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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
Pneumothorax is common in infants because of how thin their lungs are, this can decrease
CO, which presents as HoTn
26
A child’s condition can be made worse by their breathing effort
Apnea —> hypoxia —> bradycardia —> worse hypoxia
27
What makes breathing harder for children
Horizontal ribs, weak accessory muscles, poor respirator reserve, poor chest compliance (often known as belly breathers)
28
Higher metabolic demand + low reserve =
High sensitivity to AW / breathing problems
29
What is cystic fibrosis
The abnormal chlorine ion transport on surface of epithelial cells in exocrine glands leading to viscus secretions
30
Asthma is chronic AW inflammation caused by
Bronchial hyperreactivity, bronchospasm, mucous production
31
Classic asthma triad
Dyspnea, cough, wheezing
32
What is status asthmaticus
CO2 retention, hypoxemia and respiratory failure where pt wheezes w retractions (OFTEN SILENT ARREST)
33
Status asthmaticus can cause
A silent chest, lethargy, can lead to pneumothorax, <3 word dyspnea
34
Bronchiolitis (1-12m)
Inflammation in LRT, can lead to necrosis, transmitted by oral droplets
35
Presentation of bronchiolitis
Recent fever, cold, dyspnea, wheezing, crackles, chest retractions
36
Pneumonia is the infection of
The lung parenchyma, causing inflammation/alveolar exudate
37
S/S of pneumonia
Fever, dyspnea, cough w productive sputum, pleuritic CP, diaphoresis, fatigue, malaise, bronchovesicular sounds over consolidation, decreased AE, unilateral crackles
38
If pt is wheezing, how can you provide tx
Salbutamol
39
What does salbutamol do
Beta 2 antagonist - bronchodilator
40
How can you give salbutamol by MDI for pt under 25kg
Up to 6 puffs (600mcg), every 5-15 mins with a max of 3 doses
41
How can you give salbutamol by MDI for pt over 25kg
Up to 8 puffs (800mcg) 5-15min interval between the max of 3 doses
42
How can you give salbutamol by neb for pt under 25kg
Dose (and max sin. dose) 2.5mg, with 5-15 mins apart maxing at 3 total doses
43
How can you give salbutamol by neb for pt over 25kg
Dose (and max sin. dose) 5mg, with 5-15 mins between max of 3 doses
44
If you are BVMing your pt in respiratory distress, you should be giving ___ if pt has a history of ___
Epi // asthma
45
How to give epi for asthma respiratory distress
Given IM, same as for anaphylaxis but only 1 dose
46
If giving dex for asthma/COPD/smoking hx
PO/IM/IV, (0.5mg/kg, max at 8mg), one dose only
47
Why is hypovolemia the most common shock in children
Smaller bodies = less blood to lose
48
How to treat hypovolemia in children
Fluid = up to 3x20ml/kg (bolus)
49
How to treat cardiogenic shock in children
5-10ml/kg (over 10-20 mins)
50
How to treat septic shock in children
20ml/kg , up to 60ml/kg w a patch
51
DKA treatment for kids in the field
Will require a patch, 10-20m/kg (over 60-120 mins)
52
TBI management in pediatrics
Elevate head 30 degrees, prevent hypoxia and HoTN
53
Fluid loss is greatest in the first ___ with burn injuries
12-36hr
54
Poor prognosis for submerged patients
Prolonged submersion (>25mins), delayed CPR, resuscitation (>25mins)
55
Hypoxemia is the most frequent cause of
Bradyarrhythmias
56
Signs of bradydysrhythmias
Hypoperfusion, altered LOA, agitation, poor skin colour, delayed cap refill
57
Bradycardia
<100 in newborn, <80 in small child
58
Sinus tachycardia
HR 180+
59
Causes of sinus tach
Hypoxemia, hypovolemia, hyperthermia, metabolic stress, toxins, poisons, drugs, pain or anxiety
60
SVT
HR >220, can reach >340
61
Ventricular tachycardia
Prolonged QT, quick infrequently
62
Meningitis
Infection and inflammation of the meninges, s/s usually vary by age
63
Sudden infant death syndrome
Typically <1y/o, obtain as much history as much as possible
64
Neonates are likely to have seizures that lack the
Tonic-clonic seizure activity
65
Elements suggesting true seizure
Lateral tongue biting, flickering eyes, dilated pupils w blank stare, lip smacking, increased HR and BP
66
How old are infants often to practice breath holding / during seizures
9-18months
67
Simple febrile seizure
6m-5y, single seizure in 24hrs, post-ictal w return to baseline
68
What can ca+ channel blockers cause
HoTN and weakened cardiac contractility or AHF
69
Physical abuse
Long sleeves in warm months / excessive crying / avoidance of physical contact / whispered speech / clinging
70
Emotional abuse
Desperately affectionate / unexplained stomach/headaches / habit disorders / extremely obedient
71
Consider HT when
Frequency EMS calls, substance abuse, incongruent behaviour
72
Neglect
Missing clothing, persistent hunger, body odour / always tires
73
Infants (0-12m) developmental markers
-Generally respond to the voice of face of their parents -Likely to be held by caregivers -Crying can indicate pain, discomfort, or hunger
74
Toddlers (1-3y) developmental markers by age
-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
Preschoolers (3-5y) developmental markers by age
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
School-aged kids (6-12y) developmental markers
-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
Adolescents (13-18) developmental markers
-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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