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PARA 240 > PALS > Flashcards

PALS Flashcards

1
Q

Neonate age

A

Up to 28 days

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2
Q

Problems in neonates

A 
Respiratory distress
•Jaundice
•Vomiting
•Fever
•Sepsis
•Meningitis
•Physical/sexual abuse
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3
Q

Problems in infants 1-5 months

A 
Respiratory distress
•Fever
•SIDS
•Vomiting/diarrhea
•Sepsis
•Meningitis
•Physical/sexual abuse
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4
Q

Infant 6-12 months

A 
Fever, febrile seizures
•Vomiting/diarrhea
•Broncholitis
•Croup
Sepsis
•Meningitis
•Respiratory distress(foreign body aspiration)
•Abuse
•FBAO
•Falls/injury MVA
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5
Q

Child 1-3 years

A 
Fever/febrile seizure
•Vomiting/diarrhea
•Resp distress (asthma, croup)
Sepsis
•Meningitis
•Ingestions
•FBAO
Falls/injury MVA
•Abus
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6
Q

ABCDE

A

Airway

Breathing

Circulation

Disability (AVPU/ pupils/ BGL)

Exposure (temperature/ skin)

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7
Q

Hypoxemia

A
  • Inadequate oxygenation of blood

* A room air Sp02 of

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8
Q

4 D’s of Epiglottis

A
  • Difficulty swallowing
  • Drooling
  • Distress
  • Dyspnea
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9
Q

Infant facts

A

Most have doubled their birth weight and heart size at 4-6 months
•Mouth breather at between 3-6 months
Fears:
•separation and strangers

Approach:
•Provide consistent caretakers
•Happy parents = happy baby
•Minimize separation from parent

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10
Q

4 types of respiratory problems in the identify stage

A

Upper Airway Obstruction

Lower Airway Obstruction

Lung Tissue Disease

Disordered Control of Breathing

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11
Q

Severity of Respiratory problems

A

Respiratory Distress

Respiratory Failure

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12
Q

4 Types of Circulatory Problems

A

Hypovolemic Shock

Distributive Shock

Cardiogenic Shock

Obstructive Shock

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13
Q

Two severities of shock

A

Compensated

Hypotensive

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14
Q

Rr for infant

A

30-60

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15
Q

RR for Infant 1-3yrs

A

24-40

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16
Q

RR for Preschooler 4-5

A

22-34

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17
Q

RR for School age child 6-12

A

18-30

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18
Q

RR for Adolescent 13-18

A

12-16

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19
Q

SV (stroke volume) is determined by what factors?

A

Preload

Contractility

After-load

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20
Q

CO (Cardiac Output)=

A

SVxHR

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21
Q

S&S of decreased Cardiac Output

A

Tachycardia

Cool, pale,diaphoretic

Delayed Cap refill

Weak peripheral pulses

Oliguria

Vomiting

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22
Q

Hypotension formula

A

Anything less than

70 + (age in years * 2)

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23
Q

After-load

A

The pressure ventricles have to overcome or push against to pump out blood

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24
Q

4 main types of Shock

A

Hypovolemic

Cardiogenic

Distributive

Obstructive

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25
Q

Causes of Hypovolemic shock

A

Hemorrhage

Diarrhea

Vomiting

Osmotic Diuretic use

Third Spacing

Burns

26
Q

Hypovolemic shock Effects on Cardiac Output

A

Preload: decreased

Contractility: Normal or increased

Afterload: Increased

27
Q

S&S of Hypovolemic Shock

A

Wuiet Tachypnea

Tachycardia

Narrow pulse pressure

Delayed Cap refill

Pale, cool, diaphoretic

Oliguria

Changes in mentation

28
Q

Normal Cap refill time

A

Less than 2 seconds

29
Q

Types of distributive shock

A

Septic

Anaphylactic

Neurogenic (spinal)

30
Q

Most common type of distributive shock

A

Septic

31
Q

Septic shock

A

Vasodilation and venodilation cause blood to pool (petechi or purpura)

