Peds Lecture 1

Question 1

Neonate: Normal Vital Signs

HR:

Systolic BP:

Diasolic BP:

Answer 1

HR: 140

Systolic BP:70-75

Diastolic BP: 40

Question 2

12 months (Infant): Normal Vital Signs

HR:

Systolic BP:

Diastolic BP:

Answer 2

HR: 120

Systolic BP: 95

Diastolic BP: 65

Question 3

3 yrs (toddler): Normal Vital Signs

HR:

Systolic BP:

Diastolic BP:

Answer 3

HR: 100

Systolic BP: 100

Diastolic BP: 70

Question 4

12 yrs (school age): Normal Vital Signs

HR:

Systolic BP:

Diastolic BP:

Answer 4

HR:120

Systolic BP: 110

Diastolic BP: 60

Question 5

Neonatal/infant normal HR

Answer 5

100-160

Question 6

You can estimate an appropriate MAP of a preterm baby by what?

Answer 6

Gestational age

○ Ex: 25 weeker should have a MAP ~ 25mmHg

Question 7

HoTN for neonates is SBP < _____ mmHg

Answer 7

60 mmHg

Question 8

What is the formula to estimate SBP for older kids?

ex. 5 yr old

Answer 8

(age X 2) + 70

(5x2) + 70 = 80

SBP of 80 is normal for a 5 year old

Question 9

HoTN for:

Term Neonates (0-28day):

Infants (1-12 mths):

Children (1-10 yrs)

Children > 10 yrs:

Answer 9

HoTN for:

Term Neonates (0-28day): < 60 mmHg

Infants (1-12 mths): < 70 mmHg

Children (1-10 yrs):
< 70 mmHg + (2x age)

Children > 10 yrs: < 90 mmHg

Question 10

Hemoglobin lvls at birth are?

Answer 10

18-20 g/dL

Question 11

neonates have what % of fetal hemoglobin?

Answer 11

about 70-90%

Question 12

Why do infants around 3-4 months experience physiological anemia

Answer 12

decreased erythropoietin activity and decreased in rate of hematopoiesis (RBC production)

Question 13

Estimated Blood Volume:

-Premature:

Answer 13

90-100 mL/kg

Question 14

Estimated Blood Volume

-Newborn (<1mnth):

Answer 14

80-90 mL/kg

Question 15

Estimated Blood Volume

-Infant –> toddler
(1month-3yrs)

Answer 15

75-80 mL/kg

Question 16

Estimated Blood Volume:

child >6yr

Answer 16

65-70 mL/kg

Question 17

Estimated Blood Volume:

adult:

Answer 17

65-70 mL/kg

Question 18

HgB F P50 is ___

Hgb P50 is ___

Answer 18

HgB F P50 is 19 mmHg

Hgb P50 is 26.5 mmHg

Question 19

Hgb F has 2 ___ chains & ___ gamma chains

Answer 19

Hgb F has 2 alpha chains & 2 gamma chains

Question 20

T or F: Hbg F can bind to 2,3-DPG

Answer 20

F it can not bind to 2,3-DPG bc it doesn’t have the beta chain

Question 21

Adult Hbg has 2 ___ chains and ___ beta chains

Answer 21

○Hgb A with 2 alpha chains & 2 beta chains

Question 22

alveolar ductal development starts around ___ wks of gestation

Answer 22

24 weeks

children born before 24 wks have a low survival chance dt immature lungs and vascular system that allows adequate gas exchange

Question 23

Neonatal aveloar surface area is ____ of the adult. the alveoli will increase in # and size until about ___ yrs old

Answer 23

1/3 surface size

& 8 yrs old

Question 24

Surfactant production & secretion begins at ___ - ___ weeks gestation

Answer 24

22-26 weeks gestation

Question 25

What type of cells create surfactant

Answer 25

Type II pneumocytes peak production occurs at 35-36 wks gestation

Question 26

4 breathing mechanics that put newborns at a disadvantage with breathing include:

Answer 26

pliable chest wall ■d/t lack of muscular development Horizontal ribs ■Don’t provide a lot of assistance w/ chest wall expansion ■When the neonate inhales - the chest wall collapses inward and they have a paradoxical breathing pattern Flat diaphragm : ■Less dome-shaped than the adult diaphragm Less type 1 muscle fibers ■Type 1: Slow-twitch muscle fibers that are resistant to fatigue ■When the infant starts using the intercostal muscles when breathing, they fatigue faster ●this leads to resp. depression/distress

Question 27

Newborns metabolic rate and O2 consumption is __ x that of an adult

Answer 27

2x

Question 28

Vm in newborns are dependent on ___?

Answer 28

dependent on RR not Vt They have relatively fixed Vt 6-8mL/kg, so they cannot increat their Vt to compensate for a low Vm

Question 29

Normal RR for a newborn is ___

Answer 29

40-60 BPM

Question 30

Normal RR for a 3yr old is ___

Answer 30

30s

Question 31

T or F: newborn to young children have a greater FRC

Answer 31

F: decreaed FRC dt changes with musculature and alveoli. Even worse under GA. ■Paired w/ increased metabolic rate & O2 consumption → they desaturate very rapidly! ■A lot less reserves than in adults ■important when ventilating/intubating children → preoxygenate & don’t take a long time to intubate