Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatric Anesthesia > Exam 1: growth&development, preop eval, gen approach > Flashcards

Exam 1: growth&development, preop eval, gen approach Flashcards

1
Q

what is a question we always ask about baby in preop

A

-term/how many weeks it was born
-troubles after birth
-problems with pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is definition of pre-term infant

A

<37 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is definition of term infant

A

37-40 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is definition of post term infant

A

> 42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is considered extremely low birth weight

A

<1000g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is considered very low birth weight

A

<1500 g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is considered low birth weight

A

<2500 g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is premature

A

<37 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are anesthesia concerns with premature babies

A

airway control
fluid management
temperature regulation
retinopathy of prematurity
apnea of prematurity
<60 weeks PCA highest incidence of post anesthetic complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what patient has the highest incidence of post anesthetic complications

A

<60 weeks PCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is definition of small for gestational age

A

<10% for gestational age at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is a cause of small for gestational age

A

chronic placental insufficiency
chromosomal abnormalities
mother:
-smoking
-DM
-chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how can we prep the OR for small for gestational age/ all pediatric patient

A

warm room, warm them throughout case

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is a common hematology issue with small for gestational age

A

polycythemia leading to hyperviscosity syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how do we manage hyper-viscosity syndrome intraop

A

maintain or slightly elevate BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SGA/LGA issues

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is definition of LGA infant

A

> 90% for gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are common issues with LGA infants

A

birth injuries
hypoglycemia
hypocalcemia
difficult intubation/IV sticks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are issues with SGA infants (chart)

A

congenital anomalies
chromosomal abnormalities
chronic intrauterine infection
heat loss
asphyxia
metabolic abnormalities
hypoglycemia
hypocalcemia
polycythemia
hyperbilirubinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are issues with LGA infants (chart)

A

birth injuries
asphyxia
meconium aspiration
metabolic abnormalities
hypoglycemia
hypocalcemia
polycythemia
hyperbilirubinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are common birth injuries with LGA infant

A

brachial
phrenic nerve
fractured clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the most sensitive indicators of a babies well being

A

weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what issues can cause changes in babies weight

A

CHF
endocrine
malignancy
infection
malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what issues can we find through head circumfrence

A

severe malnutrition
hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what can cause a sunken fontanelle

A

fluid status changes
hemorrhage, fluid loss, dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what three measurements do we use to assess baby

A

weight
length
head circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how does newborn weight change in first week after birth

A

decrease by 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how do you calculate length in cm using age

A

(age in years x 6) + 77

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

by 6 month an infants weight is _______x

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

by 1 year an infants weight is __x

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

when does a baby regain its weight after its initial loss

A

2nd week
30g/day then
12g/day 1st year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the rule of 10s for males

A

10 lbs per year until 16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the rule of 10s for females

A

10 lbs a year until 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

how much weight does a preterm infant lose in first week

A

15% then gain it back slower than term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

T/F SGA infants lose more weight than others

A

F, dont lose weight, gain weight in first week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

preop screening chart

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what are preop of screenings for airway

A

history of difficult airway, adjuncts for ventilation and intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are preop of screenings for cardiovascular: murmur with pathologic findings

A

preop echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are preop of screenings for History of syncope or poor functional capacity:

A

preop ECG, consider preop echo and cardiology eval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are preop of screenings for asthma

A

preop albuterol if not well controlled
delay elective for poorly controlled
stress dose steroid if prolonged steroid exposure (>7 days) in last 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what are preop of screenings for cystic fibrosis

A

V/Q mismatch common,
preop oxygen sat,
bronchial hyper reactivity,
evaluate recent CXR and PFTs,
Echo if pulm htn suspected\may have liver disease,
total bili,
INR,
albumin
may have renal insufficiency from aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what are preop of screenings for severe OSA

A

overnight observation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what are preop of screenings for seizures

A

continue meds day of sx
AED (antiepileptic drug) interactions with NMB blockade
AED induced metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what are preop of screenings for ADHD

A

continue meds day of sx, consider alpha 2 agonist premedication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what are preop of screenings for CP?

