NEW PNP - AC (PEDIATRIC NURSE PRACTITIONER -
ACUTE CARE) CERTIFICATION EXAM LATEST COMPLETE
ACTUAL TEST WITH REAL QUESTIONS AND CORRECT
ANSWERS (100% CORRECT VERIFIED SOLUTION)
NEWEST UPDATED VERSION |GUARANTEED PASS.
What is the fluid distribution in the body?
29% extracellular
19% interstitial
6% plasma, protein, and
lipids 45% intracellular
neonates gastric acid compared to adults
higher (more alkaline)
How do catecholamines effect fluid and nutritional status in acutely
ill children?
reduction of insulin secretion and peripheral insulin action and
stimulates the production of glucagon and adrenocorticotropic
hormone, resulting in hyperglycemia, lipid intolerance, and
protein catabolism
,during inflammation, hepatic protein synthesis changes, what does
this lead to?
elevated crp and reduced production of albumin and prealbumin
how does the pH tract of infants effect bioavailability of oral
medications?
less acidic
increased oral bioavailability of acid-liable compounds (Penicillin G)
which would require lower dosing
decreased oral bioavailability of weak acids (phenobarb) so may
require large dose
Why do infants have enhanced percutaneous absorption?
thinner skin and much higher ratio of total body surface area to body
mass
what is the intramuscular drug absorption in infancy
the greater vascularity of infant skeletal muscle permits equal if not
greater IM drug absorption
,what drugs compete with bilirubin for binding to albumin in
neonatal patients?
ceftriaxone and sulfamethoxazole
Glomerular filtration rate of preterm neonates and term neonates
preterm - 0.6-0.8 mL/ minute per 1.73
m^2 term- 2-4 ml / minute per 1.73
m^2
What is the revised Schwartz equation used for?
creatinine clearance (CrCl)
What is the revised Schwartz equation? (CrCl)
CrCl = [ k x height (cm) ] / serum creatinine
where k usually = 0.413 but can vary on age dependence
, dosing considerations for pediatrics vs adults
weight or BSA based
higher weight based doses are often needed for comparable
exposure
children clear medications more quickly so shorter dosing intervals
may be needed
Vancomycin trough range
10-20 mg/kg
gentamicin, tobramycin peak and trough
peak 6-12 mg/L
trough <1 mg/L
phenytoin steady state concentration
10-20 mg/L
ACUTE CARE) CERTIFICATION EXAM LATEST COMPLETE
ACTUAL TEST WITH REAL QUESTIONS AND CORRECT
ANSWERS (100% CORRECT VERIFIED SOLUTION)
NEWEST UPDATED VERSION |GUARANTEED PASS.
What is the fluid distribution in the body?
29% extracellular
19% interstitial
6% plasma, protein, and
lipids 45% intracellular
neonates gastric acid compared to adults
higher (more alkaline)
How do catecholamines effect fluid and nutritional status in acutely
ill children?
reduction of insulin secretion and peripheral insulin action and
stimulates the production of glucagon and adrenocorticotropic
hormone, resulting in hyperglycemia, lipid intolerance, and
protein catabolism
,during inflammation, hepatic protein synthesis changes, what does
this lead to?
elevated crp and reduced production of albumin and prealbumin
how does the pH tract of infants effect bioavailability of oral
medications?
less acidic
increased oral bioavailability of acid-liable compounds (Penicillin G)
which would require lower dosing
decreased oral bioavailability of weak acids (phenobarb) so may
require large dose
Why do infants have enhanced percutaneous absorption?
thinner skin and much higher ratio of total body surface area to body
mass
what is the intramuscular drug absorption in infancy
the greater vascularity of infant skeletal muscle permits equal if not
greater IM drug absorption
,what drugs compete with bilirubin for binding to albumin in
neonatal patients?
ceftriaxone and sulfamethoxazole
Glomerular filtration rate of preterm neonates and term neonates
preterm - 0.6-0.8 mL/ minute per 1.73
m^2 term- 2-4 ml / minute per 1.73
m^2
What is the revised Schwartz equation used for?
creatinine clearance (CrCl)
What is the revised Schwartz equation? (CrCl)
CrCl = [ k x height (cm) ] / serum creatinine
where k usually = 0.413 but can vary on age dependence
, dosing considerations for pediatrics vs adults
weight or BSA based
higher weight based doses are often needed for comparable
exposure
children clear medications more quickly so shorter dosing intervals
may be needed
Vancomycin trough range
10-20 mg/kg
gentamicin, tobramycin peak and trough
peak 6-12 mg/L
trough <1 mg/L
phenytoin steady state concentration
10-20 mg/L
