Test 2 Study Guide Flashcards
Best type of xray to identify rib fractures
Oblique xrays
What type of xray is used for pleural effusion
Lateral decubitus
Xray signs of asthma in children
Flattened diaphrams
widened intercostal spaces
What does the inspiratory hold do during an xray?
enables the image to capture the lungs fully
Inflated for a better evaluation
What is the first thing to do to check ETT placement?
Get an xray ASAP
How does croup appear on an xray?
Steeple sign
What will appear white on an xray?
A foreign body aspiration or mass
Trachea bifurcates at the carina into the right and left mainstem bronchi at the ___ thoracic vertebrae in children and the ____ thoracic vertebra in neonate.
6th for children
4th for neonates
How far should the ETT be from the carina?
3-5 cm
Where should PICC line be placed?
In the R atrium of the heart
(If its in the wrong spot, the patient will have arrythmias and can cause pneumothorax)
What are UVC catheters used for?
medications and feeding
What are UAC catheters used for?
used for BP and getting blood
Lower gestational ages are more prone to ____ between 24-26 weeks
ARDS
(blown glass appearance)
The first line of treatment for ARDS to improve oxygenation
Proning
Causes rounded lucencies (looks like cobwebs) on xray
Pulmonary Interstitial Edema (PIE)
What causes Pulmonary Interstitial Edema?
Mechanical Ventilation and ARDS
(will have abnormal breath sounds)
What causes air bronchograms on xray?
Pneumonia (treated with antibiotics)
appears opaque/gray looks like filled in spaces between ribs
How does a pneumothorax appear on xray?
makes the whole side of the xray look black, won’t hear anything on that side - usually caused by a medical procedure.
(collapsed lung)
looks like a sail - caused by esophageal rupture
pneumomediastinum
Distress, grunting, floppy, retractions - treat with surfactant and antibiotics
Meconium Aspiration Syndrome
stomach moves up on xray - fixed surgically
Diaphragmatic hernia
Overproduction of mucus
Cystic Fibrosis
edema or inflammation surrounding the bronchi. Looks like a cuff or halo around the bronchi - viral or bacterial pneumonia
Peribronchial cuffing
lungs are underdeveloped, congenital
Pulmonary hypoplasia (small thorax)
Where should chest tube placement be?
between the 3rd and 4th intercostal rib
has no risk of ionizing radiation
MRI
Test of choice for diagnosing pediatric conditions
MRI
Signs of respiratory distress in children
____ tubes are used for kids 8 and under only
Uncuffed tubes
Formula for choosing correct ETT size in pediatrics
Age of child (3)/4 +4 = 4.75, decrease to size 4
Only type of intubation blade used for children
Miller (causes less trauma)
gold standard for determining ETT placement
Xray
Formula for tube placement
Tube size X 3 for children, for infants weight (inches) + 6
______ will move tip of ETT, even
when well secured
Head flexion or extension
Normal cuff pressure for children
No higher than 25
How to measure the size of suction catheter
multiply the tube’s inner diameter by 2, then use next smallest size catheter
ex. If the patient has a size 5 ETT: 2 X 5 = 10 and the next smallest size catheter is an 8
Image from back to front, taken with board in front of pt
Posteroanterior positioning
Widened intercostal spaces and flattened diaphragm indicate:
Acute asthma exacerbation
Inspiratory pauses allow for:
Better image/evaluation of the lungs (especially in infants)
Chest x rays are used as a diagnostic tool to:
Assess the position of lines, drains, and tubes
Lateral decubitus x ray identifies:
Presence of air, fluid or foreign body aspiration in pleural space
Oblique positioning is mainly for:
Rib fractures
Infants trachea bifurcates and get intubated between the:
T4-T6 vertebrates; anything else causes hyperinflation of right lung
Et tube will appear deeper with:
Small variation of pt neck
For head extension, place the ET tube:
Superiorly and place tip of tube above the thoracic inlet or even in the esophagus
Tip of lines/drains should rest:
In the stomach, below the left hemidiaphragm
UVC are for:
giving fluid and medicines
UVA is for:
getting blood
Central venous catheter (PICC line) rests:
In the right atrium of the heart
If any central venous line is misplaced it can cause:
Arrhythmias
MRI has no risk of:
Ionizing radiation
You can administer medications through
PICC Line
Probe has two sides of independent LED light source
One red and the other infrared
Fastest/most reliable SpO2 readings from
Right hand
One of the factors affecting SPO2 accuracy include:
Poor skin integrity
Co2/capnometry checks patients’:
Ventilation
CO2/capnometry measures patients’:
PetCO2 (partial pressure of end tidal co2)
-Periods of apnea and no more end tidal indicate:
Dislodged ET tubes
Useful for monitoring changes in CO2 with nonconventional ventilation
Transcutaneous Monitoring (TCM)
Hazards of ABG analysis include:
Thromboses, arterial spasm
Correct procedure for abg on infant:
Warm the site first, heel of foot
Capillary Blood Gas Analysis disadvantages/limitations:
Oxygenation status varies
Hazards/complications of Peripheral Artery Catheter:
Thrombosis
Transcutaneous monitoring is very useful for monitoring
changes in Co2 with non conventional ventilation
Below heart:
Post ductile
CAP gasses will not correlate with
O2 because it is venous
UAC is for:
babies who are too small
Complications of UAC include:
Thrombosis and infection
Complications of central lines
Pneumothorax and arrhythmias, thrombosis
Type of ET tube used in children < 8 yrs
Uncuffed
Primary parameter for selecting ET tube size
Size = Age (years) / 4 + 4 (age 2 years and older
