Intro to ped
Terms
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- Activated Charcoal
- Reduces drug absorbtion in toxic ingestions
- Adenosine
-
SUPRAVENTRICULAR
TACHYCARDIA - ATROPINE SULFATE
- TREATS SYMPTOMATIC BRADYCARDIA
- BRETYLIUM TOSYLATE
-
TREATS VENTRICULAR
TACHYCARDIA AND VENTRICULAR
FIBRILLATION PROPHYLAXIS - CALICUM CHLORIDE
-
TREATS HYPOCALCEMIA,
HYPOMAGNESIUMA, HYPERKALEMIA,
CALIUM CHANNEL BLOCKER OVERDOSE - DEXTROSE
- TREATS HYPOGLYCEMIA- CAUSE OF DEHYRDATION
- INOTROPIC AGENTS
- Treats hypotension or hypoperfusion, CHF, or cardiovascular shock
- Epinephrine
- Treats bradycardia or asystolic arrest
- Lidocaine
- Treats recurrent ventricular tachycardia, ventricular fibrillation, or ventricular ectopy
- Naloxone Hydrochloride
- Reverses effects of some narcotics
- Sodium Bicarbonate
- Treats severe acidosis associated with cardiac arrest, unstable hemodynamic status, hyperkalemia, or certain toxic ingestions
- Infants and children up to the age of 18 months can show signs of what kind of anxiety?
- Separation and stranger anxiety
- Toddlers do not respond well to what?
- Restrictions and they tend to push any limits imposed
- Pre-School age is the stage of?
- Fear and Fantasy
- Teach school age children ....
- Coping techiniques that work for them
- Most common emotions expierenced by parents of children cared for in emergencies is?
- Fear and Anxiety
- Parents are afriad of the following possibilities...
-
Their child might die,
Their child might experience pain, and that their child may be permenantly altered. - Developmental Guidelines for Infants
- allow use of pacifier, use quiet soothing voice, touch rock or cuddle, keep warm, try to relieve parents fears so they are not communicated with child
- Developemental Guidelines for toddlers
- Keep toddler up when giving procedure, perform most distressing procedure last, allow familiar objects, keep away frightening objects, give praise and use distraction
- Developmental Guidelines for Pre-Schoolers
- explain procedures right before performing, talk threwout whole procedure discribing how it will feel, distract child with noises or objects, avoid criticism, encourage talk
- Guidelines for School Age Children
- Offer simple choices whenever possible, ask child about level of understanding, address fears and concerns directly, give rewards
- Guidelines for Adolescents
- Preserve modesty, give choice about parents in or out of room, provide opportunity for questions, listen to concerns nonjudmentally, don't tease them, explain procedures carefully and allow choices.
- First Impression Assessment without touch
- Respiratory Rate and Effort, Skin Color, and Response to the Environment.
- You assess the ABCDE's during
- the primary assessment
- 2 Most common ways of death in children
- Respiratory Failure and Shock
- Signs of serious breathing disorders
- Substernal, intercoastal subclavicular retractions, nasal flaring, head bobbing, grunting, stridor, upright positioning, prolonged expirations, slow respiratory rate
- Abnormal Skin Coloring
- Cyanosis, Mottled, or Pale
- Children are more at risk for what than adults
- Airway Problems
- When assessing airway pay particular attention to these airway sounds
- Snoring, stridor, wheezing, and grunting
- Snoring is
- caused by an obstruction in the upper airway and can be heard in children with decreased mental status
- Stridor is
- High pitched sound heard on inspiration or both inspiration and expiration
- Wheezing is
- high pitched musical sound heard primarily on expiration, signals obstruction of the lower airway
- Crackles or Rales are
- fine popping noises heard on inspiration and usually indicate that fluid is in the lungs signaling pneumonia
- Nasal Secretion can cause
- respiratory compromise
- A child airway is _____________ than an adult
- narrower
- Cartiage of the larnyx is relatively __________ and trachea is __________ and more _________ than an adult
-
Soft
Thinner
Flexible - Infants and children have a higher ___________ rate and increased __________ demand
-
Metabolic
Oxygen - Hypoxia occurs more of less rapidly in children
- More
- A rapid repiratory rate and shallow breathing indicate
- Respiratory Distress
- Very slow breathing in an ill child is an ominous sign indicting
- Respiratory Failure
- Increased work of sounds breathing with quiet breath sounds indicate
- An absence of breathing with quiet sounds indicating an absence of air entry into the lung fields
- Abdominal breathing is normal in an infant of young child so nurses observe for the rise and fall of the _______ instead of the chest
- Abdomen
- Normal respiratory rate for children vary by range and are faster than adults, but any rate over ___ breaths per minute is abnormal
- 60
- Cardiovascular assessment includes
- skin color and temp, capillary refill, assessing central and peripheral pulse rate and quality
- Tachacardia and decreased peripheral perfusion are early signs of
- cardiovascular compromise in a child and require immediate intervention
- Alteration in level of consciousness can be the first sign in
- respiratory distress
- Rapid neurologic assessment consists of 2 components
-
pupillary reactivity and size
and a brief mental status assessment - AVPU stand for
- Alert, responds to Voice, responds to Pain, Unresponsive
- Progressive loss of consciousness may be a result of
- Hypoxemia, Hypoglycemia, Increased intercranial pressure
- Exposure is
- removing the childs clothing to identify additional injuries or indicators of illness
- Components of secondary assessment
- Vital Signs, assessing for pain, history and head to toe assessement and inspection
- For Vitals of children take _________ first, than _________. ___________ and ________ should be taken last
-
Respiratory Rate
Pulse
Temp and BP -
A
M
P
L
E - Allergies, Medications taking and immunizations, Prior illness or injury, Last meal and eating habits, Events leading to injury or illness
- Sign of hematuria suggest
- Urinary/Genital injury or infection
-
Estimate Child Weights
1 year
5 years
10 years -
1= 10kg
5= 20kg
10= 30kg - 1 breath for every in cpr
- 3 seconds or 20 a minute
- Most common type of shock is hypovolemic shock, and it is caused from
- Hemorrhage, burns and dehydration.
- Distributive Shock is the result of an abnormality in the distribution of
- Blood flow or inability of the body to maintain vascular tone through vasoconstriction.
- Septic shock is most common form of distributive shock and it occurs when
- Microbial toxins are present in blood
- Anaphylaxis, central nervous system or spinal injury and drug intoxication are other forms of _________ shock
- Distributive Shock
- Signs of Hypovolemic Shock
- Dry mucous membranes, depressed fontanel, cold clammy skin, oliguria, poor skin turgor, reduced capillary refill
- Signs of Distributive Shock (Septic) Early
- Vasodilation, extermities that are warm to touch, purpuric skin lesions, tachypnea
- Signs of Septic Shock Late
- Rapid, thready pulse, cyanosis, cold clammy skin, narrow pulse pressure, oliguria or anuria
- Signs of Cardiogenic Shock
- Hepatomegaly, Cardiomegaly, increased central venous pressure, periorbital edema, crackles, diaphoresis, oliguria, reduced capillary refill, reduced peripheral pulses
- Cardiogenic shock occurs when
- Myocardial function is impaired so that cardiac output is not sufficient to meet the body's metabolic demands