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