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Flashcards in Peds facts Deck (80)
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1
Q

what is the age for neonates

A

less than 30 days of age

2
Q

what is the age for infants

A

1-12 months

3
Q

what is the age for children

A

1-12 years

4
Q

The CO of neonates is dependent on what? and why?

A

HR

bc SV is relatively fixed by a non-compliant and poorly developed left ventricle

5
Q

CO is depedendent on what

A

HR

6
Q

Neonate and infants compared to adult:

HR is what?

A

faster

7
Q

Neonate and infants compared to adult:

BP is what?

A

lower

8
Q

Neonate and infants compared to adult:

RR is what?

A

faster

9
Q

Neonate and infants compared to adult:

lung compliance is what?

A

lower lung compliance

10
Q

Neonate and infants compared to adult:

chest wall compliance

A

greater chest wall compliance

11
Q

Neonate and infants compared to adult:

FRC

A

lower functional residual capacity

12
Q

Neonate and infants compared to adult:

ratio of body surface to body weight

A

higher ratio of body surface to body weight

13
Q

Neonate and infants compared to adult:

total body water content

A

higher total body water content

14
Q

Neonate and infants compared to adult:

compliance of LV

A

non-compliant (less compliant than adult)

15
Q

they have large what anatomically

A

head an tongues

16
Q

Neonate and infants Anatomic differences:

what is unique about the nasal passage

A

narrow

17
Q

Neonate and infants Anatomic differences:

what is unique about the larynx

A

narrow and cephalad

18
Q

Neonate and infants Anatomic differences:

what is unique about their epiglottis

A

longer

19
Q

Neonate and infants Anatomic differences:

what is unique about their trachea and neck

A

short

20
Q

Neonate and infants Anatomic differences:

they usually have prominent what in the oral cavity

A

tonsils and adenoids

21
Q

Neonate and infants Anatomic differences:

are their intercostal and diaphragm muscles weak or strong

A

weak

22
Q

Neonate and infants Anatomic differences:

do they have high or low resistance to airflow

A

high resistance

23
Q

Neonate and infants Pharmacologic differences:

what is unique about their hepatic biotransformation

A

it is immature

24
Q

Neonate and infants Pharmacologic differences:

do they have increased or decreased protein binding?

A

decreased protein binding

25
Q

Neonate and infants Pharmacologic differences:

do they have fast or slow induction and recovery?

A

rapid (fast)

26
Q

Neonate and infants Pharmacologic differences:

do they have a large or small Vd for water soluble

A

large volume of distribution

27
Q

Neonate and infants Pharmacologic differences:

what is unique about their NMJ

A

immature

28
Q

where is the laryngeal location in the adult?

A

C3-C6

29
Q

where is the laryngeal location in the per?

A

C2-C4

30
Q

what is the narrowest part of the adult airway?

A

Glottis

31
Q

what is the narrowest part of the ped airway

A

Cricoid (controversial lately)

32
Q

what is the shape of the adult epiglottis?

A

V

33
Q

what is the shape of the ped epiglottis?

A

Omega

34
Q

what does the right main stem bronchus look like in the adult

A

more vertical

35
Q

what does the right main stem bronchus look like in the pediatric

A

less vertical

36
Q

Airways significance:

neonates are preferential what type of breathers

A

nasal

37
Q

Airways significance:

the have narrow nares.. what does this mean

A

resistance is 12 times that of an adult

38
Q

Airways significance:

what is a problem with their tongue

A

its large

39
Q

Airways significance:

what is a problem with their glottis?

A

high glottis (more cephalad)

40
Q

Airways significance:

what is the narrowest point of the airway in children younger than age 5

A

cricoid cartilage (controversal as of late)

41
Q

ETT sizes ID:

Neonates

A

3-3.5 mm

42
Q

ETT sizes ID:

infant 6 months to 1 year

A

3.5 - 4.0 mm

43
Q

ETT sizes ID:

children 1-2 yrs

A

4.0-4.5 mm

44
Q

ETT sizes ID:

what is the calcualtion for ETT size in peds

A

ETT = (16 + age) / 4

or (age / 4 ) + 4

45
Q

ETT sizes:

how do you calculate the tube length at mouth

A

(cm / 10 ) + 5
or
( Kg / 5 ) + 12

46
Q

Lung Volume

Va (mL /kg /min) of neonate? Child? adult?

