Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EMRG 1305 > Week 4- Pediatrics > Flashcards

Week 4- Pediatrics Flashcards

1
Q

What age is considered a neonate?

A

Birth to 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What age is an infant considered?

A

1 month to 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What age is a child considered?

A

1 to 12 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What age is a adolescent considered?

A

12 to 18 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

By what age does a child anatomy become similar to and adults?

A

8 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pediatrics head & neck

A
  • They have a large head, short neck and a prominent occiput
  • The tongue is relatively large
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pediatrics Airway

A
  • The larynx is high and anterior, at the level of C3-C4.
  • The epiglottis is long, stiff and U-shaped. It flops posteriorly
  • Their narrow nasal passages are easily blocked by secretions
  • The larynx is funnel shaped with the most narrowest region located at the cricoid ring
  • Small amounts of secretions/ edema can lead to airway obstructions & breathing difficulties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pediatric chest & lungs

A
  • Chest wall is thin, with little musculature and less subcutaneous fat
    Chest wall more pliable and don’t afford same protection to internal structures; prone to splenic injury in trauma
  • Diaphragmatic breathers and prone to gastric distention (prevent by positioning and using the proper mask)
  • Organs are closer together, contributes to risks of trauma
  • Muscle of ventilations are easily subject to fatigue
  • More vulnerable to pulmonary contusion, cardiac tamponade, and diaphragmatic rupture
  • Look for signs of these injuries in children with suspected chest trauma (note that the signs pf pnemo or hemo are often subtle in children)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pediatric hearts

A
  • Myocardium is less contractile causing ventricles to be less compliant and less able to generate tension during contraction
  • Cardiac output is rate dependent
  • Vagal parasympathetic tone is the most dominant, which makes neonates & infants more prone to bradycardia (which affects cardiac output)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do infants have a distended abdomen?

A
  • Weak abdominal wall muscles
  • The size of solid organs (vulnerable to blunt trauma)
  • Liver and spleen extend below the rib cage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Circulating blood volume in pediatrics

A

Children= 80ml/kg
- Small losses of blood can be truly devastating
- They have a great ability to compensate by constricting their peripheral vasculature= increase to systemic vascular resistance (maintaining a BP & increased HR)
- BP is a very late sign- falling vitals indicate a child who will be difficult to resus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pediatrics Central Nervous System

A
  • CNS develops throughout childhood an this immature system is susceptible to influx in temp regulation (this is why peds are prone to febrile seizures)
  • Brain/ Spinal cord are less protected
  • Fontanelle’s remain open until 18 months, causing more risk of direct trauma
  • Blood brain barrier is poorly formed (very susceptible to overdoses)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pediatric Temperature Control

A
  • Babies and infants have a large surface area to weight ratio with minimal subcutaneous fat. They have poorly developed shivering, sweating and vasoconstriction mechanisms
  • Low body temp causes resp depression, acidosis, decreased cardiac output, increases the duration of action of drugs, decreases platelet function and increases the risk of infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pediatric Musculoskeletal System

A
  • Growth plates of the child’s bones are made of cartilage; they are relatively weak and easily fractured
  • Bones are weaker than their ligaments, making fractures more common than sprains
  • Children’s ligaments are sturdier than the long bones, sprains are uncommon; joint dislocations without associated fractures are not often encountered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do we calculate a pediatric pulse?

A

150 bpm - (5 x age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do we calculate Pediatric BP?

A

Normotension: (2 x age) + 90

Hypotension: (2 x age) + 70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do we calculate a pediatric weight?

A

(2 x age) + 10kg

To change to pounds multiply this # by 2.2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pediatric Low Blood Glucose

A

<2 yr= <3.0 mmol/L
>2 yr= <4.0 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pediatric Assessment Triangle

A

Appearance: tone, interactiveness, consolability, look/ gaze, speech

Circulation: pallor, mottling, cyanosis

Work of Breathing: breath sounds, positioning, retractions, flaring, apnea/ gasping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the revised AVPU for infants/ toddlers?

A
  • Verbal: include cooing & babbles
  • Motor: reaching & grabbing
  • Point to mother & ask who that is for talking children
  • Is it the child’s sleeping time? Are they tired?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What should you observe for WOB?

A
  • Grunting
  • Wheezing
  • Tripod position
  • Retractions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to apply oxygen to pediatrics?

A
  • Have parent/ escort hold mask close to pt’s face
  • Demonstrate oxygen use by placing the mask on a doll/ stuffed animal 1st
  • Blow by oxygen- hold tubing close to face
  • Decrease O2 admin if child’s anxiety/ anxiety appears to be getting worse & fearful of subsequent airway compromise- ex. epiglottis pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Airway assessment for peds

A
  • Gurgling- air moving thru a liquid; common with mucus in oro
  • Snoring- air moving thru a partial obstruction, can be positional
  • Stridor- high pitch sound usually during inspiration, caused by blockage to the airway- larynx/ trachea
  • Audible wheezing- audible wheezing during expiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Breathing assessment for peds

A

Look for ventilation adequacy:
- Depth- indicates volume, hyperventilating can cause hypoxia
- Hypoventilation
- Rate- look at abdo or chest rise while counting
- Effort- trach tugging, diaphragmatic breathing, sternal restrictions, nasal flaring, sternal retractions

25
Q

What are some peds medical emergencies?

A
  1. Seizures- febrile vs non-febrile
  2. Meningitis
  3. Dehydration
  4. Respiratory conditions- asthma vs bronchiolitis & croup vs. epiglottitis
  5. SIDS
  6. Trauma
  7. Child abuse
26
Q

Pyrexia: Febrile Convulsions

A
  • Age usually <6 yrs of age, the avg is the 1st 2 years of life (Rule out trauma/ OD/ etc)
  • Hx. of recent illness, ex. ear infection/ usually viral/ associated with fever “spikes”
27
Q

SS of pyrexia: febrile convulsions

A
  • can include generalized tonic-clonic seizure activity
  • short in nature (<5 min)
  • fully body uncoordinated muscle activity
  • grunting
  • incontinence
  • increase secretions followed by postictal phase
28
Q

Postictal Phase

A
  • Child usually returns to normal over a period of time 2-10 mins but can be longer
  • May cry, irritable or lethargic
  • TX Plan: don’t put a blanket on a pt with a fever (cool them down)
29
Q

What is epilepsy?

A
  • Having recurrent seizures not provoked by any other illness, due to abnormal neuronal firing
  • Normally requires 2 in 24 hrs for dx
  • Require ongoing care & meds
  • Seizure can occur in isolated are of brain (focal seizure) or occur throughout the brain (generalized seizure); the latter causes the classic tonic (stiffening)- clonic (twitching) seizure
  • Can experience an aura prior to event ex. nausea, anxiety, smells, sensations
30
Q

What is meningitis?

A
  • Inflammation of the meninges (fluid membrane surrounds spinal cord and brain)
  • Can be caused by bacteria, viral or other microorganisms
  • Can be immunized for some strains, but don’t assume all ppl are inoculated
31
Q

S/S of Meningitis

A
  • Fever
  • decreased LOA
  • projectile vomiting due to increased ICP
  • petechial rash
  • headache
  • nuchal rigidity (stiff neck)

If severe can progress to seizure, coma, death or permanent disability

32
Q

What are signs to indicate meningitis?

A
  • Kernig’s sign: loss of ability to flex leg when supine or sitting
  • Brudsinski sign: involuntary flexion of the arm, hip, knee with neck is flexed
33
Q

What is dehydration?

A
  • Results from any body fluids loss- (remember the child’s circulating blood volume)
  • Excessive vomiting/ diarrhea- with no or limited eating or drinking
  • Exposure to heat or hot conditions
  • Illness causing poor fluid intake or fever burns
34
Q

S/S of dehydration

A
  • poor skin turgor
  • dry mucous membranes (tongue white in colour)
  • obvious weight loss
  • tachycardia >130 bpm
  • depressed fontanelle in the nerborn
  • lethargy or irriability
  • dizziness, headache, tiredness, thirt, dry mouth, crankiness, dark-coloured pee, dry skin, constipation
  • fever, unusual tiredness, no tears, dry mouth, no wet diapers
35
Q

What are some common respiratory emergencies?

A
  1. Asthma
  2. Bronchiolitis
  3. Croup
  4. Epiglottitis
36
Q

What is asthma?

A
  • Most common chronic illness of childhood
  • Bronchospasm, mucus production, and airway inflammation lead to obstruction and poor gas exchange
  • Results in hypoxia
37
Q

What can trigger asthma?

A
  • Upper resp infections
  • Environmental allergies
  • Exposure to cold
  • Changes in weather
  • Physical activity
  • Secondhand smoke
38
Q

Clinical signs of asthma?

A
  • Frequent coughing
  • Wheezing
  • More general signs of resp distress
39
Q

What is bronchiolitis?

