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Pediatric Respiratory Care > Ken's Final > Flashcards

Ken's Final Flashcards

1
Q

What are the four questions?

A

Is the baby term?
Is the amniotic fluid clear?
Is the baby breathing effectively?
Does the baby have good muscle tone?

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2
Q

What four things should you be prepared to do when receiving a newborn?

A

Be prepared to

  • Keep baby warm
  • Provide blended oxygen
  • Provide nasal CPAP
  • Deliver exogenous surfactant
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3
Q

How do you figure out what size ET tube to use on a baby?

A
  • <1000 grams = 2.5
  • 1000-2000 grams = 3.0
  • 2000-3000 grams =3.5
  • 3000 grams = 3.5 to 4.0
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4
Q

What ventilator breath type should you use on a neonate?

What breath type should you never use?

A

SIMV with TCPL or PC.

Never use volume control.

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5
Q

How much tidal volume should you aim for when ventilating a newborn?

A

4-7 ml.kg.

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6
Q

What is the vent setting basic recipe?

A

20/5 x40 at 40%

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7
Q 
PRDS CXR appearance:
\_\_\_\_, ground \_\_\_\_ appearance
\_\_\_\_\_ and \_\_\_\_\_
Air \_\_\_\_\_\_\_\_\_
No \_\_\_\_\_ \_\_\_\_\_\_\_
A

Bilateral ground glass appearance
Atelectasis -> volume loss
Air bronchograms
No pleural effusions

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8
Q

Neonatal lungs should be inflated to ___.

A

T9 with rounded diaphragms

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9
Q

A newborn will be predisposed to PRDS if the mother is younger than ___ or older than ___ or if the mother smokes _____ or _____

A

Younger than 16
Older than 35
Smokes tobacco or crack. (Drug abuse)

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10
Q

These two kinds of deliveries will predispose a baby to PRDS.

A

C-section

Multiple births

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11
Q

Neonatal acidosis can reduce/impair these three things.

Also it will increase this:

A

Reduced myocardial contractility
Abnormal brain function
Decreased surfactant
Increased pulmonary vascular resistance

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12
Q 
What's the treatment for PIE?
Gentile \_\_\_\_ and 
use of \_\_\_\_
\_\_ \_\_ as necessary
Place the affected side \_\_\_\_\_\_
Consider single \_\_\_\_\_ \_\_\_\_\_\_ 
and \_\_\_\_\_\_ \_\_\_\_\_\_
A 
Gentile ventilation with PHY
Chest tubes as necessary
Affected side down
Single lung ventilation
Mainstem intubation
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13
Q

What do you do to decrease PaCO2 in Jet PIP?

A

Adjust upward

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14
Q

What do you do to decrease PaCO2 in Jet rate?

A

Adjust downward

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15
Q

What three things determine PaO2 in HFJV?

A

CV FiO2
CV PEEP
CV Sigh rate

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16
Q

In HFOV, how do you decrease PaCO2?

A

Turn up Delta P (aka Power/Amplitude)

Decrease the frequency (aka hertz)

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17
Q 
Treatment for CDH:
Don't \_\_\_\_ these pt's.
\_\_ immediately.
Have a \_\_ \_\_ \_\_ \_\_ placed.
The pt needs \_\_\_\_\_
A

Don’t bag these pt’s.
Intubate immediately and have double lumen gastric tube placed.
Needs surgery

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18
Q

Ventilation concerns for CDH:
Anticipate __due to __ __.
__ is preferred but __ __ is OK

A

Anticipate pulmonary HTN due to refractory hypoxemia

HFOV is preferred but jet ventilation is OK

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19
Q

In HFOV, what is the target FiO2?

A

55-65

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20
Q

How are CDH & MAS the same?

A 
Signs of hypoxia
Low APGAR
Don't bag them.
Gentile ventilation or HFOV
Nitric Oxide
ECMO: Last resort
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21
Q

MAS pt’s need _____. CDH pt’s need ____

A

MAS needs suctioning. CDH needs intubation and surgery

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22
Q

Complications of nitric oxide delivery

A

Methmoglobinemia (rare)
inadvertent nitrus oxide delivery
Hyperthermia (rare)

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23
Q

Four conditions that nitric oxide should be considered.

A

Neonatal pulmonary HTN secondary to MAS or diaphragmic hernia
Hypoxia
Bad lung development
ECMO avoidance

24
Q

These maternal factors do not cause BPD (x3)

A

Pregnancy induced HTN
Prenatal Steroids
Maternal Age

25
Q

Two things that do not cause BPD:
The baby’s ____
A low ______
Also, the _____ ______ will not cause BPD.

