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Flashcards in Exam 3 - Review Deck (201)
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31

if its a short or long pediatric case can you use regular rubing

no! just because its a short case you should never use regular tubing.

32

If positive pressure ventilation, 100% oxygen, and jaw thrust maneuver fail to break the laryngospasm, further intervention should be undertaken before desaturation and bradycardia develop. Appropriate treatment would include in the following order

IV or IM atropine (0.02 mg/kg), IV propofol (1 mg/kg), and IV or IM succinylcholine (1 to 2 mg/kg IV or 4 to 5 mg/kg IM).

33

For third-space losses,

the replacement volume is based on the severity of the losses: 1 to 2 mL/kg/hr for minor surgery, 2 to 5 mL/kg/hr for moderate surgery, and 6 to 10 mL/kg/hr for major surgery and large third-space losses.

34

how much balanced salt solution should be administered to a child for every 1 ml of fluid lost.

Initial blood loss may be replaced with balanced salt solution at a rate of 3 mL of solution for every 1 mL of blood loss.

35

parental anxiety may be most extreme with children what age?

<12 mos

36

the fear of death is greatest in :

teenagers/ adolescent (13-19 yr o)

37

in peds, the larynx has a higher position in

the neck.

38

the narrowest portion of the larynx in ped patients

the cricoid cartilage (as opposed to the VC's in adults)

39

Full term neonates require higher or lower concentrations of volatiles than infants 1-6 mos of age do?

lower *younger the greater their metabolic rate

40

MAC in preterm neonates increases or decreases with decreasing gestational age?

decreases

41

MAC steadily increases until what age:

2-3 mos

42

After 3 mos, MAC steadily

declines with age *there is a slight increase at puberty

43

Neonates and infants require more succinylcholine on a ______ basis than do older children to produce similar degrees of neuromusculuar blockade b/c of :

-more sux per kilogram basis -the increased ECF volume and larger volume distribution

44

sux is limited to cases requiring

RSI and tx of laryngospasm b/c of risks for bradycardia and MH

45

uptake of inhaled anesthetics is more rapid in infants than older children or adults b/c of the infants

high alveolar ventilation relative to FRC

46

Protein binding of many drugs in decreased in infants which can result in

high circulating concentrations of UNBOUND and pharmacologically active drugs

47

as a group, low gestation age NB's have immaturity of all organ systems and represent the most vulnerable of all peds patients with the highest

morbidity and mortality

48

surfactant is produced by

Type 2 pneumocytes

49

surfactant does

reduces alveolar surface tension -helps maintain alveolar stabiltiy

50

RDS is apparent within

minutes of birth

51

during anesthesia, arterial O2 saturation should be maintained near pts

pre-op levels *100% before = 100% during

52

goal HCT to optimize systemic O2 delivery

40% (but you might see something like 45%)

53

excessive hydration should be avoided; so use colloids over crystalloids. whats the replacement ratio?

3:1

54

Bronchopulmonary dysplasia (BPD) is a form of

chronic lung disease of infancy

55

the canalicular phase of lung development is at how many weeks?

24-26 weeks

56

BPD is a clinical dx defined as

-O2 dependence at 36 weeks post conceptual age or -O2 requirement to maintain PaO2 > 50mmHG beyond 28 days of life in infants with birth weights of less than 1500g

57

BPD tx is to maintain oxygenation of: why? prevents and promotes what?

PaO2 > 55 mmHG and O2 sat >94% prevents cor pulmonale (RHF) and promote growth of lung tissue and remodeling of pulmonary vascular bed

58

IN children w/a hx of mechanical ventilation, an ET one to one half size smaller than that predicted for age should be use because:

subglottic stenosis may be present

59

in the preterm newborn, airway hyperreactivity is likely. what plane of anesthesia must be established before airway instrumentation?

deep plane

60

in the preterm newborn, fluids should be administered judiciously to avoid

pulmonary edema