Special Populations

what is blow by oxygen

the “mask” is held near patient’s mouth to increase O2 percentage

when is blow by oxygen used

when a pediatric patient won’t tolerate a mask

6 things to successfully relate to pediatric patients

don’t lie, introduce yourself, appear calm and non threatening, explain what you are doing, involve parents when appropriate, offer an age-appropriate toy

7 differences in pediatric and adult respiratory system

tongue is larger and takes up more space in the mouth, mouth and nose are smaller, trachea is more pliable, funnel shaped larynx w/ narrowest portion at the cricoid ring, trachea narrower and more affected by inflammation and swelling, chest walls less muscular and more pliable, they breathe more from the diaphragm

epiglottitis

infection of epiglottis

how do children with epiglottitis present (6)

hoarseness, drooling, retractions, fever, stridor, sitting forward in “sniffing” position

At what age do children begin to resist separation from their parents?

begins later in infancy and continues through toddler and school age

polypharmacy

use of multiple medications by the same patient

How often should you ventilate a neonate requiring respiratory support?

40-60/min for newborn

if neonate is older, 30-40/min

what makes fontanelles bulge

increased pressure in skull from head injury and meningitis

what makes fontanelles sunken

dehydration

CROUP

viral infection that causes swelling around larynx and trachea

2 s/sx of CROUP

difficulty breathing and seal bark cough

fontanelles

soft spots in infant’s skull

4 types of abuse that children or geriatric patients may face

neglect, psychological, physical, sexual

formula for determining hypotension in a child (greater than 1)

70 + (2 x child's age in years)

For each of the following vital signs explain whether you would see an increase or decrease in the geriatric patient when compared to an adult:

Body temperature

Pulse

Respirations

Blood pressure

Capillary refill

decreased body temp, increase pulse, increase respirations, hypertension, increase in cap refill

2 signs of respiratory distress that are more commonly seen in children

nasal flaring and see saw breathing

why are infants and young children more prone to head injury

they have large, heavy heads that are more likely to strike objects in falls and fontanelles

LVAD

left ventricular assist device used for whose left ventricle is no longer strong enough to pump blood to the body

why are sick infants prone to hypoglycemia

they have limited glucose stores and fast metabolic rates, so when infants are sick, rapid pulse and RR use up limited fuel

atrial fibrillation

irregular heart beat

7 S/Sx of shock in infants and children

lethargy or AMS

not responding to parents or environment

rapid pulse and respirations

crying w/out tears

infrequent urination

sunken fontanelles

increased cap refill

gravida

how many times a woman has been pregnant

3 types of retractions seen in pediatric patients in respiratory distress

intercostal retractions (between the ribs)

suprasternal retractions (above the sternum)

supraclavicular retractions (above the clavicles)

What are the values for each body area in the pediatric rule of 9s?

Head

Anterior Torso

Posterior Torso

Legs

Arms

Genitalia

Head - 18

Anterior Torso - 18

Posterior Torso - 18

Legs - 14 (7 front, 7 back)

Arms - 9

Genitalia - 1