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► Med Misc 44 > Peds-other > Flashcards

Peds-other Flashcards

1
Q

Tonsillectomy and Adenoidectomy:

All children undergoing T&A should be considered at increased rick for what periop complication

A

airway complication esp if diagnosed w/ sleep apnea

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2
Q

Tonsillectomy and Adenoidectomy:

what is the position postop

A

Left lateral head down

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3
Q

Myringotomy and Tympanotomy Tubes:

what is good anesthestic

A

VAA and N2O

Facemask/LMA

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4
Q

Malignant Hyperthermia:

what are 6 early signs/symptoms

A 
Masseter muscle spasm
Tachypnea
Rapid exhaustion of soda lime
tachycardia
Irregular HR
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5
Q

Malignant Hyperthermia:

4 intermediate signs/symptoms

A

warm
Cyanosis
dark blood in surgical site
irregular HR

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6
Q

Malignant Hyperthermia: Signs and Symptoms

4 late signs/symptoms

A

Prolonged bleeding
dark urine
irregular HR
muscle rigidity

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7
Q

Malignant Hyperthermia: Monitor Changes

3 early changes

A

Increased MV
Increased ETCO2
Peaked T waves

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8
Q

Malignant Hyperthermia: Monitor Changes

what is the 1st sign of MH

A

Increased ETCO2

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9
Q

Malignant Hyperthermia: Monitor Changes

what is 3 intermediate changes

A

Increased body temp
decreased O2 sat
Peaked t waves

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10
Q

Malignant Hyperthermia: Monitor Changes

how much does the temp increase

A

1 C Q 5 min

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11
Q

Malignant Hyperthermia: Monitor Changes

1 late change

A

peaked T waves

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12
Q

Malignant Hyperthermia:

what usually causes death

A

V-fib
Renal failure
DIC

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13
Q

Malignant Hyperthermia: Biochemical Changes

3 early signs

A

Hyperkalemia
Increased PaCO2
Acidosis

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14
Q

Malignant Hyperthermia: Biochemical Changes

1 intermediate sign

A

hyperkalemia

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15
Q

Malignant Hyperthermia: Biochemical Changes

3 late signs

A

hyperkalemia
increased CK
Myoglobinurinia

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16
Q

Malignant Hyperthermia: treatment

what drug do u give

A

dantrolene

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17
Q

Malignant Hyperthermia: treatment

how much dantrolene and how often do you dose it

A

2.5 mg/kg Q 5-10 min

18
Q

Malignant Hyperthermia: treatment

what is the max total dose of dantrolene

A

10 mg/kg

19
Q

Malignant Hyperthermia: treatment

what is the treatment

A 
call for help
IV dantrolene
turn off VAA
maintain anesthetic
hyperventilate w/100% O2 (ambu bag)
Initiate cooling
correct metabolic acidosis
maintain UOP
20
Q

Malignant Hyperthermia:

how do you prepare the machine?

A

vaporizers out
high O2 flow (10 LPM)
for 20-30 min

21
Q

Neonate: Post birth

what are they placed in

A

radiant warmers in slight trendelenburg

22
Q

Neonate: Post birth

what are normal respiration

A

30-60 bpm

23
Q

Neonate: Post birth

normal HR

A

120-160 bpm

24
Q

Neonate: Post birth

w/ APGAR the 1 min correlates to what?

A

survival

25
Q

Neonate: Post birth

w/ APGAR the 5 min correlates to what?

A

neurological outcome

26
Q

Neonate: Post birth

what is the most common cause of neonatal depression

A

intrauterine asphyxia

27
Q

Neonate: what should you do?

APGAR 0-2

A

intubate chest compressions

28
Q

Neonate: what should you do?

APGAR 3-4

A

temp assist w/ ventilation

29
Q

Neonate: what should you do?

APGAR 5-7

A

stimulation and O2 across the face

30
Q

Neonate:

what are indications for positive pressure ventilation

A

Apnea

HR

31
Q

Neonate:

assisted ventilation with bag and mask should be at what rate

A

40/min w/ 100% O2

32
Q

Neonate:

start chest comressions if HR

A

60 bpm

33
Q

Neonate:

cardiac compression is at what rate

A

120 bpm

34
Q

Neonate:

vascular access via cancelation of what?

A

umbilical vein

35
Q

Neonate:

umbilical artery cannulation allows for measurement of what 2 things

A

blood pressure

ABG monitoring

36
Q

Neonate:

volume expansion may be with what 2 things?

A

O-neg blood or 10mL/kg of 5% albumin or LR

37
Q

Pediatric laryngospasm can usually be avoided by extubating the pt with certain techniques. identify these tech

A

awake
deep
(anything in-between is hazardous)

38
Q

which inhalation agent has become the preferred induction agent for peds anesthesia

A

Sevoflurane

39
Q

the pediatric pt becomes hypothermic in the OR: list 5 expected anesthetic concerns

A 
delayed awakening
cardiac irritability
resp depression
increased pulmonary vascular resistance
altered drug responses
40
Q

why is maintenance of heart rate so crucial in neonates and infants?

A

stroke volume is fixed by noncompliant and poorly developed LV
CO is therefore strongly dependent of HR

41
Q

A child unexpectedly has cardiac arrest after SCh administration. how would you immediately treat this situation?

A

treat for hyperkalemia

also long and heroic resuscitation efforts may be required

► Med Misc 44 (72 decks)

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