32
Q

S&S of Septic Shock

A

Warm flushed skin (warm shock)

Pale mottles skin (cold shock)

Hypotension with widened pulse pressure

Bounding peripheral pulses

Petechi or purpura rash

33
Q

Effect of septic shock on Cardiac Output

A

Preload: decreased

Contractility: normal to decreased

Afterload: variable

34
Q

Anaphylactic shock

A

Multisystem allergic response

Veno and vasodilation

Increased capillary permeability

Pulmonary vasoconstriction

35
Q

Anaphylactic shock effect on Cardiac Output

A

Preload: decreased

Contractility: variable

Afterload: L ventricle decreased/ R ventricle increased

36
Q

Neurogenic shock

A

Loss of sympathetic signals to smooth muscle (particularly in blood vessels)

Uncontrolled vasoconstriction and tachycardia prevented

37
Q

S&S of Neurogenic shock

A

Hypotension with widened pulse pressure

Normal or bradycardic HR

38
Q

Neurogenic shock effect on cardiac output

A

Preload: decreased

Contractility: normal

Afterload: decreased

39
Q

Fluid replacement for:

Hypovolemic
Distributive
Obstructive

A

20ml/kg PRN

Rapidly over 5-10min

40
Q

Fluid replacement for:

DKA

A

10-20ml/kg

Over 1 hr

41
Q

Fluid replacement for:

Cardiogenic

Poisoning

Calcium channel blocker OD

Beta blocker OD

A

5-10ml/kg PRN

slowly over 10-20min

42
Q

Causes of cardiogenic shock

A

Congenital heart defect

Myocarditis

Cardiomyopathy

Arrhythmias

Poisons/toxins

Myocardial injury

43
Q

S&S of cardiogenic shock

A

Retractions, nasal flaring, grunting (pulmonary Edema)

Cyanosis

Pale, cool, diaphoretic

Narrow pulse pressure

Mentation changes

Delayed cap refil

44
Q

Effects of cardiogenic shock on cardiac output

A

Preload: variable

Contractility: decreased

Afterload: increased

45
Q

Causes of obstructive shock

A

Cardiac tamponade

Tension Pneumothorax

Ductal dependant lesions

Pulmonary embolism

46
Q

Becks triad

A

Three signs of cardiac tamponade

Pulsus paradoxus

JVD

muffled or diminished heart sounds

47
Q

Signs of cardiac tamponade

A

Pulsus parodoxus

JVD

muffled or diminished heart sounds

48
Q

Signs of Tension Pneumothorax

A

JVD

hyper-resonance

Diminished breath sounds on affected side

Tracheal deviation (late)

49
Q

Leading cause of bradycardia in children

A

Hypoxia

50
Q

Primary Bradycardia

A

Congenital or acquired heart conditions causing bradycardia

Use Atropine here

51
Q

Secondary Bradycardia

A

Bradycardia that results in a NON CARDIAC condition that alter the normal function of the heart

Hypoxia, acidosis, hypotension, hypothermia, and drug effects.

USE EPI HERE

52
Q

Normal QRS in Children

A

Less than 0.09

53
Q

SVT rate in children

A

180

54
Q

Infant SVT rate

A

220bpm

55
Q

Infant vagal maneuver

A

Ice pack to the face 15-20 seconds

56
Q

PALS Tachycardia Synchronized Cardio Version

A

Begin 0.5-1J/kg. if that is not effective then increase to 2J/kg

57
Q

Three things to look at on initial arrival

A

Consciousness

Breathing

Color

58
Q

Leading cause of symptomatic bradycardia in children?

A

Tissue hypoxia

59
Q

Two most common potentially reversible causes of bradycardia

A

Hypoxia

Increased vagal tone

60
Q

Neonate hypotension

A

Less than 60

61
Q

Infants hypotension (1mon-12mon)

A

Less than 70

62
Q

Hypotension in children older than 10

A

Less than 90

PARA 240 (6 decks)

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