Peds Flashcards
Infants Stage and one thing to go with it
Trust vs mistrust sensory motor exploration
Toddlers stage and two things that go along with it
Autonomy vs shame and doubt
Fear of strangers, and separation and anxiety
Preschool stage and one thing
Initiative vs guilt vivid imagination
School age kids stages 2 things
Industry vs Inferiority understands concept of time and right/wrong
Adolescent stage
Identity vs role confusion
nociceptive pain
Nociceptive pain is a type of pain caused by damage to body tissue. Nociceptive pain feels sharp, aching, or throbbing. It’s often caused by an external injury, like stubbing your toe, having a sports injury, or a dental procedure.
Neuropathic
Neuropathic pain can happen if your nervous system is damaged or not working correctly. You can feel pain from any of the various levels of the nervous system—the peripheral nerves, the spinal cord and the brain
Somatic vs visceral
tissues vs organs
What to remember about infants and pain?
They may feel more pain because of immature CNS
Physiological changes with pain in kids
Change in vitals or ICP
Toddlers and pain 3
can react to painless, point to where it hurts, regressive behaviors
FLACC
Preschool and pain
Magical thinker, may not say it because mom must know, more vocab to describe pain and location.
School age range
5-12
School age pain 3
Tell all about it, may hide it because embarrassed, body reaction.
QUESTT
Pain assessment Question the child Use s reliable and valid scale Evaluate child trends Secure parent's involvement Take the cause of pain into account when interventing Take action
FLACC scale and what age groups
Non verbal, preschool, preschool Behavioral scale including face, legs, Activity, Cry, consolability. Ranked 0-2 adding up to ten
Oucher pain scale and who used for
Have pictures of real kids for school age
What are sweeties?
Satisfaction and soothing from sucking on sucrose pacifier
Ibuprofen dosage for peds
5-10mg/kg every 6 hours not given to kids under 6
What not to give kids? Meds
Asprin
Acetaminophen peds dose
10-15mg/kg q 4-6hrs no more than 5 doses in 24 hours
Cream to give kids for pain Name Function depth for? How to apply and time age
EMLA cream Eutectic mix of local anesthetics, lidocaine and prilocainel.
3-4mm
blood draws, IV, IM
Glob with occlusive dressing on top to keep in place 30-90mins or longer if tissue for deeper procedures
37 weeks gestation and older
Synera and age
EMLA patch and 3yr
What is Vulnerable child Syndrome?
Because of a serious illness parents have a hard time separating from a child and have significant anxiety which the child feels and develops symptoms that reinforce parents fears. Parents may try to regain control and don’t foster independence and don’t discipline kid which affects development
Simple What is failure to thrive?
Inadequate nutrition
Organic Failure to thrive nonorganic?
Inability to consume adequate calories within the body
Psychosocial
FTT discharge rule for babes
gain an oz a day for a few days before discharge
PKU
What is it
what can/ can’t have
What can it cause
An inborn error of metabolism that interferes with a liver enzyme that processes amino acid phenylalanine.
sugar/fruit /veggies/ special stuff
protein aspartame
Brain damage
Galactosemia
what can it cause? 5
One thing long term
Inborn error of metabolism liver, galactose can cause organ damage jaundice cataracts, feeding intolerance, N/V, sepsis.
No dairy for life
Maintenance fluids for peds rule
First 10kg x100ml
Second 10kg X 50ml
Everything past X20ml
Maintenance fluids for peds rule
First 10kg x100ml
Second 10kg X 50ml
Everything past X20ml
How much IM/Subcut given to kids
no more than 2mL
Weight of kids 5 things
Birth-7.5lbs Lose about 10% in in first week of life regain in 2 weeks double by 4-5 months triple by one year
Height and new borns
average at birth
What is it after birth
Average is 50cm or 20 in
1 in per month for first 6 months and then 1/2 in/month next 6 months
Head circumference normal birth
in a year how does it change?
What does it show?
13.5 About four in in first year
indicative of brain growth
when do the fontanels close?
Posterior around 2 months
anterior- 12-18months
Respiratory rate
newborns
1-12months
type?
30-60
25-55
irregular with pause
6 things to know about infants respiratory system
Nasal passageway is narrower trachea and chest wall more compliant Larynx more funnel shaped tongue is longer Fewer alveoli bronchioles are shorter narrower
Normal HR for newborns
for babes?
and what happens
up to 180
120-140
slows to 100 by 12 months
how much can a newborn stomach hold?
about 0.5-1 oz
up to how many stools per day for kids?
