Module 4 Flashcards
Paediatric anat and phys variables AIRWAY
Weaker CSPine
Hypothermia labs
increased potassium (means hypoxia before hypothermia)
Things that increase CVP
CHF
Renal failure
Fluid resus
Things that Decreased CVP
aggressive diuretic therapy
Haemorrhage
Diarrhea
Normal CVP
2-6
CVP
reflects end diastolic pressure (preload ) in R ventricle
ABP risks
Infection
decreased tissue perfusion to distal area
Potential embolism
Blood loss
CVP risks
infection
Air embolus
Pneumothorax
Dysrhthmias
Paediatric anat and phys variables Breathing
Flexible rib cage, softer and thinner chest wall
Paediatric anat and phys variables Circulation
Thin skin
higher metabolism
Strong initial compensatory mechanism
higher blood volume to KG
Paediatric anat and phys variables other trauma risks
Small body mass- greater force per body unit (increased internal damage
Large head- higher incidence of head injury (higher centre of gravity
Thinner more pliable cranium
Thin walled round abd with less developed muscles and decreased subQ fat (less organ protection)
organs are less firmly anchored
Soft bones
Large body surface
Hypothermia I (Mild)
Conscious, shivering 35-32 ℃
Hypothermia II (Moderate)
Impaired consciousness, may or may not be shivering ﹤32-28 ℃
Hypothermia III (Severe)
Unconscious, vital signs present ﹤28℃
Hypothermia IV (Severe)
Apparent death, vital signs absent
What is the best position to keep a patient with moderate to severe hypothermia in?
supine. Keeping the patient supine helps avoid both after-drop and dysrhythmias. It is also recommended to keep the patient stable with as little movement as possible.
potential side effects of rewarming patients
hypotension afterdrop burns to the skin from active warming dysrhythmias electrolyte imbalances
Thermoregulatory
located in the hypothalamus
Triggers regulations
Vasodilation and sweating for heat loss
Vasoconstriction and shivering
Ways we loose heat
Conduction-contact with something cold
Convection- cold wind
Radiation- sun heats you
Evaporation- wet clothes
methods of rewarming
behr hugger
warm fluids
take off wet clothes
CBI
3 nursing requirements to make sure the blood pressure monitoring are accurate
level the transducer
zero the transducer
square waveform test
Comparison of the arterial BP and the non-invasive BP (NIBP)
NIBP is acceptably 10-15 mmHg lower than the arterial BP.
Hypothermia can cause
shivering.
enhanced fibrinolysis.
cardiac arrhythmias.
The effects of moderate to severe hypothermia on cardiac rhythm are
bradycardia.
What pediatric circumstances make intubation complications more likely in comparison to adults
The airway is more anterior and difficult to visualize.
The trachea is shorter so the tube can be easily displaced.
The health care provider may be more nervous or more experienced in adult intubations and push the tube further into the right bronchus.
Complications associated with mass transfusion include
Hemodilution
Hyperkalemia
Hypocalcemia
Hypothermia
risk of fetal injury in blunt abdominal trauma
The thin-walled and prominent uterus later in pregnancy exposes the fetus to potential injury
The risk of fetal injury is highest in the 3rd trimester
The abundant amount of amniotic fluid in the 2nd trimester
The CVP monitoring system should be attached to which lumen of a triple lumen central line for accurate monitoring
distal
Acute respiratory distress syndrome is a common complication following a near drowning due to impairment of what substance
surfactant
The transducer needs to be levelled at the approximate height of the patient’s
atria
