2430 Exam Flashcards
What is the difference between the placenta and the uterus?
The placenta is known as the “organ of pregnancy” and the uterus provides a site for fetal development.
which pregnancy organ allows gas exchange between mom and the baby?
the placenta
What is the name of the transition after delivery when the newborn begins to breathe air on its own?
Extrauterine life
When assessing children, when do you assess the painful area?
last
What is kyphosis?
upper back curvature
What is Scoliosis?
S curvature of the spine
What is Lordosis?
Lower back curvature
What are most emotional and medical problems for children a result of?
neglect
What is the difference between child abuse, neglect, and abandonment?
Abuse represents an action against a child (physical/mental injury)
Neglect represents a lack of action (failure to meet basic needs)
Abandonment - left the child
What is the gestational period of pregnancy?
38-40 weeks
What has been the largest cause of preterm births in the US?
Narcotic use
If the parent says there is something wrong with the child, you should???
believe them. The parents know how the child is supposed to be acting.
What is stenosis?
narrowing of the blood vessels.
What is the difference between human trafficking and sexual exploitation?
Exploitation is for self use. Human trafficking is sending a person for others to use and for the trafficker to gain money
What happens to a mothers GI tract during pregnancy?
Moves slower which may lead to constipation or trouble emptying the stomach.
What is peristalsis?
series of involuntary wave like muscle contractions which move food along the digestive tract.
What is one of the factors that stimulates a newborns first breath?
hypoxia. Expect the newborn to be slightly blue.
Where is a pulse assessed in a newborn/child?
brachial pulse. Easiest to palpate.
What is the most common sensory change for the elderly?
Lose their vision and hearing. can lead to falls.
What is specialized care for people in the end stages of living called? ex. renal failure
comfort care/palliative care. These patients receive comfort care only. No advanced care is provided.
Medical term for pregnant
gravida
Medical term for deliveries?
Para
If a newborn remains blue in its trunk, what is it called?
centralized cyanosis.
What is the difference between epiglottitis and croup?
Epiglottitis is a bacterial infection of the upper airway accompanied by high fever and inflammation of the epiglottis. Child has trouble speaking, drools, cant fully open mouth.
Croup is a viral infection. Low grade fever. Barking cough, fever, hoarseness, labored or noisy breathing.
What are elderly people who can maintain muscle mass less likely to get?
arthritis
People in hospice or with a terminal illness usually call ems with something related to???
pain or if the issue has gotten worse.
When can a female become pregnant?
after their first menstral period.
What is the most common cause of bradycardia in infants?
hypoventilation and hypoxia. Second most common cause is hypothermia.
Most kids are predominantly what kind of breathers?
nose breathers due to large tongue size.
Newborn breathing rate is 40-60 times/min, normally can hear them make what sound when breathing?
grunting
What should be considered when assessing geriatrics?
social environment. often afraid of losing their independence.
Which population is more likely to delay calling EMS?
Poverty stricken/low income people.
What is something that should be considered when dealing with a female in labor with a hx of c-sections?
try not to deliver in the field. can cause a uterine rupture
What is the purpose of drying off the infant after birth?
keep them warm. Unable to regulate temperature yet.
Normal HR range for anyone past puberty? 11-12yr and up.
60-80
Normal HR for infant:
140-160
normal HR for toddler
120-140
Normal HR for school aged child:
100-120
What could be the cause of an acute onset of ripping or tearing sensation in the chest or abdomen?
dissecting aneurysms. More common in tall thin males.
When do you contact CPS or adult protective services?
when you suspect abuse. required by law.
What happens generally with each subsequent pregnancy/labor?
faster delivery on average.
When is an APGAR score obtained?
1 minute and 5 minutes after birth.
What does APGAR stand for?
appearance, pulse, grimace, activity, respirations
Why are kids prone to hypothermia and hyperthermia?
cannot regulate their temperature as well and because they have low fat stores.
What is an issue with high blood pressure in pregnancy?
pre-eclampsia/eclampsia
Above what systolic pressure is pre-eclampsia?
140
What medication is given to treat a seizure due to eclampsia?
mag
What is the difference between pre-eclampsia and cardiomyopathy in pregnant females?
Eclampsia is treated with Mag and will present with elevated blood pressure.
Cardiomyopathy associated with obesity and normal BP in pregnancy.
What is needed to give fluid to a pedi?
weight.
What is the formula for a fluid bolus for a pediatric patient?
20ml x weight
If you dont know the weight of the child, how can it be estimated?
2x age +8 = approximate weight in Kg.
What is a complication of constipation in pregnancy?
Sepsis from bowel obstruction
Cool, pale, clammy, HTN, and fluid in the lungs are all s/s of what?
CHF
What are S/S of pneumonia?
warm to the touch, fluid in the lungs. Temp is the major differentiator between CHF and pneumonia.
