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► Med Misc 44 > Peds-other > Flashcards

Flashcards in Peds-other Deck (41)
1

Tonsillectomy and Adenoidectomy:
All children undergoing T&A should be considered at increased rick for what periop complication

airway complication esp if diagnosed w/ sleep apnea

2

Tonsillectomy and Adenoidectomy:
what is the position postop

Left lateral head down

3

Myringotomy and Tympanotomy Tubes:
what is good anesthestic

VAA and N2O
Facemask/LMA

4

Malignant Hyperthermia:
what are 6 early signs/symptoms

Masseter muscle spasm
Tachypnea
Rapid exhaustion of soda lime
tachycardia
Irregular HR

5

Malignant Hyperthermia:
4 intermediate signs/symptoms

warm
Cyanosis
dark blood in surgical site
irregular HR

6

Malignant Hyperthermia: Signs and Symptoms
4 late signs/symptoms

Prolonged bleeding
dark urine
irregular HR
muscle rigidity

7

Malignant Hyperthermia: Monitor Changes
3 early changes

Increased MV
Increased ETCO2
Peaked T waves

8

Malignant Hyperthermia: Monitor Changes
what is the 1st sign of MH

Increased ETCO2

9

Malignant Hyperthermia: Monitor Changes
what is 3 intermediate changes

Increased body temp
decreased O2 sat
Peaked t waves

10

Malignant Hyperthermia: Monitor Changes
how much does the temp increase

1 C Q 5 min

11

Malignant Hyperthermia: Monitor Changes
1 late change

peaked T waves

12

Malignant Hyperthermia:
what usually causes death

V-fib
Renal failure
DIC

13

Malignant Hyperthermia: Biochemical Changes
3 early signs

Hyperkalemia
Increased PaCO2
Acidosis

14

Malignant Hyperthermia: Biochemical Changes
1 intermediate sign

hyperkalemia

15

Malignant Hyperthermia: Biochemical Changes
3 late signs

hyperkalemia
increased CK
Myoglobinurinia

16

Malignant Hyperthermia: treatment
what drug do u give

dantrolene

17

Malignant Hyperthermia: treatment
how much dantrolene and how often do you dose it

2.5 mg/kg Q 5-10 min

18

Malignant Hyperthermia: treatment
what is the max total dose of dantrolene

10 mg/kg

19

Malignant Hyperthermia: treatment
what is the treatment

call for help
IV dantrolene
turn off VAA
maintain anesthetic
hyperventilate w/100% O2 (ambu bag)
Initiate cooling
correct metabolic acidosis
maintain UOP

20

Malignant Hyperthermia:
how do you prepare the machine?

vaporizers out
high O2 flow (10 LPM)
for 20-30 min

21

Neonate: Post birth
what are they placed in

radiant warmers in slight trendelenburg

22

Neonate: Post birth
what are normal respiration

30-60 bpm

23

Neonate: Post birth
normal HR

120-160 bpm

24

Neonate: Post birth
w/ APGAR the 1 min correlates to what?

survival

25

Neonate: Post birth
w/ APGAR the 5 min correlates to what?

neurological outcome

26

Neonate: Post birth
what is the most common cause of neonatal depression

intrauterine asphyxia

27

Neonate: what should you do?
APGAR 0-2

intubate chest compressions

28

Neonate: what should you do?
APGAR 3-4

temp assist w/ ventilation

29

Neonate: what should you do?
APGAR 5-7

stimulation and O2 across the face

30

Neonate:
what are indications for positive pressure ventilation

Apnea
HR

31

Neonate:
assisted ventilation with bag and mask should be at what rate

40/min w/ 100% O2

32

Neonate:
start chest comressions if HR

60 bpm

33

Neonate:
cardiac compression is at what rate

120 bpm

34

Neonate:
vascular access via cancelation of what?

umbilical vein

35

Neonate:
umbilical artery cannulation allows for measurement of what 2 things

blood pressure
ABG monitoring

36

Neonate:
volume expansion may be with what 2 things?

O-neg blood or 10mL/kg of 5% albumin or LR

37

Pediatric laryngospasm can usually be avoided by extubating the pt with certain techniques. identify these tech

awake
deep
(anything in-between is hazardous)

38

which inhalation agent has become the preferred induction agent for peds anesthesia

Sevoflurane

39

the pediatric pt becomes hypothermic in the OR: list 5 expected anesthetic concerns

delayed awakening
cardiac irritability
resp depression
increased pulmonary vascular resistance
altered drug responses

40

why is maintenance of heart rate so crucial in neonates and infants?

stroke volume is fixed by noncompliant and poorly developed LV
CO is therefore strongly dependent of HR

41

A child unexpectedly has cardiac arrest after SCh administration. how would you immediately treat this situation?

treat for hyperkalemia
also long and heroic resuscitation efforts may be required

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