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10 Cards in this Set
- Front
- Back
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Expected urine output
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Minimum Expected Urine Output
1-2 ml/kg/hr ≤ 0.5 ml/kg/hr is cause for concern |
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Daily fluid requirements
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By child’s body weight:
1-10 kg 100 ml/kg/day 11-20 kg 1000 ml + 50 ml/kg/day each kg >10 kg >20 kg 1500 ml + 20 ml/kg/day each kg > 20 kg |
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Meningitis
age and temperature |
Age of the child
Temp of 100.4 in neonates and infants is a fever, sickness develops more rapidly in neonates and infants (2 months and under), fussiness, poor feeding, increased sleeping will have baby admitted. Increased risk for infection to due immune system immaturity, could be born with infection from mother, immunizations not fully completed yet for entire series, contact with siblings, |
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Assessment for Meningitis
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Health history – premature or full term
Physical exam – how patient is acting, info from parent is very important and must be believed, look for rashes, bulging, look in the mouth, assess for dehydration (dry mucosa membranes, sunken in soft spots, tenting of skin, mottling of the skin), diarrhea, strong smelling urine, bp increase, pulse decrease Admission if < 2-3 months and febrile, symptoms are often non-specific |
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Meningitis Symptoms
< 2-years-old |
Neonates to 2-months
Non-specific; Poor feeding, weak cry, lethargy, normal neck 2-months to 2-years (most common age for meningitis is 3-8 months Poor feeding, fever, vomiting Irritability, high-pitched cry Bulging fontanel (usually closes at 9-18 months), seizures ? + Brudzinski or + Kernig |
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Meningitis Symptoms
> 2-years old |
Over 2-years-old
Abrupt onset with fever, chills, headache, vomiting Nuchal rigidity, + Kernig, + Brudzinski signs Cyanotic extremities, stupor, seizures, coma Photophobia Concurrent pneumonia S. pneumoniae Petechiae and/or purpuric rash, arthritis N. meningitidis |
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“Rule out Sepsis”
(Suspected Meningitis) |
< 2-3 months, admitted for fever alone, or if thought to have bacteremia or meningitis
Older child would have other symptoms to suggest meningitis to be admitted Chest x-ray Urinalysis Complete blood count Blood cultures (want to be on computer checking for results) Lumbar Puncture for culture and signs of infection (want to be on computer checking for results) |
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Meningitis Diagnosis
CSF Meningitis Interventions |
Respiratory isolation, removed if cultures are negative after 48hrs
IV antibiotics for 14-21 days will also be put on drugs to treat herpes Anticonvulsants Antipyretics – under six months don’t use ibuprofin, use acetaminphen Antivirals if thought to have encephalitis |
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Bacterial Meningitis
Prevention |
N. meningitidis (meningococcus)
Given at 10-12-years old, college freshman in dorms Covers four strains-’quadravalent’ S. pneumoniae (pneumococcus) Prevnar-7 strains (13 strain vaccine in phase 3 trials) Infants to two-years, 4 doses Pneumovax-23 strains Greater than two-years for certain high risk groups Given every 5 years if asplenic or with sickle cell disease H. influenzae type b Given to infants 2 ,4, 6 and 15-months |
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N. meningitidis
Cause of meningococcemia |
Spread by droplet from nasopharynx where it colonizes and then spreads
To bloodstream Then to joints, meninges or disseminates through the body 5% of people are long-term carriers Kissing, smoking, close contact increase risk of becoming infected Invasive Hib Disease per 100,000 Population, USA |