A

constinue seizure and reflux medications day of sx
consider preop warming giving airway hypotonia
consider ICU or step down for recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what are preop of screenings for muscular dystrophy

A

preop ECG, ECHO, CPK, room air O2 sat, FVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what are preop of screenings for gastointestinal

A

continue reflux medications preop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what are preop of screenings for renal

A

check K
anemia may be present: preop HCT
continue HTN meds preop
assess most recent dialysis
volume status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what are preop of screenings for sickle cell

A

preop admission
IV hydration
tranfuse if hb<10 g/dl
consider echo for pulm htn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what are preop of screenings for oncology

A

evaluate for lesion location
evaluate end organ dysfunction from chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what are preop of screenings for mitochondrial myopathy

A

avoid prolonged fasting,
use dextrose containing IVF at maintenence rate,
consider peop echo and ECG
consider anxiolytic premedications midazolam, dexmetomidine, or ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are preop of screenings for type 1 diabetes

A

HbA1C prior to day of sx
continue long acting insulin (glargine)
continue insulin pump without reduction
reduce evening NPH by 50%
check awakening and preop BS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are preop of screenings for trauma/emergency

A

full stomach precautions
preop HCT
coagulation studies
C-spine films/precautions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what are preop of screenings for apnea of prematurity

A

require apnea-bradycardia monitoring post op (44-54 weeks PCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what are preop of screenings for prematurity, bronchopulmonary dysplasia, OLD

A

inflammation, smooth muscle hypertrophy, fibroproliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what are preop of screenings for prematurity, bronchopulmonary dysplasia, NEW

A

O2 dependence, >28 days old and disruption of lung growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what are preop of screenings for prematurity, subglottic stenosis

A

prolonged intubation, stridor may be present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what are preop of screenings for prematurity, airway

A

predict difficult airway
mucopolysaccharoidosis
pierre robin
treachear collins
goldernhar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what are preop of screenings for prematurity, others

A

intraventricular hmmg, hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

how do we calculate age for premature infants

A

Post-Conceptual Age = gestational age + post-maternal age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

u: How do we differentiate a benign murmur vs congenital pathology?

A

Functional capacity history
-can they play/run
-cyanosis/poor activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what congenital issues require cardiac consult

A

williams
noonan
trisomy 21
turner
marfan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

how can the CRNA prevent subacute bacterial endocarditis

A

preop abx
amoxicillin or clindamycin 60 min before dental case

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

how can we distinguish an innocent murmur

A

*Still’s: left lower sternal border and may radiate to the base of the heart. Heard supine and diminished when sitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

how can we distinguish a pathological murmur

A

*Congenital Disease: pansystolic, Grade 3 or above, Left upper sternal border, harsh, abnormal 2nd heart sound, early or midsystolic click

*Diastolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what volatile do we avoid in asthma

A

des

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

if a patients asthma is not well controlled and asymptomatic, what do we do

A

proceed with anesthetic after short- acting beat agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

T/F a patient with asthma can have surgery with minimal risk

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

if a patients asthma is well controlled and they have an expiratory wheese what do we do

A

if expiratory wheeze is resolved with SABA, proceed with sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

if a patient has poorly controlled asthma what do we do

A

consider reschedule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

preop asthma care

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

controlled vs not well controlled vs poorly controlled chart

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

what are risk factors for URI

A

intubation < 5 years
reactive airway disease
paternal smoking
premature
airway sx
copious secretions
nasal congestions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

a patient has moderat to severe URI with additional URI risk factors, what do you do

A

postpone for 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what can happen when a patient with URI is anesthetized

A

laryngospasm
bronchospasm
oxygen desaturation
severe coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

how do we manage autism patient

A

minimize stimulation
maximize routine
preop oral precedex, clonidine, ketamine, versed- mix with juice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

how do we manage ADHD patient

A

premedicate with versed or alpha 2 agonist
continue meds
stimulants can cause more tachy with ephedrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

how do we manage seizures

A

ID baseline sz
continue AEDs day of surgery
oral or IV midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what medication do we avoid in Cerebral palsy

