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Peds > Pedslab1 > Flashcards

Pedslab1 Flashcards

1
Q

An infant’s head is ______% of total body surface.

A

25%

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2
Q

Infants & children have _____ tongues compared to size of oral cavity. (smaller, larger)

A

Larger

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3
Q

TorF: Intubation is normally easier in infants than adults due to abscence of airway diseases.

A

False: False; Intubation is more diffictult as airway obstruction is more prevalent

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4
Q

What two anatomical features can predispose children to airway obstruction during illness when they may swell.

A

Tonsils, adenoids

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5
Q

What is the narrowest portion in the pediatric patient making the airway funnel shaped until around 8 yrs old

A

Cricoid

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6
Q

T or F: In blood pressure assessment; after 1 year of age leg pressure is 10-20 mm/hg higher than arm

A

True

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7
Q

T or F: Assessing blood pressure changes is a quick, non invasive way to catch changes in status early.

A

False: Blood pressure will compensate for a long time so not a really good tool to assess degree of distress

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8
Q

What is a normal BP for a neonate?

A

50/30

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9
Q

What is a normal BP for infants?

A

87-105 / 53-66 : 90/60

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10
Q

What is a normal BP for Toddler?

A

97-112 / 57-71; or 100/60

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11
Q

What is a normal BP for school age child?

A

97-112 / 57-71; 105/66

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12
Q

What is a normal BP for a teen?

A

112-128/66-80 same as adult

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13
Q

What is a normal urine output for an infant?

A

1-2 cc/kg/hr

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14
Q

What is a normal urine output for a child?

A

1cc/kg/hr

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15
Q

What is a normal urine output for a teen?

A

0.5 cc/kg/hr

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16
Q

Name some signs of increased intracranial pressure?

A

Decreased responsiveness (irritability, lethargy
Inability to follow commands
decreased spontaneous movement
decreased response to painful stimulus
Pupil dilation with decreased response to light
Bulging Fontanel

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17
Q

What are the late signs of increased intracranial pressure?

A

Hypertension
Change in HR
Apnea

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18
Q

When inspecting a patient and you notice a barrel chest shaped chest what does this indicate?

A

Barrel Chest Chronic hyperinflation

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19
Q

When you inspect a child and notice a dusky color of membranes, what could this mean?

A

THis is a cyanotic sign of hypoxia (cynasos itself may be a late sign)

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20
Q

When viewing the skin & it appears mottled this may mean?

a. anemia
b. severe vasoconstriction
c. decreased perfusion
d. increased PVR

A

C. Decreased perfusion may be evidenced with a mottled appearance on the skin

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21
Q 
If you notice a gray or ashen appearance to the skin of an infant this may indicate:
A. severe vasoconstriction or anemia
B. severe vasoconstriction
C. decreased perfusion
D. late sign of cyanosis
A

B. severe vasoconstriction

if you see a pale appearance this can indicate severe vasoconstriction or anemia

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22
Q

What is a normal respiratory rate for a neonate (28 days or younger)?

A

30-60 bpm

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23
Q

What is a normal respiratory rate for toddlers/infants?

A

24-40 bpm

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24
Q

what is a normal respiratory rate for children from 3-12 yrs old?

A

18-34 bpm

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25
Q

How does a neonate compensate for the fact they cannot regulate depth of breathing?

A

They will increase or decrease their respiratory rate

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26
Q

Periodic breathing may occur and is not seen as pathologic as long as it does not last longer than _____.

A

10 seconds; also may not be color change or bradycardia

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27
Q

True apnea is ______ in duration and associated with ______ dysfunction.

A

15-20 seconds; CNS dysfunction

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28
Q

_______ indicate the use of accessory muscles to expand the chest outward, in an attempt to increase chest volume.

A

Retractions

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29
Q

A normal capillary refill should be less than ___ seconds

A

2

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30
Q

A normal heart rate for the following:

Birth - 1 yr

A

100-188

31
Q

In the servo I there are 2 patient population selections: adult or infnat; If I accidentally select infant how does this affect ventilation?

A

When you select infant it limits the Vt; likewise; if you select adult you will not be able to get Vt below 1

32
Q

On the Servo I there is a mode that instead of measuring pressure or flow measures what?

A

Diaphragm movement via an esophogeal proble; its used as a way to minimize the WOB

33
Q

When an infant is intubated where should the ET tube appear on the x-ray?

A

Below the clavicle, above the carina

34
Q

If you have an infant that ways 2.4 kg what size ET tube should you use & how many should be made available & at what sizes?

A

2.4 kg baby should have a 3.5 mm ET tube; During intubation you should have a tube 1/2 size smaller at 3 mm & 1/2 size larger at size 4.0 mm

35
Q

What is the most appropriate ET tube size for a baby weighing over 3 kg?

