Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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|
Term
| If anion gap is less than 12 |
|
Definition
| no anion gap metabolic acidosis |
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|
Term
| if anion gap is greater than 12 |
|
Definition
anion-gap metabolic acidosis
loss of bicarbonate due to buffering of endogenous acids |
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Term
|
Definition
| calculated anion gap - 12 |
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Term
|
Definition
| indicates the amount of bicarb lost to buffering acids |
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|
Term
| If measured bicarb + excess gap is less than 22 |
|
Definition
| non-anion gap metabolic acidosis (the bicarb level would still be low even if they didn't buffer the acids) |
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Term
| if measured bicarb + excess gap is greater than 26 |
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Definition
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|
Term
| when is using NaHCO3 appropriate in metabolic acidosis? |
|
Definition
| severe acidemia, renal dysfunction (when kidneys can't regenerate enough bicarb), intoxications |
|
|
Term
| when is using NaHCO3 inappropriate for metabolic acidosis |
|
Definition
| lactic acidosis, ketoacidosis |
|
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Term
| what are the limitations of using NaHCO3 for pts with metabolic acidosis |
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Definition
| can't give more than half of the HCO3 deficit (or can cause volume overload, hypernatremia, hyperosmolarity, overshoot alkalemia, hypokalemia) |
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Term
| What are the limitations in using NaHCO3 in pts with respiratory acidosis |
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Definition
| can generate CO2 and worsen acidemia |
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Term
|
Definition
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Term
|
Definition
| 29 days to less than 12 mos. |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| age from date of mother's first day of last menstrual period to date of birth |
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Term
|
Definition
| describes infants born at 38-wks gestation or after? |
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Term
|
Definition
| describes infants born before 37-wk gestation |
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Term
|
Definition
| neonates with birth weight below the 10th percentile among neonates of the same GA |
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Term
|
Definition
| neonates with birth weight above the 90th percentile among neonates of the same GA |
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Term
| chronological (post natal) age |
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Definition
| age from birth to present measured in days, wks, mos, or yrs |
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Term
|
Definition
| may be used to describe the age of a premautre child up to 3 yrs of age |
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Term
|
Definition
| chronological age (mos.) - [(40 - GA in wks at birth)/4 wks] |
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Term
|
Definition
| Premature infant with birth weight between 1500 and 2500 g |
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Term
|
Definition
| Premature infant with birth weight 1000 g to less than 1500 g |
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Term
|
Definition
| Premature infant with birth weight less than 1000 g |
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|
Term
| How do you calculate hourly fluid maintenance requirements in children |
|
Definition
first 10 kg = 4ml/kg/hr
second 10 kg = 2ml/kg/hr
remain kg = 1 ml/kg/hr |
|
|
Term
| how do you calculate daily fluid maintenance requirements in children |
|
Definition
first 10 kg = 100ml/kg/day
second 10 kg = 50 ml/kg/day
remain kg = 20 ml/kg/day |
|
|
Term
| significant clinical signs of mild dehydration in children |
|
Definition
| decreased urine output and thirst. no physical changes yet. behavior, HR and BP are normal |
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|
Term
| significant clinical signs of moderate dehydration in children |
|
Definition
| listlessness, physical changes begin, heart rate increases, BP is normal, markedly decreased UO |
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|
Term
| significant clinical signs of severe dehydration in children |
|
Definition
| behavioral changes, intense physical changes, BP and HR changes, no urine output |
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|
Term
| what are the percentages of degrees of dehydration in older children |
|
Definition
mild = 3%
moderate = 6%
severe = 9% |
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|
Term
| what are the percentages of dehydration in infnats |
|
Definition
mild = 5%
moderate = 10%
severe = 15% |
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|
Term
| how do you calculate rehydration fluid? |
|
Definition
phase I (immediate) = 20ml/kg
phase II (8 hours) = 1/2 remaining deficit + 1/3 daily maintenance fluid
phase III (16 hours) = 1/2 remaining deficit + 2/3 daily maintenance fluid |
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|
Term
| how do you calculate fluid deficit in children? |
