Pediatrics Part 1 Flashcards
1
Q
Head size reflects what?
A
growth of brain; correlates with intracranial volume and brain weight
2
Q
how much does head circumference increase in the first year of life?
A
10cm
3
Q
when does head circumference reach 50% of the adult?
A
9 months
4
Q
how much does the head circumference increase in the second year?
A
2.5 cm or 75% of the adult size
5
Q
does the face and base of skull develop faster or slower than the cranium?
A
slower
6
Q
3 abnormalities associated with the failure of prenatal development of the mandible?
A
Pierre Robin
Treacher Collins
Goldenhar syndrome
7
Q
after age 2, cranial vault growth ____ and face grows ____.
A
cranial vault slows and face grows rapidly.
8
Q
when do frontal sinuses develop?
A
2-6 years
9
Q
when do maxillary, sphenoidal, and ethmoidal sinuses appear?
A
after age 6 years
10
Q
when does the first tooth appear?
A
around 6 months
11
Q
when are all teeth present?
A
around 20 months
12
Q
when do permenant teeth begin to appear?
A
6 years
13
Q
HR for premature infant
A
120-170
14
Q
HR for 0-3 months
A
100-150
15
Q
HR for 3-6 months
A
90-120
16
Q
HR for 6-12 months
A
80-120
17
Q
HR for 1-3 years
A
70-110
18
Q
HR for 3-6 yers
A
65-110
19
Q
HR for 6-12 years
A
60-95
20
Q
HR for >12 years
A
55-85
21
Q
SBP for premie
A
55-75
22
Q
SBP for 0-3 mo
A
65-85
23
Q
SBP for 3-6 mo
A
70-90
24
Q
SBP for 6-12 mo
A
80-100
25
SBP 1-3 yrs
90-105
26
SBP 3-6 yrs
95-110
27
SBP 6-12 yrs
100-120
28
SBP >12 years
110-135
29
DBP premie
35-45
30
DBP 0-3 mo
45-55
31
DBP 3-6 mo
50-65
32
DBP 6-12 mo
55-65
33
DBP 1-3 yrs
55-70
34
DBP 3-6 yrs
60-75
35
DBP 6-12 yrs
60-75
36
DBP >12 yrs
65-85
37
Neonate
up to 4 weeks old
38
infant
4 weeks to 1 year
39
toddler
1-3 years
40
preschool
4-6 years
41
school age
6-13 years
42
adolescent
13-18 years
43
NPO for clear liquids
2 hours
44
NPO for breast milk
4 hrs
45
NPO for infant formula
6 hrs
46
NPO for solids (fatty or fried foods)
8 hrs
47
is the removal of piercings necessary to minimize complications?
yes
48
what are some potential complications of piercings?
electrocautery burns, airway difficulty, tissue damage
49
what are the recommendations to avoid electrocautery burns?
use bipolar cautery, harmonic knife, grounding pad should be remote from piercing
50
what are airway complications associated with piercings?
laryngospasm and hypoxia
| pulmonary aspiration
51
tissue damage associated with piercings?
necrosis
| bleeding
52
what are the primary implications associated with smoking?
```
increased carboxyhemoglobin levels
decreased ciliary function
decreased FVC
decreased FEF 25-75%
increased sputum production
```
53
what are the secondary considerations associated with smoking?
environmental tobacco smoke (ETS)
| more likely to have astham, otitis media, atopid eczema, hay fevre, dental caries
54
factors to consider during preop evaluation
```
stressful for child and family
family dynamics
developmental and behavioral status
cultural biarses
ability to provide information
```
55
perioperative anxiety concerns for 0-6 months
maximum stress for parent
| minimum stress for baby
56
perioperative anxiety concerns for 6mo-4 yrs
maximum fear of separation
not able to understand process and explanations
significant post op emotional upset and behavior regression
begins to have magical thinking
cognitive development and increased temper tantrums
57
perioperative anxiety concerns for 4-8yrs
begins to understand process and explanations
fear of separation remains
concerned about body integrity
58
perioperative anxiety concerns for 8years-adolescence
tolerates separation well
understands process and explanations
may interpret everything literally
may fear waking up during surgery or not waking up at all
59
perioperative anxiety concerns for adolescence
independent
issues regarding self-esteem and body image
developing sexual characteristics and fear of loss of dignity
fear of the unknown
60
parental presence during induction
some encourage it, some not ok with it, evaluate each situation, parents should remain informed.
