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316 Cards in this Set
- Front
- Back
Children with cardiac tamponade may have no physical signs other than ____? |
Hypotension
|
|
A moderate brain injury on the pediatric GCS is ______?
|
A GCS of 9 to 12
|
|
S/S of a pediatric intracranial herniation include?
|
* asymmetrical pupils
* decordicate posturing * decerebrate posturing |
|
Consider using ______ prior to intubation of the pediatric pt with a head injury?
|
Lidocaine
|
|
What is the dosage of lidocaine for the pediatric pt?
|
1 mg/Kg loading dose with 20 to 50 mcg/kg/min infusion
|
|
The fulcrum of cervical mobility in a young child is?
|
C2 - C3
|
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_____, ______, and ______ can irritate or destroy the gastrointestinal system if ingested by a child.
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ASA, corrosives, and hydrocarbons
|
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Do not use this type of analgesics for the pediatric pt.
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Synthetic. ie: Butorphanol, Stardol, Nubane
|
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60 to 70% of pediatric spinal fractures occur here.
|
C1 - C2
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supplements containing _____ are the leading cause of poisonings in toddlers and preschoolers.
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Iron
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A child with a petechial rash is typical of _______ meningitis?
|
Bacterial
|
|
S/S: recent ear, respiratory tract infection, high fever,lethargy, and headaches
|
Meningitis
|
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Bacterial meningitis most commonly results from ______ ?
|
Stepococcus pneumonia, Hemophilus influenza, neisseria meningingitis
|
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The more severe form of meningitis is _____?
|
Bacterial
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Meningitis can result from both _____, and _____?
|
Bacteria or viruses
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Childs dosage for acetaminophen is ?
|
15 mg/kg
|
|
Digitalis, beta blockers, and anti-hypertensives can cause a reflex _____ ?
|
Circulatory depression
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For status epilepticus give _____?
|
Diazepam (valium)
|
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The pediatric dosage for diazepam?
|
1 month to 5 years give 0.2 to 0.5mg (max 2.5mg)*
Over 5 years give 1mg* *slow IV push |
|
This type of seizure is most often seen in the pediatric pt between 6 months and 6 years.
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Febrile
|
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This type of seizure causes sudden jerking on both sides of the body, followed by tenderness and relaxation, usually with a loss of consciousness.
|
Generalized seizures
|
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A type of seizure that involve sudden jerking of a particular part of the body, such as an arm or leg.
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Simple partial seizure (also called focal motor)
|
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Give _____ for persistent symptomatic bradycardia.
|
epinephrine 0.01 mg/kg of 1 to 10,000 If caused by an AV block give Atropine 0.02 mg/kg (max 1mg)
|
|
Pediatric dosage of epinephrine for anaphylaxis?
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0.01 mg/kg 1: 10,000 q 3 to 5 min (max dose 1mg)
|
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Pediatric dosage of atropine?
|
0.02 mg/kg (max 1mg) (min dose of 0.1mg)
|
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Brady dysrhythmias in the pediatric pt are most frequently caused from?
|
Hypoxia
|
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Synchronized cardioversion in the pediatric pt is?
|
0.5 to 1.0 joules/kg (may go up to 2 joules/kg)
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What action should you take with the pediatric pt with SVT, combined with hypotension, mental status changes, or poor skin color?
|
synchronized cardioversion at 0.5 to 1.0 joules/kg (may go up to 2 joules/kg)
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|
Tachy dysrhymithmias in children are almost always due to a secondary cause, the exception is _____?
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Structural or congenital heart disease
|
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V-tach and V-fib are rare in children but may be seen in these situations?
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Drowning or following a prolonged resuscitation.
|
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For the pediatric pt with wide complex V-tach after cardioversion and adenosine do not work, get your doctors consult and then give _____ or _____.
|
Amiodarone: 5mg/kg (over 20-60 min)
or Procainamide: 15 mg/kg (over 30 to 60 min) |
|
Synchronized cardioversion in the pediatric pt is _____ joules?
|
0.5 to 1 joules/kg second shock at 2 joules/kg.
|
|
SVT in a stable child should be treated with _____?
|
Adenosine: 0.1 mg/kg (max 6mg)
then a second dose at 0.2 mg/kg (max of 12 mg/kg) |
|
SVT in children is usually due to a problem in the _____ _____ _____.
|
Cardiac conduction system
|
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True SVT in children are a heart rate of ____ or greater; and in infants _____ or greater.
