Peds Exam 1 Flashcards
Care Prioritizing
Life threatening -> limb threatening -> new problem -> chronic problem
Maslow’s Hierarchy of Needs
Physiological (food, water, sleep) Safety (of body, employment) Love/Belonging (family, friends) Esteem (confidence, respect by others) Self-Actualization (morality, creativity)
Newborn skin permeability
Increased skin permeability, increased penetration of medication, greater risk of toxicity
Newborn gastric emptying
Reduced gastric emptying and intestinal motility, increased time to reach therapeutic concentrations
Newborn proportion of body water
Increased body water, important to consider when administering water soluble drugs (reach adult values by 12)
Newborn proportion of body fat
Lower proportion of body fat, lower doses of lipophilic drugs are required
Newborn glomerular filtration and tubular secretion rates
Decreased glomerular filtration and tubular secretion. Gradual increase in renal function, reach adult values for 1-2 years.
Things to check if respiration rate of child is too high?
Fever, room too hot, if child has a chronic condition, if child is “comfortably tachypnic”. Fast breathing children have higher aspiration risk.
Kids are abdominal breathers until…
age 7
Pre-hypertension in peds
Average systolic and diastolic pressure are in the 95th percentile from 3 separate readings. Will likely turn hypertensive in 1-2 years, monitor closely.
When to take pediatric BPs
Annually starting at 3, sooner if demonstrate htn symptoms. If hospitalized or in ED will always get BP. Always get BP if hospitalized or in ED.
Fever Parameters
Newborn - 3 months: over 38
3 - 36 months: over 38.9
Children: over 40
When can children fixate visually?
3 months
Corner of eye should line up with….
Top of ear
Child under 3 pull pinna…
down and back
Child over 3 pull pinna…
up and back
Infants are obligate _____ breathers
Nose. Can have feeding difficulties if nose is clogged with secretions.
Report to provider if tonsils are…
swollen, red, or white patches. Leave tonsil exam to end of assessment because kids don’t like it.
Toddler risk factors for anemia
Cows milk not a good source of iron, contains substances that bind to iron and impair absorption
Adolescent risk factors for anemia
Poor eating habits, rapid growth rate
IgG
80% of the antibodies in the system. Crosses the placenta. Newborn levels similar to mother’s, but disappear by 6-8 months.
IgA
Prevents colonization fo bacteria, not present at birth, normal levels by ~6 years. Children at 6 tend to be ill more often due to lack of full complement of immunoglobulins
IgE
Binds to allergens. Not present at birth, normal values achieved ~6 years
Cardiovascular considerations for peds
Immature heart is more sensitive to volume changes or pressure overload. If giving fluids monitor infants for fluid in lungs, HR changes.