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Patient Care Theory (Sem 2) > Pediatrics (W10) > Flashcards

Pediatrics (W10) Flashcards

1
Q

An infants tongue is

A

Proportionally larger in the mouth compared to adults

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2
Q

In infants the larynx is

A

Higher up than in adults

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3
Q

In infants the epiglottis is

A

Shorter and stiffer than in adults (whose is flat and flexible)

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4
Q

In infants the vocal cords are

A

More anterior than compared to adults

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5
Q

In infants the trachea is

A

Shorter, narrower and cone shaped when compared to adults

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6
Q

In infants the chest wall is

A

More pliable than adults

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7
Q

Resistance to airflow is inversely proportional to the fourth power of the radius of the AW

A

One mm of concentric edema in a newborn trachea (radius approx 2c) increases about 16 times

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8
Q

Children aged ___ are most likely to aspirate FB

A

12-24 m/o

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9
Q

How do you tx a cardiac arrest secondary to FB

A

Transport after 1 analysis; unless VT or VT, then give 3 shocks (CONTRAINDICATED FOR TOR)

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10
Q

Croup (3m-3y)

A

Subglottic, gradual onset over hours following URTI, pt will likely not have a fever and will not be drooling

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11
Q

Tx for croup

A

Exposure to cold air, nebulized epi, dexamethasone

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12
Q

Give epi and dex if

A

Pt is from 6m-8y and has an URTI and a barking cough

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13
Q

Conditions for giving epi humidified

A

HR <200PBM & stridor at rest

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14
Q

How much humidified epi does a pt under 10kg get

A

(1mg/ml 1:1,000) 2.5mg (1 dose only)

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15
Q

How much humidified epi does a pt over 10kg get

A

(1mg/ml , 1:1,000) 5mg (one dose only)

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16
Q

When can you not give dexamethasone to a peds pt w croup

A

If they have an allergy/sensitivity to it, if they have taken systemic steroids (pill/injection) in the last 48hr, or if pt cannot tolerate oral medications

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17
Q

If pt has stridor at rest, give both drugs. If no stridor at rest what is the only drug you give

A

Dexamethasone

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18
Q

How do you give dex

A

PO (0.5mg/kg) 1 dose only, max at 8mg

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19
Q

Epiglottitis (2-7y)

A

Supraglottic, rapid onset, child will likely present with a fever, SOB, stridor, retractions, cyanosis, drooling

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20
Q

Pediatric triangle includes what

A

Appearance, WOB, circulation

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21
Q

PAT Appearance

A

Muscle tone // interactiveness // consolable // gaze // speech // crying

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22
Q

PAT WOB

A

Abnormal breath sounds // position // head bobbing // retractions // gasping // grunting // nasal flaring

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23
Q

PAT circulation

A

Pallor // mottling // cyanosis // temp // palpable pulses // BP // bleeding // turgor // mucous membranes

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24
Q

What should you consider when wanting to give an OPA in a child

A

The fact that the mouth is small and it can bunch up the tongue, it can fold the glottis down, and also compress the soft laryngeal cartilages

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25
Q

Pneumothorax is common in infants because of how thin their lungs are, this can decrease

A

CO, which presents as HoTn

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26
Q

A child’s condition can be made worse by their breathing effort

A

Apnea —> hypoxia —> bradycardia —> worse hypoxia

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27
Q

What makes breathing harder for children

A

Horizontal ribs, weak accessory muscles, poor respirator reserve, poor chest compliance (often known as belly breathers)

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28
Q

Higher metabolic demand + low reserve =

A

High sensitivity to AW / breathing problems

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29
Q

What is cystic fibrosis

A

The abnormal chlorine ion transport on surface of epithelial cells in exocrine glands leading to viscus secretions

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30
Q

Asthma is chronic AW inflammation caused by

A

Bronchial hyperreactivity, bronchospasm, mucous production

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31
Q

Classic asthma triad

A

Dyspnea, cough, wheezing

32
Q

What is status asthmaticus

A

CO2 retention, hypoxemia and respiratory failure where pt wheezes w retractions (OFTEN SILENT ARREST)

33
Q

Status asthmaticus can cause

A

A silent chest, lethargy, can lead to pneumothorax, <3 word dyspnea

34
Q

Bronchiolitis (1-12m)

A

Inflammation in LRT, can lead to necrosis, transmitted by oral droplets

35
Q

Presentation of bronchiolitis

A

Recent fever, cold, dyspnea, wheezing, crackles, chest retractions

36
Q

Pneumonia is the infection of

A

The lung parenchyma, causing inflammation/alveolar exudate

37
Q

S/S of pneumonia

A

Fever, dyspnea, cough w productive sputum, pleuritic CP, diaphoresis, fatigue, malaise, bronchovesicular sounds over consolidation, decreased AE, unilateral crackles