|
180
220 |
|
The most common occuring dysrhythmias in children ?
|
Bradydysrhythmias
|
|
Severe cases of cardiomyopthy resulting in dyspnea should be treated with _____?
|
Furosemide (lasix) at 0.5 - 2 mg/kg
and pressor agents such as dobitamine or dopamine |
|
_____ develops slowly and often is not detected until heart failure starts.
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Cardiomyopathy
|
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S/S of this are early fatigue, crackles, JVD, engorgement of the liver, peripheral edema.
|
Cardiomyopathy
|
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A frequent cause of infectious cardiomyopathy is _____?
|
Coxackie virus
|
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_____ is a result of congenital heart disease or infection.
|
Cardiomyopathy
|
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A body position that will help increase cardiac return is _____?
|
knee to chest or squatting
|
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Place the child who has cyanotic spells (tet) or non cyanotic heart disease in this position.
|
knee to chest facing down or squatting.
|
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A body position that will help increase cardiac return is _____?
|
knee to chest or squatting
|
|
s/s of _____ re , irritability, inconsolable crying, altered mental statue, and dyspnea.
|
Cyanotic spells (tet)
|
|
A common symptom of congenital heart disease.
|
Cyanosis
|
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What is the primary heart disease in children?
|
congenital
|
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_____ causes a decrease in cardiac output due to the impairment of cardiac muscle contraction.
|
Cardiomyopathy
|
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A type of shock usually resulting from causes such as drowning or toxic ingestion.
|
cardiogenic shock
|
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A tube that is placed through the nose into the stomach?
|
gastric
|
|
A tube that is placed through the abdominal wall into the stomach?
|
gastrostomy
|
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Poisions can cause many different signs and symptoms depending on the _____, _____, and _____.
|
poison, route and time
|
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What position should the pt with a gastric or gastrostomy tube be transported in?
|
sitting, or lying on their left side with the head elevated.
|
|
A surgical connection from the brain to the abdomen
|
Shunt
|
|
Pediatric triage acronym tool.
|
Jump start
|
|
_____ results from inadequate cardiac output.
|
cardiogenic shock
|
|
The most commonly injured organ in children?
|
Spleen
|
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S/S of this are: tenderness in the upper left quadrant, and a hematoma of the abdominal wall.
|
splenic injury
|
|
Children tend to have _____ fractures?
|
incomplete. IE: bend fractures, buckle fractures, and greenstick fractures
|
|
Peek incidence of sids occur between _____ and _____ months of age.
|
2 to 4 months
|
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An infants underdeveloped abdominal musculature affords minimal protection to the _____?
|
Viscera
|
|
Fentanyl (sublimaze) dose for pediatrics?
|
2 mcg/kg for ages 2 to 12 y/o
|
|
A drug that can cause liver necrosis and eventually liver failure.
|
Acetaminophen (tylenol)
|
|
Morphine dose for pediatrics.
|
0.1 to 0.2 mg/kg
|
|
Cardiac output and Intravascular fluid volumes are usually _____ in neurogenic shock?
|
adequate
|
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A spinal cord injury that causes nervous control loss of the vascular system can cause _____?
|
neurogenic shock due to a sudden peripheral vasodilation
|
|
During a long transport time an anaphylatic pt may require a dose of _____?
|
methylprednisolone (solu-medrol) 0.5 to 1 mg/kg
|
|
pediatric dose of methylprednisolne?
|
(solu-medrol) 0.5 to 1 mg/kg
|
|
Treat decompensated anaphylatic shock with?
|
epinephrine 0.01mg/kg 1 to 10,000 and diphenhydramine (benedryl)
|
|
Treat severe allergic reactions with _____?
|
epinephrine 0.01 mg/kg 1: 1000 sq and an antihistamine
|
|
Tachycardia, tachypnea, wheezing, urticaria, anxiousness, edema, and hypotension are s/s of _____?
|
anaphylatic shock
|
|
For sepsis consider administering ?
|
A pressor therapy with epinephrine or dopamine. begin at 2mcg/kg/min
|
|
Ill appearance, irritability or altered mental status, fever, V&D, cyanosis, pallor, mottled skin, respiratory distress, and poor feeding are s/s of _____?
|
sepsis
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Peripheral vasodilation leading to a drop in blood pressure and decreased tissue perfusion, are signs of _____?
|
Septic shock
|
|
Septicemia from bacterial infection, anaphylactic reaction, or damage to the brain or spinal cord may cause _____ shock?
|
distributive
|
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In pediatric patients, the most common forms of shock you will treat are _____ and _____?
|
hypovolemic and distributive
|
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S/S of decompensated shock include?
|
* lethargy or coma
* tachycardia or bradycardia * absent peripheral pulses * cool, pale, dusky, mottled extremities *hypotension *decreased urine output * absence of tears |
|
The hallmark of decompensated shock?
|
A fall in Blood pressure
|
|
S/S of compensated shock.
