FP-C Neonatal & Pedi

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Author:
tamarkp
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275962
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FP-C Neonatal & Pedi
Updated:
2014-06-02 19:59:50
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Neonate fpc
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FPC
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  1. Define Neonate
    Birth to 28 days
  2. Define an infant
    28 days to 1 Y/O
  3. Define Child
    1 Y/O - 10 Y/O
  4. Which do you suction first mouth or nose?
    Mouth then nose (alphabetical)
  5. Is Meconium dangerous?
    No it is sterile but it signifies stress
  6. Is deep suction (below vocal chords) used after delivery?
    No. Unless neonate is not vigorous and meconium is present.
  7. What affect does meconium have on surfactant?
    Surfactant is inactivated by meconium.
  8. What does an isolette (incubator) do?
    • Maintains heat
    • Provides supplemental O2
    • Protects from environment
  9. What are indications that an isolette is needed?
    • < 5 Lbs
    • Distressed neonate
  10. What are the top 3 killers of neonates in the first 24 hours?
    • Sepsis
    • Respiratory Complications
    • Cardiac Problems
  11. Preterm =
    • Incubator
    • Surfactant
  12. Rupture of Membrane =
    Prepare for delivery
  13. What are sign and symptoms of infant seizures?
    • Lip smacking
    • Tongue thrusting
    • Eyes fluttering
    • Lowered O2 Sats
  14. Subtle Seizures are also known as what?
    Complex Partial Seizures
  15. What are common causes of subtle seizures?
    • Hypoglycemia
    • Opiod withdrawal
  16. If you see Choanal Atresia what should I think?
    Intubation
  17. How long are infants obligate nasal breathers?
    6 months
  18. What is another term for Respiratory Distress Syndrome (RDS)?
    Hyaline Membrane Disease (HMD)
  19. What is the #1 killer of premature infants born < 38 weeks?
    Respiratory Distress Syndrome (RDS)
  20. When transporting preterm infants what should you consider using?
    Surfactant (given via ETT)
  21. Persistent Pulmonary Hypertension of the Newborn (PPHN) will likely have what?
    • Patent foramen ovale
    • patent ductus arteriosus
  22. What is Omphalocele? How is it treated?
    • "O" Abdominal ring, protrusion viscera (missing abdominal wall)
    • Attached to the umbilical chord
    • Treatment: (Like abdominal evisceration)
    • Maintain body temperature
    • Cover with moist, sterile dressing
    • Keep NPO
    • Requires surgical repair
  23. What is Gastroschesis? What is the treatment?
    • Abdominal contents are coming out of the body on one side of the umbilical cord.
    • Treatment: (Like abdominal evisceration)Maintain body temperatureCover with moist, sterile dressingKeep NPORequires surgical repair
  24. What is used for increased CSF in congenital hydrocephalus?
    Ventriculoperitoneal Shunt
  25. What treatment for a build up of ICP for congenital hydrocephalus?
    • Mannitol
    • Raise head of bed 30 degrees (semi-fowlers)
  26. What is a tell tale sign of Shaken Baby Syndrome?
    Retinal hemorrhages
  27. In a newborn with a HR ≤ 60 and D-stick ≤ 60:
    • Administer Epi 1st (1:10000) 0.1 - 0.3 ml/kg by IV or ETT
    • Administer Glucose next 2cc/kg D10
  28. Cardiomegaly + Hepatomegaly = 
    Treatment?
    • CHF
    • Treatment:
    • Stop all IV fluids
    • Administer Digitalis
  29. What is the most common cardiac defect in children?
    • Ventricle Septal Defect (VSD)
    • A hole between the ventricles
  30. PGE1 (prostaglandin E1) keeps what open? What can it cause?
    • Patent Ductus Arteriosis (PDA)
    • Apnea
  31. How are patent Ductus arteriosis found?
    • Physical exam
    • Checking for femoral pulses
  32. What is a "tet spell"?
    How are they characterized?
    • Tetralogy of Fallot
    • Sudden cyanosis and syncope
  33. How do we treat a "tet spell"?
    • Knees to chest
    • Morphine
    • If unsuccessful:
    • RSI
    • 100% O2
  34. How many veins and arteries does and umbilical cord normally have? what is it caused when it is different?
    • 2 arteries, 1 vein
    • 1 artery, 1 vein is called "single artery cord" (Renal system is likely affected)
  35. What is the ETT Diameter formula?
  36. What is the 2/3/4/ rule?
    • 2 X ETT Size = Suction/NG Foley diameter
    • 3 X ETT Size = ETT Insertion depth
    • 4 X ETT Size = Chest Tube Size
  37. When do you use an uncuffed vs cuffed ETT?
    • ≥ 5.5 Cuffed ETT
    • < 5.5 Uncuffed
  38. At what age would you consider a cricothyroidotomy?
    >11 Y/O
  39. What is the Normal Systolic B/P formula?
    90 + (2 X Age)
  40. What is the hypotensive Systolic B/P formula?
    70 + (2 X Age)
  41. What is the Pediatric Fluid Resuscitation Formula?
    • Neonate/Infant      10cc/kg
    • Child                     20cc/kg
    • *Never give more than 2 bolus infusions
  42. What is the Pediatric Maintenance Fluid Formula? (4, 2, 1)
    1 - 10      →      4cc/kg/hr

    10 - 20    →      2cc/kg/hr

    > 20        →      1cc/kg/hr
  43. What is the Pediatric Glucose Management formula?
    • Neonate      2cc/kg   D10
    • Infant        2cc/kg    D25
    • Child          2cc/kg   D50
  44. When do we think about giving glucose?
    D-stick < 60mg/dL
  45. Stridor is a/an ___________ problem and involves the __________ airway.
    • inhalation
    • upper
  46. Wheezing is a/an ____________ problem and involves the _____________ airway.
    • exhalation
    • lower
  47. What is Bronchiolitis?
    What is it often caused by?
    • Swelling of the bronchiole walls
    • Respiratory Syncytial Virus (RSV)
  48. Is RSV contagious?
    • Yes 
    • Isolation is required
    • Watch for apnea!
  49. Is Croup life threatening?
    No
  50. What is Croup?
    What are the S&S?
    How is it treated?
    • Swelling around the vocal chords
    • S&S:
    • Gradual onset with URI, no drooling, Seal like bark
    • Steeple Sign on x-ray (the crow lives in the steeple) Crow = Croup
    • Treatment:
    • Racemic Epinephrine and steroids (Decadron)
  51. What is Epiglottitis?
    What are the S&S?
    How is it treated?
    • Swelling of the epiglottis
    • S&S:
    • Sudden onset, Drooling, "Tripod position"
    • Thumb sign on x-ray
    • Treatment:
    • DO NOT DISTURB CHILD!
    • Antibiotics, humidified o2
  52. When falling what part of the body does the child hit first?
    Head
  53. What is the most common cause of traumatic death in pediatrics?
    MVA
  54. What is the most commonly injured organ?
    Skin
  55. At what point of blood lose do children show signs of compensation?
    How do they compensate?
    • >25% blood loss
    • Tachycardia
  56. With an altered LOC pediatric of unknown cause what is the treatment?
    • Flumazenil (top choice)
    • Narcan
  57. What is a child's primary emotion?
    Fear

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