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Phy Ass & peri OP
Chap 33, 37 Mat/Chi
| Question | Answer |
|---|---|
| Normal VS Newborn Temperature | 96.8 - 99 Axillary (36 - 37.2) |
| Normal VS Newborn Pulse | 120-160 bpm |
| Normal VS Newborn Resp Rate | 30 - 60 breaths/min |
| Normal VS Newborn Blood pressure | Systolic: 60 - 99 Diastolic: 30 - 62 |
| Normal VS 4yrs Temp | 97.5 - 98.6 Axillary (36.4 - 37) |
| Normal VS 4yrs Pulse | 80-125 bpm |
| Normal VS 4yrs Resp Rate | 20-30 breaths/min |
| Normal VS 4yrs BP | Girls: Systolic: 91-104 Diastolic: 52-66 Boys: Systolic: 93-107 Diastolic: 50-65 |
| Normal VS 10yrs Temp | 97.5 - 98.6 Oral (36.4 - 37) |
| Normal VS 10yrs Pulse | 70-110 bpm |
| Normal VS 10yrs Resp Rate | 16-22 breaths/min |
| Normal VS 10yrs BP | Girls: Systolic: 102-115 Diastolic: 60-74 Boys: Systolic: 102-115 Diastolic: 61-75 |
| Normal VS 16yrs Temp | 97.5 - 98.6 Oral (36.4 - 37) |
| Normal VS 16yrs Pulse | 55-90 bpm |
| Normal VS 16yrs Resp Rate | 15-20 breaths/min |
| Normal VS 16yrs BP | Girls: Systolic: 111-124 Diastolic: 66-80 Boys: Systolic: 116-130 Diastolic: 65-80 |
| Fontanel: inspected for.... | size, tenseness, pulsation |
| Anterior Fontenal Closes at age... | 12-18 months |
| Posterior Fontenal Closes at age... | 6-8 wks |
| Bossing... | Frontal enlargement |
| 4 normal findings in children | Small,firm,nontender,shotty(freely palpable&very small)lymph nodes; Tonsils of varying size(often larger n young child); PERRLA; pulses n upper&lower extremities & bilaterally symmetric |
| 5 steps for assessing heart sounds | 1.Identify rate & rhythm 2. Identify S1 & S2. 3. assess S1 & S2 separately to determine where best heard 4. Listen for extra heart sounds. 5. Identify murmurs |
| Count RR & apical heart rate... | before taking other VS |
| Measure apical heart rate for 1 min on.... | any child <2, child being assessed for the first time, any child with irregular heartbeat, any child whos treatment decisions are determined on basis of heartrate |
| During assessment of RR and effort abdominal movement is observed in? | Infants and young children |
| During assessment of RR and effort thoracic movement is observed in? | Older children & Adolescents |
| 3 things to evaluate while assessing RR... | 1. Quality of RR; 2. symmetry of chest movement with each breath; #. any noisy respirations |
| If BP reading is hyper/hypo in a child, What do u do? | Follow up with manual cuff |
| Capillary refill on children is... | < 2sec |
| Who is head circumferance measured on? | all children from birth to 36 months |
| Philtrum | little notch between nose and upper lip (should be intact) |
| Children by age 30 months should have ? teeth | 20 |
| 5 types of eye charts: | 1. Snellen Chart- has to know alphabet(20 ft) 2. Tumbling E (20) 3. Lea Chart-4 different symbols (10) 4. HOTV Chart-points to letter on the card n their lap (10) 5. Ishihara Chart- colorblindness |
| Pectus Excavatum | Funnel Chest (curve inward at sternum) |
| Pectur Carinatum | Pigeon Chest (curve outward at sternum withsides of chest sunken in) |
| What position is best for a boy during Genitalia exam? | Tailor Position (crossed-legged) |
| Gross Motor Devel in Infants Raises head & holds position | 2wks-2mo |
| Gross Motor Devel in Infants Moves all extermities, Kicking arms/legs | 2mo |
| Gross Motor Devel in Infants Draws up knees & raises abs off table, rocks when up on knees, rolls over | 3-6mo |
| Gross Motor Devel in Infants Sits alone using hands for support (tripod fashion) | by 7mo |
| Gross Motor Devel in Infants inchworm, may move backwards (crawfishing), creeps & rolls | By 9mo |
| Gross Motor Devel in Infants Crawls in one-sided manner (use both arm and leg on right/left side) | 6-9mo |
| Gross Motor Devel in Infants crawls correctly | 6-9mo |
| Gross Motor Devel in Infants begins to pull up | by 11mo |
| Gross Motor Devel in Infants Cruises: attempts to walk with support | by 12mo |
| Gross Motor Devel in Infants Sits from standing posture | by 12mo |
| Gross Motor Devel in Infants walks alone | by 15mo |
| Define and give examples of Neurologic Soft Signs.... | R findings that indicate inability to perform activities related to age which pose a potential problem: Short attention span, poor motor cord. Hyperkinesis, uneven perceptual development, incomplete laterality(favor neither R/L), mirroring movements |
| If a Preanesthetic Drug is used what r 5 precautions u should do: | 1.Guard the patient’s safety; 2.Minimize physical discomfort or pain; 3.Minimize negative psychological responses to treatment; 4.Control behavior; 5.Return the patient to a state in which safe discharge is possible |
| 2 common Preanesthetic Drug | Midozolam (Versed) Chloral Hydrate |
| orally administered sedative/hypnotic used to decrease anxiety and induce sleep without depressing respiration or cough reflex | Chloral Hydrate |
| given orally or IV and has a short duration, predictable and rarely causes respiratory depression. Provides preoperative anxiety reduction, amnesia, and sedation. | Midozolam (Versed) |
| 6 Fasting Recommendations to Reduce the Risk of Pulmonary Aspiration | 2hr:Clear Liquids & Breast Milk 2hrs; 6hrs:Infant Formula,Non human milk,Light meal (toast & clear liquids) Meal including fried or fatty food or meat increase emptying time. |
| Atelectasis | common complication after surgery (respiratory) |
| 4 main postOP care | 1.VS 2.surgical site checked for drainage 3.assess for PAIN; 4. Neuro assessment |
| Early signs of Malignant hyperthermia | tachycardia, rising blood pressure, tachypnea, mottled skin and muscle rigidity |
| Define: Malignant hyperthermia | inherited disease that causes a rapid rise in body temperature (fever) and severe muscle contractions when the affected person receives general anesthesia. |
| 4 Restraining Methods | Therapeutic hugging Jacket restraints Mummy or swaddle restraint Limb restraints |
| 3 important assessments when using restraints | Check the extremity distal to the restraint for circulation, sensation, and motion every 15 minutes for the first hour, and subsequently as agency policy dictates. Remove restraints every 2 hours for ROM and repositioning Document care above |
| 3 readiness to advance signs for I | No vomiting or diarrhea or cramping Increased appetite Good bowel sounds |
| 1gram = | |
| Ibuprofen mayNOT be given to? | infants under 6 months old |
Created by:
mromerobr
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