 YEARS OF AGE
retreatment:
second treatment on day 9 to kill any newly hatched lice
other facts:
ask about allergy to chrysanthemum flower or ragweed
administration:
1. apply to DRY hair, behind ears, and back of neck
2. allow product to remain on hair for 10 minutes
3. use warm water to form a later, shampoo, then rinse
4. comb hair with a lice-nit comb and remove any other nits by hand
5. for head lice, easiest to part hair into sections
6. recheck for lice and nits
7. repeat treatment in 7 to 10 days |
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Term
OTC options for lice
permethrin lotion 1% (NIX) - cream, rinse |
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Definition
works by disrupting Na channels in the CNS
97% pediculicial activity
70-80% ovicidal activity
indications:
approved for those > 2 MONTHS OF AGE
retreatment:
second treatment on day 9 to kill any newly hatched lice
other facts:
ask about allergy to chrysanthemum flower or ragweed
administration:
1. wash hair with a shampoo WITHOUT conditioner
2. towel dry hair so that it is damp
3. shake the bottle of Nix well
4. saturate the hair and scalp with Nix, behind the ears, and back of neck
5. leave on hair for 10 minutes
6. rinse with warm water
7. part hair into 4 sections and remove nits with included comb
8. recheck for lice and nits
9. if live lice are seen 7 days after treatment, repeat treatment |
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Term
prescription options for lice
malathion lotion 5% (Ovide) |
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Definition
good pediculicial activity
partial ovicidal activity
indications:
approved for those > 6 YEARS OF AGE
retreatment:
recommended if live lice are still present 7-9 days post treatment
directions:
1. apply to DRY hair
2. leave on for 8-12 hours
3. shampoo hair and rinse hair
4. use comb to remove nits
5. retreat if live lice are found 7-9 days after treatment |
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Term
prescription options for lice
benzyl alcohol lotion 5% (Ulesfia) |
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Definition
good pediculicidal activity
NO ovicidal activity
indications:
approved for those > 6 MONTHS OF AGE
retreatment:
second treatment necessary on day 9 to kill any newly hatched lice
directions:
1. apply to DRY hair
2. leave on for 10 minutes
3. rinse hair and then shampoo hair
4. use comb to remove dead lice
5. retreat 1 week after the 1st treatment |
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Term
| nonpharmacologic measures for lice |
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Definition
machine wash and dry recently worn clothes on the hot water and hot air cycles
5 minutes at a temperature of > 128.3 degrees F kills lice
items that cannot be washed, place in a sealed plastic bag for 2 weeks
vacuum floors and furniture
soak brushes and combs in hot water for 5-10 minutes |
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Term
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Definition
lack of fiber and fluid in diet
ignoring the need to have a bowel movement
may have hard bowel movement then withhold the stool
embarrassed
don't want to stop playing
don't want to use bathroom outside of their home
anxiety about toilet training
don't feel the need to go because they have previously resisted the urge |
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Term
| nonpharm treatment of constipation |
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Definition
increase fluids:
infants - 2-4 oz. of water or diluted fruit juices 1-2 times/day
children - minimum of 2-3 glasses of water or fruit juices
switch to a soy formula or soy milk
increase fiber:
children > 4 months old
fruits, vegetables, cereal, whole wheat, etc.
decrease constipating foods:
cow's milk, yogurt, cheese, cooked carrots, bananas, etc. |
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Term
| pharmacologic treatment of constipation |
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Definition
STOOL SOFTENERS:
docusate
oral - all ages
rectal - older children
OSMOTICS
magnesium citrate/hydroxide
oral - all ages
glycerin
rectal - all ages
polyethylene glycol
oral - children > 6 months
LUBRICANTS
mineral oil
oral - children > 5 years
rectal - children > 2 years
MISCELLANEOUS
lactulose
oral - all ages
rectal - all ages
ENEMAS
phosphate soda
saline
mineral oil
magnesium - AVOID b/c of cardiac toxicity, vasodilation, hypotension
STIMULANTS
bisacodyl
oral - children > 3 years of age
rectal - all ages
senna
oral - children > 1 month of age
caution with using stimulants in children!