10
first tooth by when
6 months
Normal urine output for babe
Normal GFR for babe
1-3ml/kg/hr
MINIMUM is 1ml/kg/hr
when does umbilical cord fall off
10-14 days
When do kids become iron deficient?
Can become iron deficient around 6-9 months
When does object permanence begin and solidify
4-7 months and 8 months
When does babe know they are different from caregiver?
12 months
cephalocaudal
the baby learns to lift the head before learning to roll over and sit gross motor
proximodistal
Fine motor from the center to the periphery
What age should infant lift head and chest and hold position?
2 months
What age do infants lose the head lag?
4 months
What age do infants roll 2?
4-p-s
5s-p
what age do infants sit tripod? and unsupported?
6 months
8months
what age should kids pull to stand?
10 months
What age should they grasp a rattle?
5 months
what age should they transfer objects?
7 months
what age should they grasp a cheerio?
10 months
What age should they be able to bang things together?
9 months
what age should they offer objects are releases
11
Sounds in a year 4 sections
1-3 cooing
4-7 laugh
7-10 babbling
9-10 meaning to words
when is stranger danger and separation anxiety
8 months
9 months
what is the tongue extrusion reflex? and when does it go away?
push food out with tongue around 6months
S/s of IICP 5
Bulging fontenels, cranial suture separation, increase in head circumference, high pitched scream, triad.
Lennox- Gastaut what is it one thing
multiple different seizures -intellectual disability
Anencephaly
encephalocele
A-Small or missing brain hemis remaining tissue maybe exposed
E-protrusion of brain and meninges through skull defect
What is microcephaly (measure) and disease
HC 3 standard deviations below normal. Zika
Crinosynostosis
Premature closing of sutures
Chiari 2 malformation
Back of the brain is pulled down out of the skull
Myelomenigocele
Protruding meninges and spinal cord
Shunting hydrocephalus 7
ICP s/s Infection s/s seizures change in LOC poor feeding N/V HA doesn't go away
Shunting hydrocephalus 7
ICP s/s Infection s/s seizures change in LOC poor feeding N/V HA doesn't go away
What is REYE syndrome
Salicylates- asprin brain swells seizures live fail
osteomyelitis and 5 causes
Staph aureus, group a and b strep, e coli, s. pneumoniae, H influenzae
How do you get osteomyelitis
bacteria from blood invade rapidly growing bone
Osteomyelitis risk factors 5
Impetigo-strep, varcella legions, burns, trauma, ortho surg
Normal BP for infant
60-100/40-55
What does the FLACC scale stand for who to use it on?
Face, Legs, Activity, Cry, Consolability
2month to 7 years
Typical absence seizures 5 and type
nonmotor, usually happens in kids, daydreaming look. EEG has a unique pattern 3Hz spike usually does not follow into adulthood. Generalized
Atypical absent seizures 6 and type
Staring spell, lip and eye movement, somewhat responsive, commonly longer than 10 seconds, gradual beginning and end, goes into adulthood. Generalized
Atonic seizure and type
fall to ground. can resume generalized
What is neurofibromatosis
Tumors that grow on the nerves
How to Rx Neurofibromatosis 8
have to have two or more signs of cafe au lait spots (at least 6), 2 or more neurofibromas, or one plexiform, freckling in armpit or groin, optic glioma, lisch nodules, abnormal bones, 1st degree relative that has it
Fold of eye flap with downs
Epicanthal folds
When does walking stepping reflex disappear
2 months
When does moro go away
4 months
When does the suck root reflex go away?
5 give me a high five if you don’t suck
When does the palmer grasp go away?
six pay attention to s in grasp
8 months 2 things
Babble and peak a Boo
Bs and 8
what goes away at 12 months
Babinski and plantar
When does the tonic neck go away
5 months
need 5 fingers to drink a gin and tonic
How much can a newborn stomach hold? when to burp? why regurg?
1-2tsp After every oz or between breasts weak sphincters
How often do newborns eat?
Every 2-3 hours
What to remember about the neonates stomach?
It is sterile and does not produce vit k because there is no bacteria.
What is meconium and one thing about it
Black tar stool from amniotic fluid and they may poop in the womb if they are stressed.
