Chapter 34 Pediatric Emergencies

Question 1

Infancy

Answer 1

First year of life

Question 2

Neonatal or newborn period

Answer 2

The first month after birth

Question 3

The amount of time infants generally spend sleeping

Answer 3

16 hours

Question 4

An infant not easily aroused from sleep is a sign of this

Answer 4

An emergency

Question 5

The quality of an infants thermoregulation ability

Answer 5

Poor

Question 6

Infants are able to recognize caregivers at

Answer 6

2 to 6 months

Question 7

By the first year, infants can

Answer 7

Say their first word and walk

Question 8

Toddler stage

Answer 8

Each one to age three

Question 9

Toddler stage is characterized by

Answer 9

Increased mobility and vocabulary. Separation anxiety usually develops in this stage.

Question 10

Preschool age

Answer 10

Ages 3 to 6

Question 11

Preschool age is characterized by

Answer 11

Increased language ability and increased imagination

Question 12

School-age

Answer 12

Ages 6 to 12

Question 13

Direction assessments should be performed

Answer 13

Prior to school-age, begin at the feet and proceed upward. Following school age, begin at the head and proceed downward

Question 14

Adolescence

Answer 14

Ages 12 to 18

Question 15

The relative size of a pediatric airway compared to an adult airway

Answer 15

Pediatric airway is smaller in diameter and shorter in length

Question 16

Relative size of a child’s lungs to an adult’s lungs

Answer 16

A child’s lungs are smaller

Question 17

The relative location of the heart in a child compared to an adult

Answer 17

The heart is higher in a child’s chest

Question 18

The relative position of the glottic opening in a child compared to an adult

Answer 18

Glottic opening is higher in position to more anteriorly

Question 19

Relative length of the neck in a child compared to an adult

Answer 19

The neck is shorter

Question 20

The difference between a child’s head and adult’s head

Answer 20

Children have larger, rounder occiputs compared tho the rest of their heads. Requiring more careful positioning of the airway

Question 21

Difference between an adult’s and a child’s tongues

Answer 21

Children have a proportionately larger tongue relative to the size of the mouth and a more anterior location in the mouth. Child’s tongue is also larger relative to the small mandible and can easily block the airway

Question 22

Difference between child’s epiglottis an adult’s epiglottis

Answer 22

In infants and toddlers, the epiglottis is long, floppy, and U-shaped.

Question 23

The difference between a child’s trachea and an adult’s trachea

Answer 23

Child’s trachea has less developed rings of Cartlidge that may easily collapse if the neck is flexed or hyperextended

Question 24

Infants are obligate ____

Answer 24

Nose breathers

Question 25

The oxygen demand of a child

Answer 25

Is twice that of adult’s

Question 26

Normal respiratory rate of an infant

Answer 26

30 to 60

Question 27

Normal respiratory rate of a toddler

Answer 27

24 to 40

Question 28

Normal respiratory rate of a preschool age child

Answer 28

22 to 34

Question 29

Normal respiratory rate of a school age child

Answer 29

18 to 30

Question 30

No respiratory rate of an adolescent

Answer 30

12 to 16

Question 31

Children are belly breathers which means

Answer 31

They use the diaphragm the most

Question 32

Normal pulse rates in a newborn to 3 months

Answer 32

85 to 205

Question 33

Normal pulse rates at three months to 2 years

Answer 33

100 to 190

Question 34

Normal pulse rate at two years to 10 years

Answer 34

60 to 140

Question 35

Normal pulse rates at greater than 10 years

Answer 35

60 to 100

Question 36

Larger head to body ratio of an infant and young child makes them more prone to what

Answer 36

Head injuries

Question 37

Child’s brain has less cushioning due to

Answer 37

Smaller subarachnoid space

Question 38

The internal organs are ____ in children

Answer 38

Proportionally larger, situated more anteriorly, and are closer together

Question 39

The abdominal muscles are ____ in children

Answer 39

Less developed

Question 40

The bones of children are ____ than adults

Answer 40

Softer

Question 41

The skeletal system of children contain active ____

Answer 41

Growth plates

Question 42

Immobilize extremities with suspected strains and sprains in children because

Answer 42

They may be stress fractures

Question 43

Children are more susceptible to these types of fractures

Answer 43

Stress

Question 44

The anterior fontanelle closes at ____

Answer 44

18 months

Question 45

The posterior fontanelle closes at

Answer 45

6 months

Question 46

Bulging at the fontanelles is normal in an infant who is ____

Answer 46

Crying, coughing, or lying on the back or stomach

Question 47

In a non-crying, non-coughing infant who is not lying on his back, bulging fontanelles can be a sign of ____

