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Pediatric Immunization Schedules and Common Illnesses: A Quick Reference Guide, Exams of Nursing

University of Texas - Tyler Nursing

A concise overview of pediatric immunization schedules, including vaccines for hep a, hep b, dtap, tdap, hib, pneumococcal, rotavirus, polio, mmr, varicella, influenza, meningococcal, and hpv. It also covers common pediatric conditions such as otitis media, pneumonia, bronchiolitis, croup, viral gastroenteritis, and uti, detailing etiology, diagnosis, and management strategies. This resource is valuable for medical students and healthcare professionals seeking a quick reference guide on pediatric health. It includes key points on vaccine administration, adverse reactions, and treatment protocols for common childhood infections, making it an essential tool for clinical practice and exam preparation. The document emphasizes the importance of vaccination and early intervention in managing pediatric illnesses, providing a practical approach to pediatric care.

Typology: Exams

2024/2025

Available from 05/29/2025

carol-gakii 🇺🇸

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BOARDS- APEA PEDS EXAM|2025-2026|ACTUAL

EXAM WITH QUESTIONS AND ANSWERS|A+

Hep A Vaccine

- Routine immunization schedule for children at minimum age 1 yr

- 2 doses at least 6m apart

Hep B Vaccine

- 3 dose series

- #1: 0m

- #2: 1-2m

- #3: 6-18m after #1

DTaP Vaccine

- <7 yrs of age

- 5 dose series:

#1: 2m (minimum age 6 wks)

#2: 4m

#3: 6m

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BOARDS- APEA PEDS EXAM|2025-2026|ACTUAL

EXAM WITH QUESTIONS AND ANSWERS|A+

Hep A Vaccine

Routine immunization schedule for children at minimum age 1 yr
2 doses at least 6m apart Hep B Vaccine
3 dose series
#1: 0m
#2: 1-2m
#3: 6-18m after # DTaP Vaccine
<7 yrs of age
5 dose series: #1: 2m (minimum age 6 wks) #2: 4m #3: 6m

#4: 15-18m (6m after #3) #5: 4-6y (final dose >4y) Tdap

7 yrs
11-12 yrs: Tdap booster- contains tetanus, diphtheria, and acellular pertussis
Tdap can be administered regardless of last interval since the last tetanus- and diptheria-toxoid- containing vaccine
After Tdap, pts should receive Td booster 10y (routine) Pregnancy and Tdap 1 dose Tdap during each pregnancy, preferably in early part of gestational weeks 27- Hib (Haemophilus influenzae Type B)
#1: 2m
#2: 4m
#3: 6m

Oral polio no longer given in US MMR or MMRV
2 dose series
#1: 12-15m #2: 4-6 yrs
second dose of MMR may be given at any time, provided at least 1mo has elapsed since 1st dose and both doses are given at age 12m or older
Contraindicated if allergic to neomycin or gelatin Immunity with Live Attenuated Vaccines
Live attenuated vaccines must replicate to produce immunity
Fever, rash after live or attenuated immunizations represent a reaction to viral replication, not the vaccine
MMR and varicella are examples
Give them on the same day or at least 4 wks apart Live Attenuated Vaccines

Never give to children < 1 yr, pregnant women, or immunocompromised pts Varicella vaccine
Given at age 12-18m, booster 4-6yrs OR age 11-12yrs if child lacks a reliable hx of chickenpox infection
If given at age 13 yrs or later, 2 doses are required, at least 1mo apart Influenza Vaccine
Recommended annually ages >6m
Children <8 yrs receiving vaccine for first time need 2 doses separated by 4 wks
1 dose annually for all people 9yrs and older Flu Vaccine Allergic Reactions
Egg allergy, hives: administer any flu vaccine appropriate for age and health

Spacing of Vaccines

A vaccine given 4 days prior to the scheduled time to receive it is considered a valid dose
A vaccine given 5 days prior to the scheduled time to receive it is considered an invalid dose and should be repeated Common conditions in peds
Otitis media
Pneumonia
Bronchiolitis
Viral gastroenteritis
UTI
Viral exanthems
Most childhood infections are viral and self-limited
Children often have nonspecific s/s w/ infectious illnesses: fussiness/irritability, stomach upset, poor appetite, lower-than-normal energy, maculopapular rashes

Otitis Media (OM)

etiology +guidelines
referral

AOM: best predictor is cloudy, bulging TM w/ impaired mobility
OM w/ effusion is fluid accumulation in the middle ear w/o evidence of infection
Pneumococcal conjugate vaccine (PCV7) has decreased incidence of AOM since 2000
Etiologic agents: Viral: RSV and influenza most common Bacterial: Streptococcus pneumonia (40-50%), H. influenza, Moraxella catarrhalis
Dx: bulging of the TM plus new onset ear pain and/or otorrhea
Considered severe if b/l, severe pain, or fever
Pain management w/ OTC meds
Abx vs. observation
3 or more distinct and well-documented of episodes in a 6m period OR
4 episodes in 12m OR

