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Pediatrics > Chapter 7 - Postoperative Care and Pain Management > Flashcards

Chapter 7 - Postoperative Care and Pain Management Flashcards

1
Q

All children should be transported to the PACU in what position?

A

Lateral decubitus

Head extended

Oxygen

Pulse oximitry

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2
Q

T/F

Infants younger than 3 months of age, may not rapidly convert to mouth breathing if the nasal passages are blocked

A

T

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3
Q

T/F

Laryngospasm occurs most commonly during emergence

A

T

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4
Q

What is the dose of succinylcholine that will relieve laryngospasm?

A

Succinylcholine 0.2 mg/kg

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5
Q

T/F

Stridor is more common in children with down syndrome

A

T

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6
Q

Stridor usually appears within how long after extubation?

A

30 to 60 min.

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7
Q

What is the treatment for flash pulm edema after laryngospasm?

A

Positive pressure ventilation 100% O2

furosemide

fluid restriction

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8
Q

Agitation occurs most commonly in children 2 to 6 years of age after what inhaled anesthetic?

A

Sevoflurane

  • Incidence up to 80%
  • Transient
  • Dissipates within 10 to 20 min.
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9
Q

T/F

Shivering and rigidity may increase the metabolic rate of oxygen requirement

A

T

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10
Q

What medications can be used to eliminate post op shivering?

A

Demerol 0.25 mg/kg

or

Dexmedetomidine 0.5 mcg/kg (IV slowly)

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11
Q

What is the leading cause of delayed discharge from PACU?

A

Nausea & Vomiting

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12
Q

The combination of which two antiemetics provides the optimal PONV prophylactic regimen?

A

Zofran 0.05 to 0.1 mg/kg

and

Dexamethasone 0.0625 to 0.15 mg/kg

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13
Q

T/F

Biochemical and nervous components of the pain perception pathways are completely formed during fetal life.

A

T

Even the preterm can feel pain

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14
Q

When should postoperative pain be planned?

A

In the Preoperative interview

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15
Q

T/F

Optimal postop pain relief:

  • minimizes the metabolic rate for oxygen
  • reduces cardio respiratory demads
  • promotes earl ambulation
  • speed recovery
A

T

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16
Q

T/F

When treating pain at any age, it is essential to monitor the response to therapy with an objective scoring system

A

T

17
Q

T/F

Meperidine is recommended for perioperative anlagesia in children?

A

F

  • Potential for seizures
  • ONLY indication is to treat shivering
18
Q

Acetaminophen suppository can reach peak blood levels by how many min?

A

60 to 180 min

  • administer immediately after induction
  • not appropriate for brief procedures
19
Q

The daily dose of acetaminophen should not exceed 90 to 100 mg/kg and repeat doses should be given at what intervals?

A

6 hour intervals

20
Q

T/F

Ibuprophen can decrease platelet aggregation

A

T

Also:

  • N/V
  • Diarrhea
21
Q

T/F

Ibuprophen is indicated for treating tonsilectomy pain

A

F

  • Increases bleeding
22
Q

What is the dose for IV codeine?

A

MUST NOT be given IV

causes

SEVERE HYPOTENSION

23
Q

Ketorolac dose for children less than 50 kg?

Ketorolac dose for children more than 50 kg?

A

Children < 50 kg:

0.5 mg/kg - MAX of 15 mg

Children > 50 kg:

0.5 mg/kg - MAX of 30 mg

24
Q

Which opioid provides good pain relief after adenotonsillectomy?

A

Tramadol 1 to 2 mg/kg

25
Q

T/F

Tramadol can be particulary useful in children with OSA

A

T

26
Q

T/F

Children who are recieving vasopressors can have a reduced clearance rate of morphine

A

T

27
Q

What age group of children are capable of using a PCA system?

A

Older than 5 or 6 years of age

28
Q

T/F

The side effects of opioids are avoided when regional anesthesia is used

A

T

29
Q

T/F

Regional blocks established before the surgical incision may modulate total postop pain by preventing “wind up” within CNS

A

T

30
Q

What block is useful for inguinal hernia surgery?

A

Ilioinguinal and iliohypogastric

31
Q

Block for umblical surgery?

A

Bilateral T10 intercostal block

32
Q

Epidural morphine at 33 mcg/kg provides analgesia for up to how many hours?

A

12 hours

33
Q

Why is Fentanyl administered via lumber or caudal route is less likely to cause respiratory depression

A

Because of its

  • Increased Lipid Solubility
  • More limited distribution
  • Decrease rostral spread
34
Q

What are the most common side effects after regional blocks with opioids in children?

A
  • Urinary rentention
  • Pruritus
  • N/V
35
Q

If ventilatory depression does occur with a regional block with opioids, the ventilatory response to CO2 may be depressed for up to how many hours?

A

up to 24 hours

36
Q

What are some Common compications after neuraxial opiods?

A
  1. Pruritis
  2. Urinary retention
  3. N/V
  4. Respiratory depression

Pediatrics (4 decks)

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