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Test 1 Flashcards

1
Q

Why do children deteriorate more quickly than adults?

A

They have less physiologic reserve than adults

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2
Q

What are the 3 most common neonatal diagnoses?

A

newborns, hemolytic jaundice and prenatal jaundice, and premies

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3
Q

What are the 3 most common pediatric diagnoses?

A

Pneumonia, asthma, and acute bronchitis

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4
Q

As an infant what % of their body is their head?

A

25%

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5
Q

Growth and development are continuous process from what stages of life?

A

conception to death

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6
Q

When are the 2 biggest growth spurts in children?

A

0-18 months, and puberty

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7
Q

Growth and development is based on what?

A

age, sex, genetics, and enviroment

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8
Q

All body systems do not do what in kids?

A

do not develop at the same rate

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9
Q

Development is what?

A

cephalocaudal and proximodistal

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10
Q

What needs to be lost in neonates before development can proceed?

A

neonatal reflexes

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11
Q

What are some neonatal reflexes?

A

sucking, rooting, stepping, asymmetric neck reflex, grasping, and moro (startle)

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12
Q

When do neonates lose the neonatal reflexes?

A

4-6 weeks

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13
Q

age range for full term neonate?

A

38-42 weeks

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14
Q

age range for infant?

A

1-12 months

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15
Q

age range for a toddle

A

12-36 months

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16
Q

age range for preschool child

A

3-5

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17
Q

age range for school age child

A

6-12

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18
Q

age range for adolescent

A

12-18

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19
Q

age range for adult

A

> 18 years

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20
Q

In the toddler age the brain grows how much?

A

90%

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21
Q

Skills of a preschool child

A

undress self, can do simple buttons, draws 6 part man, always in motion,

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22
Q

skills of school age child

A

first molar, skipping, always in motion, coordination improves, puberty

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23
Q

Anatomic differences in peds and adults

A

smaller airways, inc. resistance to flow (Poiseulle’s law), lymphoid tissue and tongue is bigger, larynx is more anterior, epiglottis is stiffer and U shape, trachea is funnel shaped and narrowest at cricoid (softer, small cricoid membrane, shorter), carnia is at T-3

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24
Q

Implication for intubation in PEDs

A

harder to find epiglottis, use Sellick maneuver (cricoid pressure), R. mainstem intubation happens more than likely, usually used non cuffed tubes

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25
lung growth continues postnatally until when?
8-12 years of age
26
Children do no have what when it comes to alveoli?
no Pores of Kohn, alveoli shallow and thicker membranes
27
Pediatric patients are dependent on what?
diaphragmatic breathing
28
What demand is higher in infants and children?
metabolic rate
29
Infants use how much more oxygen per kg?
2 times
30
How do infants and peds respond to the need to increase minute ventilation
inc. RR
31
recognition of strangers begins at what age?
6-30 months (worse at these ages)
32
Separation from what is most difficult part of being hospitalized?
family and friends
33
stranger anxiety peaks at what age ranges?
8-10 months
34
Separation anxiety peaks at what age ranges?
12-30 months
35
What are the phases of separation between child and caregivers?
protest, despair, depression/grief, detachment
36
What age is the most routine oriented?
toddlers
37
physical stressors for PEDS in a hospital
pain/discomfort, immobility, sleep deprived, changes in pee habits, changes in diet
38
Enviromental stressors for PEDS in a hospital
unfamiliar surroundings/sounds/people, unpleasant smells, constant lights, activity related to other patients
39
Psychological stressors for PEDs in a hospital
lack of privacy, inability to communicate, inadequate level of knowledge, perception of illnee, parental behavior
40
Social stressors for PEDs in a hospital
disruption of routine, disrupted relationships, concern about missing school/work, play deprivation, financial effect on family
41
What are the most frequent injuries in PEDs
falls, bed and crib entrapment, choking, strangulation, electrocution
42
What is the most common form of restraint for children
manual
43
What are the 3 effects that affect the FiO2 available in an oxygen enclosure
seal, size of enclosure, flowrate
44
What FiO2 would you recommend an infant in an isolette would you also use a hood?
>40%
45
Documentation of hypoxemia in an infant?
PaO2 <95%
46
Documentation of hypoxemia in NICU?
PaO2 <90% ( if higher could cause issues)
47
Signs and symptoms of hypoxemia
inc. HR/RR, grunting, nasal flaring, retractions, paradoxic breathing, cyanosis, bradycardia, modeling
48
What are some complications associated with excessive O2 use
PDA (patent ductus arteriosus), retinopathy of prematurity, hypoventilation with chronic lung disease, atelectasis, pulmonary vasodilation- not good if heart problems
49
Flow for nasal catheter in infant
0.2-1 LPM
50
flow for nasal cannula for infant
0.2-2 LPM
51
flow for nasal cannula for PEDs
0.5-4 LPM
52
Approx FiO2 for nasal cath in an infant
24-35%
53
Approx FiO2 for nasal cannula in an infant and PEDs
21-50% can get up to 70%
54
Nasal cannula is used on what in a NICU?
a blender/helped to wean babies
55
Nasal cannula needs to be right size because of what?
unintended CPAP
56
Simple masks flows for an infant
5-8 LPM, Peds 5-10 LPM
57
FiO2 for simple masks
35-50%
58
Partial rebreather LPM
10-12 LPM
59
Non rebreather LPM
10-15 LPM
60
Partial rebreather FiO2
60% and up
61
Non rebreather FiO2
80% and up
62
Air entrainment flow and FiO2
flow needs to exceed inspiratory flow, FiO2 is 24-50%
63
Masks are not good for long term in PEDs because of what?
aspiration
64
LVN are bad for babies because of what?
infection, absorb too much fluid, chilling baby, noise, and possible bronchospasm
65
Tents and Huts LPM
>10 LPM
66
Tents and Huts FiO2
21-40%
67
Hoods LPM
>7 LPM
68
Hoods FiO2
21-100% possible
69
If 100% is in a hood what could be the possible problem it is trying to fix
small pneumothorax
70
What ages can you give a SVN meds?
any age
71
What ages can you give a MDI without a spacer
> or equal to 5
72
What ages can you give a DPI?
> or equal to 6, as young as 4 if the patient can demonstrate good technique
73
Peds and neonatal patients may only get what percentage of aerosolized meds no matter what device is used?
1%
74
MDI in conjunction with a ventilator has what advantages?
no additional flow is needed, less disruption of circuit, less time consuming
75
In the NICU if the patient needs an MDI what is usually done?
take baby off vent and hook ambu and MDI together

Peds Test 1 (1 decks)

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