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* irritability/anxiety
* Tcahycardia * Tachypnea * week distal pulses, full central pulses * delayed capillary refill * cool, pale extremities * normal BP * decreased urine output |
|
In compensated shock the pt exhibits a _____ blood pressure.
|
normal
|
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A child in shock has little capacity to increase _____?
|
Stroke volume
|
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A child responds to shock by increasing _____ and _____.
|
heart rate and peripheral vascular resistance
|
|
Less common causes of shock in children include.
|
allergic reactions
poisoning cardiac events |
|
More common causes of shock in children include?
|
loss of heat (hypothermia)
dehydration infection trauma |
|
The second major cause of cardiopulmonary arrest in children is _____?
|
shock
|
|
Unilateral wheezing should be considered _____ until proven otherwise.
|
aspiration of a foreign object
|
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Air trapped in the distal lung tissue can cause a _____?
|
ventilation / perfusion mismatch
|
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Low grade fever, decreased breath sounds, crackles, ronchi, and pain in the chest area are s/s of _____?
|
pneumonia
|
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Most cases of pneumonia are _____ in children and self limiting.
|
viral
|
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Bacterial or viral infection of the lower airway and lungs is called _____?
|
pneumonia
|
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Broncholitis should be managed using _____ agents.
|
Bronchodilators such as albuterol (ventolin, provental) and levabuterol (xopenx)
|
|
Asthma rarely occurs before the age of 1, where _____ is more frequent in this age group.
|
broncholitis
|
|
Resembles asthma, occurs mostly in winter, and in children less than 2 years of age.
|
Bronchiolitis
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_____ is caused by a viral infection most commonly the respiratory syncytial virus.
|
broncholitis
|
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_____ is a respiratory infection of the medium sized airways.
|
broncholitis
|
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_____ causes a greatly distended chest from continued trapping of air.
|
status asthmsticus
|
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Nebulized bronchodilator medication include..
|
Albuterol
metaproterenol levalbuterol |
|
A pt that is taking theophylline or an oral beta agonist usually has _____?
|
asthma
|
|
The second phase of asthma will not respond to ____ _____. You should use agents such as _____ instead.
|
inhaled bronchodilators
corticosteroids |
|
The two stages of asthma?
|
release of chemical mediators
inflammation of the bronchioles |
|
Bronchospasm, excess mucus production, and airway hyperresponsive are indicators of?
|
asthma
|
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_____ occurs before the age of 10 in 50% of cases and before the age of 30 in another 33% of cases.
|
asthma
|
|
A chronic inflammatory disorder of the lower respiratory tract.
|
asthma
|
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absence of stridor, wheezing during exhalation, and increased work of breathing are signs of _____ airway distress.
|
lower
|
|
Lower airway distress includes _____?
|
asthma
bronchiolitis foreign body obstruction pnemonia |
|
what type e stim for bells palsy, if they come asap.
|
dispering (low, continuous)
disperse it away!! |
|
High grade fever, coughing up pus or mucus, horse voice, may cause stridor?
|
Bacterial tracheitis
|
|
Bacterial infection of the airway, subglottic region
|
Bacterial tracheitis
|
|
Likely to follow viral croup, affects mainly toddlers and infants 1 to 5 years of age.
|
Bacterical tracheitis
|
|
The epiglottis can be seen posterior to the base of the tongue will be cherry red and swollen with _____.
|
epiglottitis
|
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Pain swallowing, sore throat, high fever, shallow breathing, dyspnea, strider, and drooling are s/s of this.
|
epiglottitis
|
|
high temprature, brassy cough, and progression may be dramatic
|
epiglottitis
|
|
An infection that usually strikes in children 3 to 7 years old.
|
epiglottitis
|
|
Bacterial infection, usually from Haemophilus influenzae type B
|
Epiglottitis
|
|
Cool air causes a decrease in subglottic edema and the patient ma be clinically improved if outside.
|
croup
|
|
Medical direction may order racemic epinephrine, albuterol or steroids for this condition.
