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pds final

wwallace pds final

QuestionAnswer
Normal PH in a child is 7.35 to 7.45, acceptable is 7.3 to 7.5
Normal PaCO2 is 35- 45 greater than 60 is chronic range
PaO2 normal range is 85- 100, 50 to 70 is safe in neonate
HCO3 normal is 22-26 (blank)
SPO2 must be at what above 92 percent
Signs of Hypoxemia in newborn are Pao2 less than 60 or SPO2 less than 90 on room air
Goal of O2 therapy in peds is adequate tissue oxygenation at lowest FIO2
Primary indication for O2 therapy is documented hypoxemia
Signs of respiratory distress are retractions, expiratory grunting, nasal flaring, cyanosis, tachycardia, tachypnea
A score of 2 on silver Anderson means what severe resp distress
Common clinical conditions with hypoxemia are post op pts, CO poisoning, cyanide poisoning, trauma, shock, acute MI
Hazards of o2 therapy are O2 toxicity, atelectasis, override hypoxic drive, ROP RLF, Fip Flp
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
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
oxyhood or headbox uses what fio2 50 or less
what gas source is used for an oxyhood blender and heated LVN
what is the liter flow for an oxyhood and why 7 lpm, to blow of co2
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)
what are the hazards of oxyhoods gas flow to low, temp to high or low, always monitor
what are the flow rates for a pediatric nasal canula .25 to 1.0
what is the fio2 for a pediatric nasal canulla 24 to 35 percent
hazards of O2 masks are aspiration of vomit, skin necrosis, decreased FIO2 if mask loose, CO2 retention if low low, minimum flow 5 liters
when do we use a tent for croup, cool mist in O2 rich environment, never with asthma
hazards of tents fog, fire, overhydration, bacteria
what is the fio2 of a self inflating resuscitator bag 80 to 100 percent
what is the fio2 of a flow inflating resuscitator bag 100 percent, needs manometer so not to over inflate lungs
SVN delivery for kids under 3 facemask or blowby
MDI spacers are best for what age over 3 years
MDI with space and face mask with what age under 3
Advantages of MDI are portable, efficient drug delivery, short prep and delivery, great inline, doesn’t stick
Disadvantages to MDI are coordination, fixed concentrations, limited drug choice, propellant allergies, aspiration of foreign body
DPI is only good for pt over what age 6 yrs
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
The 6 rights to meds are TRAPDD, Time, Route, Approach, Person, Dose, Drug
CPT indications are retained secretions, excessive secretions, aspiration, prophylaxis ie postextubation (blank)
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
Contraindications to CPT hypoxemia (all), vomiting and aspiration (PD)
How much can a child weigh before we do positions over 1500 g or 3 lbs
How do we remove secretions from older kids FET
How do we remove secretions from younger kids oral or nasal sxn
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
High frequency chest compressions is what jacket or vest
Flutter press is what 10-25
Clinically RT will see what and know suctioning is needed decreased chest excursion, rhonchi and or course crackles on auscultation, secretions in ETT
Increased secretions causes what increased Raw which decreases airflow and decreases ventilation
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)
Non intubated preemie catheter size is 5-6
Non intubated newborn catheter size is 5, 6 -8
Non intubated newborn to 6 months catheter size is 8-10
How far do we insert the catheter to the tip of the ett or ntt, add 4 cm to cm mark on tube
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
Suction pressure for newborns is 50 to 80
Suction pressure for peds is 80 to 100
Hazards of suctioning are primarily bradycardia caused by vagus nerve or hypoxemia, others are mucosal damage and atelectasis, airway contamination, extubation, mucosal plugging
When is CPAP used used in spontaneously breathing infants and children with rds or ards
What does CPAP do increases FRC to prevent atelectasis in ARDS increases CL decreases Raw decreases RR
How is CPAP administered in neonates and infants ETT and nasal prongs, ETT in children
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
What are normal pressures for cpap in peds 5 to 10 and same fio2
What are hazards of cpap misapplied level of cpap can cause hypoventilation resp acidosis decreased CO due to decreased venous return and air leak
Pediatric resuscitation ABC’s are airway, breath, check pulse (no pulse start compressions)
Pals resuscitation drugs are epi, adenosine, bicarb, glucose (aka D25), albumen
Defibrillation in children to calculate jules is 2 jules per kilo
Created by: williamwallace