peds deck 10 Flashcards
which murmurs are ALWAYS pathologic
murmurs accompanied by palpable thrill
dose of epinephrine
0.02-0.1 mcg/kg/min
anesthesia considerations for the pt with cardiac hx/dz
- preop - need cardiac records 2. has family been compliant with meds and visits? 3. do you need cardiac consult before you proceed? 4. know what situations to give fluids and which to restrict 5. bubble precautions for “hole in the heart” 6. keep pt warm 7. decrease stress
IV dose of acetaminophen
15 mg/kg
nenate MAC of isoflurane
1.6
Neonate MAC of sevoflurane
3.2
Neonate MAC of desflurane
9.2
induction dose of etomidate
0.2 mg/kg IV
pediatric dose of succinylcholine
1.5-2 mg/kg
pediatric dose of cisatracurium
0.2 mg/kg
pediatric dose of atracurium
0.5 mg/kg
pediatric dose of rocuronium
0.6-1.2 mg/kg (larger dose for RSI)
pediatric dose of pancuronium
0.1 mg/kg
pediatric dose of vecuronium
0.1 mg/kg
pediatric dose of glycopyrolate (robinol)
0.015 mg/kg IV
pediatric dose of atropine (for reversal)
0.03 mg/kg
pediatric dose of neostigmine
0.06 mg/kg
pediatric fentanyl dose
1-3 mcg/kg
pediatric hydromorphone dose
0.01-0.02 mg/kg IV
pediatric remifentanil dose (gtt)
0.1-1 mcg/kg/min
pediatric dose of sufentanil gtt
0.1-0.5 mcg/kg/hr
dose of zofran in peds
0.15-0.2 mg/kg
dose of decadron pediatrics
0.5 mg/kg IV - max = 12
dose of benedryl in peds
0.25 mg/kg IV
what is a benefit to using fentanyl in peds?
cardiac stability
_____________ is 10x more potent than fentanyl
sufentantil
IV push dose of sufentanil in peds
0.05-0.2 mcg/kg
IVP dose of remifentanil
0.5 mcg/kg
what is a concern with remifentanil if you give a bolus
bradycardia and hypotension
when would be good situations to use remifentanil intraop
- TIVA 2. neurosurgical cases (due to short acting, wake up and move ext quickly)
if you are adding clonidine to your regional block, what dose would you use?
1-2 mcg/kg
benefits to using dexmedetomidine intraop
- analgesic 2. neuroprotective properties 3. emergence delirium decreased 4. gives good sedation without DD resp dep 5. greatly reduces the need/amount of other anesthetics 6. prolongs regional blocks
good cases to consider using precedex intraop
1.TIVA/neuromonitoring 2. spontaneous breathing 3. teenagers 4. pts with autism/behavioral disorders 5. anxiety
In neuromonitoring cases, if dexmedetomidine gtt is run > ____________ mcg/kg/hr it can impair readings
0.5
disadvantages to dexamethasone
- can increase blood glucose 2. can decrease wound healing
benefits of nitrous oxide
- highly insoluble –> fast uptake and elimination 2.great for inhalational inductions 3. decreases MAC and need of volatile
disadvantages to Nitrous oxide
- increases PONV 2. expands closed spaces 3. can increase homocysteine levels
respiratory risk factors from the preop hx that increase risk of perioperative event:
- URI within previous 2 weeks 2. wheezing during exercise 3. more than 3 wheezing episodes in the past 12 months 4. nocturnal dry cough 5. eczema 6. smoking/vaping/passive smoke exposure 7. family hx of asthma, rhinitis, eczema
the _____________ the patient the more likely they are to have perioperative pulmonary complications
younger
RSV, flu, adenovirus, and pneumonia are all examples of ______________ airway infections
lower
lower airway infections result in brochiolitis which results in…
- swelling 2. hypoxia 3. hypercapnea 4. increased work of breathing leading respiratory failure
_______________ is a disruption of electrolyte transport in sweat ducts, airway, and pancreas. This disruption leads to increase in sweat chloride concentrations –> viscous mucus production
cysfic fibrosis
common surgeries neonates with Cystic Fibrosis present for
- meconium ileus 2. meconium peritonitis 3. intestinal atresia
common surgeries that children/teens present for with Cystic fibrosis
- nasal polypectomy 2. IV access 3. ENT surgery
common surgeries adults with Cystic Fibrosis present for
- esophageal varicies 2. recurrent pneumothorax 3. cholecystecomy 4. lung transplant (w/ or w/o liver)
tx of wheezing intraoperatively
- deepen anesthetic 2. albuterol MDI or nebulizer
what is the triad of sx that children commonly present with if they have hereditary spherocytosis
- anemia 2. splenomegaly 3. jaundice
T/F: most children with hereditary spherocytosis require chronic transfusions
false; only very small amount need chronic transfusion
what are the most common operations performed in children with hereditary spherocytosis
- splenectomy 2. cholecystectomy
what is the purpose of the splenectomy in child with hereditary spherocytosis
- RBC life span increases 2. which decreases the anemia and jaundice associated with the dz
