Pediatric Flashcards
What are the 3 parts of the pediatric assesment triangle
- Appearance
- Work of Breathing
- Circulation to skin
Good history questions to ask specific for kids?
- are they under the care of a physician
- chronic or congenital illnesses
- vaccinations up to date
What is the weight capacity for the neonate?
7-14 lbs
What is the weight capacity for the pedimate?
10-80 lbs
Most cardiac arrests in children are secondary to….
hypoxia
What are 2 important things to remember when treating a child with respiratory compromise?
- do not agitate the pt
- do not lay the child down
Define Croup
- Laryngotracheobronchitis
- Viral Infection of the upper airway
- common inflammatory respiratory illness
- 6 months to 3 years
What time of year does croup typically flair up?
Late fall to early winter
Signs and Symptoms of Croup
- slow onset
- barking cough
- inspiratory stridor
- occurs at night
- may have slight temperature
What should be the first drug of choice when a pt has stridor at rest
Epinepherine
What is a typical sign on an x-ray if a patient has croup?
Steeple Sign
What is the table used to calculate the severity of croup? And what does a pt need to score to qualify as severe?
Westley Croup Score and a score of greater than 6
2 indications of croup
- current history URTI
- barking cough or recent history of barking cough
Croup Management
- O2 if indicated
- cool moist air
- avoid visualizing airway or manually opening airway
- oral dexamethasone for all
- Nebulized Epi for severe cases
Define Epiglottitis
- life threatening bacterial infection
- Acute inflammation above glottis causing airway obstruction
- 3-6 year range
- sudden onset, rapid progression, high fever
- TRUE EMERGENCY
Signs and Symptoms of Epiglottitis
child will suddenly awake with
- high fever
- respiratory distress - stridor
- sore throat
- difficulty swallowing
Child may be in tripod position
- child may be drooling
How to manage epiglottitis
- blow by O2
- do not inspect airway
- keep child calm
Define Bronchiolitis
- a viral infection frequently caused by the respiratory syncytial virus (RSV)
- causes inflammation of bronchioles
- usually affects children than 2 years of age
- commonly occurs in the winter months, and generally is associated with an URI
Signs and Symptoms of Bronchiolitis
- tachypnea and wheezing
- starts as low fever, runny nose and cough - progresses to respiratory distress
- dry cough or crackles upon ausciltation
- bronchioles obstructed due to edema and mucous build up
Define Asthma
Asthma is obstruction of the lower airways characterized by inflammation and bronchoconstriction
Signs and Symptoms of Asthma
- respiratory diostress
- stridor at rest
- tachycardia
- cough of clear mucous
2 types of pneumonia
bacterial - sudden onset (<24hrs), high mortality
Viral - longer course, but less severe
Pneumonia signs and symptoms
History of - acute onset of fever, cough, poor feeding or vomiting, chest or abdo pain
- tachypnea
- respiratory distress
- Crackles (decreased air entry)
- productive cough
Define Cystic Fibrosis
- recessive gene, carried by 1 in 23, usually dx before 1 year
Chronic Pulmonary Disease
- hypertrophy and hypersecretion of glands
- obstruction and infection from stagnant mucous
98% die from cardio-respiratory complications
Define Pertusis
- whooping cough
- caused by bacteria Bordetella pertussis
- pt age less than 6 months, preterm infants, and unimmunized pts are at highest risk for severe disease and complications
- highly contagious
Signs and Symptoms of Pertussis
- obtain good history (vaccinations up to date?)
- forceful cough may provoke vomiting or pt to turn red or blue
- high pitched whoop sound during next breath of air
Common causes of seizures
- not complient with meds
- head trauma
- intracranial infection
- metabolic disturbance
- poisoning
- most common cause in children is a fever
Define febrile seizure
seizure associated with fever, but without evidence of intracranial infection or other definable cause
In what age would you usually see febrile seizure and ?
6 months - 5 years
Signs and Symptoms of Febrile Seizure
- a fever of greater than 38 degrees that came on suddenly
generalized tonic-clonic - within 5-10 min post-ictal, child returns to normal
Treatment for Febrile Seizure
- cool child
- remove clothing. tepid wet cloths
Define Status Epilepticus
- continuous seizure activity lasting 5 min or longer
- recurrent seizure without an intervening period of consciousness
Define Meningitis
- bacterial or viral
- localized in meninges and cause inflammation and cerebral edema
- typically followed by an upper respiratory infection (tonsillitis) or ear infection
Signs and Symptoms of Meningitis
- fever and or vomiting
- neck rigidity/stiffness
- rash
- severe ache
- dislike of bright lights
- altered L:OOC
- seizures
- hx of ENT infection
When a child has an altered LOC with no explainable cause what shoud you check?
Blood Glucose
When children experience blunt trauma what are 2 common reasons that they get more seriously injured to adults
- ribs are more pliable and offer less protection to organs (liver and spleen)
- abdo muscles are not developed and offer less protection
Is permissive hypotension permitted in peds?
no
In what age is greenstick fractures more common?
Children under 10 years of age
What can shaken baby syndrome cause in a child?
- cerebral contusions
- subdural hematoma
- subarachnoid hemorrhage
- retinal hemorrhage
- neck and spine injury
In what age does shaken baby syndrome occur?
Children under 2
Why can blood loss be deceptive in children?
Children have a strong cardiovascular response to hypovolemia. This can result in children having 30% blood loss and be normotensive
