Module 4

Question 1

How many colds can children have per year up to the age of 2?

Answer 1

10

Question 2

Why do healthy infants less than 3 months have less infections?

Answer 2

maternal antibodies

Question 3

How are pediatric airways different from adults?

Answer 3

-smaller diameter of the airway– more effected when narrowing or inflammation occurs
-distance between structures is also shorter which makes the spread of infection easier
-sloughing can cause obstruction because children are not able to clear the passages as effectively nd the passages are narrow
-small children and infants are not coordinated enough to blow their nose to clear nasal passage
-infants are obligate nose breathers

Question 4

What is the pediatric assessment triangle?

Answer 4

-assessment in pediatrics that is based on an initial visual assessment
-made up of work of breathing, circulation to the skin, and general appearance

Question 5

What is the General Appearance acronym?

Answer 5

TICLS
tone
interactive
consolable
look
speech

Question 6

What should the nurse look for when assessing circulation to the skin?

Answer 6

cyanosis, pale, molted, obvious blood loss

Question 7

What are some examples of increased work of breathing?

Answer 7

chest rise
rocking motion
retractions
nasal flaring
labored or fatigued
bobbing or grunting
snoring
stridor
silent respirations

Question 8

What are some respiratory assessment concerns?

Answer 8

tachypnea
nasal flaring
retractions
grunting
see-saw breathing
head bobbing
stress response
respiratory failure

Question 9

What are some abnormal heart sounds in children?

Answer 9

S3 and S4 sounds
pericardial friction rub
murmur

Question 10

What is unique about blood pressure in children?

Answer 10

-their BP does not vary much during the initial phases of illness or fluid volume loss
-children use compensatory mechanisms such as vasoconstriction and tachycardia which can maintain a normal BP despite a drop in cardiac output

Question 11

What is the formula method for determining daily fluid requirements for children?

Answer 11

(100mL for each of the first 10kg) + 50mL for each kg 11-20) + (20mL for each additional kg)/24 hours
=hourly rate

Question 12

What is the 4/2/1 method

Answer 12

(4mL for the first 10kg) + (2mL for the second 10kg) + (1mL for remaining kgs)
=hourly rate

Question 13

What is the diagnostic evaluation criteria for mild level of dehydration?

Answer 13

-weight loss of 3-5% in infants/3-4% in children
-normal pulse, resp rate, BP
-normal behaviour
-tears present
-slight thirst, moist mucus membranes
-normal fontanelles
-normal urine output

Question 14

What is the diagnostic evaluation criteria for moderate level of dehydration?

Answer 14

-weight loss of 6-9% in infants, 6-8% in children
-pulse and resp rate slightly increased
-normal BP
-irritable and more thirsty
-dry mucus membranes
-decreased tears
-fontanelle normal to sunken
-slower cap refill
-decreased urine output

Question 15

What is the diagnostic evaluation criteria for severe level of dehydration?

Answer 15

-weight loss of 10% or greater in infants/ 10% in children
-very increased pulse
-deep and rapid resp rate
-changing BP (orthostatic to shock)
-hyper irritable to lethargic
-intense thirst
-dry mucus membranes absent tears and sunken eyes
-delayed cap refill (greater than 4 seconds)
-decreased or minimal urine output

Question 16

What are the pediatric specific manifestations of dehydration?

Answer 16

-weight is a primary indicator of dehydration but may not be known in an outpatient setting
-mild to moderate dehydration can be managed at home with oral rehydration
-IV rehydration bolus of 10mL/kg-20mL/kg given over 20 min
-in children, compensation can result in an artificially high blood pressure despite hypovolemia
-children will typically compensate for a longer period than adults and will deteriorate rapidly and severely once they do begin to decompensate

Question 17

What is the urine output for children and babies?

Answer 17

baby– 1-3mL/kg/hr
child– 1-2mL/kg/hr