Care of Pediatrics Flashcards
(47 cards)
Care of Pediatrics
What makes pediatric patients different?
!Laryngospasm is fairly common problem
Care of Pediatrics
What is the age classification for neonates?
0-28d of life
44 weeks post conceptual age
HR 90-160 (asleep)
HR 100-204 (awake)
RR 30 - 53
SBP 67- 84
DBP 35 - 53
Care of Pediatrics
What is the age classification for infants?
1-12 months
HR 90-160 (asleep)
HR 100-190 (awake)
RR 30 - 53
SBP 72 -104
DBP 37 - 56
Care of Pediatrics
What is the age classification for toddler?
1-3 years
HR 80-120 (asleep)
HR 98-140 (awake)
RR 22 - 37
SBP 86 -106
DBP 42 - 63
Care of Pediatrics
What is the age classification for pre-schooler?
3-5 years
HR 65-100 (asleep)
HR 80-120 (awake)
RR 20 - 28
SBP 89 -112
DBP 46 - 72
Care of Pediatrics
What is the age classification for school age?
6-12 years
HR 58- 90 (asleep)
HR 75-118 (awake)
RR 18 - 25
SBP 97 -120
DBP 57 - 80
Care of Pediatrics
What is the age classification for adolescent?
13-18 years
HR 50- 90 (asleep)
HR 60- 100 (awake)
RR 12 - 20
SBP110-131
DBP 64 - 83
Care of Pediatrics
What is the pre-operative NPO guidelines for pediatrics?
Clear liquid - 2 hours
Breast milk - 4 hours
Infant formula - 6 hours
Non-human milk - 6 hours
Light meal - 6 hours
Care of Pediatrics
What is the normal urine output for pediatric patients?
Normal urine output for the pediatric patient is 0.5 to 1 mL/kg/h.
Drain’s Perianesthesia Nursing, Care of pediatric patient
Care of Pediatrics
At what age is Babinski reflex normal?
A positive Babinski reflex is normal in infants younger than 18 months of age but indicates increased ICP in those older than 18 months.
Care of Pediatrics
At what age is separation anxiety is highest among pediatric patients?
8 months - 2 years
Separation anxiety is highest
Most difficult for mask induction
Pre-medication/ Pre-induction useful
Care of Pediatrics
At what age is fear of loss of control highest among pediatric patients?
7-11 years (fear of loss of control)
Generally calm with mask induction
Fearful of needles
Care of Pediatrics
When is CPR initiated for bradycardic infants?
HR < 60 for infants (birth to 1 year)
Care of Pediatrics
Where to check pulse for < 2 years old.
Apical pulse
Care of Pediatrics
What are the risk factors for emergence delirium among pediatric patients?
Sevoflurane/ Desflurane anesthesia
Pain
ENT surgery
Male
Pre-op anxiety
Pre-existing behavior
Care of Pediatrics
How to evaluate emergence delirium among pediatric patients?
Pediatric Anesthesia Emergence Delirium (PAED) score
If score >10 is indicative of the presence of ED
* Child makes eye contact with the provider
* Child’s actions are purposeful
* The child is aware of his/her surroundings
* The child is restless
* Child is inconsolable
Scored from 0-4, where “0” means not at all and “4” means extremely, maximum score is 20
Care of Pediatrics
When to use FLACC behavioral pain scale on pediatric patients?
0-7 years old
(F) Face, (L) Legs, (A) Activity, (C) Cry, (C) Consolability scored from 0 to 2, which results to total score between 0 and 10.
FACES can be used as early as 3 years old
Care of Pediatrics
What are the PONV risk factors for pediatric patients?
Surgery > 30minutres
Age >= 3y/o
Strabismus surgery
History of PONV or relatives w/ PONV
10% risk factor if none of the above, 30%, 50%, 70% for each addl factor
Society for Ambulatory Anesthesia Consensus Guidelines
Care of Pediatrics
What pre medication is commonly used in pediatric patients?
Midazolam (Versed)
Care of Pediatrics
What is commonly used dosage of midazolam for pediatric patient?
PO 0.25-1mg/kg (max 20mg)
20-30 minute onset
IV 0.025-0.21 mg/kg
Care of Pediatrics
What is the common side effect of midazolam to pediatric patients?
paradoxical excitation
Care of Pediatrics
What is the advantage of Ketamine vs. other sedative hypnotic agents?
Ketamine
* also has analgesic properties
* lowers postoperative opioid requirements
* promotes spontaneous respirations
When used in small (subanesthetic) doses (0.1 to 0.5 mg/kg), the common side effects (i.e., tachycardia, delirium, hallucinations, nightmares) are minimal. It has been suggested that ketamine always be administered with a benzodiazepine (midazolam) to help reduce the incidence of delirium, hallucinations, and nightmares
When is ketamine used for pediatric patients?
pediatric patients who have behavioral d/o or very distress/ed uncooperative
What is the side effect of ketamine in pediatric patients?
hallucinations/ dysphoria
PONV
DO NOT USE if increased ICP