Week 4- Pediatrics Flashcards by Alyssa Samayoa

What is considered a neonate?

birth- 1 month

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What is considered an infant?

1 month - 1 year

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What is considered a child?

1-11 years old

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What is considered an adolescent?

12-18 years old

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What is the difference in the head and neck of a child?

they have a large head, short neck and a prominent occiput

they have a large tongue

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Describe a pediatric epiglottis:

long
stiff
u shaped
flops posteriorly

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What shape is the larynx in peds?

funnel shape

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Where is the larynx level at on a ped?

C3-C4

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Children breath with their diaphragm, making them more prone to …..

gastric distention (overfill of the lungs)

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The myocardium of the heart is less or more contractile in children??

LESS contractile causing the ventricles to be less compliant and LESS able to generate tension during contraction

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What is cardiac output dependent on in children?

HEART RATE!!!!

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What tone is most dominant in pediatric? Why is that a danger?

vagal parasympathetic tone, its a danger because you could put them into bradycardia

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Is falling BP in a child a late or early sign of deteriorating?

LATE!!!

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Approx how much blood volume per kg is there in kids?

~80ml/kg

10kg pt has about 800mls of blood ( 1 year old)

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When do fontanelles close in children?

18 months

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What is a concern about the blood flow in a children’s brain?

the poorly formed blood brain barrier which makes them more susceptible to over doses on meds

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What is hard about controlling a babies temperature?

they have a large surface area to weight ratio

poorly developed shivering, sweating and

vasoconstriction mechanisms !!

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Which one is more common in a child due to bones being weaker than ligaments?FRACTURES OR SPRAINS?

FRACTURES!!!

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How do you calculate a normal pediatric pulse? (if ALS chart isnt available lol)

150 - ( 5 x age)

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How do we calculate normotensive and hypotensive bp in peds?

normo- (2 x age) + 90

hypo- (2 x age) + 70

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What is the weight calculation in pediatrics?

( age x 2 )+ 10

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What is hypoglycemia in a child <2 y/o ??

<3.0 mmol/L

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What is hypoglycemia in a child >=2 y/o ??

<4.0 mmol/L

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What are the 3 categories in the pediatric assessment triangle?

Work of breathing
Appearance
Circulation

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How do we tell if children are struggling to breath?

accessory muscle use grunting wheezing retractions tripod position

What temp is a fever?

>37.8 ish (38)

What is pryexia?

febrile convulsions

What do we do to pts that have had febrile convulsions?

keep them cool!! Advise family to give advil or tylenol!!!!

What is epilepsy?

recurrent seizures not provoked by any other illness due to abnormal neuronal firing

What is meningitis?

inflammation of the menginges

What are the 3 layers of the brain?

Pia mater (inner) Arachnoid mater (mid) Dura mater (outer)

How is meningitis spread?

droplets wear proper PPE!!

What are the 2 signs that could present with meningitis?

kernigs sign (lose of ability to flex leg when supine or sitting) brudzinski sign ( involuntary flexion of the arm, hip knee with neck is flexed)

What is dehydration?

results from any bodily fluid loss

What would a ped pt with dehydration look like?

poor skin tugor dry mucous membranes tongue white in colour obvious weight loss tachy >130bpm depressed fontanelle in newborn w lethargy or irritability of wet diapers

What could cause dehydration in kids?

excessive vomitting/diarrhea exposure to heat or hot conditions

What does asthma ultimately result in?

hypoxia and airway obstruction and poor gas exchange

What is asthma?

bronchospasm, mucus production and airway inflammation

What could the triggers of asthma be?

URTI Enviromental allergies exposure to cold changes in weather physical activity second hand smoke

What is bronchiolitis?

mucus and inflammation in the bronchioles (tiny airways)

How do we differentiate asthma and bronchiolitis?

BRONCHIOLITIS is normally proceeds a viral infection and is associated with FEVER!!

What is the cause of bronchiolitis?

caused by common resp viruses, most are due to RSV!

What is croup??

viral illness causes swelling of the trachea, larynx and bronchi causing resp distress!!! often stridor and barking cough caused by parainfluenza but could be bacterial

What is epiglottitis?

life threatening inflammatory condition of the epiglottis and nearby structures which could lead to complete airway obstruction

What are the 3 D's in epiglottis presentation?

drooling dysphagia distress

Which one has a rapid onset?

epiglottitis

Which one presents with dyspnea?

epiglottitis

Which one has a barking cough

Croup

Which one would the pt be unable to speak?

epiglottitis

Which disease is viral and which one is bacterial?

epiglottitis- bacterial croup- viral

How do we treat croup (not meds)?

with keeping anxiety to a minimum expose to cool, humidified air (take them outside)

What are the indications for the croup medical directive as per ALS?

barking cough or current hx of UTRI

What are the conditions for EPI in the croup directive:

6 months- <8 years old <200bpm stridor at rest

What are the conditions for DEX in the croup directive:

6 months- <8 years old unaltered LOA for mild, moderate and severe croup!!

What are the contraindications for EPI? (croup directive)

ax or sensitivity

What are the contraindications for DEX? (croup directive)

ax or sensitivity to steroids steroids received within the last 48 hours unable to tolerate oral medications!!!

What is the treatment (<10kg, dose, route, concentration, max) for EPI in the croup directive??

Weight <10kg - NEB - concentration 1mg/1ml - dose 2.5 mg - max does 1

What is the treatment (>=10kg, dose, route, concentration, max) for EPI in the croup directive??

Weight >=10kg - NEB - concentration 1mg/1ml - dose 5 mg - max does 1

What is the treatment (dose, route, max) for DEX in the croup directive??

0.5mg/ kg max dose of 8mg

What is the max weight a pt to be to get the max amount of dex you are able to give:

16kg= 8mg 35 lbs

How old does a pt need to be in order to fit into the croup medical directive??

>6 months - <8 years old!!!

What is epiglottits?

severe inflammation of the supraglottic structures!!

Symptoms of epiglottis progress rapidly: T or F??

What is Kawasaki disease?

an acute febrile illness of unknown etiology that primarily affects children younger than 5 years

What is sudden infant death syndrome?

can occur any time within the 1st year, highest during the 1-6 month healthy infant which dies by unknown causes!!!!

What is commotio cordis?

blunt force to the chest during the relative refractory period putting someone into cardiac arrest

When hit by a car which way do children usually turn towards?

TOWARDS the impact! Thrown in front of the vehicle

Injury sites of a pediatric struck by a vehicle:

1st Impact Site – Bumper of Car **Abdomen / Pelvis / Femurs 2nd Impact Site – Hood of Car **Chest / Head/Face 3rd & Final Impact Site – Ground or Road **Striking Head