|
croup
|
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_____ can result in a complete airway obstruction although rare.
|
croup
|
|
Examination may result in laryngospasm and complete airway obstruction.
|
epiglottitis
|
|
Rapid onset, sits up, drooling, pain swallowing, and a temperature of 102 to 104.
|
epiglottitis
|
|
Slow onset, sits up, no drooling, temperature of 101 to 102.
|
croup
|
|
A viral infection that is most common in fall and winter.
|
croup
|
|
This service was formed for the express purpose of improving the health of pediatric health care concerns.
|
Emergency Medical Services for Children (EMSC)
|
|
Calcium Chloride dose (pediatric)
|
20 mg/kg slow
|
|
Pediatric lidocaine dose
|
1 mg/kg (max 100 mg) infuse at 25 to 50 mcg/kg/min
|
|
The treatment for neurogenic shock is directed at increasing the _____ _____ _____; and is accompished through the administration of Dopamine at 2mcg/kg/min
|
Peripheral vascular resistance
|
|
Pediatric dose of dopamine
|
2 mcg/kg/min
|
|
A particularity useful source of pediatric medicine is?
|
The center for pediatric medicine.
|
|
Up to _____% of children treated by EMS need nothing more than basic life support
|
85%
|
|
Treatment of an infant, child, or teenager begins with communication and _____ support.
|
psychological
|
|
Neonate: Birth to 1 month. Soon after birth the neonate typically looses up to _____% of its birth weight as it adjusts to extrauterine life.
|
10%
|
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The neonatal stage of development centers on _____.
|
reflexes
|
|
An infants personality begins to form at this stage.
|
neonatal
|
|
Common illnesses at this age includes jaundice, vomiting and respiratory distress.
|
neonate
|
|
Extrauterine weight loss is typically regained within _____ days.
|
10 days
|
|
A fever in a neonate should be considered _____ or other serious illness.
|
meningitis
|
|
Infants are children _____ to _____ months
|
1 to 12 months
|
|
_____ should be able to follow the movements of others with their eyes.
|
infants 1 to 5 months
|
|
In an infant 1 to 5 months, muscle control developes in a _____ progression.
|
cephalocaudal
|
|
Muscle control spreads from the _____ to the _____ in an infant 1 to 5 months
|
trunk to extremities.
|
|
Personality still centers closely on the parents or caregivers at this stage.
|
infant 1 to 5 months
|
|
Infants in this age group may stand or even walk with assistance.
|
6 to 12 months
|
|
Enjoy exploring the world with their mouths and at an increased risk of a FBAO
|
6 to 12 months
|
|
At this age a child has a considerable anxiety toword strangers and do not like to lay on their backs.
|
6 to 12 months
|
|
Common illnesses in this age group includes febrile seizures, V&D, dehydration, broncholitis, car crashes, croup, abuse, poisonings, falls, airway obstruction, and meningitis.
|
6 to 12 months
|
|
Great strides in gross motor development occur in this stage.
|
toddler 1 to 3 years
|
|
Toddlers are age _____ to _____?
|
1 to 3 years
|
|
Become braver, curious, stubborn, and stray away from parents more frequently.
|
toddler 1 to 3 years
|
|
Language development begins at this stage.
|
toddler 1 to 3 years
|
|
V&D, febrile seizures, poisoning, falls, abuse, croup and meningitis are common in this age group.
|
Toddler 1 to 3 years
|
|
Children in this age group may resist being touched.
|
toddler 1 to 3 years
|
|
Preschoolers age age _____ to _____.
|
preschooler 3 to 5 yers
|
|
This age group show a tremendous increase in fine and gross motor control
|
preschool 3 to 5 years
|
|
This age group know how to talk but may refuse to speak if scared or to strangers.
|
preschool 3 to 5 years
|
|
Have tempers, fear mutilation and feel threatened by treatment.
|
preschool 3 to 5 years
|
|
This age group stick up for people they love, openly affectionate, seek support and comfort at home.
|
preschool 3 to 5 years
|
|
Imagination may interfere with facts and a distorted sense of time.
|
preschool 3 to 5 years
|
|
Use toe to head exams on this age group
|
6 months to 3 years
|
|
Examine chest first and head last in this age group
|
preschool 3 to 5 years
|
|
Protect and proud of parents and seek their attention but also value peers at this age.
|
school age 6 to 12 years
|
|
Common illness in this age group include drownings, auto collisions, bicycle accidents, falls, sports injury, abuse and burns.