chronic use may lead to dependency
can result in electrolyte and fluid imbalance
do not use longer than 1 week |
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Term
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Definition
virus - rotavirus, enterovirus
bacteria - E. coli, salmonella, campylobacter, shigella
parasite - giardia, cryptosporidium |
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Term
| when to call a doctor about diarrhea |
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Definition
< 6 months of age
severe or prolonged episode of diarrhea
fever > or equal to 102 degrees F
repeated vomiting or refusal to drink fluids
severe abdominal pain
diarrhea that contains blood, pus, or mucus
co-morbid disease
severe dehydration
if haven't urinated in 8 hours |
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Term
| diarrhea and dehydration signs and symptoms |
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Definition
sunken eyes
decreased frequency of urination; decreased number of wet diapers
sunken fontanel
no tears when child is crying
dry or sticky mucous membranes
lethargic
irritable and inconsolable |
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Term
diarrhea and dehydration treatment
oral rehydration solutions |
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Definition
recommend products that end in "lyte"
pedialyte solution, Rehydralyte solution, Infalyte solution
rehydration phase:
50-100 mL/kg over 3-4 hours
replace for stool and vomiting loss - 10 mL/kg for each
use an ORS with 75-90 mEq Na
maintenance phase:
use Holiday-Segar method:
0-10kg = 100mL/kg/day
11-20kg = 1000mL/day + 50mL/kg/day for each kg > 10
> 20kg = 1500mL/day + 20mL/kg/day for each kg > 20
recommend ORS with 40-60 mEq Na |
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Term
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Definition
live microorganisms which increase the amount of beneficial bacteria n the intestinal tract and:
aid in digestion
boost body's natural defenses
fight off harmful bacteria
may help to shorten duration of diarrhea by about one day in those with acute viral gastroenteritis
no evidence showing treatment in antibiotic associated diarrhea
may not help, but they have not been shown to harm children |
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Term
| community acquired pneumonia |
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Definition
guidelines updated August 2011
states that the following conditions are beyond the scope of these guidelines:
neonates and young infants < or equal to 3 months of age
immunocompromised children
children on home mechanical ventilation
children with chronic conditions or underlying lung disease |
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Term
| CAP - most common pathogens |
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Definition
Streptococcus pneumoniae
Group A streptococcus
Staphyloccus aueus
Haemophilus influenzae
Mycoplasma pneumoniae
Chlamydophila pneumoniae |
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Term
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Definition
fully immunized infants or school aged children should be administered AMPICILLIN OR PENICILLIN G if substantial high level penicillin resistance for invasive S. pneumoniae is not an issue
empiric therapy with a 3rd generation cephalosporin, ceftriaxone, or cefotaxime, should be administered to:
infants and children who are not fully immunized
in regions where there is a documented high level penicillin resistance to invasive pneumococcal strains
infants and children with life threatening infections (empyema)
children with a concerm for M. pneumoniae and C. pneumoniae just empiric therapy with a macrolide and beta lactam antibiotic
children with a concern for S. aureus use empiric therapy with a vancomycin or clindamycin + beta lactam antibiotic |
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Term
| inpatient treatment of CAP |
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Definition
fully immunized with conjugate vaccines for Haemophilus influenzae type b and Streptococcus pneumoniae; local penicillin resistance in invasive strains of pneumococcus is minimal:
AMPICILLIN OR PENICILLIN G
alternatives - ceftriaxone or cefotaxime; addition of vancomycin or clindamycin for suspected CA-MRSA
not fully immunized for H. influenzae type b and S. pneumoniae; local penicillin resistance in invasive strains of pneumococcus is significant
CEFTRIAXONE OR CEFOTAXIME; addition of vancomycin or clindamycin for suspected CA-MRSA
alternative - levofloxacin; addition of vancomycin or clindamycin for suspected CA-MRSA |
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Term
| outpatient treatment of CAP |
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Definition
< 5 years old (preschool):
AMOXICILLIN, oral (90 mg/kg/day in 2 doses)
alternative - oral amoxicillin clavulanate (amoxicillin component 90 mg/kg/day in 2 doses)
> or equal to 5 years old:
oral AMOXICILLIN (90 mg/kg/day in 2 doses to a maximum of 4 g/day)
for children with presumed bacterial CAP who do not have clinical, laboratory, or radiographic evidence that distinguishes bacterial CAP from atypical CAP, a macrolide can be added to a beta-lactam antibiotic for empiric therapy
alternative - oral amoxicillin clavulantae (amoxicillin component 90 mg/kg/day in 2 doses to a maximum dose of 4 g/day)
amoxicillin counseling - rash, diarrhea, N/V, tastes better if cold, better if taken with food (easier on stomach), shake well |
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