A

Neo- 100-150
Child- 80
Adult - 60

47
Q

Lung Volumes:

Frequency ( Min) of neonate? Child? adult?

A

Neo- 40
Child- 20
Adult- 10

48
Q

Lung Volumes:

TLC ( mL/kg) of neonate? Child? adult?

A

Neo- 60
Child- 70
adult-80

49
Q

Lung Volumes:

FRC ( mL/ kg) of neonate? Child? adult?

A

Neo- 30
Child- 32
Adult - 34

50
Q

the decreased FRC in the infant means what with induction w/ inhalation agents

A

faster induction

51
Q
Lung Volumes:
Reserve volume (mL/kg) of neonate? Child? adult?
A

Neo- 20
child- 19
adult- 17

52
Q

Lung Volumes:

Vt (mL/Kg) of neonate? Child? adult?

A

Neo- 6
Child - 7
Adult - 7

53
Q

the increased closing capacity and decreased FRC make neonate prone to what?

A

atelectasis and hypoxia during anesthesia

54
Q

why are neonates diaphragmatic breathers?

A

intercostals muscles underdeveloped
Diaphragm is high
chest cavity is small

55
Q

State the HR; Systolic BP; and Diastolic BP:

Preterm

A

120-180
45-60
30

56
Q

State the HR; Systolic BP; and Diastolic BP:

term

A

100-180
55-70
40

57
Q

State the HR; Systolic BP; and Diastolic BP:

1 yr

A

100-140
70-100
60

58
Q

State the HR; Systolic BP; and Diastolic BP:

3yr

A

85-115
75-110
70

59
Q

State the HR; Systolic BP; and Diastolic BP:

5 yr

A

80-100
80-120
70
adult values

60
Q

EBV:

premature

A

90 mL/kg

61
Q

EBV:

infant

A

80 mL/kg

62
Q

EBV:

toddler 6wk-2yrs

A

75 ml/kg

63
Q

EBV:

child 2yrs - 12 yrs

A

72 mL/kg

64
Q

EBV:

adult male

A

70 mL/kg

65
Q

EBV:

Adult female

A

65 mL/kg

66
Q

how much blood could a 4 kg, 4 month old loose if the hot is 36 and your lower level o f acceptance is hot of 29

A
75 mL/kg x 4 kg =300 mL
300 (36-29) / 36 = X
300 (7) / 36 = X
2100 / 36 = X
58.3 mL = X
67
Q

how do you calculate fluid maintenance for a child

A

4:2:1 rule
4mL/kg for 1st 10 Kg
2mL/kg for 2nd 10 kg
1mL/kg for each kg over 20 kg

68
Q

calculate the hourly fluid maintenance for a 27 kg child

A

4 x 10 = 40
2 x 10 = 20
1 x 7 = 7
= 67 mL/hr

69
Q

State the fetal circulation

A

RA to RV to PA through PDA to aorta (bypass lungs) to infant

RA through FO to LA to LV to Aorta to infant

70
Q

state the normal circulation post delivery

A

RA to RV to PA to Lungs to PV to LA to LV to Aorta to RA

71
Q

what is the TBW%:

preterm

A

90%

72
Q

what is the TBW%:

Term

A

80%

73
Q

what is the TBW%:

6-12 mo

A

60%

74
Q

why are infants of diabetic mothers prone to hypoglycemia?

A

the infant with produce insulin in response to maternal blood sugar to control it’s own blood glucose level. After delivery of the infant, the cord is clamped eliminating maternal blood flow. Now the infant will have their own stored insulin and this insulin will decrease the newborn;s blood sugar

75
Q

why are infants prone to GERD and aspiration

A

incompetent LES

76
Q

what is the most commonly used LA in infants and children i north america

A

Bupivacaine

77
Q

what is the preferred concentration of LA for peripheral nerve block in the neonate

A

0.25% bupivacaine

78
Q

What is the LA drug of choice for continuous infusion in the neonate?

A

Bupivacaine 0.1%

79
Q

which LA can be used for most peripheral blocks and for caudal and epidural infusion in infants and children

A

Bupivacaine

80
Q

what is the suggested maximum dose for bolus of injection int he caudal space or epidural space for older children and neonates? for infants?

A

4 mg/kg

2mg/kg

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