|
school age 6 to 12 years
|
|
Puberty begins at age ______ for girls and age_____ for boys.
|
11
13 |
|
Adolescents are ages _____ to _____
|
adolescents 13 to 18 years
|
|
Preceptions of events may differ from that of parents at this age.
|
Adolescence 13 to 18 years
|
|
The combination of _____ and _____ makes infants and children especially susceptible to hypoxia.
|
increased O2 requirements
decreased O2 reserve |
|
When inserting an intrasseous needle, be sure and avoid the _____.
|
growth plate
|
|
The two organs that are larger proportionatlly in the child are?
|
liver and spleen
|
|
A child's larynx is at level _____ and extends into the _____.
|
C3 and C4
pharynx |
|
The fontanelle may become tight and bulging, and pulsations may disappear due to _____?
|
ICP, meningitis, head trauma
|
|
The anterior fontanelle should be level with the surface of the skull or slightly _____, and may _____
|
sunken
pulsate |
|
The posterior fontanelle diminishes after _____ and the anterior fontanelle diminishes after _____ months and close between _____ and _____ months.
|
4 months
6 months 9 and 18 months |
|
_____ is a late sign of shock in a pediatric patient and is a sign of imminent cardiopulmonary arrest.
|
hypotension
|
|
Shock in infants and children is based on clinical signs of _____?
|
tissue perfusion
|
|
Suspect shock if _____ is present
|
tachycardia
|
|
The emphasis on warmth in infants and children is based on what metabolic considerations?
|
* limited stores of glycogen and glucose
* greater BSA to weight ratio * volume loss from V&D *newborns & neonates lack the ability to shiver. |
|
_____ is a rapid approach that allows you to detect a life-threatening situations without using a stethoscope.
|
eyes open, hands on
|
|
The pediatric assessment triangle consists of?
|
appearance, work of breathing, circulation to skin
|
|
The _____ can serve as the "AV" part of the AVPU and includes
|
TICLS
Tone *** interactiveness*** consolability***look/gauze*** speech/cry |
|
Check capillary fefill on children _____ years and younger and BP in children _____ years and older
|
5 years
3 years |
|
_____ and _____ are the most common cause of cardiac arrest in infants and young children.
|
airway and respiratory problems
|
|
Ascultate for breath sounds in the pediatric patient here.
|
near each armpit
|
|
Cyanosis of the extremities alone is more likely due to _____ than to respiratory failure.
|
circulitory failure
|
|
Pulse rate and RR for infants 0 to 12 months
|
Pulse 100 to 160
RR 30 to 60 |
|
Pulse and RR in toddlers 1 yr to 3 yr
|
pulse: 80 to 110
RR: 24 to 40 |
|
Pulse, RR, and BP in preschoolers 3 yr to 5 yr
|
Pulse: 70 to 110
RR: 22 to 34 BP: 90 + 2Xage / 2/3 systolic |
|
Pulse, RR and BP in school age children 6 yr to 10 yr
|
pulse: 65 to 110
RR: 18 to 30 BP: 90 + 2Xage / 2/3 systolic |
|
Early adolescence are ages _____ to _____.
|
adolescence: 11 to 14 years
|
|
pulse, RR and BP in early adolescence ages 11 to 14 years.
|
pulse: 60 to 90
RR: 12 to 26 BP: 90 + 2xage / 2/3 systolic |
|
End organ perfusion is most evident where?
|
skin, kidneys, brain
|
|
Normal urine output for children
|
1 to 2 ml/Kg/hr (if < 1ml you have poor renal purfusion)
|
|
Conditions that place a pediatric patient at risk of cardiopulmonary arrest include?
|
RR > 60
Heart rate > 180 or < 80 (under 8 yr) > 180 or < 60 (over 8 yr) increased respiratory distress, Trauma, Burns, Cyanosis, ALC, seizures, fever with petechiae. |
|
A _____ phase is intended for the conscious, non-acutely ill patient to become familiar with you.
|
transitional
|
|
A GCS of _____ to _____ is of moderate severity.
|
9 to 12
|
|
Suction catheter size for
0 to 1 years 2 to 6 years 7 to 15 years |
8
10 12 |
|
Suction pressure for infants?
|
less than 100 mmHg
|
|
_____ is the hallmark of pediatric patient management
|
oxygenation
|
|
One complication of placing a nasopharyngeal in a child is due to an enlarged _____.
|
adenoids (lymphatic tissue in the nasopharynx
|
|
A device that is contraindicated in pediatric resuscitation?
