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Pediatrics Flashcards

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1
Q

Sensorimotor development takes place at what age?

A

0-2

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2
Q

Preoperational development takes place at what age?

A

2-6

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3
Q

Concrete operational development takes place at what age?

A

6-12

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4
Q

Formal operational development occurs at what age?

A

12-adult

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5
Q

Which group of patients are more inclined to experimental, high-risk behaviours which impact health, response to intervention?

A

adolescents

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6
Q

Psychological development stage when the pt explores the world through direct sensory and motor contact; object permanence and separation anxiety develop during this stage:

A

sensorimotor (0-2 years)

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7
Q

Psychological development stage when the pt uses symbols to represent objects; doesn’t reason logically, is egocentric and has the ability to pretend

A

preoperational (2-6 years)

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8
Q

Psychological development stage when the pt can think logically about concrete objects, can add and subtract, understands conversation

A

concrete operational (6-12 years)

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9
Q

Psychological development stage when the pt can reason abstractly and thinks in hypothetical terms

A

formal operational (12-adult)

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10
Q

Pediatrics have ____ skin and ____ BSA.

A
  • thinner
  • larger
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11
Q

Pediatrics have _____ CNS receptivity and ____ metabolic rate.

A
  • enhanced
  • higher
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12
Q

Anatomical/physiological differences of Peds vs. Adults - the tongue

A

is larger

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13
Q

Anatomical/physiological differences of Peds vs. Adults - trachea

A

more pliable, smaller in diameter

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14
Q

Anatomical/physiological differences of Peds vs. Adults - tracheal rings

A

immature

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15
Q

Anatomical/physiological differences of Peds vs. Adults - epiglottis

A

larger, more U shaped or oblong shaped

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16
Q

Anatomical/physiological differences of Peds vs. Adults - larynx

A

sits at 1st or 2nd cervical vertebra

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17
Q

Anatomical/physiological differences of Peds vs. Adults - mainstem bronchi

A

less angled

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18
Q

Broselow tape is used to:

A

help measure and weigh, calculate meds, airway sizes
(fast and reliable for quick response esp. with trauma)

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19
Q

What assessment is used for general assessment of a sick child?

A

PAT

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20
Q

The goal of PAT assessment is?

A
  1. form general impression of child
  2. establish severity of presentation and category of pathophysiology
  3. determine type, urgency of intervention
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21
Q

The PAT answers what question?

A

sick or not sick

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22
Q

For pediatrics you should maintain a high index of suspicion because:

A

pediatric patients may deteriorate rapidly

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23
Q

Other considerations to your primary survey should include (6):

A
  • change in appetite
  • changes in behaviour
  • excessive drooling (epiglottis)
  • number of wet diapers
  • patient positioning
  • work of breathing
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24
Q

In your secondary assessment of the head, which additional assessment needs to be made for peds (particularly infants):

