Care of Pediatrics Flashcards

Question

What is the dosage of ketamine for pediatric patients?

Answer 1

PO 5-10mg/kg IV 1mg/kg

Answer 2

flumazenil (0.1 mg/kg IV) naloxone (1 to 10 mcg/kg IV)

Answer 3

In order of appearance * croupy cough * hoarseness * inspiratory stridor * aphonia These symptoms are accompanied by increasing restlessness, tachypnea, use of accessory muscles of respiration, retraction of the suprasternal notch and intercostal spaces, and drawing in of the upper abdomen.

Answer 4

Caused by glottic or tracheal edema. 1 mm of edema decreases the diameter of the airway by 75%.

Answer 5

relieve the obstruction administer supplemental O2 notify anesthesia provider who will consider corticosteroid therapy (racemic epinephrine) cool humidified mist with additional O2 as necessary | Possible rebound edema, check patient after 1 hour. Consider admission.

Answer 6

Laryngospasm - **partial** or **complete obstruction** associated with increasing abdominal and chest wall efforts to breathe against a closed glottis, an exaggerated or prolonged laryngeal closure reflex. Laryngospasm - leading cause of perioperative cardiac arrest from respiratory origin in children.

Answer 7

Contributing factors include the type of surgical procedure such as **tonsillectomies**, **dental work**, **strabismus repair**, **hypospadias repair**, as well as a history of reactive airway disease; living with household smokers; and recent upper respiratory tract infections.

Answer 8

open mandible to adjust jaw Administered 100% humidified O2 **Apply continuous positive pressure by mask** propofol (initial medical treatment to deepen anesthesia and relax vocal cords) succinylcholine (0.25–1 mg/kg) if all other attempts to break the spasm have been unsuccessful reintubate if necessary Posterior oral pharyngeal suctioning can cause additional trauma and should be avoided (or performed very carefully) after the child has been extubated.

Answer 9

Partial airway obstruction can lead to stridor during inspiration due to swollen airway

Answer 10

humidified oxygen racemic epinephrine nebulized medication, if needed iv corticosteroid medication if needed delay discharge to ensure resolution If wheezing, nebulized albuterol and corticosteroids. Epinephrine for refractory bronchospasm.

Answer 11

!Uncuffed ETT must be used until 8 years old to allow slight air leak to be present

Answer 12

Uncuffed - (age in years / 4) + 3.5 Cuffed - (age in years / 4) + 4

Answer 13

Morphine is gold standard for opioids PCA as young as 5 years old based on manual dexterity and ability to understand the concept

Answer 14

Infancy (0-1yr) - Basic trust vs. mistrust **Toddler (2-3yr) - Autonomy vs. shame/doubt** Preschool (3-6yr) - Initiative vs. guilt **School age (6-12yr) - Industry vs. inferiority** Adolescense (12-20yr) - Identify vs. role diffusion

Answer 15

monitoring in PACU for 2-4 hours

Answer 16

Patient placed in 3/4 prone position (tonsillar position) after intraoral surgical procedure to facilitate adequate drainage of secretions and blood

Answer 17

Children who are 8 years of age and younger should have a ratio of 1:1 nursing care until the critical elements of care are met and/or parents are at the bedside.

Answer 18

**Non-shivering thermogenesis** is a physiologic response of the newborn infant during periods of hypothermia with stimulation of the sympathetic catabolism of brown fat with release of energy in the form of heat. Brown fat is primarily located in the neck and chest of the infant.

Answer 19

For 6 y/o and older, sniffing position - a folded towel or small pillow placed under the occiput in combination with extension of the head For infants and younger children, usually the size of the head is large relative to the trunk, and hyperflexion of the neck occurs with lying flat on a bed. Further elevation of the occiput with a folded towel most likely hinders airway management. Mild flexion of the neck with slight extension of the head can be accomplished with the placement of a shoulder roll.

Answer 20

Ask “Should I (the nurse) give this to you or should mommy give this to you?” or “Should we do this now or right after your story?” The proper approach to medication administration is as something that has to be done. Do not ask “Can you take your medicine?” or “Can I give you your medicine?” because when child answers “no” beccause trust is broken in patient - healtchcare relationship because since the child need to take the medicine despite the negative response.

Answer 21

4:2:1 method of calculation * For the first 10 kg of weight, the calculation 4 mL of fluid/kg/h - for first 10kg of weight 2 mL of fluid/kg/h - every kg over 10kg-20kg 1 mL of fluid/kg/h - for each kg over 20kg

Care of Pediatrics Flashcards

(47 cards)