|
flow restricted oxygen powered ventilation device
|
|
Airway size in children preclude the use of _____, _____, and _____ but a _____ may be used, but do not protect the airway from asperation.
|
EOA, PtL, ETC's
LMA's |
|
A straight blade should be used on children due to their glottis being _____ and _____.
|
Cephalad and anterior
|
|
To calculate a Et tube size for children use this formula.
|
years in age + 16 (4) = tube size
|
|
Cuff pressure on an ET tube for children should not exceed?
|
20 cm H2O
|
|
ET tube size X _____ will give an approximate depth in centimeters.
|
3 ie: 3.0 X 3 = 9cm
|
|
The best method of determining ET tube depth in children is _____
|
direct visualization
|
|
The dosage for succinycholine is _____, and acts in _____ seconds and lasts for _____ min.
|
1 to 2 mg/kg IV push
60-90 seconds 3 to 5 min. |
|
Succinylcholine (anectine) has no effect on _____ or _____.
|
consciousness or pain
|
|
Neuromuscular blocking agents are called _____. Examples _____
|
paralytics
succinycholine (anectine) |
|
Commonly used sedatives include?
|
Midazolam (versed)
Diazepam (valium) thiopental fentanyl |
|
If longer paralysis is required use _____ or _____.
|
Pancuronium or vecuronium
|
|
The mnemonic DOPE stands for _____ in deterioration of an intubated child.
|
displacement
obstruction phenumothorax equipment failure |
|
NG tube size in the newborn/ infant
toddler/preschool school age adolescents |
8 french
10 12 14 to 16 |
|
Measure an NG tube how?
|
From the tip of the nose, over the ear to the xiphoid process.
|
|
A child with septic shock may requir _____ ml/kg IV fluid
|
60 to 80 ml/kg
|
|
Initial dose for defibrillation in children is _____. and additional shocks are at _____.
|
2 joules/kg
4 joules/kg |
|
Children in respiratory distress will initially have a slight decrease in the _____ as the respiratory rate increases, but will gradually increase.
|
atrial carbon dioxide tension
|
|
Viral, 6 months to 4 years, inflammation of the upper respiratory tract involving the sub-glottic region
|
croup
|
|
Leads to edema beneath the glottis and larynx narrowing the lumen of the airway.
|
croup
|
|
Amiodarone dose in children?
|
5mg/kg repeat up to 15 mg/kg
max: 300mg |
|
Amiodarone is a _____ and acts on_____?
|
antiarrhythmic
acts on the SA and AV nodes and slows conduction |
|
Epinephrine dose for children with anaphylaxis.
|
0.01 mg/kg of 1 to 10,000 q 3 to 5 min
|
|
Epinephrine is a _____ and does what?
|
Sympathomemmic. Constricts blood vessels. increases heart rate. dialiates airway
|
|
Glucose dose in children
|
0.5 to 1.0 g/kg IV
D 10 5 to 10 ml/kg D25 2 to 4 ml/kg D50 1 to 2 ml/kg |
|
Atrophine sulfate dose in children
|
0.02 mg/kg repeat dose
max dose in child 0.5 mg max dose in adolescents 1.0 mg min dose 0.1 max dose 0.5 |
|
Atropine sulfate does what and is a _____
|
increases firing of the SA node and conduction through the AV node. used for bradycardias.
is an anticholenergic and is an antagonist for acetylcholine receptor |
|
Adenosine dose for children?
max? |
0.1 to 0.2 mg/kg
max of 12 mg |
|
Adenosines (adenocard) actions
|
relaxes smooth muscle in the artery walls. Slows conduction through the AV node.
Use with PSVT |
|
Sodium bicarbonate dose in children
|
1mEq/kg
|
|
procainamide dose in children
|
15 mg/kg over 30 to 60 min.
|
|
Naloxone dose for children
|
< 5 yr is 0.1 mg/kg IV
> 5 yr is 2 mg. |
|
A neonate is the time from time of birth to _____?
|
1 month
|
|
About 80% of newborns weighing less than _____ at birth require resucitation.