A

Versed-airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what are cerebral palsy patients at risk for

A

seizures
reflux
visual dysfunction
cognitive dysfunction
hypo/hyperthemia
airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

what are s/s cerebral palsy

A

spasticity, dystonia, ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

what heart issue is common with duchene and becker muscular dystrophy

A

cardiomyopathy (do preop TTE, EKG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what muscular dystrophy may be difficult to intubate

A

duchenne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what resp test might be done preop for duchene and becker muscular dystrophy

A

proep PFC (FVC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

if FVC is <50% what is risk

A

increased risk of respiratory complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

if FVC is <30% what is risk

A

severe risk of postop resp complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what do we treat hemophilia A with

A

recombinant factor 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

what do we treat hemophilia B with

A

recombinant factor 9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what do we treat von willebrands with

A

DDAVP
Humate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what do stressors induce in mitochondrial myopathy

A

metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

what are triggers for mitochondrial myopathy

A

prolonged fasting
hypoglycemia
hypothermia
prolonged tourniquets
hypovolemia
NV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

what do we premedicate mitochondrial myopathy patients with

A

versed and alpha 2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

what do we do preop of mitochondrial myopathy patients

A

EKG
echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

what medications are okay to take day of sx

A

AntiEpileptic Drugs
asthma medications
GERD meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

what medications do we hold for sx

A

anticoagulants, ACEI, ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

T/F stop BB intra op

A

F, continue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

what are most common cause of anaphylaxis intraop

A

abx and NMBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

how do we pretreat allergies

A

benadryl
pepcin
decadron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

how do we treat anaphylaxis

A

benedryl
pepcin
decadron
epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

who is at risk for latex allergy

A

Children with spina bifida
He of multiple surgeries
meningomyelocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

what are s/s allergic response

A

rash
pruritis
facial swelling
anaphylaxis

102
Q

what is the most common inherited disease

A

von willebrand

103
Q

what gender is more at risk for hemophilia

A

males, X-linked recessive

104
Q

risk of PONV

A
105
Q

what are pediatric predictors of difficult airway

A

craniofacial syndromes
facial asymeetry
micrognathia
cleft pallate
large tonsil size
loose teeth
airway/tongue masses
high arched pallate

106
Q

what can large tonsil size lead to

A

OSA
difficult mask
airway obstruction

107
Q

when do we chart dentition in peds

A

pre and post op
airway in and out

108
Q

what is normal HR BP for preterm

A

120-180 BPM
45-60/30

109
Q

what is normal HR BP for term

A

100-180 bpm
55-70/40

110
Q

what is normal HR BP for 1 year

A

100-140 bpm
70-100/60

111
Q

what is normal HR BP for 3 years

A

85-115
75-110/70

112
Q

what is normal HR BP for 5 years

A

80-100
80-120/70

113
Q

how do we find high systolic in peds
low systolic

A

age in years x2 +90
age in years x2 +70

114
Q

pediatric VS chart

A
115
Q

NPO chart

A
116
Q

what is NPO for clear liquids

A

2 hrs

117
Q

what is NPO for breast milk

A

4 hrs

118
Q

what is NPO for formula

A

6 hrs

119
Q

what is NPO for light meal

A

6 hrs

120
Q

what is NPO for heavy meal

A

8 hrs

121
Q

what are clear liquids for pediatric

A

water,
Pedialyte,
carbonated beverages,
clear tea,
plain gelatin,
and fruit juices without pulp

