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Pediatrics Flashcards

1
Q

Peds: fasting recs for clear liquids

A

2 hours

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2
Q

What is the fasting recommendation for breast milk in peds?

A

4 horus

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3
Q

What is the fasting recommendation for infant formula in pediatrics?

A

6 hours

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4
Q

In pediatrics, what is the fasting recommendation for solids (fatty or fried food)?

A

8 hours

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5
Q

What pediatric age range is there minimal stress for the kid?

A

0-6 months

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6
Q

When does max fear of separation occur in pediatris?

A

6 months - 4 years

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7
Q

When do pediatrics have magical thinking?

A

6 months to 4 years

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8
Q

What should be removed prior to procedures in teens?

A

peircings

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9
Q

What age group interprests every thing literally? (peds)

A

8 years- adolsescnce

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10
Q

What physiologic change happens with croup?

A

subglottic narrowing

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11
Q

What could cause a heart murmur in kids?/

A

septal defects, avoid air bubles in IV

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12
Q

What causes cyanosis in kids

A

right to left shunt

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13
Q

A history of squatting indicates what?

A

tetralogy of fallot

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14
Q

What is a s/s of coarctation or renal dx in kids?

A

HTN

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15
Q

Valvular heart dx in kids can manifest as what?

A

rheumatic fever

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16
Q

What genitourinary symptom can be r/t hypercalcemia?

A

frequncy

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17
Q

In pediatrics, routine ___ testing and a ___ test is no indicated for most elective procedures

A

hemoglobin

urinalysis

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18
Q

Diazepam premed dose in Peds (PO)

A

0.1-0.5 mg/kg

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19
Q

Diazepam premed rectal dose in peds

A

1 mg/kg

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20
Q

Versed PO premed dose in peds

A 
0.25-0.75 mg/kg 
Other class syas 0.5 mg/kg max of 20 mg
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21
Q

Versed nasal premed dose in peds

A

0.2 mg/kg

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22
Q

versed rectal premed dose in peds

A

0.5-1 mg/kg

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23
Q

versed IM premed dose in peds

A

0.1-0.15 mg/kg

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24
Q

Lorazepma PO premed dose peds

A

0.025-0.05 mg/kg

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25
Ketamine premed PO dose in peds
3-6 mg/kg
26
Ketamine premed dose in peds (nasal)
3 mg/kg
27
Ketamine rectal premed dose in peds
6-10 mg/kg
28
IM ketamine premed dose in peds
2-10 mg/kg
29
What is an important consideration when administering benzos nasally?
must use preservative free
30
Why must you use preservative free nasal benzos?
neurotoxicity risk
31
what type of drug is scopolamine
anticholinergic
32
What drug class inhibits sweating
anticholinergics
33
Which 2 anticholinergics cross the BBB
atropine and scopolamine
34
PEDS recommended dose of Atropine?
0.01 - 0.02 mg/kg
35
PEDS recommended dose of Scopolamine?
0.005 to 0.01 mg/kg
36
What does atropine block?
vagus nerve
37
Scopolamine is better at what than atropine?
sedation antisialagogue amnestic
38
Atropine is better at what than scololamine
blockign vagus nerve
39
What type of chemical makeup is glycopyrrolate?
synthetic quaternary anmmonium
40
Does glycopyrrolate cross the BBB?
no
41
What works longer: Robinul or Atropine?
Robinul
42
What is the recommended dose of Robinul in peds?
0.01 mg/kg
43
What is one of the most essential monitors used during the induction in pediatrics?
precordial stethoscope
44
What is the traditional mask induction of anesthesia in a child?
N2O:O2 in a 2:1 ratio for 1-2 minutes, then starting Sevo
45
Will Sevo cause a signfiicant decrease in HR or BP in otherwise healthy kids?
no
46
What is the recommended initial dose of Sevo for induction in kids?
8%
47
IV induction dose of Thiopental or Thiamylal in peds
5-8 mg/kg
48
IV induction dose of Methohexital in peds
1-2.5 mg/kg
49
IV induction dose of Propofol in peds
2.5-3.5 mg/kg
50
IV induciton dose of Etomidate in peds
0.2-0.3 mg/kg
51
IV induction dose of ketamine in peds
1-2 mg/kg
52
In peds, what is most likley the cause of airway obstruction during anesthesia?
Loss of muscle tone in the pharyngeal and laryngeal structure
53
What is the sniffing position?
extension of the head at the atlantooccipital joint with anterior displacement of the cervical spine
54
What position improves airway dimensions in pediatrics?
Lateral positioning
55
What is the most effective way to improve airway patency and ventilation in kids undergoing adenotonsillectomy?
jaw thrust maneuver
56
What age group has increased risk of laryngospasm?
infants (greatest in infants than older kids and adults)
57
Secretionsi n the oropharynx, recent URTI within 2 weeks, and inhaled anesthesia (Des adn Iso) are all associated with laryngospasm. T/F
true
58
What is reflex closure of the false and true vocal cords?
Laryngospasm
59
What is a complete laryngospasm?
closure of the false vocal cords adn apposition of the laryngeal surface of the epiglottis adn interarytenoids.
60
Complete cessation of air movement occurs with complete larygospasm. T/F
ture
61
What is a partial laryngospasm?
incomplete apposition of the vocal cords w/ a residual small gap between the cords posteriorly that permits a persistent inspiratory stridor
62
What is the first step of laryngospasm management?
apply CPAP and 100% O2 - AP valve at 30
63
What medications are given to pediatrics that experience a laryngospasm (in proper order)
IV or IM atropine 0.02 mg/kg IV propofol 1 mg/kg IV or IM Sux 1-2 mg/kg or 4-5 mg/kgIM
64
What kind of IV fluid managmenet should be used in pediatrics?
buretrol to minmize inadvertently overinfusing
65
What size LR bag should be hung in young kids?
500 mL w/ graduated buretrol
66
What size LR bag should be hung in infants <1 year?
250 mL w/ buretrol
67
What fluid should be hung in kids over 8?
1L balanced salt solution w/ macro or micor gtt w/o buretrol
68
What is the rate of fluid replacement of blood loss in peds?
3 mL for every 1 mL blood loss
69
For 3rd space loss, what is the replacemnt volume for minor surgery?
1-2 ml/kg/hr
70
For 3rd space loss, what is the replacemnt volume for moderate surgery?
2-5 ml/kg/hr
71
For 3rd space loss, what is the replacemnt volume for major surgery?
6-10 ml/kr/hr
72
PRBC cannot be rapidly infused through ___ gauge IV
24
73
What is the smallest IV cannula that PRBC can be rapidly infused?
22 g
74
What is the 4-2-1 rules
4 ml/kg/hr - 1st 10 kg 2 ml/kg/hr -2nd 10 kg 1 ml/kg/hr - each kg after
75
What is estimated deficit
maintenance rate x hours NPO
76
How you you replace estimated deficits?
1/2 in 1st hour 1/4 in 2nd hour 1/4 in 3rd hour
77
In order to extubate the trachea deep, the depth of inhalational anesthesia should be turned down by 50%. T/F
False - MAC should be 1.5-2 x MAC
78
What is the optimal position for transfer of a kid after surgery?
Recovery position - lateral decubitius
79
What agents causes emergence agitation in peds?
Sevo and Des and Iso
80
When is the peak of emergence delirium in kids?
2-6 years
81
How do you treat emergence delirium in kids?
it will either spontaneously resolve or you can give IV prop, versed, clonidine, precedex, ketamine, or opioids

Anesthesia Principles (10 decks)

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