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Stuff I should know. Maybe. > PALS > Flashcards

PALS Flashcards

1
Q

Initial impression, what to assess for

A

Consciousness
Breathing
Color

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2
Q

Normal respiratory rate for infants <1 year

A

30-60 bpm

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3
Q

Normal respiratory rate for toddler’s 1-3y

A

24 to 40 bpm

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4
Q

Normal respiratory rate for Preschoolers 4-5y

A

22 to 34 bpm

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5
Q

Normal respiratory rate for School age 6-12y

A

18 to 30 bpm

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6
Q

Normal respiratory rate for Adolescent 13 to 18years

A

12 to 16 bpm

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7
Q

Central apnea

A

no respiratory effort because of an abnormality or suppression of the brain or spinal cord

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8
Q

Obstructive apnea

A

there is inspiratory effort without airflow.

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9
Q

Mixed apnea

A

There are periods of obstructive apnea and periods of central apnea

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10
Q

Causes of tachypnea

A 
high fever
pain
metabolic acidosis
sepsis
congestive heart failure
severe anemia
TPA
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11
Q

causes of bradypnea

A

muscle fatigue
central nervous system injury
hypothermia
medications

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12
Q

Mild to moderate breathing difficulty types of retractions

A

subcostal (retraction of the abd just below rib cage)
substernal (retraction of the abd at the bottom of breast bone)
intercostal (btwn ribs)

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13
Q

severe breathing difficulty types of retractions

A

Supraclavicular
Suprasternal
Sternal

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14
Q

Tidal volume

A

the volume of air inspired with each breath

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15
Q

Normal tidal volume #s

A

5 to 7ml/kg of body weight

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16
Q

what is stridor

A

coarse, higher pitched breathing sound heard on inspiration. A sign of upper airway obstruction

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17
Q

what is grunting

A

short, low pitched sound heard on expiration. It may be a response to fever. It helps keep small airways and alveolar sacs open.

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18
Q

What is wheezing

A

high pitched sound heard most often during expiration that is caused by airway obstruction. Caused by asthma or bronchiolitis.

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19
Q

Crackles/rales

A

crackling inspiratory sounds, indicate accumulation of alveolar fluid.

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20
Q

SpO2

A

the percentage of the child’s hgb that is saturated with o2.

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21
Q

Normal heart rate for newborn to 3 months

A

85 to 205

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22
Q

Normal heart rate 3 months to 2 years

A

100 to 190

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23
Q

Normal heart rate 2 years to 10 years

A

60 to 140

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24
Q

Normal heart rate greater than 10 years

A

60 to 100

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25
Q

Most common cause of bradycardia

A

hypoxia

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26
Q

GCS criteria

A 
Eye opening (spontaneous, speech, pain, none)
Orientation (oriented, confused, inapp words, incomphrehensible sounds, none)
Ability to follow commands (obeys, localizes, withdraws, abnl flexion, extensor response, none)
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27
Q

Lowest acceptable systolic bp > 10 years

A

90 mmHg

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28
Q

Lowest acceptable systolic bp 1-10 years

A

70 mmHg + (2 x age in years)

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29
Q

Lowest acceptable systolic bp 1mo -1 year

A

70 mmHg

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30
Q

Lowest acceptable systolic bp newborn

A

60 mmHg

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31
Q

Normal urine output values

A

1 ml/Kg per h or 30 mL/h for adolescent

32
Q

early signs of cardiopulmonary compromise

A

tachycardia and tachypnea

33
Q

Method for assessing breathing RACE

A

Rate-tachypnea or
Airway sounds
Color– pink, pallid, cyanotic or mottled
Effort/mechanics–positioning/retractions etc

34
Q

Time limit for suctioning at once

A

10 seconds, may cause bradycardia and hypoxia

35
Q

What to do for foreign body for a pt that can speak and is awake

A

allow them to cough and clear the airway. make no attempts to remove it

36
Q

What to do for foreign body if it is completely obstructed

A

remove only if object is visible. do not to blind finger sweeps

37
Q

flow rate of nasal cannula

A

1-4 L/min to deliver O2 concentrations of 25-40%

38
Q

flow rate for simple o2 mask

A

6-10 L/min to deliver O2 concentrations of 35-60%

39
Q

flow rate for o2 mask w reservoir

A

the reservoir bag must be greater than the tidal volume and 90% o2 can be delivered if rate is 10-15 L/min

40
Q

noninvasive positive pressure ventilation advantages

A

decreases work of breathing, improving oxygenation, avoiding complications of intubation.

41
Q

Indications for noninvasive positive pressure ventilation

A

status asthmaticus, bronciolitis, acute pulmonary edema, neuromuscular disease. Patient must be stable, spontaneously breathing, alert, and cooperative.