A

3.5 to 4.0 mm

36
Q

If a baby weighs less than 1 kg what is the correct ET tube size for this baby.

A

2.5 mm

37
Q

What is the formula you can use to find the correct et tube for a child who is 4 yrs old and what is the correct tube size for this child? Should it be cuffed or uncuffed?

A

Formula for uncuffed = 4 + (age in yrs/4)

correct tube size is 5 mm

38
Q

What is the formula you use to find ET tube size on a cuffed tube?

A

3 + (age in years/4)

39
Q

When bagging an infant you should bag every 1 to 1.5 seconds with a total of ________. breaths a min.

A

30-40

40
Q

What is correct suction pressure for preemies & neonates?

A

60-80 for neonates

80-100 for full term

41
Q

What are two ways you can find the correct catheter size?

A

3xID/2 or

ID x 2 & take next smallest size

42
Q

If a baby weighs less than ____ they cannot be trachd

A

5 kg

43
Q

Name the 5 parameters of assessment of a newborn to determine the apgar score?

A 
Respiratory effort
Heart rate
Color
Tone
Reflex irritability
44
Q

If you noticed a baby who was born acrocyanotic; he is pink with blue extremities; how would you score this parameter?

A

1

45
Q

When evaluationg reflex irritability and you see the baby cry/ actively withdraw; what apgar score would you assign?

A

2–best socre for category; if grimace only=1 or if no response then a 0

46
Q

If a baby is born with a HR below 100 what would you score this parameter of APGAR?

A

1

47
Q

If you noticed a baby born exhibiting a weak cry or hypoventilation how would you score this in APGAR?

A

Under respiratory effort he would socre a 1; absent respiratory effort would be 0 & good, strong crying would be a 2

48
Q

What is a normal HR for a neonate?

A

120-160

49
Q

Tachycardia is defined as a HR above ____; bradycardia is defined as HR below ____.

A

> 160

<100

50
Q

Name 3 items you can assess to judge ventilation?

A

Chest Movement; labored breathing, respirations

51
Q

What items can help you assess oxygenation?

A

HR, Color, mucous membranes, Spo2, sensorium

52
Q

Hemodynamics are an indicator of _____.

A

Perfusion

53
Q

Name 4 mandatory parts of self inflating bags?

A

Air inlet: 1 way valve that air to bag
Oxygen inlet: connects to O2 source
Patient outlet: where air goes to et tube
Valve assembly: this valve opens when bag is squeezed releasing O2/air to the lungs of patient; at exhale the valve will close

54
Q

Which part of the self inflating bag will prevent rebreathing

A

Valve assembly

55
Q

When using the babylog 8000; this vent is ____ cycled and ____ limited

A

time cycled & pressure limited

56
Q

What is the max weight that can be ventilated on babylog 8000?

A

22 lbs

57
Q

What setting on the babylog allows you to adjust your levels of bias flow?

A

VIVE

58
Q 
In the Baby log vent; what modes will allow for spontaneous breathing?
1. CMV
2. SIMV
3. Assist Control
A. 1&2
B. 1 & 3
C. 2 & 3
D.  All of the above
A

A. CMV & SIMV will allow for spontaneous breathing

59
Q

In the baby log vent what mode requires all mandatory breath?

A

Assist Control

60
Q

This mode on the babylog allows for spontaneous breathing but is not synchronized

A

CMV

61
Q

T or F: CPAP is permissible on babylog 8000

A

True

62
Q

What is the rationale for using the VIVE feature?

A

To reduce the work of breathing

63
Q

T or F: ATC will compensate for the compressible volume lost in the patient’s circuit?

A

False; ATC is designed to compensate for the ET Tube, not vent circuit

64
Q

If the flow sensor is not in place on the baby.og 8000 what alarm is disabled?

A

Apnea

65
Q

On the Babylog, which alarms are therapist set?

A

MV, Alarm delay, apnea time, tachypnea

66
Q

In what patients should PSV not be utlized?

A

Leakage rates ?> 40%

67
Q

In VIVE, when is inspiratory flow applied? When is expiratory flow applied?

A

Inspiratory flow applied to mandatory breaths

Expiratory flow applied to spontaneous or CPAP

68
Q

On the waveform graphic, what does the dotted line represent?

A

End of Expiration time, or peak Paw

69
Q

What could be a potential problem if your flows are too low on the oxyhood? What is a good lpm to use?

A

Would not be adequate for CO2 washout; need to maintain minimum of 4-6 lpm

70
Q

What type of problem can be created for a baby in an oxyhood?

A

Loud noise

71
Q

What is the maximum weight you can use in a high flow oscillator:

A

2 kg

72
Q

What is a normal Vt in babies & children?

A

6-8 ml/kg

73
Q

In CPAP, what parameters cannot be monitored?

A

Vt or I:E

Peds (6 decks)

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