Answer 47

Increases ICP

Question 48

A sunken fontanelle is an indication of ____

Answer 48

Dehydration

Question 49

The thoracic cage in children is largely composed of ____

Answer 49

Cartilage

Question 50

The ribs and vital organs are less protected by _____ in children

Answer 50

Muscles and fat

Question 51

Children’s skin is ____ and has less ____

Answer 51

Thinner, less subcutaneous fat

Question 52

Infants and children typically suffer from more significant fluid and heat loss due to

Answer 52

A larger body-surface-area-to-body-mass-ratio

Question 53

Pediatric assessment triangle (PAT)

Answer 53

Observational tool meant to assist assessment of pediatric patients at a glance

Question 54

The three categories of the PAT

Answer 54

Appearance (muscle tone in mental status), work of breathing, and circulation to the skin

Question 55

The number of signs of increased work of breathing

Answer 55

Seven

Question 56

First sign of increased work of breathing

Answer 56

Abnormal airway noise such as grunting or wheezing

Question 57

Second sign of increases work of breathing

Answer 57

Accessory muscle use such as contraction of the muscles above the clavicles (supraclavicular)

Question 58

Third sign of increased work of breathing

Answer 58

Retractions: drawing in the muscles between the ribs (intercostal retractions) or of the sternum (substernal retractions) during inspiration

Question 59

Fourth sign of increased work of breathing

Answer 59

Head bobbing: The head lifts and tilts back during inspiration, then moves forward during expiration

Question 60

Fifth sign of increased work of breathing

Answer 60

Nasal flaring

Question 61

Sixth sign of increased work of breathing

Answer 61

Tachypnea

Question 62

The seventh sign of increased work of breathing

Answer 62

Tripod position

Question 63

TICLS Mnemonic

Answer 63

``` Pediatric assessment tool. T: tone I: interactiveness C: consolability L: look or gaze S: speech or cry ```

Question 64

Through vasoconstriction

Answer 64

Blood from areas of lesser need such as the skin is shunted to areas a greater need such as the brain, heart, and kidneys.

Question 65

Mottling

Answer 65

Caused by constriction of peripheral blood vessels

Question 66

Sniffing position

Answer 66

An upright position in which the patient’s head and chin are thrust slightly forward to keep the airway open; the optimal position for the uninsured child that requires airway management

Question 67

Symmetric chest wall movement can be assessed by

Answer 67

Placing both hands on pediatric patients chest

Question 68

When bradypnea sets in, this can be a sign of

Answer 68

Impending respiratory arrest

Question 69

In infants pulse is assessed using

Answer 69

The brachial or femoral pulses

Question 70

In children older than one year, pulse is assessed using

Answer 70

The carotid pulse

Question 71

Central pulses in infants

Answer 71

Brachial or femoral

Question 72

Bradycardia in children

Answer 72

Heart rate is less than 80 bpm

Question 73

Bradycardia in newborns

Answer 73

Heart rate is less than 100 bpm

Question 74

Crackles

Answer 74

Crackling or bubbling sound we heard on inspiration; indicates inflammation or infection (such as pneumonia)

Question 75

Stridor

Answer 75

High-pitched inspiratory sound; indicates a partial upper airway obstruction (such as in croup or from a foreign body)

Question 76

Wheezing

Answer 76

High or low pitch sound heard usually during expiration; indicates a partial lower airway obstruction (such as in asthma or bronchitis)

Question 77

Grunting

Answer 77

An uh sound heard during exhalation; reflects the pediatric patient’s attempt to keep the Alveoli open by increasing pressure in the chest cavity

Question 78

How to estimate capillary refill time

Answer 78

Squeeze the end of the finger toe for several seconds. Normal color should return within two seconds after you let go

Question 79

Capillary refill is most reliable in children younger than

Answer 79

Six years old

Question 80

Difference between infant GCS scale and normal GCS scale

Answer 80

``` Verbal: 5 - Coos, babbles 4 - irritable cry 3 - cries to pain 2 - moans to pain 1 - no response ```

Question 81

Infants younger than six months

Answer 81

Lack the ability to shiver in response to a cold stimulus

Question 82

Hypothermia in pediatric patients can lead to

Answer 82

Convulsive seizure activity

Question 83

Pediatric patients younger than two years must be transported in this position due to lack of mature neck muscles

Answer 83

The rear facing position

Question 84

When asking about pediatric medications, you should ask about these to types

Answer 84

Analgesics or antipyretics