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Definition
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|
Term
| which acid-base disorder is hyperkalemia associated with? |
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Definition
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|
Term
| Which fluid is sodium found in? |
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Definition
|
|
Term
| Which fluid is Potassium found in? |
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Definition
|
|
Term
| which organs control potassium regulation? |
|
Definition
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|
Term
|
Definition
| cramps, muscle weakness, polyuria, ECG changes, cardiac arrhythmias |
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|
Term
|
Definition
| renal/GI losses, inadequate intake, medications (insulin, diuretics, corticosteroids) |
|
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Term
|
Definition
potassium replacement
-check for hypomagnesemia |
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|
Term
| patient with hypokalemia and low phosphate levels, use: |
|
Definition
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|
Term
| hypokalemic patient with acidosis |
|
Definition
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|
Term
| hypokalemic patient with alkalosis |
|
Definition
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|
Term
|
Definition
| muscle weakness, hypotension, ECG changes, cardiac arrhythmias, decreased pH |
|
|
Term
|
Definition
| increased intake (salt substitutes, IV, potassium sparing diuretics), decreased excretion (renal failure, Addison's disease), potassium release from ICF (tissue breakdown, blood transfusions, metabolic acidosis) |
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|
Term
| treatments of hyperkalemia |
|
Definition
D/C potassium-sparing diuretics, salt substitutes, potassium supplements
antagonize proarrhythmic effects (IV calcium)
drive potassium into ICF (dextrose, insulin, beta agonists)
lower total potassium content
(sodium polysterene sulfonate, loop diuretics, hemodialysis) |
|
|
Term
| cause of high anion gap metabolic acidosis |
|
Definition
| lactic acidosis, ketoacidosis, renal failure |
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|
Term
| cause of normal anion gap metabolic acidosis |
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Definition
|
|
Term
| causes of metabolic alkalosis |
|
Definition
| loss of acid, prevention of excretion (hypovolemia), drugs (bicarb, corticosteroids) |
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|
Term
| respiratory acidosis causes |
|
Definition
| respiratory failure (NM and pulmonary disease), impaired CNS control of respiration |
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|
Term
| cause of respiratory alkalosis |
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Definition
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|
Term
| cause of hypertonic hyponatremia |
|
Definition
| hyperglycemia (inc in TBW) |
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|
Term
| causes of hypotonic hypervolemic hyponatremia |
|
Definition
| CHF, cirrhosis, nephrotic syndrome |
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|
Term
| causes of hypotonic euvolemic hyponatremia |
|
Definition
| SIADH, hypothyroidism, kidney failure, mineralocorticoid deficiency |
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|
Term
| causes of hypotonic hypovolemic hyponatremia |
|
Definition
| diuretics, sweating, wound drainage, GI losses |
|
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Term
|
Definition
| loss of water, decrease in intake, diuresis, DI |
|
|
Term
|
Definition
losses: GI, renal
Inadequate intake
alkalosis
meds: insulin, loop diuretics |
|
|
Term
|
Definition
increased intake
decreased excretion:renal failure, addison's
movement into the ECF: tissue breakdown, blood transfusions, metabolic acidosis |
|
|
Term
|
Definition
inadequate intake
losses:hypoparathyroidism, renal failure, alkalosis, pancreatitis, blood product infusion, vitamin D deficiency |
|
|
Term
|
Definition
| hyperparathyroidism, hyperthyroidism, malignancy, addison's, bony fractures, immobilization, acidosis |
|
|
Term
|
Definition
| decreased absorption: starvation, antacids, vitamin D deficiency, diarrhea increased renal loss: diuretics, ketoacidosis inc distribution to ICF:hyperglycemia, insulin, malnourishment |
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|
Term
| causes of hyperphosphatemia |
|
Definition
increased intake: enemas, laxatives
decreased excretion: renal failure
movement into ECF |
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|
Term
| causes of hypomagnesemia: |
|
Definition
inadequate intake:
losses: GI, urinary |
|
|
Term
| causes of hypermagnesemia: |
|
Definition
increased intake: meds
decreased loss: renal failure |
|
|
Term
| treatment of hypertonic hyponatremia: |
|
Definition
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|
Term
| hypotonic hypervolemic hyponatremia treatment: |
|
Definition
sodium and fluid restriction
treat underlying cause (CHF, cirrhosis, nephrotic syndrome) |
|
|
Term
| hypotonic euvolemic hyponatremia treatment: |
|
Definition
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|
Term
| treatment of hypotonic hypovolemic hyponatremia |
|
Definition
| water and salt replacement (isotonic) |
|
|
Term
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
rehydration
diuresis
bisphosphonates in renal insufficient pts |
|
|
