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PARA 240 > PALS > Flashcards

PALS Flashcards

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1
Q

Neonate age

A

Up to 28 days

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2
Q

Problems in neonates

A 
Respiratory distress
•Jaundice
•Vomiting
•Fever
•Sepsis
•Meningitis
•Physical/sexual abuse
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3
Q

Problems in infants 1-5 months

A 
Respiratory distress
•Fever
•SIDS
•Vomiting/diarrhea
•Sepsis
•Meningitis
•Physical/sexual abuse
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4
Q

Infant 6-12 months

A 
Fever, febrile seizures
•Vomiting/diarrhea
•Broncholitis
•Croup
Sepsis
•Meningitis
•Respiratory distress(foreign body aspiration)
•Abuse
•FBAO
•Falls/injury MVA
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5
Q

Child 1-3 years

A 
Fever/febrile seizure
•Vomiting/diarrhea
•Resp distress (asthma, croup)
Sepsis
•Meningitis
•Ingestions
•FBAO
Falls/injury MVA
•Abus
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6
Q

ABCDE

A

Airway

Breathing

Circulation

Disability (AVPU/ pupils/ BGL)

Exposure (temperature/ skin)

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7
Q

Hypoxemia

A
  • Inadequate oxygenation of blood

* A room air Sp02 of

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8
Q

4 D’s of Epiglottis

A
  • Difficulty swallowing
  • Drooling
  • Distress
  • Dyspnea
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9
Q

Infant facts

A

Most have doubled their birth weight and heart size at 4-6 months
•Mouth breather at between 3-6 months
Fears:
•separation and strangers

Approach:
•Provide consistent caretakers
•Happy parents = happy baby
•Minimize separation from parent

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10
Q

4 types of respiratory problems in the identify stage

A

Upper Airway Obstruction

Lower Airway Obstruction

Lung Tissue Disease

Disordered Control of Breathing

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11
Q

Severity of Respiratory problems

A

Respiratory Distress

Respiratory Failure

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12
Q

4 Types of Circulatory Problems

A

Hypovolemic Shock

Distributive Shock

Cardiogenic Shock

Obstructive Shock

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13
Q

Two severities of shock

A

Compensated

Hypotensive

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14
Q

Rr for infant

A

30-60

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15
Q

RR for Infant 1-3yrs

A

24-40

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16
Q

RR for Preschooler 4-5

A

22-34

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17
Q

RR for School age child 6-12

A

18-30

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18
Q

RR for Adolescent 13-18

A

12-16

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19
Q

SV (stroke volume) is determined by what factors?

A

Preload

Contractility

After-load

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20
Q

CO (Cardiac Output)=

A

SVxHR

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21
Q

S&S of decreased Cardiac Output

A

Tachycardia

Cool, pale,diaphoretic

Delayed Cap refill

Weak peripheral pulses

Oliguria

Vomiting

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22
Q

Hypotension formula

A

Anything less than

70 + (age in years * 2)

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23
Q

After-load

A

The pressure ventricles have to overcome or push against to pump out blood

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24
Q

4 main types of Shock

A

Hypovolemic

Cardiogenic

Distributive

Obstructive

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25
Causes of Hypovolemic shock
Hemorrhage Diarrhea Vomiting Osmotic Diuretic use Third Spacing Burns
26
Hypovolemic shock Effects on Cardiac Output
Preload: decreased Contractility: Normal or increased Afterload: Increased
27
S&S of Hypovolemic Shock
Wuiet Tachypnea Tachycardia Narrow pulse pressure Delayed Cap refill Pale, cool, diaphoretic Oliguria Changes in mentation
28
Normal Cap refill time
Less than 2 seconds
29
Types of distributive shock
Septic Anaphylactic Neurogenic (spinal)
30
Most common type of distributive shock
Septic
31
Septic shock
Vasodilation and venodilation cause blood to pool (petechi or purpura)
32
S&S of Septic Shock
Warm flushed skin (warm shock) Pale mottles skin (cold shock) Hypotension with widened pulse pressure Bounding peripheral pulses Petechi or purpura rash
33
Effect of septic shock on Cardiac Output
Preload: decreased Contractility: normal to decreased Afterload: variable
34
Anaphylactic shock
Multisystem allergic response Veno and vasodilation Increased capillary permeability Pulmonary vasoconstriction
35
Anaphylactic shock effect on Cardiac Output
Preload: decreased Contractility: variable Afterload: L ventricle decreased/ R ventricle increased
36
Neurogenic shock
Loss of sympathetic signals to smooth muscle (particularly in blood vessels) Uncontrolled vasoconstriction and tachycardia prevented
37
S&S of Neurogenic shock
Hypotension with widened pulse pressure Normal or bradycardic HR
38
Neurogenic shock effect on cardiac output
Preload: decreased Contractility: normal Afterload: decreased
39
Fluid replacement for: Hypovolemic Distributive Obstructive
20ml/kg PRN Rapidly over 5-10min
40
Fluid replacement for: DKA
10-20ml/kg Over 1 hr
41
Fluid replacement for: Cardiogenic Poisoning Calcium channel blocker OD Beta blocker OD
5-10ml/kg PRN slowly over 10-20min
42
Causes of cardiogenic shock
Congenital heart defect Myocarditis Cardiomyopathy Arrhythmias Poisons/toxins Myocardial injury
43
S&S of cardiogenic shock
Retractions, nasal flaring, grunting (pulmonary Edema) Cyanosis Pale, cool, diaphoretic Narrow pulse pressure Mentation changes Delayed cap refil
44
Effects of cardiogenic shock on cardiac output
Preload: variable Contractility: decreased Afterload: increased
45
Causes of obstructive shock
Cardiac tamponade Tension Pneumothorax Ductal dependant lesions Pulmonary embolism
46
Becks triad
Three signs of cardiac tamponade Pulsus paradoxus JVD muffled or diminished heart sounds
47
Signs of cardiac tamponade
Pulsus parodoxus JVD muffled or diminished heart sounds
48
Signs of Tension Pneumothorax
JVD hyper-resonance Diminished breath sounds on affected side Tracheal deviation (late)
49
Leading cause of bradycardia in children
Hypoxia
50
Primary Bradycardia
Congenital or acquired heart conditions causing bradycardia Use Atropine here
51
Secondary Bradycardia
Bradycardia that results in a NON CARDIAC condition that alter the normal function of the heart Hypoxia, acidosis, hypotension, hypothermia, and drug effects. USE EPI HERE
52
Normal QRS in Children
Less than 0.09
53
SVT rate in children
180
54
Infant SVT rate
220bpm
55
Infant vagal maneuver
Ice pack to the face 15-20 seconds
56
PALS Tachycardia Synchronized Cardio Version
Begin 0.5-1J/kg. if that is not effective then increase to 2J/kg
57
Three things to look at on initial arrival
Consciousness Breathing Color
58
Leading cause of symptomatic bradycardia in children?
Tissue hypoxia
59
Two most common potentially reversible causes of bradycardia
Hypoxia Increased vagal tone
60
Neonate hypotension
Less than 60
61
Infants hypotension (1mon-12mon)
Less than 70
62
Hypotension in children older than 10
Less than 90

PARA 240 (6 decks)

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