42
Q

Contraindications for noninvasive positive pressure

A

hemodynamically unstable, lethargic, vomiting, or w cardiac dysrhythmias

43
Q

Settings for inspiratory positive airy pressure for CPAP or BIPAP

A

8-10 cmH2O. Titrate these settings upwards in 2 cmH2O increments until the desired effects are achieved

44
Q

Settings for expiratory positive airy pressure for CPAP or BIPAP

A

3-5 cmH2O. Titrate these settings upwards in 2 cmH2O increments until the desired effects are achieved

45
Q

How to monitor patients on BIPAP or CPAP once treatment is started

A

watch for worsening respiratory failure with serial lung exams, vital sign measurements, and oxygen saturation. If their respiratory status deteriorates or worsens, discontinue NIPPV and perform tracheal intubation.

46
Q

Fluid resuscitation bolus amount

A

20 ml/Kg. Can give additional boluses up to 60 ml/kg until vital signs and perfusion are restored. Consider inotropy if further fluid is needed. If patient is septic, fluid boluses as large as >60 ml/kg may be required.

47
Q

epinephrine dose and indication

A

0.01mg/kg IV/IO (1:10,000; 0.1ml/kg)
or
.1 mg/kg 1:1000 solution
bradycardia

48
Q

atropine dose and indication

A

0.02 mg/kg IV/IO (Minimum dose: 0.1mg; maximum total dose for children: 1mg
bradycardia

49
Q

SVT treatment

A

adenosine .1mg/kg

50
Q

Wide QRS with pulse treatment

A

amiodarone 5mg/kg iv over 20 to 60 minutes
or
Procainamide 15 mg/kg over 30 to 60 mins

51
Q

WIDE QRS (torsades de points) treatment

A

magnesium 25-50mg/kg over 10 mins

52
Q

SAMPLE history

A 
Symptoms
Allergies
Medications
Past history
Last intake
Events that caused the incident
53
Q

signs of potential signs of respiratory failure

A 
Tachypnea
Tachycardia
Anxiety
Retractions
Nasal flaring
54
Q

signs of probable respiratory failure

A

Lethargy
Head bobbing
Grunting
Cyanosis/pallor

55
Q

signs of cardiopulmonary failure

A

Agonal breathing

bradycardia

56
Q

signs of respiratory failure

A

slow breathing

bradycardia

57
Q

Early signs of shock

A

tachycardia
decreased perfusion of skin (cool, pale mottled or delayed cap refill)
Altered mental status
Discrepancy in volume between peripheral and central pulse

58
Q

Symptoms: brisk capillary refill and bounding central pulses

A

septic shock

59
Q

what is compensated shock

A

patient showing signs of shock with a normal b/p

60
Q

shock tx

A

maintain airway
administer high flow o2
maintain body temp
ECG and pulse ox
Admin fluid bolus 20 ml/kg NS or LR in under 20 min
Pressors for refractory, cardiac or septic shock
Reduce o2 demand by supporting breathing, controlling pain and anxiety, manage fever

61
Q

what does low co2 mean during cardiac arrest

A

low perfusion

62
Q

epinephrine dosing

A

.1 mg/kg 1:10,000

repeat every 3-5 minutes

63
Q

site for io placement

A

proximal tibia on the medial aspect 2 finger widths below the tibial tuberosity

64
Q

shock fluid resuscitation bolus amount

A

20ml/kg of an isotonic crystalloid solution

65
Q

What things to check to assess a patients hydration status

A 
mental status
quality of pulses
blood pressure
heart rate
cap refill
urine output
66
Q

In patients with septic shock, what can you give them and how much

A

Large fluid volumes 60ml/kg and can give with 5% albumin in 10 ml/kg doses

67
Q

Dopamine dose for cardiogenic shock

A

5-10mcg/kg per min. titrate to desired effect

68
Q

Dobutamine dose for cardiogenic shock

A

2-10mcg/kg per min but at doses greater than 10 mcg/kg it might cause hypotension because of afterload reduction and decreased svr it is works on selective beta adrenergic receptors

69
Q

Epinephrine dose

A

0.1-1mcg/kg per min

70
Q

Epinephrine effects

A

It is an inotropic agent that increases myocardial perfusion pressure. Low dose causes inc hr, decreased svr, decreased diastolic blood pressure bc of beta 1 and beta 2 receptors.

71
Q

What does epinephrine cause at doses >.3mcg/kg per min

A

alpha adrenergic effects result in increased blood pressure

72
Q

What receptors does norepinephrine act on

A

alpha and beta adrenergic receptors to produce inotropic effects and beta peripheral vasoconstriction to increase MAP

73
Q

What is the dose for norepinephrine

A

01.-1mcg/kg per min

74
Q

Minimal glucose level before giving dextrose

A

<60 mg/dl

75
Q

Dextrose dose to raise blood sugar

A

.5 gm/kg

Use 2 mL/kg of a 25% dextrose solution

Stuff I should know. Maybe. (20 decks)

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