|
3 pounds, 5 oz or 1,500 grams
|
|
antepartum
|
before the onset of labor
|
|
intrapartum
|
occurring during childbirth
|
|
multiple gestation, inadequate prenatal care, mothers age <16 or >35, history of perinatal morbidity or mortality, post-term gestation, drugs/medication, toxemia, hypertension, diabetes are _____ type of risk factors
|
antepartum - before the onset of labor
|
|
premature labor, meconium-stained amniotic fluid, rupture of membraines more than 24 hours, narcotic use within 4 hours of delivery, abnormal presentation, prolonged or preciptious delivery, prolapsed cord or bleeding are all _____ factors
|
Intrapartum - occurring during childbirth
|
|
protrusion of abdominal contents into the thoracic cavity through an opening in the diaphragm
|
Diaphramatic hernia
|
|
meingomoyelocele
|
herniation of the spinal cord and membranes through a defect in the spinal column.
|
|
Do not use bag valve mask in the infant suffering from _____?
|
diaphragmatic hernia
|
|
Do not place an infant on its back with this condition.
|
meningomyelocele
|
|
Treatment of meningomyelocele consists of...
|
Cover the spinal defect with sterile gauze pads soaked in warm sterile saline and inserted in a plastic covering
|
|
Omphalocele is a _____
|
congenital hernia of the umbilicus
|
|
Abdominal contents may fill this defect, resulting in an _____?
|
omphalocele
|
|
in the infant treat an Omphalocele with
|
Cover with an occlusive dressing to decrease water and heat loss
|
|
_____ _____ can cause upper airway obstruction and respiratory distress in the newborn.
|
choanal atresia
|
|
The most common birth defect involving the nose
|
choanal atresia
|
|
The presence of a bony membranous septum between the nasal cavity and the pharynx
|
choanal atresia
|
|
Suspect this condition if you are unable to pass a catheter through either nare.
|
choanal atresia
|
|
Two conditions that make it hard to keep a seal on a BVM
|
cleft palate, cleft lip.
|
|
_____ is a congenital condition characterized by a small jaw and large tongue in conjunction with a cleft plate.
|
Pierre Robin syndrome.
|
|
With this condition the tongue is likely to cause an upper airway obstruction.
|
Pierre Robbin syndrome
|
|
a nasal or oral airway will usually bypass this type of airway obstruction
|
Pierre Robin syndrome
|
|
Expect a normal heart rate of _____ to _____ bpm at birth
|
150 to 180
|
|
Acrocyanosis is
|
cyanosis of the extrenities.
|
|
An active and vigorous newborn who require only routine care will have an APGAR score between _____ and _____.
|
7 to 10
|
|
A moderately distressed newborn who will require oxygenation and stimulation will have an APGAR score between _____ and _____.
|
4 to 6
|
|
An infant who scores below a 4 on the APGAR scale will require...
|
immediate resuscitation
|
|
_____ % of newborns require no resuscitation other than suctioning of the airway, mild stimulation, and body temperature maintenance.
|
80%
|
|
A suction device that can be powered by the mouth of the operator or an external vacuum source.
|
DeLee suction trap
|
|
Most heat loss in an infant is due to?
|
evaporation
|
|
an excess of red blood cells.
|
polycythemia
|
|
A condition that may reflect hypovolemia or prolonged intrauterine hypoxia
|
polycythemia, (excess of RBC)
|
|
polycythemia can contribute to red blood cell destruction, which may in turn lead to _____?
|
hyperbilirubinemia
|
|
An increase of bilirubin may cause _____?
|
jaundice
|
|
_____ is the most important indicator of neonatal distress.
|
fetal heart rate
|
|
A newborn has a relatively fixed _____ _____
|
stroke volume
|
|
The newborn cardiac output depends more on the _____ _____ than on the stroke volume.
|
heart rate
|
|
Resuscitation of the newborn follows an _____?
|
inverted pyramid.
|
|
On the newborn assessment parameter you should check the _____ first then the _____
|
Respiratory effort
heart rate |
|
A peep should be set at _____ for a newborn.
|
2 to 4 cm/H2O
|
|
measure an orogastric tube how?
|
from the lips to the xyphoid process.
|
|
The umbilical cord has _____ veins and _____ arteries
|
1
2 |
|
For vascular access on a newborn insert a ____ sized umbilical catheter.
|
5 french
|
|
Heart rate and color must first be restored by supporting ventilations before administration of _____
|
Naloxone 0.1 mg/kg q 2 to 3 min for newborn
|
|
meconium stained amniotic fluid occurs in aprox __ to __ % of deliveries
|
10 to 115 %
|
|
Meconium staining mostly occur in infants that are _____ or _____.
|
post-term or small for gestational age
|
|
Diazepan (valum) dose?
