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critical care > Neonatal and Peds > Flashcards

Neonatal and Peds Flashcards

1
Q

Ped dose for Epi during cardiac arrest

A

0.01mg/kg

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2
Q

Pretreatment drug used during DSI to prevent bradycardia

A

Atropine
0.02 mg/kg
Lidocaine pretreatment for ICP 1.5mg/kg

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3
Q

What should be administered for pre term respiratory distress (28-32weeks)

A

Surfacatant

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4
Q

What is a seizure described as repetitive mouth or tongue movemen, bicycling movement, eye deviations, repetitive blinking, staring or apnea

A

Subtle seizure

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5
Q

What seizure is characterized by repetitive jerky movement of the limbs, which may move from limb to limb in a disorganized fashion

A

Clonic

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6
Q

What seizure resembles posturing, disturbed respiratory pattern, extention of the limb/limbs or flexion of the upper limbs and extension of the lower limbs

A

Tonic

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7
Q

Characterized by multiple jerking motion of the upper (common) and lower (uncommon) extremities

A

Myoconic

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8
Q

What would you want to administer to a PDA dependent patient

A

Prostaglandin

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9
Q

How do you calculate ETT size and depth in preterm

A

28 weeks 2.5
28-34weeks 3.0
34-38 weeks 3.5
6+wgt in kG

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10
Q

How do you calculate ETT size and depth in full term newborn

A

<6 months 3.5-4.0
6+weight in kG

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11
Q

How do you calculate ETT size and depth in one year and above

A

(age in years+16)/4

ETT size x 3

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12
Q

What is the purpose of a cuffless ET tube

A

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

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13
Q

Persistent pulmonary hypertension in neonate is a syndrome characterized by persistent elevation PVR resulting in

A

Right-to-left shunt at the ductus arterious or the foramen ovale leading to hypoxemia

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14
Q

What is the most common side effect of prostaglandin administration

A

Apnea/hypoventilation

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15
Q

What medication is utilized in the neonate that accelerates closure of the PDA

A

Ibuprofen, indomethacin

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16
Q

What are the 4 anomalies in Tetrology of Fallot

A

Pulmonary stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular septal defect

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17
Q

Recommended urinary output when caring for a ped

A

30-50ml/hr
neonates 2ml/kg/hr
toddlers 1.5mg/kg/hr
older children 1 ml/kg/hr

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18
Q

What should be considered an ominous sign and treated aggressively in the ped patient

A

Hypotension and bradycardia

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19
Q

What lab test is used to diagnose Reye’s syndrome

A

Ammonia

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20
Q

What should be done to prevent right to left shunting

A

Maintenance of the systemic blood pressure

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21
Q

List the ways the pediatric airway anatomy differs from the adult’s

A

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

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22
Q

What is the primary cause of bradycardia in the neonate and ped patient

A

Hypoxia

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23
Q

What is the drug of choice for the profoundly hypotensive septic ped patient

A

Levophed
0.01-5mcg/kg/min

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24
Q

What sign would you expect to find on the chest x ray of a patient with Laryngotracheobronchitis (croup)

A

Steeple Sign, croup often caused by parainfluenza B

25
Q

TV formula for pediatric patient

A

4-8 ml/kg

26
Q

Scaphoid abdomen, unequal breath sounds, dyspnea and a shift in the PMI are classic presentations of what

A

Diaphragmatic hernia

27
Q

What sign would you expect to find on the lateral x ray to confirm epiglottitis

A

Thumb print sign

28
Q

Formla to estimate the weight of a child

A

(2 x age in years)+8=approx weight in kg

29
Q

At what position is the umbilical vein located

A

12o’clock position

30
Q

A ped patient has how many ml of circulating volume/kg

A

70-80 ml/kg

31
Q

What is the minimum age a surgical chricothyrotomy can be preformed

A

11 years
a needle cricothyroidotomy may be preformed on younger children

32
Q

What is the maximum depth an umbilical catheterization may be placed and why

A

5 cm to prevent liver catheterization

33
Q

What is the recommenation for noninitiation or discontinuation of resuscitation for newborns

A

<500G
confirmed trisomy 13 or 18
congenital hydrocephalus
severe fetal growth restriction
<24 weeks

34
Q

localized necrotic skin of unknown origin with a bulls eye appearance

A

brown recluse bite

35
Q

sharp pinprick, dull numbing pain to the area, muscle cramping with intense abdominal pain with an acute onset

A

blackwidow spider bite

36
Q

What should not be preformed to a snake envenomation

A

compression

37
Q

The infant who is hypoxic on room air but demonstrates an PaO2 of >150 in 100% oxygen is more likely to have

A

pulmonary disease

38
Q

What is Gastroschisis

A

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

39
Q

When transporting a neonate suspected of having esophageal atresia you should immediately

A

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

40
Q

What does APGAR stand for

A

Appearance
Pulse
Grimace
Activity
Respiratory

41
Q

How is apgar scored

A

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

42
Q

How is a neonate defined

A

1-28 days of life

43
Q

When is hypoglycemia treated in the neonate

A

<40

44
Q

Hypothermia is defined as__ in the neonate patient

A

36.5C or 97.7F

45
Q

CPR ratio in the neonate

A

3:1

46
Q

What are the key things to remember for Cyanotic heart lesion patient’s that are pre surgery

A

DONT GIVE OXYGEN
Prostaglandins 0.05-0.1mcg/kg/min

47
Q

Acyanotic heart lesions such as Hypoplastic left heart syndrome present with

A

Wet lung sounds,pink red skin
often take cardiac meds
Small LV, Prone to HF, Hepatomegaly is a sign of HF in neonates

48
Q

Prematurity is defined as

A

before 36 weeks

49
Q

What is administered to pre mature neonates with respiratory distress syndrome

A

Surfactant

50
Q

What is an important consideration for the spinal bifida (Myelomeningocele) patients

A

transport prone

51
Q

What is the FLACC scale

A

Used to measure pediatric pain 0-1-2 points for each
Face
Legs
Activity
Crying
Consolability

52
Q

Fluid resuiscitation admin for neonates

A

10ml/kg

53
Q

What is the treatment for Choanal Atresia (congenital narrowing of the back of the nasal cavity)?

A

Intubation

54
Q

4 common causes of seizures in the neonate

A

Hypoxic ischemic encephalopathy
interventriuclar hemorrhage
withdrawl
hypoglycemia

55
Q

VP shunt complications

A

Gastric distention
AMS
Vomiting
Seizures

56
Q

Most common cardiac defect of the newborn

A

VSD

57
Q

Formula for hypotension for ped

A

70+2(age)

58
Q

Circulating volume for peds

A

80ml/kg

59
Q

What is the 4:2:1 rule for maintenance fluids

A

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

critical care (13 decks)

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