Peds week one Flashcards
1
Q
Midazolam po :
A
0.5-0.7 mg/kg (max. 20 mg)
2
Q
Cefazolin IV :
A
25 mg/kg
3
Q
Succinylcholine IV :
A
1.5‐2 mg/kg
4
Q
Atropine IV :
A
10‐20 mcg/kg IV or 20‐40 mcg/kg IM, (no less than 0.1 mg)
5
Q
Propofol IV:
A
2‐4 mg/kg
6
Q
Vecuronium IV :
A
0.1 mg/kg
7
Q
Fentanyl IV :
A
1‐2 mcg/kg
8
Q
Hydromorphone IV :
A
10‐20 mcg/kg (10x the fentanyl dose)
9
Q
Neostigmine IV:
A
0.07 mg/kg (max 5 mg)
10
Q
Glycopyrrolate IV :
A
10 mcg/kg (no less than 100 mcg’s)
11
Q
Ondansetron IV :
A
0.1 mg/kg
12
Q
Versed iv:
A
0.05 mg/kg (1/10th of the PO dose)
13
Q
2 % Lidocaine iv:
A
1 mg/kg
14
Q
Dexamethasone iv (antiemetic):
A
0.1 mg/kg
15
Q
Prematurity
A
weighing less than 2500gm at birth.
16
Q
Preterm infant is born before
A
37 weeks
17
Q
Term infant is born after
A
37 wks and before 42
completed weeks of gestation.
18
Q
Post‐term infant is born after
A
42 completed
weeks of gestation.
19
Q
The preterm infant is less able to:
A
suck, shiver (maintain normothermia), swallow, eat, breathe
20
Q
Neonates are less than
A
30 days of age
21
Q
Infants are
A
1‐12 months of age
22
Q
Children are
A
1‐12 years of age
23
Q
Adolescents are
A
13‐19 years of age
24
Q
LBW = low birth weight
A
less than 2.5kg
25
VLBW = very low birth weight
less than 1.5kg
26
Extremely low birth weight is less than
1 kg.
27
“Micropremies” = weighing less than
750gm
28
At full‐term birth, the infant has a __ neck
short
29
infants are prone to upper airway
| obstruction during sleep.
they oughta come with their own little CPAP machines
30
In infants with tracheostomy, the orifice is often
buried under the chin unless the head is extended
with a roll under the neck.
put a roll under the neck
31
infants are more prone to upper airway
obstruction under GETA because upper airway muscles, which normally support the airway patency,
are disproportionally sensitive to the depressant
effect of GETA, resulting in pharyngeal airway
collapse and obstruction.
Coté
put in an oral airway
32
infant’s larynx is more __ (C2‐3) vs. adult’s (C4‐5)
cephalad
33
_ primary teeth
20
34
__ permanent teeth
32
35
AVOID nasal trumpets in children with
coagulopathy, thrombocytopenia, or suspicion of a
| traumatic basilar skull fracture!!!
36
What size LMA for child weighing <5 kgs
1
37
What size LMA for child weighing 5-10 kgs
1.5
38
What size LMA for child weighing 10-20
2
39
What size LMA for child weighing 20-30 kgs
2.5
40
What size LMA for child weighing 30-50
3
41
What size LMA for child weighing 50-70 kgs
4
42
How deep should you place the tube?
6 cm for a preterm 2000g, 10 cm for a newborn, 11cm for a 1‐y/o and 12cm for a 2y/o.
43
(MRI/CT studies show __ as narrowest part of the infant larynx
subglottic
| area
44
Laryngospasm is ellicited by stimulation of ___
afferent fibers contained in
| the internal branch of superior laryngeal nerve (SLN). Think A-I-SLN
45
Laryngospasm treatment
identify and remove the offending
stimulus, apply jaw thrust (pressure on “laryngospasm notch” ‐ behind the earlobe), insert oral or nasal airway, apply positive pressure ventilation with 100%
O2, …., deepen anesthesia with SEVO or 0.5 mg/kg
propofol IV, …., 0.1mg/kg succinylcholine IV or up to 4
mg/kg IM (with Atropine 10‐20 mcg/kg IV or 20‐40 mcg/kg
IM)
46
Which cells produce surfactant?
Type 2 pneumocytes
47
At what gestational age is surfactant developed?
between 23-24 weeks gestation and increases in concentration during the subsequent 10 weeks of gestation
48
What does the foramen ovale connect?
right atrium to left atrium, similar to a "valley" between the atria
49
What does the ductus arteriosis connect?
Pulmonary arteries to aorta, so blood can skip pulmonary circulation.
50
What are the two crucial events involved in the immediate transition from the fetal circulation to the normal postnatal pattern?
Decreased PVR and increased SVR (loss of the
| umbilical circulation)
51
The increase in systemic afterload causes an
immediate closure of the flap valve mechanism of
the foramen ovale and reverses the direction of
shunt through the ductus arteriosus
52
Increased pulmonary vascular resistance in response
| to hypoxia and acidosis may precipitate a reversal to
right‐to‐left shunting leading to cyanosis
53
Because the Infant’s rib cage is cartilaginous and the thorax is too compliant to resist inward recoil of the lungs, the chest wall is easily deformed, tending to move
inward on inspiration.
Therefore, inspiration occurs almost entirely as a result of
diaphragmatic descent.
54
Periodic breathing commonly occurs in newborns ‐recurrent
| pauses in ventilation lasting no more than
5 to 10 seconds
55
During hypoxemia, the principle response in adults is
systemic vasodilation, however,
Neonates exposed to hypoxemia experience
pulm &
systemic vasoconstriction, bradycardia and
decreased cardiac output (CO). Give Atropine & 100% oxygen
56
What is an appropriate SaO2 and PaO2 for premature infants?
SaO2 90-95%
| PaO2 60-80 mmHg
57
PCA = sum of
gestational age and chronologic age
58
It is recommended that former preterm infants who
are 55 to 60 weeks' PCA who are not anemic and
not experiencing apnea be observed for an extended
period of time and, if stable, later discharged.
However, infants younger than 55 weeks' PCA, those
| who are anemic (hematocrit
59
Surgery is safe from the __ to the __ day postgestation in the full-term infant
15-56 day, or 2- 8 weeks
60
elective or outpatient procedures should be deferred until the preterm infant reaches at least __ weeks post-conception
60 weeks post-conception
61
Ductus venosus
(connection between the umbilical
vein and IVC) ‐ most umbilical venous blood from the
placenta bypasses the liver IVC RA
62
During the early neonatal period, reversion to the fetal circulation can occur: If hypoxia occurs, ___increases and reopens ductus arteriosus decline
in arterial oxygenation which results in acidosis
which further increases ___ hypoxemia
PVR
| PVR
63
infants have a predominately ___ nervous system with a slowly improving
predominately parasympathetic, slowly improving sympathetic nervous system
64
Stroke volume is __
fixed
65
What is an appropriate heart rate for the infant?
100-180
66
What is the estimated blood volume of the Preterm neonate
90‐100 ml/kg
67
What is the estimated blood volume of the Full‐term neonate
80‐90
68
What is the estimated blood volume of the Infant (< 12mo)
70‐80
69
What is the estimated blood volume of the School‐age child (< 12 yrs)
70
70
What is the estimated blood volume of the Teenager (> 12yrs)/ Adult
65‐70
71
What is the estimated blood volume of the Obese child
60‐65
