Neonatal and Peds Flashcards
Ped dose for Epi during cardiac arrest
0.01mg/kg
Pretreatment drug used during DSI to prevent bradycardia
Atropine
0.02 mg/kg
Lidocaine pretreatment for ICP 1.5mg/kg
What should be administered for pre term respiratory distress (28-32weeks)
Surfacatant
What is a seizure described as repetitive mouth or tongue movemen, bicycling movement, eye deviations, repetitive blinking, staring or apnea
Subtle seizure
What seizure is characterized by repetitive jerky movement of the limbs, which may move from limb to limb in a disorganized fashion
Clonic
What seizure resembles posturing, disturbed respiratory pattern, extention of the limb/limbs or flexion of the upper limbs and extension of the lower limbs
Tonic
Characterized by multiple jerking motion of the upper (common) and lower (uncommon) extremities
Myoconic
What would you want to administer to a PDA dependent patient
Prostaglandin
How do you calculate ETT size and depth in preterm
28 weeks 2.5
28-34weeks 3.0
34-38 weeks 3.5
6+wgt in kG
How do you calculate ETT size and depth in full term newborn
<6 months 3.5-4.0
6+weight in kG
How do you calculate ETT size and depth in one year and above
(age in years+16)/4
ETT size x 3
What is the purpose of a cuffless ET tube
Prevent subglottic stenosis and ulcerations and recommended in children younger than 8 because cricoid cartilage is the narrowest portion of the trachea and will work as a physiologic cuff
Persistent pulmonary hypertension in neonate is a syndrome characterized by persistent elevation PVR resulting in
Right-to-left shunt at the ductus arterious or the foramen ovale leading to hypoxemia
What is the most common side effect of prostaglandin administration
Apnea/hypoventilation
What medication is utilized in the neonate that accelerates closure of the PDA
Ibuprofen, indomethacin
What are the 4 anomalies in Tetrology of Fallot
Pulmonary stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular septal defect
Recommended urinary output when caring for a ped
30-50ml/hr
neonates 2ml/kg/hr
toddlers 1.5mg/kg/hr
older children 1 ml/kg/hr
What should be considered an ominous sign and treated aggressively in the ped patient
Hypotension and bradycardia
What lab test is used to diagnose Reye’s syndrome
Ammonia
What should be done to prevent right to left shunting
Maintenance of the systemic blood pressure
List the ways the pediatric airway anatomy differs from the adult’s
Airway diameter in children is smaller
the larynx is located more anterior in the infants/children
The epiglosttic is long and narrow and angled away from the trachea
What is the primary cause of bradycardia in the neonate and ped patient
Hypoxia
What is the drug of choice for the profoundly hypotensive septic ped patient
Levophed
0.01-5mcg/kg/min
What sign would you expect to find on the chest x ray of a patient with Laryngotracheobronchitis (croup)
Steeple Sign, croup often caused by parainfluenza B
TV formula for pediatric patient
4-8 ml/kg
Scaphoid abdomen, unequal breath sounds, dyspnea and a shift in the PMI are classic presentations of what
Diaphragmatic hernia
What sign would you expect to find on the lateral x ray to confirm epiglottitis
Thumb print sign
Formla to estimate the weight of a child
(2 x age in years)+8=approx weight in kg
At what position is the umbilical vein located
12o’clock position
A ped patient has how many ml of circulating volume/kg
70-80 ml/kg
What is the minimum age a surgical chricothyrotomy can be preformed
11 years
a needle cricothyroidotomy may be preformed on younger children
What is the maximum depth an umbilical catheterization may be placed and why
5 cm to prevent liver catheterization
What is the recommenation for noninitiation or discontinuation of resuscitation for newborns
<500G
confirmed trisomy 13 or 18
congenital hydrocephalus
severe fetal growth restriction
<24 weeks
localized necrotic skin of unknown origin with a bulls eye appearance
brown recluse bite
sharp pinprick, dull numbing pain to the area, muscle cramping with intense abdominal pain with an acute onset
blackwidow spider bite
What should not be preformed to a snake envenomation
compression
The infant who is hypoxic on room air but demonstrates an PaO2 of >150 in 100% oxygen is more likely to have
pulmonary disease
What is Gastroschisis
A defect in the abdominal wall that has completed its development. The defect allows for protrusion of the abdominal contents and is not covered by a membrane
When transporting a neonate suspected of having esophageal atresia you should immediately
Elevate the head of the bed to prevent gastric reflux
esophageal atresia is a condition where the esphagous is not connected to the distal aspect
What does APGAR stand for
Appearance
Pulse
Grimace
Activity
Respiratory
How is apgar scored
0, 1 or 2 points per topic
Max of 10
Scored at 1 and 5 minutes
0-3 critically low
4-6 fairly low
7-10 normal
How is a neonate defined
1-28 days of life
When is hypoglycemia treated in the neonate
<40
Hypothermia is defined as__ in the neonate patient
36.5C or 97.7F
CPR ratio in the neonate
3:1
What are the key things to remember for Cyanotic heart lesion patient’s that are pre surgery
DONT GIVE OXYGEN
Prostaglandins 0.05-0.1mcg/kg/min
Acyanotic heart lesions such as Hypoplastic left heart syndrome present with
Wet lung sounds,pink red skin
often take cardiac meds
Small LV, Prone to HF, Hepatomegaly is a sign of HF in neonates
Prematurity is defined as
before 36 weeks
What is administered to pre mature neonates with respiratory distress syndrome
Surfactant
What is an important consideration for the spinal bifida (Myelomeningocele) patients
transport prone
What is the FLACC scale
Used to measure pediatric pain 0-1-2 points for each
Face
Legs
Activity
Crying
Consolability
Fluid resuiscitation admin for neonates
10ml/kg
What is the treatment for Choanal Atresia (congenital narrowing of the back of the nasal cavity)?
Intubation
4 common causes of seizures in the neonate
Hypoxic ischemic encephalopathy
interventriuclar hemorrhage
withdrawl
hypoglycemia
VP shunt complications
Gastric distention
AMS
Vomiting
Seizures
Most common cardiac defect of the newborn
VSD
Formula for hypotension for ped
70+2(age)
Circulating volume for peds
80ml/kg
What is the 4:2:1 rule for maintenance fluids
First 10kg gets a bolus of 4ml/kg/hr
Second 10kg gets a bolus of 2 ml/kg/hr
All remaning weight after 20kg gets 1 ml/kg/hr