Term
| hypophosphatemia treatment |
|
Definition
|
|
Term
| hyperphosphatemia treatment |
|
Definition
dietary restriction
phosphate binder
IV calcium |
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|
Term
|
Definition
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|
Term
| hypermagnesemia treatment |
|
Definition
D/C meds with mag
normal saline infusion
furosemide
IV calcium |
|
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Term
|
Definition
| ECF replacement, TBW depletion |
|
|
Term
| use for half normal saline |
|
Definition
| treatment for hypertonic patients (they lost ECF) |
|
|
Term
| use for hypertonic saline |
|
Definition
|
|
Term
| what is use for ringer's lactate |
|
Definition
| replace ECF, buffer acids |
|
|
Term
|
Definition
| severe hypernatremia, KVO |
|
|
Term
| a patient with elevated anion gap tells us |
|
Definition
| they have metabolic acidosis due to acids present |
|
|
Term
| a non-elevated anion gap metabolic acidosis tells us |
|
Definition
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|
Term
|
Definition
| isotonic, but acts as hypotonic |
|
|
Term
| infant's absorption in stomach |
|
Definition
| slower gastric emptying, so increased absorption in stomach |
|
|
Term
|
Definition
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|
Term
| volume of distribution in babies |
|
Definition
| larger for w/s drugs, lower for lipophilic drugs |
|
|
Term
| protein binding in babies |
|
Definition
| smaller albumin stores > less protein binding |
|
|
Term
| describe metabolism as you age |
|
Definition
| depressed at birth, then exceeds adult. at 12, starts to level off |
|
|
Term
| phase II metabolism in infants |
|
Definition
glucoronidation is decreased
sulfation is increased
acetylation is decreased |
|
|
Term
|
Definition
| depressed, bc of low GFR, renal blood flow, and tubular secretion |
|
|
Term
| what is the normal urine output in infants |
|
Definition
|
|
Term
| how to estimate creatinine clearance in babes |
|
Definition
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|
Term
| effect of reduced metabolism and clearance on dosing in peds |
|
Definition
| longer half-lives >>> extended dosing intervals |
|
|
Term
| what is appropriate for fluid boluses? |
|
Definition
| isotonic (NS, lactate ringer) |
|
|
Term
| how are GI fluid losses replaced in children? |
|
Definition
|
|
Term
|
Definition
| (desired Na - measured Na)x.6 x wt |
|
|
Term
| formulation of pancreatic enzymes |
|
Definition
| eneteric-coated microspheres |
|
|
Term
| monitoring parameters of pancreatic enzymes in CF |
|
Definition
| stool output, steatorrhea, abdominal symptoms, weight gain, nutritional status |
|
|
Term
| antibiotics used in CF outpatients-pseudomonas |
|
Definition
| oral fluoroquinalones with tobramycin |
|
|
Term
| inpatient therapy for CF, antibiotics: |
|
Definition
| antipseudomonal beta-lactam (cephaloasporins) plus aminoglycoside (tobramycin) |
|
|
Term
| volume of distribution in CF |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| dose of aminoglycosdies in pts with CF |
|
Definition
|
|
Term
|
Definition
| inhaled med for CF that improves respiratory system, FEV, and reduces productive cough |
|
|
Term
| how is pulmonary system measured/evaluated in CF |
|
Definition
|
|
Term
| use of azithromycin in CF |
|
Definition
| antiinflammatory, improves lung function |
|
|
Term
| side effect of taking supplemental iron when pregnanct |
|
Definition
|
|
Term
| purpose of taking folic acid while pregnancy |
|
Definition
| prevents neural tube defects |
|
|
Term
| effect of pregnancy on absorption |
|
Definition
|
|
Term
| effect of pregnancy on distribution |
|
Definition
| increased Vd, decreased protein binding |
|
|
Term
| effect of pregnancy on metabolism |
|
Definition
|
|
Term
| effect of pregnancy on renal elimination and dosing |
|
Definition
| increases clearance, so drugs need to be dosed more frequently |
|
|
Term
| first line therapy for n/v |
|
Definition
| promethazine, prochlorperazine, or pyridoxine/doxylamine |
|
|
Term
| first line treatment constipation |
|
Definition
|
|
Term
| first line therapy for hemorrhoids |
|
Definition
|
|
Term
|
Definition
| antacids (avoid aluminum products), all other OTC meds are fine |
|
|
Term
| management of pain in pregnancy |
|
Definition
|
|
Term
| cough and congestion treatment during preg |
|
Definition
| DM, gauifenacin, pseudofed (in 2 and 3 trimester) |
|
|
Term
| treatment for allergies during preg |
|
Definition
|
|
Term
| what can and can't you give for bacteriuria in pregn? |
|
Definition
give amox, ceph, and nitrofurantoin
don't give bactrim or fluroquinalones |
|
|
Term
| how to treat bacterial vaginosis in pregn |
|
Definition
|
|
Term
| how to treat bacterial vaginosis during lactation |
|
Definition
|
|
Term
| treatment for vulvovaginal candidiasis |
|
Definition
|
|
Term
| treatment for chlamydia during preg? |
|
Definition
|
|
Term
| treatment of chlamydia during lactation |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| treatment of syphillis during preg |
|
Definition
|
|
Term
| treatment of syphillis during lactation |
|
Definition
| erythromycin or doxycycline |
|
|
Term
|
Definition
|
|
Term
| treatment for preterm labor |
|
Definition
antenatal corticosteroids
tocolytic agents (CCB)
antibiotics |
|
|
Term
| treatment for group B strep |
|
Definition
|
|
Term
|
Definition
|
|
Term
| nipple candidiasis treatment |
|
Definition
| topical antifungal and nystatin to baby |
|
|
Term
| lactation enhancement therapy |
|
Definition
|
|
