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PEDS Flashcards

1
Q

Fetal to neonatal physiology transition takes place in _______________

A

the first 24-72hours (delay surgery if possible)

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2
Q

Avoid ________ and __________ so PDA does not reopen in the neonate

A

hypoxia and acidosis

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3
Q

The baby modulates Cardiac Output by …….

A

Changing HR

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4
Q

The baby has a ______________________ which gives them limited ability to handle fluid load or increase in SV

A

Noncompliant LV

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5
Q

Infants have limited ____________ and have a very mature ___________ system

A

catecholamine stores

PSNS

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6
Q

Neonates consume how much more O2 than adults?

A

double

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7
Q

The normal systolic BP in an infant is _____… neonate ______ …. 5yrs of age ______

A

95
65
95

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8
Q

The normal heart rate in a neonate is _____

A

130

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9
Q

RESP: Infants have the same _______ & _______ as adults but differ in ________

A

TV & Dead space

RR (theirs is 2-3x higher)

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10
Q

RESP: Infants have decreased _________ muscle fibers in their diaphragm

A

Type I (they have less “marathon” muscle)

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11
Q

RESP: Infants have a smaller number of ________ in their lung until around age 8.

A

alveoli

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12
Q

The infant and neonate’s O2 consumption is _____ml/kg/min. Pediatric o2 consumption is __-__ ml/kg/min

A

5-6

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13
Q

_________ & __________ DEPRESS ventilation

A

hypoxia and hypercapnia

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14
Q

Describe lung compliance and chest wall compliance in the infant vs adult

A

adult - good lung compliance and non-compliant chest wall

PEDS - decreased lung compliance and compliant chest wall

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15
Q

The FRC in the neonate is _____ compared to _______ mL/kg in the adult

A

25

40

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16
Q

Do infants breath more from the nares or mouth?

A

Obligate Nasal breathing

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17
Q

____________ is the Narrowest park of the pediatric airway. It is at the level of C_-C_

A

cricoid cartilage

C2-C3

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18
Q

What position is ideal for intubation of the very young child?

A

neutral or slightly flexed

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19
Q

ECF in a neonates is ______% of their body weight and ____% of body weight by age 2

A

40

20

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20
Q

The baby will have normal kidney function by age ___________

A

6 months

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21
Q

The normal hog at birth is between ___-___ g/dL and at 2 months is ____-____. A newborn blood loss >___% may not be tolerated d/t FETAL hbg.

A

18-20
10-12
10-15%

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22
Q

Describe the glucose metabolism in infants:

