Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HANA PM4B 3 > (SYNOPTIC) Neonates + Paediatrics > Flashcards

(SYNOPTIC) Neonates + Paediatrics Flashcards

1
Q

How do we assess pain in children?

A

Self-report (if child is able)
Behavioural indicators
Physiological indicators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How should pain be assessed when they are unable to tell you verbally, i.e. a neonate?

A

Facial Expression?
0 - relaxed
1 - grimace

Crying?
0 - no
1 - whimper
2 - vigorous crying

Arms?
0 - relaxed
1 - flexed/ extended

Legs?
0 - relaxed
1 - flexed/ extended

Posture?
0 - relaxed
1 - flexed/ extended

State of arousal?
0 - asleep/ awake
1 - restless

Heart rate?
0 - baseline
1 - increase by 10-40BPM
2 - increase by ≥40BPM

Respiratory rate?
0 - baseline
1 - alteration in breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When observing pain of a neonate, and having allocated a score, how are the scores interpreted?

A

1-3: Nurse-controlled measure

  • non-nutritive sucking
  • repositioning

4-7: Consider sucrose/ alternative pain relief + nurse-controlled measures

8-10: Review with medical team
- discuss alternative prescription for pain relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is FLACC, with regard to pain?

A

Pain assessment score

Face
Legs
Activity
Crying
Consolability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some behavioural indicators of pain?

A
  • Irritability
  • Unusual quietness or lethargy
  • Restlessness
  • Sobbing, screaming or whimpering
  • Increased clinging
  • Loss of appetite
  • Laying ‘scared stiff’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some physiological indicators of pain?

A
  • heart rate
  • respiratory rate
  • blood oxygen
  • blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment for mild pain

A

Paracetamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment for mild to moderate pain

A

Paracetamol + NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment for moderate pain

A

Paracetamol + NSAID + codeine?? look at codeine cards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment for severe and very pain

A

Paracetamol + NSAID + morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

For what patient age group is codeine considered suitable?

A

Patients older than 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

For what patient age group is codeine contraindicated?

A

All children under 18yrs who undergo removal of tonsils/ adenoids

For the purpose of sleep apnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do you do in suspected asthma?

A

Diagnosis and assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do you do in diagnosed asthma?

A
  • assess symptoms
  • measure lung function
  • check inhaler technique and adherence
  • adjust dose appropriately (up or down)
  • update self-management plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the management of suspected asthma in neonates and paediatrics?

A

Initiation of treatment with very low-> low dose ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management ladder of diagnosed asthma in neonates and paediatrics?

A

(1) Regular preventer

(2) Initial add-on therapy
- VERY low dose ICS
- ≥5 add LABA/ LTRA
- <5 add LTRA

(3) Additional controller therapies:
- Consider increasing ICS to low dose
- ≥5 add LABA/ LTRA
- no response to LABA: consider stopping

(4) Refer for specialist care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When would you consider moving up the ladder?

A

If using 3 doses or more a week

18
Q

If child is at 5 and still have symptoms what would we do?

A

Objective tests
- FeNO
- Spirometry
- Bronchodilator reversibility

Monitor peak flow for 2-4 weeks if there is diagnostic uncertainty

19
Q

FeNO

A

35ppb or more

20
Q

Spirometry

A

FEV1/FVC ratio < 70%

21
Q

What is LTRA treatment?

A

Leukotriene receptor antagonist therapy

22
Q

What dose of beclometasone dipropionate is considered to be a very low dose for use in children?

A

50 microgram

2 puffs

BD

23
Q

What dose of beclometasone dipropionate is considered to be a low dose for use in children?

A

100 micrograms

2 puffs

BD

24
Q

What dose of beclometasone dipropionate is considered to be a medium dose for use in children?

A

200 micrograms

2 puffs

BD

25
Q

Why should you use a spacer with your child’s inhaler?

A
  • Spacers help get medicine into the lungs more effectively
  • Stop meds from sticking to the back of the mouth
  • Reduces risk of thrush and sores
26
Q

What is the treatment for mild atopic eczema in children?

A
  • emollients
  • mild topical CS

- mild topical corticosteroids (hydrocortisone)

27
Q

What is the treatment for moderate atopic eczema in children?

A
  • emollients
  • moderate topical corticosteroids (betamethasone/ clobetasone)
  • topical calcineurin inhibitors
  • bandages
28
Q

What is the treatment for severe atopic eczema in children?

A
  • emollients
  • potent topical CS (betamethasone/ mometasone)
  • topical calcineurin inhibitors
  • bandages
  • phototherapy
  • systemic treatment
29
Q

Name some side effects of systemic corticosteroid use.

A
  • impairment of growth and healing
  • fluid retention
  • osteoporosis
  • weight gain
  • peptic ulcers
  • altered mood/ psychosis
  • electrolyte imbalances
  • blood glucose increase
30
Q

Name some side effects of topical corticosteroid use.

A
  • may thin skin if very potent

- if used on younger children, may get systemic exposure via skin

31
Q

When should oral antihistamines be offered to children with eczema?

A

Not to be used routinely

Offer 1 month trial of NON-SEDATING to children with SEVERE atopic eczema/ severe itching

Offer 7-14 day trial of SEDATING if ≥6 months with sleep disturbance

32
Q

What is the first line treatment for secondary infections of eczema in children?

A

Flucloxacillin

Erythromycin
- if penicillin allergy

33
Q

What is the treatment for a meningitis infection in children?

A

Broad spectrum ABx

(1) Cephalosporin
- ceftriaxone
- cefotaxime

(2) Add amoxicillin for babies <3 months

34
Q

What is a potential complication of this drug when used in children?

Chloramphenicol

A

Neonates cannot metabolise

Can result in grey baby syndrome

Liver is not mature enough to metabolise correctly

35
Q

What is a potential complication of this drug when used in children?

Sulfonamides

A

Kernicterus in neonates

- Brain damage due to high levels of bilirubin in blood

36
Q

What is a potential complication of this drug when used in children?

Ceftriaxone

A

Kernicterus in neonates
- Brain damage due to high levels of bilirubin in blood

Forms precipitate with calcium

37
Q

What is a potential complication of this drug when used in children?

Nitrofurantoin

A

Haemolytic anaemia in children <3 months

38
Q

What is a potential complication of this drug when used in children?

Tetracyclines

A

Bind to calcium in growing bones + teeth

Causes discolouration

39
Q

What is a potential complication of this drug when used in children?

Quinolones

A

Arthopathy in children

- joint disease

40
Q

What are some common reasons for having to admit term babies?

A
  • Hypoglycaemia
  • Hyperbilirubinaemia
  • Infection
  • Poor feeding
  • Asphyxia during birth
41
Q

What are some common issues for preterm babies?

A
  • hypoglycaemia
  • electrolyte imbalance
  • hyperbilirubinaemia
  • infection/ necrotising colitis
  • respiratory distress syndrome
  • patient ductus arteriosus
    ø condition where blood flows back to lungs from heart
  • intraventricular haemorrhage
42
Q
A

HANA PM4B 3 (67 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions