Pediatric Cardiopulmonary

Question 1

Apgar Assessment

Answer 1

-Administered at 1 and 5 minutes after birth:
Normal: 7-10
respiratory distress: <4

A-Activity
P-Pulse
G-Grimace (reflex irritability: cough, sneeze)
A-Appearance (skin)
R-Respiration (cry?)

Question 2

Respiratory characteristic of infants

Answer 2

DRAIN:
D-Diaphragmatic nose breather
R-Respiratory rate= ard 60,
A-Accessory muscles are weak and do not aid in ventilation
I-Immature alveoli structure
N- Narrow airways

Question 3

Pediatric CP structure characteristic

Answer 3

Inc. compliance of chest wall+paradoxical movement of upper chest
–>compliance dec. with age inc (ossification of rib cage+inc. intercostal muscle tone)

Shape of lung: triangle+rib horizontal (10 yo:normal)

**Preferentially ventilate upper most lungs

RR+HR: slowly decrase (12 yo: 12-20)

BP: slowly increase (2yo: 85/60)

Question 4

Bronchiolitis

Answer 4

Caused:
Respiratory syncytial virus–> inflammation+secretion in bronchioles

Presentation:
V/Q mismatch causes hypoxia + hypercapnia

Question 5

Bronchopulmonary Dysplasia

Answer 5

Cause: Abnormal development of lungs
-common in premature babies/require ventilator

Presentation:
-Cynosis
-Hypoxemia+Hypercapnia
-Delay growth/developement
-Frequent lower respiratory tract infections
-Auscultation: crackles, wheezing, dec breath sound
CXR: Hyperinflation, atelectasis, flat diaphragm

Rx:
secretion clearance

Question 6

Hirschsprung’s Disease

Answer 6

Cause:
-Constipation by absent ganglion cells in large intestine
-muscles in the bowels –>dun contract

Presentation:
-fail to pass first stool within first 48 hrs after birth
-abdominal distention