A

Gender
Low APGAR
Delivery route

26
Q

What systems are involved with CF?

A

Pulmonary, digestive, endocrine, and reproductive

27
Q

You will have a 25% chance of getting CF if ___.

A

Both parents carry the gene.

28
Q

What are the CF transplant eligibility factors?

A

Severe CF
No other organ failure
Can’t have Burkholderia Cepacia

29
Q

What are the success rates of transplant for CF patients? ___ live beyond one year and ____ live beyond 5 years.

A

90%

50%

30
Q

RCP interventions for mild flail chest

A

Pain meds

Bronchial hygiene

31
Q

RCP interventions for severe flail chest: For instability or paradoxical breathing, use __ __.
Set __ on the ventilator.
Monitor for __ __.
Pharmacology: Use __.

A

For instability or paradoxical breathing, use Mech Ventilation
PEEP
Monitor for ARDS onset
Sedation

32
Q

How do you figure out ET tube depth?

A

Use ET tube size x3

33
Q

What is the most common cause of pediatric ARDS?

A

Septic shock is most common

34
Q

What does a swimming pool have to do with the causes of pediatric ARDS?

A

Near drowning can cause it.

35
Q

What kind of trauma can cause pediatric ARDS?

A

Blunt chest trauma- pulmonary contusion

36
Q

RSV patients are usually ___ months old.

A

4-6

37
Q

RSV is most common during these times of the year.

A

Autumn and winter, also early spring

38
Q

Symptoms of RSV include these upper airway symptoms.
What kind of lung sounds (x2)
Heart rate will be __.
This will be noted with breathing.

A 
Fever, runny nose, cough
Moist wheezes
Upper airway crackles
Tachypnea
Retractions
39
Q

What does an RSV virus look like under a microscope?

How is it spread?

A

Variably shaped RNA virus.
Spread by close contact with respiratory secretions of an infected person, or droplet inhalation, or by contact with contaminated surfaces.

40
Q

What percentage of children with RSV will be symptomatic?

A

25-40%

41
Q

What percentage of children with RSV will need hospitalization?

A

0.5-2%

42
Q

How long does it take to recover from RSV?

A

About 1-2 weeks

43
Q

RSV is more dangerous amongst children with pre-existing ___, ___, or ___ conditions.

A

Cardiac, pulmonary, or immunosuppressant

44
Q

Which babies are most at risk of RSV?

A

Ex-Premies
Infants <6 weeks old
Former BPD patients

45
Q

Children are more at risk of RSV if they are not _____.

A

Not breastfed

46
Q

Babies at risk of RSV are given ___.

A

Synagis

47
Q

Do not give ___ to RSV patients. Instead, you can try ___.

A

Do not give Albuterol.

Nebulized racemic epinephrine may help.

48
Q

For severe RSV patients, treatment may include (Ventilatory modalities)

A

CPAP or BIPAP
Heated high flow n/c
Mech ventilation

49
Q

For severe RSV patients, treatment may include (Drugs)

A

Ribavirin

Lasix

50
Q

Croup has this telltale sign on an Xray:

A

Pencil Point Sign

51
Q

Epiglottitis has this telltale sign on an Xray:

A

Thumb Sign

52
Q 
Croup is (bacterial / viral)
Epiglottitis is (bacterial / viral)
A

Croup is viral (usually)

Epiglottitis is bacterial

53
Q 
Croup is (above/below) the trachea
Epiglottitis is (above/below) the trachea
A

Croup: Below the trachea

Epiglottitis is above

54
Q

Why is Mg effective in asthma?

A

Inhibits smooth muscle contraction
Decreases histamine release
Decreases acetylcholine release

55
Q

How do you minimize air trapping in an asthmatic?

A

Low respiratory rates
Long expiratory times
Consider PHY

56
Q

Ventilator considerations for status asthmatic?

A

PC/SIMV, rate of 12. Monitor optimal resp rate and inspiratory time when the wave form goes back to baseline.

57
Q

When ventilating a baby with pulmonary hypertension, __ is preferred.
Secondary is __ __ and __ __ ventilation due to __ __.

A

Ventilation: HFOV is preferred.

Secondary is low PIP & low PEEP ventilation due to hypoplastic lung

Pediatric Respiratory Care (6 decks)

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