NL Peds Vitals Flashcards
NL - Newborn RR
30-60 b/m
The less mature the neonate changes RR how?
Higher
And progression of below NL interventions
120-160
>100 = routine care 60-99 = ventilation support <60 = ventilation + chest compressions
> 40mmhg - elevated pulse pressure indicates
PDA
After age 3 - BP calculation tool
SBP = 80+(age x 2) DBP = 2/3 SBP
NL Temp mean temp
Fever
And
Acceptable range
NL mean - 37 Celsius (98.6 F)
Fever- >38C (>100.4F)
Range - 97-99.6 F
Pediatric pattern of diurnal fever
Lower in AM
Higher in PM
Definition of fever
> 100.4F - rectally (38C)
Rectal versus Oral pediatric temp? Which is higher?
Rectal > oral by 1 degree
Do not get pediatric temperatures from what sites?
Do not get tympanic, axillary, or temporal artery temps
Fever vs hyperthermia?
Fever - altered set point
Hyperthermia - excess external heat w/out regulation
SPO2 goals immediately after birth
1m - 60-65% 2m - 65-70% 3m - 70-75% 4m - 75-80% 5m - 80-85% 10m - 85-95%
NL HR after birth?
> 100 bpm
Intervention for HR <100
1L - PPV and SO2 observation
Intervention for HR <60
Consider intubation
Chest compressions and
PPV
Fail = IV Epi
What is chest compression rate for newborn?
120 bpm
3:1 compression:respiration
Neonates 1st sign following hypoxia is?
Apnea (Not tachypnea)
Neonatal Blow by O2 rate?
10 LPM < 1/2inch from face
BVM / PPV rate?
40-60 breaths/min in sniffing position
What is the preferred placement of Pulse oximetry?
Right upper extremity (Due to PDA)
Neonatal hypoglycemia is?
<45 mg/dL
Very low birth weight equals how many grams?
<1500
Low birth weight indicates how many grams?
<2500
NL heart rate range for newborns?
120-160 bpm
NL respiratory rate range for newborns?
40-60 RR
NL systolic blood pressure for newborns?
60-90 mmHg
NL temperature for newborn?
97.7-99.5
NL weight of newborn? Female/male
F - 6lb 3oz - 8lb 14oz
M - 6lb 7oz - 9lb 5oz
NL length range of newborn?
19-21”
NL head circumference range for newborn?
13-15”
Pulse ox screening for newborn congenital heart disease - negative result
> = 95% in Right hand/foot w/ <3% difference between the two
Pulse ox screening for newborn congenital heart disease - Repeat readings in 1 hour if?
O2 is 90-94% in right hand/foot or >3% absolute difference between right hand/foot
3 readings will indicate an echocardiogram
Pulse ox screening for newborn congenital heart disease -
Positive result
< 90% O2 in right hand or foot = echocardiogram
Weak pulses may indicate?
Poor CO (aortic stenosis)
Bounding pulses may indicate?
High cardiac output (PDA)
> 40 mmHg pulse pressure (between brachial/femoral) may indicate?
PDA
Decreased pulse pressure (between brachial/femoral pulses) may indicate?
Coarctation of the aorta
NL pediatric weight per growth charts?
5-85th percentile
Is weight loss normal the first few days of life?
Yes
How much wgt loss is NL for the first few days of life?
5-10%
When does a child return to their birth wgt?
Day 7-10 age
When does a child double birth wgt?
4-5mo (triple in 1 yr)
Daily wgt gain amount 1st 3-4mo?
20-30g (15-20g rest of yr)
When does a child double their birth length?
4yo
Average head circumference?
35cm (13.5in)
Head circumference growth rate 1st year?
1cm per month - (2cm 1st 3mo)
Number one reason pediatric growth is stunted?
Caloric intake adequate (then chronic illness)
Red flags of growth development (take action)?
<5%
Infant crosses 2 percentile lines w/out cause.
LRG discrepancy between Wgt/Hgt/Head
NL BP calculation >3yo (SBP/DBP)
SBP - 80+(age x 2)
DBP - 2/3 SBP
When to screen for anemia?
12mo or 4mo if high risk
When to screen for lead?
12 and 24mo (5-10ug/dL = learning issues)
CI to immunization
Hx of anaphylaxis
NO live vaccines (pregnant/x-imm)
Moderate/severe illness
Egg allergy (Flu/yellow fever)
Vaccinate premmie’s when?
Same schedule
Only time a vaccination is post-poned?
<2000g and mom is HBV negative (Give at 1mo instead)
How long is breastfeeding recommended?
6mo
How often is feeding 1st few weeks of life?
8-12/day
NL diaper habits of infant?
6-8 wets/d
>3 stools/d (except food transition periods -up to 1w)
When to begin solid foods?
6mo
When to give honey?
12mo
What is normal volume of feeds/day?
18-30oz/d
How much juice to give per day?
<4oz/day (toddlers/young)
<8oz/day (7-18yo)
When can you give cow’s milk?
12mo
NL amount of cows milk?
<24oz per day
Does overweight children need to be on diets?
Not before 3yo
Toilet training occurs when?
2-3yo
Deciduous teeth Teeth eruption order?
- Lower incisors
- Upper incisors
- Lateral incisors
If teeth eruption is delayed what are possibilities?
Check TSH/Calcium
Permanent teeth occurs when?
Starts 6yo
Ends 12yo
Third molars - 18yo
When does dental visits begin?
1yo (q 6mo)
At 1 yr to protect teeth?
Avoid prolonged/nighttime bottles
Soda/juice
Begin fluoride brushing when?
2yo
When to evaluate female for primary amenorrhea?
No menarche by age 15yo
Basic calorie requirement of adolescents?
Girls 14-18 = 1800-2400
Boys 14-18 = 2000-3200
Calcium requirements of adolescents?
1300mg