pediatric adult |
pediatric: 0.1 to 0.3 mg/kg
5 to 10 mg |
|
Racemic epinephrine dose
pediatric adult |
pediatric: 0.5 ml
adult:" 0.5 ml |
|
After initial hypoxia, the infant rapidly gasps for breath. If the asphyxia continues respiratory movement ceases and heart rate begins to fall then enters a period known as ?
|
Primary apnea
|
|
The infant takes several last deep gasping breaths. The infant becomes unresponsive and will not spontaneously return. This is known as ?
|
Secondary apnea
|
|
Most blood pumped by the heart bypasses the nonfunctional respiratory system by flowing through the?
|
ductus arteriosus
|
|
Blood flow is diverted from the ductus arteriosus to the lungs due to ?
|
decreased pulmonary vascular resistance
|
|
If the ductus arteriousis reopens it will trigger fetal circulation. This is called ?
|
persistant fetal circulation
|
|
If the ductus arteriousis fail to close it is called?
|
persistant ductus arteriosus
|
|
A condition where the right and left ventricals are switched?
|
Transposition of the greater vessels
|
|
A narrowing of the aorta causing obstruction of blood flow
|
Coarctation of the aorta
|
|
The left side of the heart is underdeeloped in this condition?
|
hypoplastic left heart syndrome
|
|
A diaohragmatic hernia is most often located where?
|
posterolateral segments of the diaphragm.
|
|
A diaphragmatic hernia is caused by failure of the ____?
|
pleuroperitoneal cavity to close completely
|
|
S/S of cyanosis unresponsive to ventilations. small, flat abdomen. Bowel sounds in the chest. Heart sounds displaced to the right. Are dut to _____?
|
Diaphragmatic hernia
|
|
As soon as you suspect a diaphragmatic hernia place the infant in this position.
|
head and thorax higher than the abdomen and feet.
|
|
hypoxia, ICP, hypothyroidism, or acidosis may cause _____ in the newborn
|
bradycardia
|
|
Use of _______ may be helpful for prolonged resuscitation.
|
Sodium Bicarbonate 1mEq/kg (slow)
|
|
The leading cause of shock in the newborn is _____?
|
Hypovolemia
|
|
A seizure consisting of chewing motions, excessive salivation, blinking, swimming motions and pedaling motion of the legs
|
Subtle
|
|
Seizure characterized by rigid posturing of the extremities and trunk.
|
Tonic
|
|
Seizure consisting of rhythmic twitching of muscle groups, mostly in the extremities and face.
|
Focal clonic
|
|
A seizure that most often occurs in full-term newborns.
|
multifocal
|
|
A seizure consisting of rhythmic twitching of multiple muscle groups?
|
Multifocal
|
|
A seizure of brief focal or generalized jerks.
|
myoclonic
|
|
Average normal temperature in a newborn?
|
37.5 C or 99.5 F
|
|
_____ may be the only sign of meningitis in a neonate
|
fever
|
|
A body temperature of _____ is hypothermia in the neonate
|
35 C or 95 F
|
|
Hypothermia may also be a sign of _____ in the newborn.
|
Sepsis
|
|
Hypoglycemia in the newborn may be due to _____?
|
inadequate glucose intake or increased glucose utilization.
|
|
A normal newborn's glycogen stores are sufficient to meet the needs for _____ hours?
|
8 - 12
|
|
A blood glucose of less than _____ indicated hypoglycemia in the newborn
|
45 mg/dL
|
|
Vomiting in the neonate usually occurs due to an anatomical abnormality such as ______?
|
tracheoesophageal fistula or upper gastrointestinal obstruction.
|
|
Most often vomiting in the neonate is due to _____?
|
ICP or sepsis
|
|
A large scalp hematoma developed during childbirth is called _____?
|
Caput succedaneum
|
|
_____ refers to a baby in the first hours of life
|
newborn
|
|
Infants should have doubled their birth weight by ___ months
|
5 to 6 months
|
|
Language development begins at ages __ to __
|
1 to 3 years
|
|
Infants and children have a tidal volume proportionately the same as adults, they require _____ the metabolic oxygen.
|
Double
|
|
Funding for (CPEM) Center for pediatric medicne comes from where?
|
(EMSC) Emergency medical services for children
|
|
The agency formed for the express purpose of improving the of pediatric patients.
|
EMSC
|
|
On the pediatric patient placing the stethoscope near the armpits will do what?
|
minimize transmitted breath sounds.
|
|
_____ is often the first manifestation of respiratory distress in children.
|
Tachypnea
|