A

minimal glycogen stores

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23
Q

Coordination of swallowing and breathing is not mature until ___-___ months

A

4-5

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24
Q

Plasma albumin levels are _____ in term newborns

A

low

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25
Babies control thermoregulation using __________________
brown fat metabolism
26
The E1/2t in infants is ____________ for most drugs and it is _____________ for children 2-12years
prolonged | shortened
27
Will the infant have a large or small Vd with H2O soluble drugs?
Large
28
A _________ blade is more optimal for intubation
Miller
29
MAC values for an infant are _________ compared to adults
1/3 higher
30
MAC values lowest to highest from preemie to adult are?
``` preemie adult child neonate infant ```
31
The speed of inhalational induction is faster in PEDS d/t what 2 main factors?
High minute ventilation and LOW FRC
32
The doses of IV induction agents for PEDS are.......
on the adult high end of dosing
33
The normal dose of propofol in a 1 year old is _____mg/kg IV
3
34
The normal dose of propofol for a 6 year old is _____ mg/kg
2
35
We want to avoid using morphine in young babies because .......
they have a very immature/permeable BBB... it is easier to overdose
36
Fentanyl is most common in PEDS and the dose is ____-___ mcg/kg
.5-1.0
37
Succinylcholine can cause _____________ in PEDS. You must mix it with ______________
profound bradycardia | atropine
38
The normal dose of Sch in children is ____-____mg/kg IV or ____-____mg/kg IM
1-2 | 4-5
39
NDMR doses for PEDS are....
the same as adults
40
Which do you use more in kids... oral or nasal airway?
oral
41
Beyond 2 years of age the formula for uncuffed ETT sizes is --->
[age(yrs) + 16]/4
42
At 1-2 yrs old, the uncuffed ETT size should be between ___-___
4-5
43
A premature baby less than 1000gms should have an ETT size of__________
2.5
44
A premature baby greater than 1000gms should have an ETT size of ______
3
45
A neonate to 1 year old should have an uncuffed ETT size of _____-_____
3-4
46
Your cuff leak should be between ___-___cm
20-30
47
To estimate the size of a cuffed ETT in PEDS what should you do?
use the uncuffed formula and then subtract 1/2 size
48
Cuff pressure should be
25
49
You would use a miller 2 or Mac 2 in children aged > _______
6
50
you would use a miller 0 in ______
neonates to 2yo
51
A miller 1 is best used in ages ____-____
2-6
52
The formula for ETT insertion distance is:________________ this comes into effect after age _____
age/2 +12 | 2
53
``` The estimated circulating volumes are: Preemie:______ ml/kg Neonate:______ Infant:______ Child >6: ______ ```
90-100 80-90 75-80 65-75 ml/kg
54
The neonate has a HCT of ____%.... which is primarily HBG-____
55 | F
55
To estimate the volume of PRBCs you should transfuse... the equation is:
EBV x Desired HCT x (actual HCT/HCT of PRBCs)
56
The platelet dose in PEDS is ____-____U/kg
.1 - .3
57
The best fluid to give pecs for deficits and third space losses is __________ and the best for maintenance is ___________
LR | D5 .45NS
58
With NPO guidelines the child may have clear liquids ____ hours prior to induction
2
59
A baby can have breast milk until ____ hours preop
4
60
Less than ____ months, the baby probably does not need a premed
9
61
By ____ months to _______ age, the peds patient will probably need a premed such as versed
10 - preschool
62
The dose for ketamine premed IM is ___-___mg/kg
5-10
63
Premedication doses in PEDS for midazolam are ____mg/kg PO, ____ mg/kg nasal, and ___mg/kg IM
.4 (roughly) .2 .1
64
Treatment for laryngospasm in order: 1. 2. 3.
Jaw Lift Positive pressure ventilation Sch .5-1.0mg/kg IV
65
Post Intubation croup is treated with _____________ &/or _____________
dexamethasone (.25-.5 mg.kg) | Racemic Epinephrine
66
For a caudal epidural block you use a ___-___mm short beveled needle into the _____________
2-3mm | sacral canal
67
There is a high failure rate for caudal epidural blocks in patients older than ______ years
7
68
Dosing for caudal epidural blocks go from _____cc/kg for sacral to ______ cc/kg for mid thoracic block with a max of _____ cc's.
.5 1.25 20
69
Blood volume approximations: _____ml/kg for a premature infant
100
70
Blood volume approximations: _____ml/kg for a full term infant
90
71
Blood volume approximations: _____ml/kg for a baby 3 to 12 months old
70-80
72
Blood volume approximations: _____ml/kg for a child > than 1 yo
70
73
HgbF is ___-____% of the hgb at burt. This will change to adult hgb by ___ months
70-80% | 6
74
``` The Average hgb concentrations are: Premature infant: ___-___ g/dL Full Term Infant ___-___ 2-6 months old ___-___ 6months to 6 years old ___-___ 6yo -12yo ____-____ ```
``` 13-15 18-20 9-13 12-13 13-14 ```
75
The P50 for hgbF is _____ compared to _____ for adults
18-20 | 26.6 (27)
76
CMRO2 and CBF levels are _______ in children and _______% lower in neonates compared to adults
double | 20
77
Autoregulation to the brain in PEDS is about ____-____mmHg for MAP vs ___-____mmHg in adults
20-80 | 60-160
78
The anterior fontanelle closes by ____months and the posterior is ____ months
20 | 3
79
The total body water % in a term newborn is around _____% versus ____% in an adult
78 | 55
80
An infant will have a a smaller or larger Vd of water soluble drugs?
larger
81
Infants carry their water more intracellularly or extracellularly?
extracellularly - at risk for dehydration
82
____________ is a congenital facial anomaly that presents as micrognathia, glossoptosis, and cleft palate. It gets better or worse with age?
Pierre Robin Syndrome | Better
83
Treacher- Collina syndrome gets better or worse with age?
worse
84
In children ____ml/kg of PRBC will increase the HCT by 1%
4
85
The HCT of PRBC is _____%
60
86
Give FFP if you give a massive blood transfusion of > ___-___ the childs blood volume
1-1.5
87
Transfusion rates > ____ml/kg/min of FFP can lead to severe hypocalemia
1
88
The starting dose of platelets is between ___- ___ U/kg
.1 - .3
89
The IV induction dose of Propofol for
3 | 2.2
90
The IV induction dose of ketamine is __-__mg/kg. The IM dose is __-__mg/kg and the PO dose is ___-___mg/kg
1-2 3-4 5-6
91
Precedex is a __________ agonist. Its PEDs dosing is ___-____mcg//kg IV BOLUS followed by ___-____mcg/kg/HR infusion
alpha-2 Adrenergic agonist .7-1 .5-1
92
Dosing for Fentanyl is ___-___mcg/kg increments for a total of __-___mcg/kg
.5-1 | 10-12
93
Its okay to give Morphine after the age of _______ with an initial dose of ____mg/kg
>6 months | .1
94
DOsing for Remifentanyl is ___-___mcg/kg bolus followed by an infusion at ___mcg/kg/min
.1-.25 | .25

Coexisting Diseases (4 decks)

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