38
Q

If pt is wheezing, how can you provide tx

A

Salbutamol

39
Q

What does salbutamol do

A

Beta 2 antagonist - bronchodilator

40
Q

How can you give salbutamol by MDI for pt under 25kg

A

Up to 6 puffs (600mcg), every 5-15 mins with a max of 3 doses

41
Q

How can you give salbutamol by MDI for pt over 25kg

A

Up to 8 puffs (800mcg) 5-15min interval between the max of 3 doses

42
Q

How can you give salbutamol by neb for pt under 25kg

A

Dose (and max sin. dose) 2.5mg, with 5-15 mins apart maxing at 3 total doses

43
Q

How can you give salbutamol by neb for pt over 25kg

A

Dose (and max sin. dose) 5mg, with 5-15 mins between max of 3 doses

44
Q

If you are BVMing your pt in respiratory distress, you should be giving ___ if pt has a history of ___

A

Epi // asthma

45
Q

How to give epi for asthma respiratory distress

A

Given IM, same as for anaphylaxis but only 1 dose

46
Q

If giving dex for asthma/COPD/smoking hx

A

PO/IM/IV, (0.5mg/kg, max at 8mg), one dose only

47
Q

Why is hypovolemia the most common shock in children

A

Smaller bodies = less blood to lose

48
Q

How to treat hypovolemia in children

A

Fluid = up to 3x20ml/kg (bolus)

49
Q

How to treat cardiogenic shock in children

A

5-10ml/kg (over 10-20 mins)

50
Q

How to treat septic shock in children

A

20ml/kg , up to 60ml/kg w a patch

51
Q

DKA treatment for kids in the field

A

Will require a patch, 10-20m/kg (over 60-120 mins)

52
Q

TBI management in pediatrics

A

Elevate head 30 degrees, prevent hypoxia and HoTN

53
Q

Fluid loss is greatest in the first ___ with burn injuries

A

12-36hr

54
Q

Poor prognosis for submerged patients

A

Prolonged submersion (>25mins), delayed CPR, resuscitation (>25mins)

55
Q

Hypoxemia is the most frequent cause of

A

Bradyarrhythmias

56
Q

Signs of bradydysrhythmias

A

Hypoperfusion, altered LOA, agitation, poor skin colour, delayed cap refill

57
Q

Bradycardia

A

<100 in newborn, <80 in small child

58
Q

Sinus tachycardia

A

HR 180+

59
Q

Causes of sinus tach

A

Hypoxemia, hypovolemia, hyperthermia, metabolic stress, toxins, poisons, drugs, pain or anxiety

60
Q

SVT

A

HR >220, can reach >340

61
Q

Ventricular tachycardia

A

Prolonged QT, quick infrequently

62
Q

Meningitis

A

Infection and inflammation of the meninges, s/s usually vary by age

63
Q

Sudden infant death syndrome

A

Typically <1y/o, obtain as much history as much as possible

64
Q

Neonates are likely to have seizures that lack the

A

Tonic-clonic seizure activity

65
Q

Elements suggesting true seizure

A

Lateral tongue biting, flickering eyes, dilated pupils w blank stare, lip smacking, increased HR and BP

66
Q

How old are infants often to practice breath holding / during seizures

A

9-18months

67
Q

Simple febrile seizure

A

6m-5y, single seizure in 24hrs, post-ictal w return to baseline

68
Q

What can ca+ channel blockers cause

A

HoTN and weakened cardiac contractility or AHF

69
Q

Physical abuse

A

Long sleeves in warm months / excessive crying / avoidance of physical contact / whispered speech / clinging

70
Q

Emotional abuse

A

Desperately affectionate / unexplained stomach/headaches / habit disorders / extremely obedient

71
Q

Consider HT when

A

Frequency EMS calls, substance abuse, incongruent behaviour

72
Q

Neglect

A

Missing clothing, persistent hunger, body odour / always tires

73
Q

Infants (0-12m) developmental markers

A

-Generally respond to the voice of face of their parents
-Likely to be held by caregivers
-Crying can indicate pain, discomfort, or hunger

74
Q

Toddlers (1-3y) developmental markers by age

A

-Curious, more apt to have an ingestion emergency of FBAO
-Fear separation from their parents, using stuffed animals and allowing them to sit on their parents laps might help build trust

75
Q

Preschoolers (3-5y) developmental markers by age

A

Can talk with simple words, but often can’t understand what’s happening and are scared by the sight of blood (it’s important to bandage even the simplistic cuts and give constant reassurance)

76
Q

School-aged kids (6-12y) developmental markers

A

-Generally can answer questions and follow instruction but have very vivid imaginations, especially about death
-Constant reminders that they’ll be okay may be needed

77
Q

Adolescents (13-18) developmental markers

A

-Can provide accurate information but fear permanent scarring with trauma
-Feel modesty is very important to them and they can get caught up in the hysteria of a 911 call, so it is important to be well versed in a variety of calming measures

Patient Care Theory (Sem 2) (10 decks)

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