What is the first step when dealing with a seizure due to high blood pressure?
need to stop the seizure first.
What needs to be done for a healthy newborn who becomes bradycardic?
recheck airway and temp. airway and temp are the most common causes of newborn bradycardia.
How often are vitals rechecked for critical patients?
every 5 minutes.
What is likely the issue with an elderly patient who wakes up in the middle of the night and feels like they are drowning?
Early sign of CHF and pulmonary edema called paroxysmal nocturnal dyspnea
When mag doesnt work to stop a seizure in a pregnant patient, what is the next step?
benzo
Where does the pulse oximetry device go on a newborn?
right hand . Right hand is closest to the brachial artery after branching directly off the aorta.
What should the SPO2 % for a newborn be 10 minutes after birth?
85-95%. This is after the ductus arteriosus valve closes.
Why do some people call 911 rather than transport themselves to the ED?
think they will be seen faster if they go by ambulance.
If the patient looks like she has gone into hemorrhagic shock during delivery, she may have a???
ruptured uterus. maintain radial pulse with fluid. keep mom alive.
What is the first drug and dose given during pediatric CPR?
Epi 0.1mg/kg 1:10,000.
How should a child be transported to the hospital in the ambulance if possible?
car seat
What should be considered early for patients above 12 with pulmonary edema?
CPAP
What is the order of operations for suctioning a newborn?
mouth first then nose
What is usually the cause of a viral wheezing infection?
bronchiolitis. Common in toddlers. inflammation of the small airways.
What is usually the issue when a patient has wheezing not associated with infection?
asthma
What are the signs and symptoms of a UTI and how is it treated?
urinary frequency, burning when urinating, fever, abdominal pain, cloudy urine. Treat sepsis that may result from UTI.
what is the difference between abuptio placenta and placenta previa?
abruptio placenta - minimal vaginal bleeding, rigid abdomen, severe abdominal pain, signs and symptoms of shock, pain does not cease.
Placenta previa - paleness; occurs without warning, heavy vaginal bleeding, usually bright red blood.
What can happen if you hyperventilate a newborn?
increase intrathoracic pressure and decrease preload.
what should be done when immobilizing a pediatric patient?
pad beneath the shoulders.
What is usually the issue with a patient who has missed dialysis?
fluid overload.
What is usually the issue with a renal patient who has an issue after dialysis?
electrolyte depletion.
what is the fluid dose for pediatrics?
20ml/kg
What is something that should be considered with a patient on new medication who only wants to sleep?
medication may be over sedating them
What should be done with a nuchal chord?
slip the chord over the neck. if that doesnt work, clamp and cut. make sure there is no pulse between the clamps before you cut.
What should be checked if a newborn remains inactive after stimulation?
check BGL. Newborns 40 BGL, kids, 60 BGL, adults 80 BGL.
What happens as pacemaker patients age?
pacemaker doesnt work as well. may develop bradycardia
What is hydrocephalus?
extra fluid in the brain.
How is hydrocephalus treated and what are common complications?
shunt from the back of the skull to the abdomen. Shunt can become occluded and cause seizures.
What are the signs and symptoms of meningitis?
fever and stiff neck
What does suckling do for the mother?
releases oxytocin to help the uterus to contract?
What should be done for a pediatric patient with a HR below 60?
start CPR
What should be done early to prevent bradycardia in pediatric patients?
Early O2 and temperature control.
What are signs of autism?
withdrawn, moaning sounds
What should be done as the mom starts crowning?
support the babys head and assist with delivery.
what is the most common cause for not having chest rise with BVM?
poor airway seal
What should you be concerned about with a pediatric patient with a blank stare?
could be petit mal seziure (absence seizure)
What can happen with a basilar skull fracture?
can result in cardiac arrest almost immediately.
Signs and symptoms of muscular dystrophy?
instability, frequent falls.
Pregnant woman with a peritoneal laceration?
Mom needs to go to the hospital for repair.
First steps with unresponsive child?
look to ventilate and suction the child.
What are brown secretion in the trachea a sign of?
meconium aspirations. need suction and intubation. sign of fetal distress.
Pts who get tube feeding in nursing home can aspirate the food into lungs and get pneumonia if?
they are laid down too flat in bed.
If a baby is crowning and a thick white membrane over the babys head is present, what should be done?
Amniotic sack is still intact. Gently tear with two fingers.
If mom has delivered twins, what is something that should be considered?
need three ambulances if something is wrong with both kids. 3 possible patients.
If you intubate a newborn and they are difficult to bag, what should be checked?
pneumothorax
Order of operations for issues bagging intubated newborn:
D: displaced tube
O: obstructed tube
P: Pneumothorax
E: equipment
dextrose concentration for babies under 1:
D10
Dextrose concentration for 1-12y olds
d25
Dextrose concentration for people over the age of 12?
D50
How could you make D10 from D50?
diluting with saline at 5:1 ratio.
