ENPC 6th ed Chap. 3 Pediatric Differences

Question 1

What should your attitude be towards infants that are inconsolable?

Answer 1

They warrant immediate further treatment (31 RF)

Question 2

Compare a peds stroke volume to that of an adult?

Answer 2

Peds SV is fixed due to a lack of myocardial stretch so in order for CO to increase HR must increase in peds. (33)

Question 3

What are some physiologic causes of a higher respiratory rate in children?

Answer 3

A lack of tidal reserves and increased cellular o2 consumption. (33)

Question 4

How much volume will be lost before a ped exhibits a decrease in blood pressure? (range as a percent)

Answer 4

25-50% of volume is lost (34 RF)

Question 5

What is the PALS definition of hypotension in a neonate (0-28 days)?

Answer 5

SBP < 60 mmHg (34)

Question 6

What is the PALS definition of hypotension in an infant (1-12 mos)?

Answer 6

SBP < 70 mmHg (34)

Question 7

What is the PALS definition of hypotension in a child 1- 10 years

Answer 7

SBP < [ 70 + (2x age in years)] mmHg (34)

Question 8

What is the PALS definition of hypotension in a child older than 10?

Answer 8

SBP < 90 mmHg (34)

Question 9

At what age is a Childs respiratory system developed to the point that it is similar to an adults?

Answer 9

8 years old (34)

Question 10

What two criteria need to be presents for a label of apnea to be applied to an infants respiratory pattern?

Answer 10

1. 20 seconds w/o a breath OR
2. “associated with other physiologic effects such as bradycardia” (34)

Question 11

AT what age do infants start to breath through their mouths?

Answer 11

4-6 mos (34)

Question 12

What might be the cause of a neonate with respiratory or shock symptoms and no fever or exposure to ill contacts?

Answer 12

congenital heart disease (35 CP)

Question 13

At what age do growth plates close?

Answer 13

14 years old (35)

Question 14

Why are fractures in infants rare?

Answer 14

the bones are softer and more prone to bending. When fractures are present consider maltreatment of significant underlying injury (35RF)

Question 15

What should you consider monitoring in ped with altered mental status?

Answer 15

Glucose. children have smaller glucose stores in the liver and increased glucose consumption by the brain. (36 RF)

Question 16

What physiologic diffeences from adults make children’s organs more prone to injury?

Answer 16

decreased protection from the rib cage (36 CP)

Question 17

Until what age is gluconeogenesis delayed?

Answer 17

About 12 months old (36)

Question 18

What the age range for a neonate?

Answer 18

0-28 days (30)

Question 19

What the age range for a infant?

Answer 19

1-12 mos

Question 20

What the age range for a toddler?

Answer 20

1-3 years

Question 21

What the age range for a preschooler ?

Answer 21

3-6 years

Question 22

What the age range for a school age?

Answer 22

6-12 years

Question 22

What the age range for a adolescent ?

Answer 22

13-18 years

Question 22

How wide should a properly fitting BP cuff be?

Answer 22

2/3 the width of the patients arm (34)

Question 22

What is the narrowest part of the pediatric airway?

Answer 22

Just above the cricoid cartilage (34)

Question 23

Why is it easier for children to vagal with suctioning and rectal temp?

Answer 23

Their parasympathetic nervous system is more pronounced and easier to stimulate (35)

Question 24

How might a nurse easily determine that the patient likely has a congenital heart defect?

Answer 24

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)

Question 25

By what age do fontanelles close?

Answer 25

18 months (36)

Question 26

By what age are cranial sutures fused?

Answer 26

Age 12 (36)

Question 27

What renal difference between children and adults can contribute to DHN?

Answer 27

Limited ability to concentrate urine (36)

Question 28

What is the leading cause of septic bacterial infection in children under 3 years old?

Answer 28

UTI (36)

Question 29

Why are children more susceptible to heat and fluid loss?

Answer 29

Their skin is thinner (37 CP)

Question 30

What is the ideal age range for scalp veins to be accessed?

Answer 30

Less than 9 months (37)

Question 31

When accessing a scalp vein, toward what direction must the cannula point?

Answer 31

Towards the heart (37)

Question 32

Why might blood collection be easier via a scalp vein?

Answer 32

The have no valves (37)

Question 33

What volume should intranasal medications be limited to?

Answer 33

1 m l (39)

Question 34

By what age can children effectively use number scales?

Answer 34

By age 8 kids understand smaller and larger numbers (41)

Question 35

Compare MDI to nebulized medications?

Answer 35

MDI are more effective than nebs are providing “timely delivery of prescribed meds” (39)