Pediatrics

Question 1

Caregiver

Answer 1

• Listen to, and support, the caregivers
  
  • Calm caregivers = calm child
  • Agitated caregivers = agitated child
• Keep caregiver informed
• Remain calm, caregivers are watching you for support

Question 2

Development stages

Answer 2

• Neonate (birth- 1m)
• Infant (1m -1y)
• Toddlers (1-2y)
• Preschoolers (3-5 y)
• School age and pre-adolescent (6-12 y)
• Adolescent (12-18y)

Question 3

Neonate

Answer 3

• Birth to one month
• Completely dependent on caregivers

Question 4

Infant

Answer 4

• One month to one year
• Less than 6 months: can you recognize caregivers face and voice
• Over 6 months: do not like to be taken from caregivers (Let caregivers hold child during assessment)

Question 5

Toddler

Answer 5

• 1-2 years
• Do not like
  
  • To be touched
  • To be taken from caregiver
  • Having clothing removed
• Fear of pain

Question 6

Preschoolers

Answer 6

• 3-5 years
• Believe illness or injury is their fault
• Have caregiver hold child on their lap

Question 7

School age and pre-adolescents

Answer 7

• 6-12 years
• Modest
• Fear permanent injuries and disfigurement

Question 8

Adolescents

Answer 8

• 12-18 years
• Preoccupied by their bodies and are modest
• Capable of hysterical reactions to event

Question 9

PAT

Answer 9

Pediatric Assessment Triangle
- Appearance
- Work of breathing
- Circulation

Question 10

Appearance

Answer 10

• Tone: assess muscle tone
• Interactivity and irritability: Alert or disinterested in event?
• Consolability: Can child be consoled by caregiver
• Look or gaze: Is there a “nobody home” look on the child’s face?
• Speech or cry: Good strong cry or speech pattern?

Question 11

Work of Breathing

Answer 11

• Abnormal sounds
• Abnormal posture or position
• Retractions
• Nasal flaring
• Head bobbing

Question 12

Circulation

Answer 12

• Pallor
• Mottling
• Cyanosis

Question 13

PAT findings

Answer 13

• Respiratory distress
• Respiratory failure
• Compensated shock
• Decompensated shock
• Brain Injury
• Cardiopulmonary failure

Question 14

Respiratory DISTRESS

Answer 14

Appearance: Normal
Work of breathing: Abnormal
Circulation: Normal

Question 15

Respiratory FAILURE

Answer 15

Appearance: Abnormal
Work of breathing: Abnormal
Circulation: Normal or Abnormal

Question 16

Compensated shock

Answer 16

Appearance: Normal
Work of Breathing: Normal
Circulation: Abnormal

Question 17

Decompensated shock

Answer 17

Appearance: Abnormal
Work of breathing: Normal or abnormal
Circulation: Abnormal

Question 18

Brain Injury

Answer 18

Appearance: Abnormal
Work of breathing: Abnormal
Circulation: Abnormal

Question 19

Cardiopulmonary Failure

Answer 19

Appearance: Abnormal
Work of breathing: Abnormal or Absent
Circulation: Abnormal

Question 20

Croup

Answer 20

Common infection of the upper airway
- usually viral
- 6 months to 4 years
- Swelling of the glottis

Question 21

SXSX Croup

Answer 21

• Stridor in inhalation
• Seal bark cough

Question 22

Epiglottitis

Answer 22

Swelling of the epiglottis
- Bacterial
- 2 to 7 years
- Life threatening emergency

Question 23

SXSX Epiglottitis

Answer 23

• Painful swallowing
• High fever
• Drooling
• Stridor

Question 24

Asthma

Answer 24

Narrowing of airway due to edema and mucus production
- Reversible
- Has definite cause and is REPEATABLE
- Patient is little older and has a repeatable cause of wheezing

Question 25

SXSX Asthma

Answer 25

- Shortness of breath - Wheezing

Question 26

Bronchiolitis

Answer 26

Narrowing of airway due to swelling/ viral infection/ RSV (Respiratory Syncytial virus) - Usually happens to the very young/ less than 2 years of age

Question 27

SXSX Bronchiolitis

Answer 27

- Similar s/s to asthma - Patient is very young and has a viral infection

Question 28

Seizures

Answer 28

Fever is most common cause of seizures in children

Question 29

Treatment Seizures

Answer 29

- Strip child down to diaper - Give sponge bath with a cloth soaked with tepid (Luke warm) water - Watch for shivering!

Question 30

BRUE/ ALTE

Answer 30

Brief Resolved Unexplained Event/ Apparent Life Threatening Event - Children is less than one year

Question 31

BRUE/ ALTE Examples

Answer 31

- Cyanosis or Pallor - Absent, decreased, or irregular breathing - Changes in muscle tone - ALOC

Question 32

Sudden Infant Death Syndrome

Answer 32

- Children less than one year of age - Most common in 2-4 months - Crib death - Death of a child with no cause found on autopsy

Question 33

Child Abuse

Answer 33

Indicators: - Multiple bruises in various stages of healing - Multiple injuries/ unusual wound patterns - Fearful child - Injuries don't match MOI - if suspected, alert law enforcement at scene and hospital staff - Contact child protective services (CPS) -Immediately by phone - Written report send in to CPS in 36 hours