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Exam Prep > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Sensorimotor development takes place at what age?

A

0-2

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2
Q

Preoperational development takes place at what age?

A

2-6

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3
Q

Concrete operational development takes place at what age?

A

6-12

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4
Q

Formal operational development occurs at what age?

A

12-adult

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5
Q

Which group of patients are more inclined to experimental, high-risk behaviours which impact health, response to intervention?

A

adolescents

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6
Q

Psychological development stage when the pt explores the world through direct sensory and motor contact; object permanence and separation anxiety develop during this stage:

A

sensorimotor (0-2 years)

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7
Q

Psychological development stage when the pt uses symbols to represent objects; doesn’t reason logically, is egocentric and has the ability to pretend

A

preoperational (2-6 years)

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8
Q

Psychological development stage when the pt can think logically about concrete objects, can add and subtract, understands conversation

A

concrete operational (6-12 years)

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9
Q

Psychological development stage when the pt can reason abstractly and thinks in hypothetical terms

A

formal operational (12-adult)

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10
Q

Pediatrics have ____ skin and ____ BSA.

A
  • thinner
  • larger
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11
Q

Pediatrics have _____ CNS receptivity and ____ metabolic rate.

A
  • enhanced
  • higher
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12
Q

Anatomical/physiological differences of Peds vs. Adults - the tongue

A

is larger

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13
Q

Anatomical/physiological differences of Peds vs. Adults - trachea

A

more pliable, smaller in diameter

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14
Q

Anatomical/physiological differences of Peds vs. Adults - tracheal rings

A

immature

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15
Q

Anatomical/physiological differences of Peds vs. Adults - epiglottis

A

larger, more U shaped or oblong shaped

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16
Q

Anatomical/physiological differences of Peds vs. Adults - larynx

A

sits at 1st or 2nd cervical vertebra

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17
Q

Anatomical/physiological differences of Peds vs. Adults - mainstem bronchi

A

less angled

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18
Q

Broselow tape is used to:

A

help measure and weigh, calculate meds, airway sizes
(fast and reliable for quick response esp. with trauma)

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19
Q

What assessment is used for general assessment of a sick child?

A

PAT

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20
Q

The goal of PAT assessment is?

A
  1. form general impression of child
  2. establish severity of presentation and category of pathophysiology
  3. determine type, urgency of intervention
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21
Q

The PAT answers what question?

A

sick or not sick

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22
Q

For pediatrics you should maintain a high index of suspicion because:

A

pediatric patients may deteriorate rapidly

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23
Q

Other considerations to your primary survey should include (6):

A
  • change in appetite
  • changes in behaviour
  • excessive drooling (epiglottis)
  • number of wet diapers
  • patient positioning
  • work of breathing
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24
Q

In your secondary assessment of the head, which additional assessment needs to be made for peds (particularly infants):

A

assess fontanelles

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25
Q

3 components of PAT:

A
  • appearance
  • work of breathing
  • circulation to skin
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26
Q

Components of appearance (PAT):

A
  • abnormal tone
  • decreased interactiveness
  • decreased consolability
  • abnormal look/gaze
  • abnormal speech/cry
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27
Q

Components of work of breathing (PAT):

A
  • abnormal speech
  • abnormal positioning
  • retractions
  • flaring
  • apnea/gasping
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28
Q

Components of circulation to skin (PAT):

A
  • pallor
  • mottling
  • cyanosis
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29
Q

Immediate clinical intervention is required when there is an abnormality in how many arms of the PAT

A

1

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30
Q

5 categories of the PAT

A
  • respiratory distress
  • respiratory failure
  • shock
  • CNS or metabolic disorder
  • cardiopulmonary failure
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31
Q

Interpret the following PAT finding - normal a, normal WOB, normal CtS

A

stable

32
Q

Interpret the following PAT finding - normal a, abnormal WOB, normal CtS

A

resp distress

33
Q

Interpret the following PAT finding - abnormal a, abnormal WOB, normal CtS

A

respiratory failure

34
Q

Interpret the following PAT finding - normal/abnormal a, normal WOB, abnormal CtS

A

shock

35
Q

Interpret the following PAT finding - abnormal a, abnormal WOB, abnormal CtS

A

cardiopulmonary failure

36
Q

Interpret the following PAT finding - abnormal a, normal WOB, normal CtS

A

CNS/metabolic disturbance

37
Q

GCS for Pediatrics 2-5 - Verbal

A

appropriate words/phrases = 5
inappropriate words = 4
persistent cries and screams = 3
grunts = 2
no response = 1

38
Q

GCS for Pediatrics 2-5 - Verbal

A

smiles/coos appropriately = 5
cries and is consolable = 4
persistent inappropriate crying and/or screaming = 3
grunts, agitated, and restless = 2
no response = 1

39
Q

Top 4 pediatric presenting complaints:

A
  • fever
  • respiratory difficulties
  • injuries
  • vomiting/diarrhea (dehydration)
40
Q

What shunts are present in fetal circulation?

