Lifespan Flashcards
1
Q
Paediatric Assessment Triangle:
A
- Appearance: tone, interactiveness, consolability, look/gaze, speech/cry
- Work of breathing: abnormal breathing sounds, abnormal positioning, retractions, nasal flaring
- Circulation to the skin: pallor, mottling, cyanosis
2
Q
Airway differences for paeds:
A
- large head
- short neck
- small face and mandible
- large tongue
- epiglottis is horseshoe shaped and projects posteriorly at 45 degrees
- larynx is higher and anterior, more flexible
- trachea is short and soft
- narrow airway
- nasal breathers
- smaller lung capacity
- poorly developed intercostal muscles
3
Q
Breathing differences for paeds:
A
- lungs are relatively immature at birth
- both the upper and lower airways are small
- infants rely primarily on diaphragmatic breathing
- ribs lie more horizontally
- increases RR to compensate for respiratory difficulty
4
Q
Heart and circulation differences for paeds:
A
- anatomically same heart as adult
- heart increases SV by strengthening by increasing HR
- low compliance
- HR important
5
Q
Estimating a child’s weight:
A
<10yrs: weight = (age+4)x2kg
> 10yrs: weight = 3xage kg
6
Q
Endotracheal size of paeds:
A
(age/4) + 4
7
Q
Mason-Likar lead placement
A
- if a child is squirming and wriggly for an ECG, place limb leads on shoulders and lower torso
8
Q
ECG paeds:
A
- V3R and V4R (mirror images of V3 and V4 but on right side) may be requested because newborns have comparatively stronger and bigger right ventricles than left.
- reverses in first few months of life
9
Q
Physical assessment (paeds):
A
- Appearance: skin (bruises, rashes, eczema), hygiene, teeth, clothing, behaviour
- general behaviour: communication, recognition of familiar people/objects
10
Q
Paeds history:
A
- Ante/post natal history: C-section, vaginal, easy, complications
- Immunisations
- parents concerns and beliefs
- legal orders (parents divorced/custody)
- parents
- adolescents may not want parents
- eating habits
- toileting
- daily routine
- sleep patterns
- emotional state, comforters
11
Q
Development of the neonate and infant:
A
- Average weight = 2.7-3.8kg
- Average height = 50cm
- Average head circumference = 35cm
- height and weight of infant is affected by genetics and ethnicity
- vision
- hearing
- smell and taste
- touch
- motor development
12
Q
Fontanelle:
A
- soft spot on head where the skull has not fused together yet
13
Q
Young children’s health risks:
A
- Child abuse (physical, neglect, emotional, sexual)
- Respiratory tract infection
- Gastroenteritis
- Respiratory distress
- other (eg. injuries, poisonings, drownings)
14
Q
Lower airway (paeds)
A
- asthma
- caused by contraction of smooth muscle and airway inflammation
- bronchial airway becomes obstructed and expiration of air is prolonged
- rate and depth of inspiration increases leading to hyperinflation of lungs
- bronchiolitis
- acute inflammatory disease in lower respiratory tract
- bronchioles obstructed due to mucous production
- decreased lung compliance, hyperventilation, ventilation perfusion mismatch
- symptoms: runny nose, cough, fever, expiratory wheeze
15
Q
Upper airway infections (paeds)
A
- croup
- viral infection
- vocal cords, subglottic tissue and trachea inflamed and oedematous
- stridor
- signs of worsening: hypoxia, fatigue, decreased conscious state, increasing WOB
16
Q
Signs of respiratory distress (paeds)
A
- accessory muscle use
- subcostal and substernal recession
- nasal flaring
- tracheal tug
- SOB
- increased WOB
- fatigue
- cyanosis
- head bobbing
- tachypnoea
17
Q
Respiratory assessment (paeds)
A
- Look (level of activity, mental/conscious state, colour, RR, respiratory effort)
- Listen (stridor, wheeze, grunting, speech)
- Feel (skin?)
- use of accessory muscles (intercostal, subcostal, abdominal, nasal flaring)