A

assess fontanelles

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25
3 components of PAT:
- appearance - work of breathing - circulation to skin
26
Components of appearance (PAT):
- abnormal tone - decreased interactiveness - decreased consolability - abnormal look/gaze - abnormal speech/cry
27
Components of work of breathing (PAT):
- abnormal speech - abnormal positioning - retractions - flaring - apnea/gasping
28
Components of circulation to skin (PAT):
- pallor - mottling - cyanosis
29
Immediate clinical intervention is required when there is an abnormality in how many arms of the PAT
1
30
5 categories of the PAT
- respiratory distress - respiratory failure - shock - CNS or metabolic disorder - cardiopulmonary failure
31
Interpret the following PAT finding - normal a, normal WOB, normal CtS
stable
32
Interpret the following PAT finding - normal a, abnormal WOB, normal CtS
resp distress
33
Interpret the following PAT finding - abnormal a, abnormal WOB, normal CtS
respiratory failure
34
Interpret the following PAT finding - normal/abnormal a, normal WOB, abnormal CtS
shock
35
Interpret the following PAT finding - abnormal a, abnormal WOB, abnormal CtS
cardiopulmonary failure
36
Interpret the following PAT finding - abnormal a, normal WOB, normal CtS
CNS/metabolic disturbance
37
GCS for Pediatrics 2-5 - Verbal
appropriate words/phrases = 5 inappropriate words = 4 persistent cries and screams = 3 grunts = 2 no response = 1
38
GCS for Pediatrics 2-5 - Verbal
smiles/coos appropriately = 5 cries and is consolable = 4 persistent inappropriate crying and/or screaming = 3 grunts, agitated, and restless = 2 no response = 1
39
Top 4 pediatric presenting complaints:
- fever - respiratory difficulties - injuries - vomiting/diarrhea (dehydration)
40
What shunts are present in fetal circulation?
- ductus venosus (bypasses liver) - ductus arteriosus (bypasses liver) - foramen ovale (wall of heart)
41
Asphyxiation causes _______ of blood vessels in the lungs, bowels, kidneys, muscles and skin
vasoconstriction
42
With prolonged asphyxia - what begins to decline?
- myocardial function - cardiac output
43
What is caused when a neonate does not effectively breathe?
asphyxia
44
Priorities when clearing the airway
mouth than nose
45
Steps after delivery:
1. airway (clear mouth, nose) 2. cord (clamp/cut) 3. position - neonate supine w/ head/neck slightly extended 4. record time of delivery 5. tag - neonate arm w/ time of delivery/mom's name 6. transport - skin-to-skin, mom can nurse
46
If suspecting a child is in need of protection who do you report to?
- receiving hospital - Children's Aid Society
47
Pediatric fever:
>=38 degrees
48
meningitis concerns (s&s):
- stiff neck - altered mental status - petechiae
49
Dx for pediatric respiratory difficulties:
- reactive airway disease - asthma exacerbation - croup - epiglottis
50
History taking questions in peds respiratory difficulties
- fever - upper respiratory infection s&s - cough - sick contacts - travel - puffer use - wheezing - WOB - drooling
51
What is the leading cause of hospitalization in peds?
falls
52
Trimodal death distribution - first peak
second to mins after injury - only prevention can affect mortality
53
Trimodal death distribution - second peak
mins to hours (rapid assessment, tx can improve mortality)
54
Trimodal death distribution - third peak
days to weeks (multi-organ system failure, definitive care at specialized pediatric center)
55
Peds factors in trauma:
- smaller size - increased risk for multiple organ system injury - higher metabolic rate, larger BSA (increased heat loss) - smaller absolute blood volume (small amounts of blood loss can be a significant % of total blood volume) - head injuries (manage airway, avoid hypoxia, and hypotension)
56
Usually volume depletion in peds is due to:
vomiting/diarrhea
57
Intrauterine, most blood bypasses the liver via ____ and enters _____
ductus venosus; IVC
58
Intrauterine, blood enters right atrium, ___ to ___ % directed through _____ to left atrium
50-60%; foramen ovale
59
Blood from SVC enters right atrium - right ventricle - pulmonary artery - blood moves through ____ to bypass pulmonary vasculature and move into _____
ductus arteriosus; aorta
60
2 potential problems in neonatal transition
- fluid remains in alveoli - blood flow to lungs may not increase
61
1/3 fetal lung fluid is removed during _____ ______
vaginal delivery (remaining fluid passes through alveoli into lymphatic tissues)
62
If neonate is experiencing apnea or weak respiratory effort it means?
fluid is unable to be cleared from lungs
63
Primary apnea
deprived of O2, heart rate falls, respiratory efforts cease
64
Secondary apnea
asphyxia continues, develops deep gasping respirations, HR continues to decline, BP begins to fall, respirations weaken
65
What type of apnea can happen in utero?
primary and secondary
66
Fetus is defined as:
2nd trimester until live birth (still-born may still be considered a fetus)
67
Neonate is defined as:
gestational age + 30 days
68
Infant is defined as:
1-12 months
69
Child is defined as:
toddler to puberty (age 9-12)
70
Adolescent is defined as:
puberty to 18
71
What is the clinical importance of knowing the difference between an infant and a neonate
we can shock an infant but NOT a neonate
72
If core of the baby is blue, we know the problem is what?
lungs haven't opened and started inflating
73
The risk of postpartum hemorrhage significantly increases after how long once the baby has delivered without placenta delivery?
30 mins
74
Third trimester bleeding causes:
- placental abruption - placental previa - preterm birth
75
4 Ts of postpartum hemorrhage:
- Tone - Trauma - Tissue - Thrombin
76
Prolapsed cord with strong pulse - what to do?
- transport - wrap in a warm, moist sterile dressing
77
Possible causes for an unconscious pregnant women:
- head injury - eclampsia - diabetes
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