A
  • ductus venosus (bypasses liver)
  • ductus arteriosus (bypasses liver)
  • foramen ovale (wall of heart)
41
Q

Asphyxiation causes _______ of blood vessels in the lungs, bowels, kidneys, muscles and skin

A

vasoconstriction

42
Q

With prolonged asphyxia - what begins to decline?

A
  • myocardial function
  • cardiac output
43
Q

What is caused when a neonate does not effectively breathe?

A

asphyxia

44
Q

Priorities when clearing the airway

A

mouth than nose

45
Q

Steps after delivery:

A
  1. airway (clear mouth, nose)
  2. cord (clamp/cut)
  3. position - neonate supine w/ head/neck slightly extended
  4. record time of delivery
  5. tag - neonate arm w/ time of delivery/mom’s name
  6. transport - skin-to-skin, mom can nurse
46
Q

If suspecting a child is in need of protection who do you report to?

A
  • receiving hospital
  • Children’s Aid Society
47
Q

Pediatric fever:

A

> =38 degrees

48
Q

meningitis concerns (s&s):

A
  • stiff neck
  • altered mental status
  • petechiae
49
Q

Dx for pediatric respiratory difficulties:

A
  • reactive airway disease
  • asthma exacerbation
  • croup
  • epiglottis
50
Q

History taking questions in peds respiratory difficulties

A
  • fever
  • upper respiratory infection s&s
  • cough
  • sick contacts
  • travel
  • puffer use
  • wheezing
  • WOB
  • drooling
51
Q

What is the leading cause of hospitalization in peds?

A

falls

52
Q

Trimodal death distribution - first peak

A

second to mins after injury - only prevention can affect mortality

53
Q

Trimodal death distribution - second peak

A

mins to hours (rapid assessment, tx can improve mortality)

54
Q

Trimodal death distribution - third peak

A

days to weeks (multi-organ system failure, definitive care at specialized pediatric center)

55
Q

Peds factors in trauma:

A
  • smaller size - increased risk for multiple organ system injury
  • higher metabolic rate, larger BSA (increased heat loss)
  • smaller absolute blood volume (small amounts of blood loss can be a significant % of total blood volume)
  • head injuries (manage airway, avoid hypoxia, and hypotension)
56
Q

Usually volume depletion in peds is due to:

A

vomiting/diarrhea

57
Q

Intrauterine, most blood bypasses the liver via ____ and enters _____

A

ductus venosus; IVC

58
Q

Intrauterine, blood enters right atrium, ___ to ___ % directed through _____ to left atrium

A

50-60%; foramen ovale

59
Q

Blood from SVC enters right atrium - right ventricle - pulmonary artery - blood moves through ____ to bypass pulmonary vasculature and move into _____

A

ductus arteriosus; aorta

60
Q

2 potential problems in neonatal transition

A
  • fluid remains in alveoli
  • blood flow to lungs may not increase
61
Q

1/3 fetal lung fluid is removed during _____ ______

A

vaginal delivery (remaining fluid passes through alveoli into lymphatic tissues)

62
Q

If neonate is experiencing apnea or weak respiratory effort it means?

A

fluid is unable to be cleared from lungs

63
Q

Primary apnea

A

deprived of O2, heart rate falls, respiratory efforts cease

64
Q

Secondary apnea

A

asphyxia continues, develops deep gasping respirations, HR continues to decline, BP begins to fall, respirations weaken

65
Q

What type of apnea can happen in utero?

A

primary and secondary

66
Q

Fetus is defined as:

A

2nd trimester until live birth (still-born may still be considered a fetus)

67
Q

Neonate is defined as:

A

gestational age + 30 days

68
Q

Infant is defined as:

A

1-12 months

69
Q

Child is defined as:

A

toddler to puberty (age 9-12)

70
Q

Adolescent is defined as:

A

puberty to 18

71
Q

What is the clinical importance of knowing the difference between an infant and a neonate

A

we can shock an infant but NOT a neonate

72
Q

If core of the baby is blue, we know the problem is what?

A

lungs haven’t opened and started inflating

73
Q

The risk of postpartum hemorrhage significantly increases after how long once the baby has delivered without placenta delivery?

A

30 mins

74
Q

Third trimester bleeding causes:

A
  • placental abruption
  • placental previa
  • preterm birth
75
Q

4 Ts of postpartum hemorrhage:

A
  • Tone
  • Trauma
  • Tissue
  • Thrombin
76
Q

Prolapsed cord with strong pulse - what to do?

A
  • transport
  • wrap in a warm, moist sterile dressing
77
Q

Possible causes for an unconscious pregnant women:

A
  • head injury
  • eclampsia
  • diabetes

Exam Prep (10 decks)

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