Neonatal and Peds Flashcards by jorden flieg

Ped dose for Epi during cardiac arrest

0.01mg/kg

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Pretreatment drug used during DSI to prevent bradycardia

Atropine
0.02 mg/kg
Lidocaine pretreatment for ICP 1.5mg/kg

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What should be administered for pre term respiratory distress (28-32weeks)

Surfacatant

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What is a seizure described as repetitive mouth or tongue movemen, bicycling movement, eye deviations, repetitive blinking, staring or apnea

Subtle seizure

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What seizure is characterized by repetitive jerky movement of the limbs, which may move from limb to limb in a disorganized fashion

Clonic

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What seizure resembles posturing, disturbed respiratory pattern, extention of the limb/limbs or flexion of the upper limbs and extension of the lower limbs

Tonic

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Characterized by multiple jerking motion of the upper (common) and lower (uncommon) extremities

Myoconic

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What would you want to administer to a PDA dependent patient

Prostaglandin

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How do you calculate ETT size and depth in preterm

28 weeks 2.5
28-34weeks 3.0
34-38 weeks 3.5
6+wgt in kG

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How do you calculate ETT size and depth in full term newborn

<6 months 3.5-4.0
6+weight in kG

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How do you calculate ETT size and depth in one year and above

(age in years+16)/4

ETT size x 3

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What is the purpose of a cuffless ET tube

Prevent subglottic stenosis and ulcerations and recommended in children younger than 8 because cricoid cartilage is the narrowest portion of the trachea and will work as a physiologic cuff

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Persistent pulmonary hypertension in neonate is a syndrome characterized by persistent elevation PVR resulting in

Right-to-left shunt at the ductus arterious or the foramen ovale leading to hypoxemia

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What is the most common side effect of prostaglandin administration

Apnea/hypoventilation

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What medication is utilized in the neonate that accelerates closure of the PDA

Ibuprofen, indomethacin

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What are the 4 anomalies in Tetrology of Fallot

Pulmonary stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular septal defect

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Recommended urinary output when caring for a ped

30-50ml/hr
neonates 2ml/kg/hr
toddlers 1.5mg/kg/hr
older children 1 ml/kg/hr

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What should be considered an ominous sign and treated aggressively in the ped patient

Hypotension and bradycardia

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What lab test is used to diagnose Reye’s syndrome

Ammonia

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What should be done to prevent right to left shunting

Maintenance of the systemic blood pressure

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List the ways the pediatric airway anatomy differs from the adult’s

Airway diameter in children is smaller
the larynx is located more anterior in the infants/children
The epiglosttic is long and narrow and angled away from the trachea

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What is the primary cause of bradycardia in the neonate and ped patient

Hypoxia

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What is the drug of choice for the profoundly hypotensive septic ped patient

Levophed
0.01-5mcg/kg/min

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What sign would you expect to find on the chest x ray of a patient with Laryngotracheobronchitis (croup)

Steeple Sign, croup often caused by parainfluenza B

TV formula for pediatric patient

4-8 ml/kg

Scaphoid abdomen, unequal breath sounds, dyspnea and a shift in the PMI are classic presentations of what

Diaphragmatic hernia

What sign would you expect to find on the lateral x ray to confirm epiglottitis

Thumb print sign

Formla to estimate the weight of a child

(2 x age in years)+8=approx weight in kg

At what position is the umbilical vein located

12o'clock position

A ped patient has how many ml of circulating volume/kg

70-80 ml/kg

What is the minimum age a surgical chricothyrotomy can be preformed

11 years a needle cricothyroidotomy may be preformed on younger children

What is the maximum depth an umbilical catheterization may be placed and why

5 cm to prevent liver catheterization

What is the recommenation for noninitiation or discontinuation of resuscitation for newborns

<500G confirmed trisomy 13 or 18 congenital hydrocephalus severe fetal growth restriction <24 weeks

localized necrotic skin of unknown origin with a bulls eye appearance

brown recluse bite

sharp pinprick, dull numbing pain to the area, muscle cramping with intense abdominal pain with an acute onset

blackwidow spider bite

What should not be preformed to a snake envenomation

compression

The infant who is hypoxic on room air but demonstrates an PaO2 of >150 in 100% oxygen is more likely to have

pulmonary disease

What is Gastroschisis

A defect in the abdominal wall that has completed its development. The defect allows for protrusion of the abdominal contents and is not covered by a membrane

When transporting a neonate suspected of having esophageal atresia you should immediately

Elevate the head of the bed to prevent gastric reflux esophageal atresia is a condition where the esphagous is not connected to the distal aspect

What does APGAR stand for

Appearance Pulse Grimace Activity Respiratory

How is apgar scored

0, 1 or 2 points per topic Max of 10 Scored at 1 and 5 minutes 0-3 critically low 4-6 fairly low 7-10 normal

How is a neonate defined

1-28 days of life

When is hypoglycemia treated in the neonate

<40

Hypothermia is defined as__ in the neonate patient

36.5C or 97.7F

CPR ratio in the neonate

3:1

What are the key things to remember for Cyanotic heart lesion patient's that are pre surgery

DONT GIVE OXYGEN Prostaglandins 0.05-0.1mcg/kg/min

Acyanotic heart lesions such as Hypoplastic left heart syndrome present with

Wet lung sounds,pink red skin often take cardiac meds Small LV, Prone to HF, Hepatomegaly is a sign of HF in neonates

Prematurity is defined as

before 36 weeks

What is administered to pre mature neonates with respiratory distress syndrome

Surfactant

What is an important consideration for the spinal bifida (Myelomeningocele) patients

transport prone

What is the FLACC scale

Used to measure pediatric pain 0-1-2 points for each Face Legs Activity Crying Consolability

Fluid resuiscitation admin for neonates

10ml/kg

What is the treatment for Choanal Atresia (congenital narrowing of the back of the nasal cavity)?

Intubation

4 common causes of seizures in the neonate

Hypoxic ischemic encephalopathy interventriuclar hemorrhage withdrawl hypoglycemia

VP shunt complications

Gastric distention AMS Vomiting Seizures

Most common cardiac defect of the newborn

VSD

Formula for hypotension for ped

70+2(age)

Circulating volume for peds

80ml/kg

What is the 4:2:1 rule for maintenance fluids

First 10kg gets a bolus of 4ml/kg/hr Second 10kg gets a bolus of 2 ml/kg/hr All remaning weight after 20kg gets 1 ml/kg/hr