122
Q

when does seperation anxiety in children peak

A

1 year

123
Q

what are the high risk patients for preoperative anxiety

A

1-5 years
parents with poor coping skills

124
Q

risk for preop anxiety chart

A
125
Q

premeds pediatric doses

A
126
Q

what is oral dose of midazolam

A

0.25-1 mg/kg

127
Q

what is IV dose of midazolam

A

0.05-0.1 mg/kg

128
Q

what is transmucosal (nasal) dose of midazolam

A

0.2-0.3 mg/kg

129
Q

what is the IM dose for midazolam

A

0.1-0.15 mg/kg

130
Q

what is the IV dose for fentanyl

A

0.5-1 mcg/kg

131
Q

what is the transmucosal (oral) dose for fentanyl

A

10 mcg/kg

132
Q

what is the oral dose of ketamine

A

6-10 mg/kg

133
Q

what is the IV dose of ketamine

A

1-2mg/kg

134
Q

what is the transmucosal dose for ketamine

A

5-10 mg/kg

135
Q

what is the IM dose for ketamine

A

3-7 mg/kg

136
Q

what is the oral dose for clonidine

A

2.5-5 mcg/kg

137
Q

what is the IV dose for clonidine

A

1-2 mcg/kg

138
Q

what is the IV dose for precedex

A

0.25-1 mcg/kg

139
Q

what is the transmucosal (nasal) dose for precedex

A

1-2 mcg/kg

140
Q

what is the IM dose for precedex

A

1-2 mcg/kg

141
Q

what are complications with down syndrome

A

large tongue, increased secretions

142
Q

what do we do special for set up in peds

A

2 sizes up and down of ett
warm the OR
emergency drugs: atropine and anectine on IM needles in bag

143
Q

how do we decide if parent should be there for induction

A

parent in good mindset not freaking
not parent if they will freak out in OR or are anxious
parents of 1 YO patient

144
Q

how do we prepare parent for taking patient in OR

A

tell them what to expect
tell them their role

145
Q

what are contraindications for inhalation inductions

A

MH, muscular dystrophies, central core disease, full stomach

146
Q

what is preferred inhaled induction

A

nitrous oxygen mix 2:1 for 2 min then
sevo 2, 4, 6, 8
nitrous oxygen blend 7:3

147
Q

what patients can you do single breathe induction on

A

older children >9

148
Q

how do you do single breathe induction

A

prime with 8% sevo and take VC breathe

149
Q

when do we start IV in peds after inhalation induction

A

after 2 minutes of loss of eyelash reflex

150
Q

what is induction steps of inhaled anesthetic

A

nystagmus
eyes close
limbs relax
slow/deep breaths
fast/shallow breaths
excitatory/uncontrolled movements
snoring/upper airway obstruction
eyelash reflex gone

151
Q

when do we let go of ETT in peds

A

only after taped

152
Q

when can peds patient be moved after inhalation induction

A

after IV and meds in

153
Q

when do we do IV induction

A

older children 6-7 years and up
obese child

154
Q

what is the induction dose of propofol for peds

A

2.5-3.0 mg/kg (unpremedicated ages 3-12)

155
Q

what is the induction dose of etomidate for peds

A

0.3 mg/kg

156
Q

what is the induction dose of ketamine for peds

A

2 mg/kg

157
Q

what is the robinol dose for peds with ketamine

A

0.1 mg/kg

158
Q

what is the versed dose for peds with ketamine

A

0.5 mg/kg

159
Q

what weird effects does lidocaine cause

A

ears ringing
lips tingle
taste in mouth

160
Q

what induction drug is good for asthmatics

A

ketamine, bronchodilates

161
Q

how do we treat pediatric laryngospasm

A

avoid vigorous PPV
moderate continuous PPV with 100% O2
prop 0.5 mg/kg
severe hypoxemia and bradycardia
IV succs 2 mg/kg and atropine 0.02 mg/kg
IM succs 4 mg/kg

162
Q

do children/infants have a higher or lower MAC%

A

higher

163
Q

what are contraindications of Nitrous oxide

A

pulmonary htn
pneumothorax
pneumocephalus
middle ear surgery
small bowel obstruction
severe anemia
decreased Cerebral blood flow
shock

164
Q

where is nitrous oxide metabolized

A

in gut? aerobic bacteria

165
Q

what is MAC of iso in infant

A

1.7

166
Q

what is Mac of iso in child (3-10)

A

1.6

167
Q

what is mac of des in infant

A

9.4

168
Q

what is mac of des in child (3-10)

A

8.0

169
Q

what is mac of sevo in infant

A

3.3

170
Q

what is mac of sevo in child (3-10)

A

2.5

171
Q

what is the volatile of choice in peds

A

sevo

172
Q

how does sevo effect heart

A

little effect

173
Q

how does sevo affect QTC

A

prolongs

174
Q

how does sevo affect MV/RR

A

decreases

175
Q

how does Sevo affect lungs

A

bronchodilator

176
Q

what does sevo compare with emergence

A

prolonged

177
Q

what gas do you avoid in asthma

A

des

178
Q

what are cardiovascular effects of des

A

decreased SVR
decreased BP
increased HR
no change CO

179
Q

how is emergence with des

A

rapid

180
Q

what is morphine dose for peds

A

0.05 to 0.1 mg/kg/hr

181
Q

what is fent dose for peds

A

1-3 mcg/kg/hr

182
Q

what is sufentanil dose for peds

A

0.1-0.3 mcg/kg/hr

183
Q

what is alfentanil dose for peds

A

1-3 mcg/kg/min

184
Q

what is remifentanil dose for peds

A

0.1-0.4 mcg/kg/min

185
Q

what is hydromorphone dose for peds

A

3-5 mcg/kg/hr

186
Q

What opioids cause histamine release?

A

morphine
Dilaudid
-also increased risk NV-

187
Q

what are side effects of fentanyl

A

chest wall rigidity/bradycardia

188
Q

what is best opioid for neonates

A

fentanyl

189
Q

what are side effects of morphine

A

urticaria
histamine release
resp depression (especially in kidney failure)
PONV

190
Q

what is DOA of fentanyl

A

1 hr

191
Q

what is the metabolite of morphine

A

morpine-6-glucuronide

192
Q

what is the IV dose of succs

A

1-2 mg/kg

193
Q

what is IM dose of Succs

A

4 mg/kg

194
Q

what cardiac complications are possible with succs

A

bradycardia, asystole

195
Q

what patients do you avoid succs in do to high K

A

NM disorders
burns
dysrhythmias
muscle rigidity
masseter spasm
postop myalgias

196
Q

what is dose of roc

A

0.6 mg/kg,

197
Q

what is onset of roc

A

2 min

198
Q

what is DOA of roc

A

30 min

199
Q

what is RSI dose of roc

A

1.2 mg/kg

200
Q

how do you know you pass from stage 2 to stage 1

A

grimacing
spontaneous eye opening
purposeful movement (reach for tube)

201
Q

when do we not wake kids up

A

stage 2

202
Q

what is NMB reversal doses in peds

A

robinol 0.01 mg/kg
neostigmine 0.06 mg/kg

203
Q

what are signs of adequate reversal

A

nonparadoxic breathing
NIP >30 cm H2O
hip flexion with leg elevation for 10 sec
head lift for 10 seconds

204
Q

T/F move patient during stage 2

A

no, can cause spasm

205
Q

how do you extubate peds

A

deep (unless difficult airway and full stomach)

206
Q

when do laryngospasms occur

A

stage2

207
Q

T/F use 100% O2 with kids

A

F, prevent absorption atelectasis

208
Q

what do you take to travel with peds patient

A

jackson reece, mask, O2, emergency drugs (atropine, anectine drawn up)

209
Q

what is the ranking of desaturation time in infants children, adults

A

longer in infants than children than adults

210
Q

what do we treat post op delirium with

A

versed

211
Q

what can help with emergence delirium

A

precedex

212
Q

what drug increases risk of emergence delierium

A

ketamine

213
Q

what factors increase risk of emergence delirium

A

young age
previous surgeries
type of procedures
type of anesthetic

214
Q

What are S/S of Emergence Delirium?

