Care of the Pediatric Patient in Surgery: Neonatal through Adolescence Flashcards
Neonatal period:
First 30 days of life
Typical neonate characteristics:
Highly sensitive to light and sound
Difficulty controlling head
nose breather
prone to periodic breathing
high metabolic demands
poor thermoregulation
frequently difficult to console
sensitive to stress
Neonates have the potential to develop:
Hypoglycemia
Rapid disproportionate heat loss
Dehydration
Skin injuries
Period of infancy
Beginning at 1 month until 12 months
Period of toddler
1-3 years
“work of play”
Egocentric, ritualistic and engaged in process of toilet training
Preschool age
4-5 years of age
Desire to be as independent as possible, Parental attachment, separation anxiety, loss of control, burgeoning imagination (magical thinking, viewing surgery as punishment) fear of disfigurement
Youngest group that will benefit from preoperative programs
School age
6-12 years of age
Each child develops at own rate based on personality and experience
achievement oriented, increasing desire for privacy, logical thought processes are emerging but robust imaginations, fear of loss of control, pain, disfigurement, peer groups and acceptance are important!
Adolescence
12-18 years of age
Wide range of variability/development
More mature but still fear surgery
Privacy is very important
Input and choice are essential
Prone to stoicism, anger and stubbornness
Clear liquids are generally acceptable up until __ hours prior to surgery
2 hours prior to surgery!
Emergency equipment pediatrics may need
Broslow tape
Small gauge angiocatheter
1,3,5mL syringes
small anesthesia masks
Uncuffed ET tubes
Small LMA’s
Small volume ambubags
Hypothermia in the neonate can cause a cascade of events leading to hypoxia such as
Peripheral vasoconstriction, increased oxygen consumption, respiratory acidosis
