ENPC 6th ed Chap. 3 Pediatric Differences Flashcards
What should your attitude be towards infants that are inconsolable?
They warrant immediate further treatment (31 RF)
Compare a peds stroke volume to that of an adult?
Peds SV is fixed due to a lack of myocardial stretch so in order for CO to increase HR must increase in peds. (33)
What are some physiologic causes of a higher respiratory rate in children?
A lack of tidal reserves and increased cellular o2 consumption. (33)
How much volume will be lost before a ped exhibits a decrease in blood pressure? (range as a percent)
25-50% of volume is lost (34 RF)
What is the PALS definition of hypotension in a neonate (0-28 days)?
SBP < 60 mmHg (34)
What is the PALS definition of hypotension in an infant (1-12 mos)?
SBP < 70 mmHg (34)
What is the PALS definition of hypotension in a child 1- 10 years
SBP < [ 70 + (2x age in years)] mmHg (34)
What is the PALS definition of hypotension in a child older than 10?
SBP < 90 mmHg (34)
At what age is a Childs respiratory system developed to the point that it is similar to an adults?
8 years old (34)
What two criteria need to be presents for a label of apnea to be applied to an infants respiratory pattern?
- 20 seconds w/o a breath OR
- “associated with other physiologic effects such as bradycardia” (34)
AT what age do infants start to breath through their mouths?
4-6 mos (34)
What might be the cause of a neonate with respiratory or shock symptoms and no fever or exposure to ill contacts?
congenital heart disease (35 CP)
At what age do growth plates close?
14 years old (35)
Why are fractures in infants rare?
the bones are softer and more prone to bending. When fractures are present consider maltreatment of significant underlying injury (35RF)
What should you consider monitoring in ped with altered mental status?
Glucose. children have smaller glucose stores in the liver and increased glucose consumption by the brain. (36 RF)
What physiologic diffeences from adults make children’s organs more prone to injury?
decreased protection from the rib cage (36 CP)
Until what age is gluconeogenesis delayed?
About 12 months old (36)
What the age range for a neonate?
0-28 days (30)
What the age range for a infant?
1-12 mos
What the age range for a toddler?
1-3 years
What the age range for a preschooler ?
3-6 years
What the age range for a school age?
6-12 years
What the age range for a adolescent ?
13-18 years
How wide should a properly fitting BP cuff be?
2/3 the width of the patients arm (34)
What is the narrowest part of the pediatric airway?
Just above the cricoid cartilage (34)
Why is it easier for children to vagal with suctioning and rectal temp?
Their parasympathetic nervous system is more pronounced and easier to stimulate (35)
How might a nurse easily determine that the patient likely has a congenital heart defect?
POX Is measured on the RIGHT hand and compared to the foot. If the difference is more than 3% could indicate a CHD (35 P)
By what age do fontanelles close?
18 months (36)
By what age are cranial sutures fused?
Age 12 (36)
What renal difference between children and adults can contribute to DHN?
Limited ability to concentrate urine (36)
What is the leading cause of septic bacterial infection in children under 3 years old?
UTI (36)
Why are children more susceptible to heat and fluid loss?
Their skin is thinner (37 CP)
What is the ideal age range for scalp veins to be accessed?
Less than 9 months (37)
When accessing a scalp vein, toward what direction must the cannula point?
Towards the heart (37)
Why might blood collection be easier via a scalp vein?
The have no valves (37)
What volume should intranasal medications be limited to?
1 m l (39)
By what age can children effectively use number scales?
By age 8 kids understand smaller and larger numbers (41)
Compare MDI to nebulized medications?
MDI are more effective than nebs are providing “timely delivery of prescribed meds” (39)