A
  • Bronchiolitis is a common peds illness occurs most in pt’s <2 yrs old
40
Q

What can cause bronchiolitis?

A
  • Caused by common resp viruses
  • RSV
  • Preterm
  • Immunocompromised
41
Q

How can you differentiate bronchiolitis & asthma?

A
  • Bronchiolitis normally proceeds a viral infection, and is associated with fever
42
Q

Croup vs. Epiglottitis

A
  • Croup: viral illness that causes swelling of the trachea, larynx and bronchi causing resp distress (often inspiratory stridor) and a barking cough. Caused most often by parainfluenza but can be bacterial
  • Epiglottitis: life threatening inflammatory condition of the epiglottis and nearby structures which can lead to near or complete airway obstruction
43
Q

What is management for croup?

A
  • Keep anxiety to a minimum
  • Resp. may imrpove when child is exposed to cool, humidified air
44
Q

What are the medication options for croup?

A
  • Epinephrine
  • Dexamethasone
45
Q

How does nebulized epi work?

A

causes vasoconstriction of arterioles, decreasing hydrostatic pressure and allowing for fluid reabsorb thus decreasing edema. In severe cases, edema is noted in the subglottic region (larynx to cricoid cartilage) and this is when you need to treat with epi

  • Reduces swelling in the airway and begins to work faster than dexamethasone
46
Q

How does dexamethasone?

A

can dramatically reduce the inflammation of airway obstruction secondary to croup in peds. The pathway is complex, but in general term dex decreases inflammatory mediators and reverses increased capillary permeability

47
Q

What is Epiglottitis?

A
  • Severe inflammation of the supraglottic structures
  • Now rare (childhood vaccine)
48
Q

What is the classic presentation of Epiglottitis?

A
  • Looks sick and will be anxious
  • Sits upright in sniffing position with chin thrust forward
  • Drooling, Dysphagia, Distress
  • WOB increased
  • Pallor or cyanosis
49
Q

What is kawasaki disease?

A
  • An acute febrile illness of unknown etiology that primarily affect children younger than 5 years of age
50
Q

What is Sudden Infant Death Syndrome (SIDS)?

A
  • can occur any time within the 1st year; highest during the first 6 months
  • The syndrome is defined by a healthy infant which dies by unknown causes
  • Believe to from an inappropriate response to hypoxia and hypercapnia
51
Q

95% of cases have at least one risk factor, which include:

A
  • Sleeping prone
  • Co-sleeping
  • Maternal smoking during pregnancy
  • Low birth weight, overheating
  • Lack of breastfeeding
  • Maternal age <20 yrs
  • No prenatal care
52
Q

Pediatric Trauma

A
  • Pediatric trauma is leading cause of death among children older than 1 year
  • MVC causes the most death in this age group, followed by falls and submersions
  • Children’s age-related anatomy and physiology make their injury patterns and responses to trauma different from those seen in adults
53
Q

Blunt Trauma

A
  • MOI in more than 90% of pediatric injury cases
  • Less muscle and fat mass than adults
  • Less protection against forces transmitted in blunt trauma
54
Q

Head Injuries

A
  • Cranium is thin- young infants may have a soft fontanelle
  • Low GCS score may not be as serious as in the adult pt.- cant still recover well even if decerebrate posturing is present
  • Increased ICP better tolerated in pt’s <18 months (due to lack of complete fusion of cranial suture lines= flexibility)
55
Q

What to look for during head injuries in peds?

A
  • Bradycardia
  • Hypoventilation
  • Apnea
  • Hypertension
  • Seizures
  • Bulging fontanelle in very young pt’s
  • Vomiting
56
Q

MOI- Ped struck vs vehicle

A
  • Children turn towards the impact
  • Children tend to be thrown in front of the vehicle

1st impact site- Bumper of car: abdomen/ pelvis/ femurs
2nd impact site- Hoods of car: chest/ head/ face
3rd & Final impact site- ground or road: striking head

57
Q

Falls in Pediatric

A
  • Common in peds
  • Injuries will reflect the anatomy of the child and the height of the fall
  • Falls from standing position usually result in isolated long bone injuries
  • High-energy falls may result in multiple trauma
58
Q

Bicycle Handlebars Injuries

A
  • Typically produce compression injuries to the intra-abdominal organs
  • Duodenal hematoma, pancreatic injuries, and vertebral fractures can occur with this MOI
59
Q

What would be the only sign of compensated shock in peds?

A

Elevated HR

EMRG 1305 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions