Exam 3 Pediatrics Part 1 Flashcards
Head size reflects growth of ____
brain
During 1st year of life, head circumference increases about ______cm
10
Anterior Fontanel closes at _______
9-18 mos
Sunken anterior fontanel means
Deyhydration
Bulging anterior fontanel means
Increased Intercranial Pressure (hydrocephalus, infection, hemorrhage, Increased PaCo2)
Posterior fontanel closes at
2-4 months
At 9 months, the infant head is _____% size of adult
50%
At 2 years old, head circumference increases an additional ____cm and is ___% of adult size
2.5cm
75%
Frontal sinuses develop ______ years of age
2-6
1st tooth arrives around
6 months old
Teeth are complete around
20 months old
Permanent teeth start at
6 years old
Face and base of skull develop more _____ than cranium
slowly
Failure of prenatal development of mandible (3 diseases)
Pierre Robin
Treacher Collins
Goldenhar Syndrome
1-3 years old
Toddler
Preschool
4-6 years old
Up to 4 weeks old
Neonate
4 weeks to 1 year
Infant
School Age
6-13 years
13-18 years
Adolescent
Toddler
1-3 years
4-6 years
Preschool
NPO Guidelines
Clear Liquids-
2 hours
NPO Guidelines
Breast Milk
4 hours
NPO Guidelines
Infant Formula
6 hours
NPO Guidelines
Solids- Fatty or fried foods
8 hours
Herbal remedies are associated with
CV instability, coagulation disturbance, prolonged anesthesia, and immunosuppression
With these Sx, Surgery needs to be postponed 4-6 weeks for Elective Nonurgent Surgeries
Fever > 38.4C Malaise Productive Cough Wheezing Rhonchi
Routine Hgb and UA are _______ for most elective surgical procedures
not indicated
Routine CXR is
not necessary
Acetaminophen dose for myringotomies
10-15mg/kg
Acetaminophen dose for T&A
Preop 40mg/kg + 20mg rectally in 2hr
Total 24 hour Acetaminophen dose not to exceed
100mg/kg
Ofirmev: 13 years and up (>50kg) max doses
1000mg q 6 hours or 650 mg q 4 hours
Ofirmev max doses for 2 y/o or < 50kg
15mg/kg Q 6 hours or 12.5mg Q 4 hours
Peds Dosing
Glycopyrrolate
0.01 mg/kg
Peds Dosing
Atropine
0.01-0.02 mg/kg
Anticholinergics do what (3 things)
Prevent Bradycardia
Minimize autonomic vagal effects
Reduce Secretions
After age 2, the face grows _____
rapidly
Maxillary, sphenoidal , ethmoidal sinuses appear after age:
6
Teeth: 1st one around ____
Complete about ____
Permanent start at _____ of age
Teeth: 1st one around 6 mon
Complete about 20 mos
Permanent start at 6 years of age
Neonatal have a _____ epiglottis (long or short), and is what shaped?
Long and narrow (this time), Omega shaped
What is a normal RR (F) for a newborn
50+/-1 (Good thing I don’t have a gun right now)
What is the normal RR for a 6 month old
30 +/- 5
What is the normal RR for a 12 month old - 5 years old
20-30 something upper range for younger ones, lower range for older ones
Normal RR for a 12 year old
18 +/- 5
Normal RR for Adult
12 +/- 3
Normal TV for Newborn
21
Normal TV for 6 mos
45
Normal TV for 12 mos
78
Normal TV for 3 years
112
Normal TV for 5 years
270
Normal TV for 12 years
480
Normal TV for Adult
575
Or…the easy way to figure out TV for anyone?
7mg/kg
VE or MV for newborn
200-260ml/kg/min
VE or MV for Adult
90ml/kg/min
Vo2 for newborn
6-8ml/kg/min
Vo2 for Adult
3-4ml/kg/min
VC for Newborn
120
VC for Adult
4000
FRC for newborn
80
FRC for Adult
3000
Ph for Newborn
7.3-7.4
Ph for Adult
7.35-7.45 Fuck a Duck
PaO2 for Newborn
60-90
PaO2 for Adult
80-100
PaCO2 for Newborn
30-35
PaCO2 for Adult
37-42
PaCo2 for 1 year old
30-40
Mean Heart Rate in BPM for Premature
120-170
Mean HR for 0-3 Months
100-150
Mean HR for 1-3 years
70-110
Mean HR for 6-12
60-95
Mean HR for > 12 years
55-85
Mean HR Newborn, 6 years, Adult
130ish
100ish
70ish
Mean BP for Preemie and Adult
Preemie 60/40
Adult 110/70
All other ages—somewhere in between
Smoking ____blood carboxyhemoglobin concentration and sputum production
increases
Smoking______ ciliary function, FVC, and FEV (25-75%)
decreades
Children exposed to second hand smoke are more likely to have
asthma, otitis media, atopic eczema, hay fever, and dental caries
What age?
Maximum Stress for Parent
Minimum Stress for infant- not old enough to be frightened of strangers
0-6months
What age? Tolerates Separation Well Understands Processes and Explanations May interpret everything Literally May fear waking up during surgery, or not waking up at all
8-Adolescence
What Age?
Maximum fear of separation
Not able to understand processes and explanations
Significant postoperative emotional upset and behavior
Begins to have MAGICAL thinking
Cognitive development and increased temper tantrums
6 mos to 4 years
What Age?
Begins to understand processes and explanations
Fear of separation remains
Concerned about body integrity
4-8years
What Age?
Independent
Issues regarding self-esteem and body image
Dev sexual characteristics and fear of loss of dignity
Fear of unknown
Adolescence
