Pediatric

Question 1

What are the 3 parts of the pediatric assesment triangle

Answer 1

• Appearance
• Work of Breathing
• Circulation to skin

Question 2

Good history questions to ask specific for kids?

Answer 2

• are they under the care of a physician
• chronic or congenital illnesses
• vaccinations up to date

Question 3

What is the weight capacity for the neonate?

Answer 3

7-14 lbs

Question 4

What is the weight capacity for the pedimate?

Answer 4

10-80 lbs

Question 5

Most cardiac arrests in children are secondary to….

Answer 5

hypoxia

Question 6

What are 2 important things to remember when treating a child with respiratory compromise?

Answer 6

• do not agitate the pt
• do not lay the child down

Question 7

Define Croup

Answer 7

• Laryngotracheobronchitis
• Viral Infection of the upper airway
• common inflammatory respiratory illness
• 6 months to 3 years

Question 8

What time of year does croup typically flair up?

Answer 8

Late fall to early winter

Question 9

Signs and Symptoms of Croup

Answer 9

• slow onset
• barking cough
• inspiratory stridor
• occurs at night
• may have slight temperature

Question 10

What should be the first drug of choice when a pt has stridor at rest

Answer 10

Epinepherine

Question 11

What is a typical sign on an x-ray if a patient has croup?

Answer 11

Steeple Sign

Question 12

What is the table used to calculate the severity of croup? And what does a pt need to score to qualify as severe?

Answer 12

Westley Croup Score and a score of greater than 6

Question 13

2 indications of croup

Answer 13

• current history URTI
• barking cough or recent history of barking cough

Question 14

Croup Management

Answer 14

1. O2 if indicated
2. cool moist air
3. avoid visualizing airway or manually opening airway
4. oral dexamethasone for all
5. Nebulized Epi for severe cases

Question 15

Define Epiglottitis

Answer 15

• life threatening bacterial infection
• Acute inflammation above glottis causing airway obstruction
• 3-6 year range
• sudden onset, rapid progression, high fever
• TRUE EMERGENCY

Question 16

Signs and Symptoms of Epiglottitis

Answer 16

child will suddenly awake with
- high fever
- respiratory distress - stridor
- sore throat
- difficulty swallowing
Child may be in tripod position
- child may be drooling

Question 17

How to manage epiglottitis

Answer 17

• blow by O2
• do not inspect airway
• keep child calm

Question 18

Define Bronchiolitis

Answer 18

• a viral infection frequently caused by the respiratory syncytial virus (RSV)
• causes inflammation of bronchioles
• usually affects children than 2 years of age
• commonly occurs in the winter months, and generally is associated with an URI

Question 19

Signs and Symptoms of Bronchiolitis

Answer 19

• tachypnea and wheezing
• starts as low fever, runny nose and cough - progresses to respiratory distress
• dry cough or crackles upon ausciltation
• bronchioles obstructed due to edema and mucous build up

Question 20

Define Asthma

Answer 20

Asthma is obstruction of the lower airways characterized by inflammation and bronchoconstriction

Question 21

Signs and Symptoms of Asthma

Answer 21

• respiratory diostress
• stridor at rest
• tachycardia
• cough of clear mucous

Question 22

2 types of pneumonia

Answer 22

bacterial - sudden onset (<24hrs), high mortality
Viral - longer course, but less severe

Question 23

Pneumonia signs and symptoms

Answer 23

History of - acute onset of fever, cough, poor feeding or vomiting, chest or abdo pain
- tachypnea
- respiratory distress
- Crackles (decreased air entry)
- productive cough

Question 24

Define Cystic Fibrosis

Answer 24

• recessive gene, carried by 1 in 23, usually dx before 1 year

Chronic Pulmonary Disease
- hypertrophy and hypersecretion of glands
- obstruction and infection from stagnant mucous

98% die from cardio-respiratory complications

Question 25

Define Pertusis

Answer 25

- whooping cough - caused by bacteria Bordetella pertussis - pt age less than 6 months, preterm infants, and unimmunized pts are at highest risk for severe disease and complications - highly contagious

Question 26

Signs and Symptoms of Pertussis

Answer 26

- obtain good history (vaccinations up to date?) - forceful cough may provoke vomiting or pt to turn red or blue - high pitched whoop sound during next breath of air

Question 27

Common causes of seizures

Answer 27

- not complient with meds - head trauma - intracranial infection - metabolic disturbance - poisoning - most common cause in children is a fever

Question 28

Define febrile seizure

Answer 28

seizure associated with fever, but without evidence of intracranial infection or other definable cause

Question 29

In what age would you usually see febrile seizure and ?

Answer 29

6 months - 5 years

Question 30

Signs and Symptoms of Febrile Seizure

Answer 30

- a fever of greater than 38 degrees that came on suddenly generalized tonic-clonic - within 5-10 min post-ictal, child returns to normal

Question 31

Treatment for Febrile Seizure

Answer 31

- cool child - remove clothing. tepid wet cloths

Question 32

Define Status Epilepticus

Answer 32

- continuous seizure activity lasting 5 min or longer - recurrent seizure without an intervening period of consciousness

Question 33

Define Meningitis

Answer 33

- bacterial or viral - localized in meninges and cause inflammation and cerebral edema - typically followed by an upper respiratory infection (tonsillitis) or ear infection

Question 34

Signs and Symptoms of Meningitis

Answer 34

- fever and or vomiting - neck rigidity/stiffness - rash - severe ache - dislike of bright lights - altered L:OOC - seizures - hx of ENT infection

Question 35

When a child has an altered LOC with no explainable cause what shoud you check?

Answer 35

Blood Glucose

Question 36

When children experience blunt trauma what are 2 common reasons that they get more seriously injured to adults

Answer 36

- ribs are more pliable and offer less protection to organs (liver and spleen) - abdo muscles are not developed and offer less protection

Question 37

Is permissive hypotension permitted in peds?

Answer 37

no

Question 38

In what age is greenstick fractures more common?

Answer 38

Children under 10 years of age

Question 39

What can shaken baby syndrome cause in a child?

Answer 39

- cerebral contusions - subdural hematoma - subarachnoid hemorrhage - retinal hemorrhage - neck and spine injury

Question 40

In what age does shaken baby syndrome occur?

Answer 40

Children under 2

Question 41

Why can blood loss be deceptive in children?

Answer 41

Children have a strong cardiovascular response to hypovolemia. This can result in children having 30% blood loss and be normotensive

Question 42

How do you calculate average amount of total blood volume for a peds pt

Answer 42

70ml/kg x pts weight Ex - 20kgx70ml/kg = 1.4L

Question 43

If a child has 1. delayed cap refill 2. sustained tachycardia 3. altered or decreased LOC - they are.....

Answer 43

SICK - don't wait for hypotension

Question 44

Define SIDS

Answer 44

- the sudden death of an apparently healthy infant that remains unexplained by history and autopsy - average age between 2-4 months - most often in fall and winter months

Question 45

How heavy does a pt need to be to use peds pads for defibrilation

Answer 45

If a pt is udner 15 kg they get the peds pads

Question 46

How many joules do you shock for a peds pt? (for one shock and multiple)

Answer 46

1st shock - 2 joules/kg Consecutive Shock - 4 joules/kg *always round up

Question 47

When do you start chest compressions on a pediatric pt?

Answer 47

once the heart rate drops below 60 AND altered mental status signs of shock sings of hypotension