PNA: peds

Infection of the lung that may include the parenchyma, alveolar spaces, and/or interstitial tissue
Pna is commonly classified as CAP or nosocomial
Most common pathogen 6m-5y: viral
Most common bacteria: Strep pneumoniae
S. pneumoniae immunization: PCV13: 2, 4, 6, and 12-15mo PCV13 plus 23 for high-risk children >2yo
Infants are a vulnerable population, protect those at high risk PNA: peds assessment findings, diagnostics
Many nonspecific findings
Fever is inconsistent finding
Cough, malaise
Increased RR: most sensitive sign of confirmed pna CXR: infiltrates
May be normal in early pna, especially if dehydrated
No need for f/u x-ray if resolves as expected

CBC w/ diff: can be differentiate viral vs bacterial pna

If bacterial: left shift (^ segs/bands) and usually WBC >15, PNA: peds management Bacterial:
High-dose amoxicillin (90mg/kg/d) first line; consider amox-clav or 3rd-gen cephalosporin if recent AB exposure
If type 1 rxn to pcn, then macrolide (clindamycin) Symptomatic Management:
Fluids
Antipyretics
Rest
Hospitalization/oxygen if respiratory distress Bronchiolitis: peds +ass't findings, dx/management

Laryngotracheitis: inspiratory stridor, barking cough, hoarseness
Viral croup most common 6m-3y
Self-limited: fever, congestion, cough usually 3 days
Steeple sign = tapering of upper trachea on AP X-ray
Spasmodic croup occurs night Viral Gastroenteritis
One of the most common infectious diseases in humans Presentation:
3 watery/loose stools in 24h
Vomiting, fever, abd pain may be present
S/S last < 1-2 wks Gastroenteritis
Most common cause: viruses
Rotavirus, norovirus
Incidence of rotavirus decreased since vaccine
Fecal-oral route is most common mode of transmission
Best prevention = hand washing

Degree of Dehydration

Most common complication of gastroenteritis
Severity = degree of dehydration Best measures of dehydration:
Weight loss
Prolonged capillary refill
Loss of skin turgor
Increased and deep respiratory pattern Dehydration
Mild to moderate dehydration = 3.9% los; severe = 10% or more
Pulse: Mild: normal, mod: rapid, severe: rapid and weak
Systolic BP: Mild: normal, mod: normal to low, severe: low
RR: normal, deep/increased rate, deep/increased rate
Mucosa: sticky, dry, parched
Anterior fontanel: normal, sunken, very sunken
Eyes: Normal, sunken, very sunken
Skin turgor: normal, reduced, tenting

Avoid antidiarrheal agents

anti motility drugs (loperamide): potential paralytic ileum, delay transit time (prolong illness)
Kaolin pectin (may reduce water loss): can be considered but evidence does not support
probiotics/prebiotics: evidence is inconsistent
diarrhea >7 days
severe dehydration
immunocompromised
inability to tolerate PO rehydration
clinical judgement Pediatric UTI
anatomic abnormalities: not common but must be ruled out
bowel or bladder dysfunction: withholding maneuvers, incontinence, constipation very common cause
vesicoureteral reflex (VER): retrograde passage of urine from bladder to upper urinary tract: very common cause (40%) First Pediatric UTI

aggressive treatment (w/in 72h) to prevent pyelonephritis and renal scarring
need specimen, get culture, treat empirically
always cover for E. coli (most common pathogen) E. coli: Consider 2nd, 3rd-gen cephalosporin (cefixime, cefdinir, ceftibuten) if no GU abnormalities
Duration 3-5 days if afebrile, 10 days if febrile High resistance to amoxicillin and cephalexin
50% resistant to amoxicillin, ampicillin
Can use cephalexin if low risk of renal involvement and low community resistance rate Imaging for ped UTI Renal and bladder u/s (RBUS):
AAP recommends for all infants 2-24m for 1st febrile UTI or any age w/ recurrent febrile UTIs
UTI w/ family hx of renal or urologic dz, poor growth, or hypertension Voiding cystourethrogram:

Maculopapular "brick red" rash
Starts on head and neck, spreads centrifugally to trunk and extremities Fifth disease (Erythema infectious):
"Slapped cheek" rash
Lacy, macular rash Rubella:
Maculopapular rash
Looks like measles rash
Remarkable lymphadenopathy; macule on soft palate (Forchheimer spots) Roseola (Exanthem subitem):
High fever for 2-4 days, then abrupt cessation of fever w/ appearance of maculopapular rash but not on face Chickenpox:
Vesicular lesions on erythematous base
Appear in crops

Scarlet fever:

Exotoxin rash secondary to Group A Strep infection
Sandpaper like rash that ultimately desquamates Peds: many other rashes
Rocky Mountain Spotted Fever
Secondary syphilis
Group A Strep rash
Ampicillin rash (secondary to mononucleosis)
Kawasaki disease
Shingels (herpes zoster)
Mycoplasma (maculopapular) A 4yo pt presents w/ a lacy, macular rash and fever. What this might be? Erythema Infectious (Fifth Disease)
caused by Parvovirus B
lacy, macular rash

Pediatric Immunization Schedules and Common Illnesses: A Quick Reference Guide, Exams of Nursing

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Partial preview of the text

Download Pediatric Immunization Schedules and Common Illnesses: A Quick Reference Guide and more Exams Nursing in PDF only on Docsity!

BOARDS- APEA PEDS EXAM|2025-2026|ACTUAL

EXAM WITH QUESTIONS AND ANSWERS|A+