Peds Intro

Question 1

What are some assessment challenges with peds pts

Answer 1

Young children may not be able to report what is bothering them
Perceptions differ from adults
Concerned parents may be challenging
Fear or pain may hamper assessment

Question 2

What are the consequences of an infant having a big head

Answer 2

-large surface area means more mass relative to the boys and more potential for heat loss.
-higher incidence for head injury

Question 3

How big is the infants head in relation to its body

Answer 3

1/4 of total body weight

Question 4

When does the posterior fontanelle close?

Answer 4

4 months

Question 5

When do anterior fontanelles close?

Answer 5

1 year

Question 6

How to asses the fontanelles

Answer 6

Look to see if it is sunken or bulging

Question 7

Why is it difficult to palpate a carotid pulse on an infant

Answer 7

They have short stubby necks

Question 8

Is a child more prone to a/w obstruction

Answer 8

Yes, the a/w is much smaller leaving them susceptible to foreign body inhalation, inflammation with infection and disproportionally large tongue

Question 9

What is the narrowest part of the child’s airway

Answer 9

The cricoid cartilage which is below the vocal cords, rather than at the vocal cords as in adults

Question 10

How is the epiglottis different in an infant?

Answer 10

-long and floppy
-u-shaped
-narrow
-extends at a 45 degree angle into the airway
Difficult to visualize the vocal cords during intubation

Question 11

A/W difference in infants

Answer 11

Tongue is larger in proportion to mouth
Pharynx is smaller
Epiglottis is larger
Larnyx is more anterior and superior
Narrowest at cricoid
Trachea narrow and less rigid

Question 12

How does a child’s chest wall differ from that of an adults

Answer 12

-it is quite thin
-less musculature and subcutaneous fat to protect lungs/organs
-Easy to hear heart and lung sounds all through the chest cavity

Question 13

Why are children more susceptible to chest wall injuries

Answer 13

Ribs are more pliable and flexible
This can lead to significant intrathoric injury with minimal external findings
Children have fewer rib fractures and flail chest events but can have substantial injuries below

Question 14

In children, which thoracic injuries are common

Answer 14

-pulmonary contusions
-cardiac tamponade
-diaphragmatic rupture

Question 15

What is the pulse rate for an infant who is compensating for an injury

Answer 15

200 beats per minute

Question 16

When should you suspect shock in an infant

Answer 16

If they present with tachycardia

Question 17

What indicates hypoxia

Answer 17

Bradycardia

Question 18

Is hypotension bad in children

Answer 18

Yes it is a very bad sign

Question 19

What are signs of vasoconstriction

Answer 19

-weak peripheral pulses
-delayed cap refill (younger than 6)
-pale cool extremities

Question 20

Why is the abdomen distended in an healthy infant

Answer 20

-weak abdominal muscles
-larger solid organs

Question 21

What the anatomical differences in the infants abdomen

Answer 21

-liver and spleen extend below rib cage in young children
-less bony protection
-rich blood supply

Question 22

Why are the kidneys susceptible to injury?

Answer 22

-more mobile
-less well supported

Question 23

Are pelvic fractures common?

Answer 23

No

Question 24

Subarachnoid space in comparison to the adults, is this good or bad?

Answer 24

It is smaller, this is bad because there is less of a cushioning effect fro the brain and head momentum can cause bruising and damage

Question 25

What does the paediatric brain require?

Answer 25

Twice as much cerebral blood flow than adults.
This makes even minor injuries significant, increases the risk of hypoxia

Question 26

What can exacerbate a pedatric brain injury

Answer 26

Hypoxia and hypotension

Question 27

What type of C-spine injuries are common in young children

Answer 27

C1-C2 injuries

Question 28

How many breaths per min does an infant take

Answer 28

30-60

Question 29

How does an infants high RR and O2 demand effect the effects from inhaled toxins

Answer 29

-proportionally larger amount of toxic fumes are typically inhaled

Question 30

What muscles does an infant use to cry

Answer 30

Abdominal muscles

Question 31

Skin differences in children

Answer 31

-thinner, more elastic
-larger body surface area BSA/ weight ratio
-less subcutaneous tissue

Question 32

What is a larger BSA/weight ratio bad

Answer 32

-increased risk of injury following temperature extremes
-increased risk of hypothermia and dehydration
-increased severity of burns

Question 33

What does stores are limited in children

Answer 33

Glycogen and glucose are rapidly depleted
Always be suspicious of hypoglycemia and always check BGL with lethargy and seizures

Question 34

When can severe hypovolemia and electrolyte imbalances occur?

Answer 34

As a result of severe vomiting and diarrhea

Question 35

What is the neonatal period

Answer 35

First month of life

Question 36

What is infancy

Answer 36

First 12 months of life

Question 37

What is the toddler period

Answer 37

Age 1 to 3

Question 38

What is a pre-school age child

Answer 38

3 to 5 years

Question 39

What is a school aged child

Answer 39

6-12

Question 40

What is the adolescent stage

Answer 40

13 to 17 years