A

Restless
Agitated
Disoriented
Thrashing
moaning
crying

215
Q

parameters for PACU discharge

A
216
Q

what is definition of neonate

A

first 28 days of full term birth

217
Q

what temp to we raise OR to for neonatal sx

A

80-85*

218
Q

what do we use to warm OR and neonate in OR

A

radiant warmer
bair hugger
warmed/humidified circuit
warmed fluid/blood
insulate head

219
Q

what Spo2 for neonatal sx

A

83-95%

220
Q

how long can we have umbilical lines for

A

5-7 days

221
Q

what are considerations for IVF for neonates

A

free of bubbles
drugs proximal to patient
minimize flushes
buritrol to limit flow

222
Q

equipment for neonatal anesthesia

A
223
Q

do males or females have more choanal atresia

A

females

224
Q

what syndome is choanal atresia often associated with

A

CHARGE
Treacher Collins
Pfeiffer & Vater

225
Q

what is CHARGE syndrome

A

Coloboma
Heart disease
Atresia choanae
Retarded growth
Genital anomalies

226
Q

Pfeiffer & Pfeiffer

A

Veterbral defects
Anal atresia
Tracheoesophageal fistula with Esophageal atresia
Radial and renal anomalies

227
Q

what type of choanal atresia is an emergency

A

bilaateral, surgery within 1st days of life

228
Q

what are s/s of bilateral choanal atresia

A

resp distress and cyanosis with feeds, relieved with crying

229
Q

what airway intervention do we do early on in induction for choanal atresia

A

OA

230
Q

what kind of choanal atresia is diagnosed in later childhood and adulthood

A

unilateral

231
Q

what are causes of laryngeal and upper tracheal obstruction

A

webs
congenital subglottic stenosis
subglottic hemangioma
tracheoesophageal fistula/esophageal atresia

232
Q

what is the procedure for laryngeal web identified intrautero

A

EXIT procedure

233
Q

what symptoms present with laryngeal or tracheal web

A

resp distress
stridor

234
Q

what complication can accompany anterior webs

A

subglottic stenosis

235
Q

what is the most common indication for neonatal tracheostomy

A

congenital subglottic stenosis

236
Q

what are treatments for subglottic stenosis

A

trache
endoscopic steroids and dilators
cricotracheal resection and laryngotracheoplasty

237
Q

what is the most common infantile vascular tumor

A

hemangiomas

238
Q

what should we suspect iwth V3 beard distribution on the face

A

subglottic hemangioma

239
Q

when do subglottic hmeangioma patients have resp distress and stridor

A

6 and 12 weeks of life

240
Q

what syndrome is subglottic hemangioma associated with

A

PHACES

*Posterior fossa malformation, Hemangioma, Arterial lesions of head and neck, Cardiac abnormalities, Eye abnormalities, Sternal cleft, or Supraumbilical hernia

241
Q

what is treatment of subglottic hemanagioma

A

propranolol and steroids
surgery with laser or open
graft with rib or thyroid cartilage

242
Q

what do we anticipate when intubating subglottic hemangioma patient

A

bleeding

243
Q

what is an error in the separation of the trachea from the floor of the foregut

A

*TRACHEOESOPHAGEAL FISTULA/ ESOPHAGEAL ATRESIA

244
Q

what syndrome is associate with *TRACHEOESOPHAGEAL FISTULA/ ESOPHAGEAL ATRESIA

A

*VACTERL Vertebral anomalies, Anus imperforate, Congenital heart disease, Tracheoesophageal fistula, Renal abnormalities, Limb abnormalities

245
Q

what is themost common type of *TRACHEOESOPHAGEAL FISTULA/ ESOPHAGEAL ATRESIA

A

dilated proximal esophageal pouch and a fistula between the distal trachea and distal esophagus

246
Q

what are signs symptoms of *TRACHEOESOPHAGEAL FISTULA/ ESOPHAGEAL ATRESIA in newborn

A

excessive secretions
spits up during initial feedings
cant pass NGT

247
Q

how do we optimize *TRACHEOESOPHAGEAL FISTULA/ ESOPHAGEAL ATRESIA patient for surgery

A

anemia
lytes
T &C
anomaly eval
G-tube

248
Q

how do we intubate *TRACHEOESOPHAGEAL FISTULA/ ESOPHAGEAL ATRESIA

A

awake intubation with videoscope
maintain SV
ETT above carina but distal to fistula

249
Q

Calculation for internal diameter of ETT

A

(Age in years/4)+4

250
Q

Calculation to advance the ETT

A

3x the internal diameter
(Age in years/2)+12

Pediatric Anesthesia (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions