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Flashcards in Exam 3 - Review Deck (201)
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fasting clear liquids

2 hours


fasting breast milk

4 hours


fasting infant formula

6 hours


fasting solid (fatty or fried foods)

8 hours


0–6 months age specific anxiety

Maximum stress for parent Minimum stress for infants—not old enough to be frightened of strangers


6 months–4 years age specific anxiety

Maximum fear of separation Not able to understand processes and explanations Significant postoperative emotional upset and behavior regression Begins to have magical thinking Cognitive development and increased temper tantrums


4–8 years age specific anxiety

Begins to understand processes and explanations Fear of separation remains Concerned about body integrity


8 years–adolescence age specific anxiety

Tolerates separation well Understands processes and explanations May interpret everything literally May fear waking up during surgery or not waking up at all


Adolescence age specific anxiety

Independent Issues regarding self-esteem and body image Developing sexual characteristics and fear loss of dignity Fear of unknown


if a child has a history of squatting what might there be a concern for?

asthma cardiovascular problems


Sickle cell disease needs

hydration, possible transfusion


The major objectives of pre-anesthetic medication are to

(1) allay anxiety (2) block autonomic (vagal) reflexes (3) reduce airway secretions (4) produce amnesia (5) provide prophylaxis against pulmonary aspiration of gastric contents (6) facilitate the induction of anesthesia (7) if necessary, provide analgesia.


premedication decrease the stress response to anesthesia by preventing what

cardiac arrhythmia


Factors to consider when selecting a drug or a combination of drugs for premedication include: 6 things

childs age idea body weight drug history and allergic status underlying medical or surgical conditions and how they might affect the response to premedication or how the premedication might alter anesthetic induction parent and child expectation the childs emotional maturity personality, anxiety level, cooperation, and physiologic and phychological status.


diazepam oral dose rectal dose

0.1-0.5mg/kg 1mg/kg


midazolam oral dose nasal dose rectal dose intramuscular dose

0.25-0.75mg/kg 0.2mg/kg 0.5-1mg/kg 0.1-0.15mg/kg


lorazepam oral dose



ketamine oral dose nasal rectal IM

3-6mg/kg 3mg/kg 6-10mg/kg 2-10mg/kg


benzodiazepines - as premedication- why do we use preservative free for nasal administration

due to fears of neurotoxicity


recommended doses of anticholinergics are

atropine 0.01-0.02mg/kg scopolamine 0.005-0.010mg/kg glyco 0.01mg/kg


why is atropine more commony used

blocks the vagus more effectively


when is scopolamine better

sedative, antisialagogue and amnestic


when is glycopyrrolate better to be used

sialorrhea associated with ketamine


if a child is seated on a parents or anesthesiologist lap during induction what is strongly recommended

this should be undertaken when the child is wearing diapers or sitting on a thick blanket


how do you engage the child and help make them feel less vulnerable during induction

have the child pick out a favorite lip balm have them seated on the or table distract them by telling them to blow up the balloon and taking deeper and deeper breaths.


airway obstruction during anesthesia is due to

loss of muscle tone in the pharyngeal and laryngeal structures rather than apposition of the tongue to the posterior wall


extension of the head at the atlantooccipital joint with anterior displacement of the cervical spine sniffing position improves hypo pharyngeal airway potency but does not necessarily change the position of

the tongue


what is the most effective means to improve airway latency and ventilation in children undergoing adentonsillectomy

jaw thrust


what is the concern with laryngospasm in children

life threatening complications


what are the factors associated with laryngospasm

Age: greater in infants than older children and adults; the risk decreases with increasing age Recent URTI (<2 weeks) History of reactive airway disease Exposure to second-hand smokeAirway anomalies Airway surgery Airway devices (tracheal tubes, LMA) Stimulating the glottis during a light plane of anesthesia Secretions in the oropharynx (e.g., blood, excess saliva, gastric juice) Inhaled anesthesia (desflurane and isoflurane) Inexperienced anesthesia provider