wwallace pds final
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| Normal PH in a child is | 7.35 to 7.45, acceptable is 7.3 to 7.5
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| Normal PaCO2 is | 35- 45 greater than 60 is chronic range
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| PaO2 normal range is | 85- 100, 50 to 70 is safe in neonate
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| HCO3 normal is 22-26 | (blank)
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| SPO2 must be at what | above 92 percent
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| Signs of Hypoxemia in newborn are | Pao2 less than 60 or SPO2 less than 90 on room air
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| Goal of O2 therapy in peds is | adequate tissue oxygenation at lowest FIO2
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| Primary indication for O2 therapy is | documented hypoxemia
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| Signs of respiratory distress are | retractions, expiratory grunting, nasal flaring, cyanosis, tachycardia, tachypnea
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| A score of 2 on silver Anderson means what | severe resp distress
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| Common clinical conditions with hypoxemia are | post op pts, CO poisoning, cyanide poisoning, trauma, shock, acute MI
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| Hazards of o2 therapy are | O2 toxicity, atelectasis, override hypoxic drive, ROP RLF, Fip Flp
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| What is flip flop | potential complication with newborns on O2, drop in PaO2 when FIo2 is lowered, then no improvement when FIo2 back up, fix with smaller changes in FIO2
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| what is a blender | mixes O2 and air from 50 PSI to manageable pressure, mixed on front dial to precise FIO2, uses flowmeter and LVN
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| oxyhood or headbox uses what fio2 | 50 or less
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| what gas source is used for an oxyhood | blender and heated LVN
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| what is the liter flow for an oxyhood and why | 7 lpm, to blow of co2
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| where and why do we always analyze co2 in an oxyhood or other equipment that covers a babies face? Close to babies face, as FIO2 can layer | (blank)
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| what are the hazards of oxyhoods | gas flow to low, temp to high or low, always monitor
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| what are the flow rates for a pediatric nasal canula | .25 to 1.0
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| what is the fio2 for a pediatric nasal canulla | 24 to 35 percent
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| hazards of O2 masks are | aspiration of vomit, skin necrosis, decreased FIO2 if mask loose, CO2 retention if low low, minimum flow 5 liters
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| when do we use a tent | for croup, cool mist in O2 rich environment, never with asthma
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| hazards of tents | fog, fire, overhydration, bacteria
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| what is the fio2 of a self inflating resuscitator bag | 80 to 100 percent
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| what is the fio2 of a flow inflating resuscitator bag | 100 percent, needs manometer so not to over inflate lungs
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| SVN delivery for kids under 3 | facemask or blowby
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| MDI spacers are best for what age | over 3 years
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| MDI with space and face mask with what age | under 3
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| Advantages of MDI are | portable, efficient drug delivery, short prep and delivery, great inline, doesn’t stick
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| Disadvantages to MDI are | coordination, fixed concentrations, limited drug choice, propellant allergies, aspiration of foreign body
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| DPI is only good for pt over what age | 6 yrs
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| What is a SPAG | small particle aerosol generator, special neb for Ribavarin, 2 gas sources, flow must be 7 no more than 15 for both. Caution to caregiver and clogged valves
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| The 6 rights to meds are | TRAPDD, Time, Route, Approach, Person, Dose, Drug
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| CPT indications are retained secretions, excessive secretions, aspiration, prophylaxis ie postextubation | (blank)
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| Signs to watch for in CPT | rr and depth apnea in infants, hr and arrhythmias, aspiration, color, bs before and after, airway patency collapse in neonate, over mobilization of secretions, abg decreased spo2, ICP, mental status
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| Contraindications to CPT | hypoxemia (all), vomiting and aspiration (PD)
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| How much can a child weigh before we do positions | over 1500 g or 3 lbs
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| How do we remove secretions from older kids | FET
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| How do we remove secretions from younger kids | oral or nasal sxn
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| PEP for older kids is done how | mask or mouth piece for 10 pep breaths then one 1 or 2 huff coughs for 10 to 15 mins, press is 10-20 cmh20
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| High frequency chest compressions is what | jacket or vest
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| Flutter press is what | 10-25
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| Clinically RT will see what and know suctioning is needed | decreased chest excursion, rhonchi and or course crackles on auscultation, secretions in ETT
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| Increased secretions causes what | increased Raw which decreases airflow and decreases ventilation
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| Suction Catheter equation 2 x ID of ETT then down one size so , a #4 ETT would be 2x4 is 8 so catheter size is 6 | (blank)
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| Non intubated preemie catheter size is | 5-6
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| Non intubated newborn catheter size is | 5, 6 -8
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| Non intubated newborn to 6 months catheter size is | 8-10
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| How far do we insert the catheter | to the tip of the ett or ntt, add 4 cm to cm mark on tube
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| Steps to suctioning are | 1. hyperoxygenate (1 min at 10 to 15 great fio2) 2. insert cath, 3. Press newborn 50 to 80 peds 80 to 100, 4. Rotate and withdraw less than 10 seconds
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| Suction pressure for newborns is | 50 to 80
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| Suction pressure for peds is | 80 to 100
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| Hazards of suctioning are | primarily bradycardia caused by vagus nerve or hypoxemia, others are mucosal damage and atelectasis, airway contamination, extubation, mucosal plugging
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| When is CPAP used | used in spontaneously breathing infants and children with rds or ards
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| What does CPAP do | increases FRC to prevent atelectasis in ARDS increases CL decreases Raw decreases RR
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| How is CPAP administered in neonates and infants | ETT and nasal prongs, ETT in children
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| What are the indications for CPAP | decreased FRC due to pneumonia, atelectasis, pulmonary edema, or airway collapse or weaning from vent, abnormal abg pao2 below 50 on fio2 of 60 or resp distress like hypoxia, tachypnea, etc
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| What are normal pressures for cpap in peds | 5 to 10 and same fio2
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| What are hazards of cpap | misapplied level of cpap can cause hypoventilation resp acidosis decreased CO due to decreased venous return and air leak
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| Pediatric resuscitation ABC’s are | airway, breath, check pulse (no pulse start compressions)
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| Pals resuscitation drugs are | epi, adenosine, bicarb, glucose (aka D25), albumen
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| Defibrillation in children to calculate jules is | 2 jules per kilo
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