61
unrelieved anxiety in child
renegotiate (rarely every successful)
hold mask farther from the childs face
IV or IM induction
62
factors to assess for respiratory system
cough
asthma
croup
apnea/bradycardia
63
possible anesthetic implications for respiratory system
```
irritable airway
bronchospasm
atelectasis
subglottic narrowing
postop apnea/bradycardia
medication history?
```
64
factors to assess for cardiac system
```
murmur
cyanosis
history of squatting
hypertension
rheumatic fever
exercise intolerance
```
65
possible anesthetic implications for cadiac system
```
septal defect
avoid air bubbles in IV line
R to L shunt
TOF
coarctation
renal disease
VHD
CHF
cyanosis
```
66
factors to assess for neurologic system
seizures
head trauma
swallowing incoordination
neuromuscular disease
67
possible anesthetic implications for neurologic system
```
medications
metabolic derangement
intracranial hypertension
aspiration
esophageal reflux
hiatal hernia
neuromuscular relaxant drug sensitivity
malignant hyperpyrexia
```
68
factors to assess for GI/hepatic systems
```
vomiting
diarrhea
malabsorption
black stools
reflux
jaundice
```
69
possible anesthetic implications for GI/hepatic system
```
electrolyte disturbance
dehydration
full stomach
anemia
hypovolemia
possible need for full stomach precautions
drug metabolism/hypoglycemia
```
70
factors to assess for GU system
frequency
time of last urination
frequent UTIs
71
possible anesthetic implications for GU system
```
UTI
DM
hypercalcemia
state of hydration
renal function
```
72
factors to assess for endocrine/metabolic systems
abnormal development
hypoglycemia
steroid therapy
73
possible anesthetic implications for endocrine/metabolic systems
```
endorinopathy
hypothyroid
DM
hypoglycemia
adrenal insuffiency
```
74
factors to assess for hematologic system
anemia
bruising
excessive bleeding
sickle cell
75
possible anesthetic implications for hematologic system
```
need for transfusion
coagulopathy
thrombocytopenia
thrombocytopathy
hydration
possible transfusion
```
76
factors to assess for allergies
medications
77
possible anesthetic implications for allergies
possible drug interactions
78
factors to assess for dental system
loose or carious teeth
79
possible anesthetic implications for dental
aspiration of loose teeth
| bacterial endocarditis prophylaxis
80
commonly expected problems with neonate based on maternal history of Rh-ABO incompatibility
hemolytic anemia
hyperbilirubinemia
kernicterus
81
commonly expected problems with neonate bsed on maternal history of toxemia
small for gestational age and its associated problems
| muscle relaxant interactions with mag therapy
82
commonly expected problems with neonate bsed on maternal history of hypertension
small for gestational age and its associated problems
83
commonly expected problems with neonate bsed on maternal history of drug addiction
withdraw, small for gestational age
84
commonly expected problems with neonate bsed on maternal history of infection
sepsis
thrombocytopenia
viral infection
85
commonly expected problems with neonate bsed on maternal history of hemorrhage
anemia
| shock
86
commonly expected problems with neonate bsed on maternal history of diabetes
hypoglycemia
birth trauma
large for gestational age
small for gestational age
87
commonly expected problems with neonate bsed on maternal history of polyhydramnios
tracheoesophageal fistula
anencephaly
multiple anomalies
88
commonly expected problems with neonate bsed on maternal history of oligohydramnois
renal hypoplasia
| pulmonary hypoplasia
89
commonly expected problems with neonate bsed on maternal history of cephalopelvic disproportion
birth trauma
hyperbilirubinemia
fractures
90
commonly expected problems with neonate bsed on maternal history of alcoholism
hypoglycemia
congenital malformations
fetal alcohol syndrome
small for gestational age
