Pediatrics & OB Practice Test

Here are the study notes for the text:

• Airway, Respiration, and Ventilation (Peds)*

Epiglottitis

• Life-threatening condition that causes swelling of the epiglottis and supraglottic tissues
• Signs and symptoms:
  • Looks sick
  • Anxious
  • Sitting upright in sniffing position with chin thrust forward
  • Drooling because of inability to swallow
  • Work of breathing increased
  • Pallor or cyanosis
  • Stridor
  • Muffled voice
  • Decreased or absent breath sounds
  • Hypoxia
  • Sudden onset of high fever and sore throat
• Treatment:
  • Transport
  • Position of comfort
  • Supplemental oxygen if tolerated
  • Do not look in mouth or start IV line
  • Prepare BVM and ET tube one to two sizes smaller than anticipated

Endotracheal Intubation

• Indications:
  • Cardiopulmonary arrest
  • Respiratory failure or arrest
  • Traumatic brain injury
  • Unresponsiveness
  • Inability to maintain a patent airway
  • Need for prolonged ventilation
  • Need for ET administration of resuscitative medications
  • If no IV or IO access available
• Laryngoscope blades used for intubation:
  • Premature newborn: Size 0 Miller/Wis-Hipple
  • Full-term newborn to 1 year old: Size 1 Miller/Wis-Hipple
  • 2 years old to adolescent: Size 2 Miller/Wis-Hipple
  • Adolescent or older: Size 3 Miller/Wis-Hipple or Mac
• Methods for endotracheal tube measurements:
  • Length-based resuscitation tapes up to 77 pounds (35 kg)
  • Uncuffed ET tube:
    • 3.5 mm tube for infants up to 1 year old
    • 4 mm tube for children between 1 and 2 years old
    • Older than 2 years old: 4 + (age / 4)
  • Cuffed ET tube:
    • 3 mm tube for infants
    • 3.5 mm tube for children between 1 and 2 years old
    • Older than 2 years old: 3.5 (age / 4)

Pharmacological Treatment for Asthma

• Bronchodilators – beta-agonists that act to relax smooth muscles in the bronchioles
  • DuoNeb: 2.5 mg of albuterol and 0.5 mg of ipratropium
  • 2.5 mg of albuterol premixed with 3 ml of normal saline
  • Larger child or child of any age in severe distress: Consider 5 mg of albuterol
  • Moderate to severe respiratory distress: Ipratropium
    • 0.25 mg or one puff for children weighing less than 10 kg (22 lbs)
    • 0.5 mg or two puffs for children weighing more than 10 kg (22 lbs)
• IM dexamethasone at 0.6 mg/kg (max dose of 16 mg) can shorten acute exacerbations of asthma

Respiratory Distress

• Signs and symptoms:
  • Pallor or mottled color
  • Irritability
  • Anxiety
  • Restlessness
  • Respiratory rate faster than normal for age
  • Retractions
    • Suprasternal, intercostal, subcostal
  • Accessory muscle use
  • Abdominal breathing
  • Nasal flaring
  • Inspiratory stridor
  • Grunting
  • Mild tachycardia
  • Tripod position

And so on for the rest of the text. Let me know if you'd like me to continue!

Here are the study notes for the text:

• Indications for Endotracheal Intubation*
• Cardiopulmonary arrest
• Respiratory failure or arrest
• Traumatic brain injury
• Unresponsiveness
• Inability to maintain a patent airway
• Need for prolonged ventilation
• Need for ET administration of resuscitative medications
• Laryngoscope blades used for intubation:
  • Premature newborn: Size 0 Miller/Wis-Hipple
  • Full-term newborn to 1 year old: Size 1 Miller/Wis-Hipple
  • 2 years old to adolescent: Size 2 Miller/Wis-Hipple
  • Adolescent or older: Size 3 Miller/Wis-Hipple or Mac
• Pharmacological Treatment for Asthma*
• Bronchodilators (beta-agonists):
  • DuoNeb: 2.5 mg of albuterol, 0.5 mg of ipratropium
  • 2.5 mg of albuterol premixed with 3 ml of normal saline
  • Larger child or child of any age in severe distress: 5 mg of albuterol
• Ipratropium:
  • 0.25 mg or one puff for children weighing less than 10 kg (22 lbs)
  • 0.5 mg or two puffs for children weighing more than 10 kg (22 lbs)
• IM dexamethasone (at 0.6 mg/kg, max dose of 16 mg) to shorten acute exacerbations of asthma
• Epinephrine IM (at 0.01 mg/kg of 1 mg/ml, max single dose of 0.3 mg) for severe respiratory distress, altered mental status, or markedly diminished air movement on auscultation
• Pharmacological Treatment for Bradycardia*
• CPR if heart rate < 60/min
• Epinephrine IV/IO (at 0.01 mg/kg, 0.1 ml/kg of 1:10,000 solution)
• ET tube epinephrine (at 0.1 mg/kg, 0.1 ml/kg of 1:1,000 solution)
• Atropine (at 0.02 mg/kg, may repeat once, min dose of 0.1 mg, max single dose of 0.5 mg) for increased vagal tone or primary AV block
• Treatment of Upper Respiratory Infections*
• Croup:
  • Transport
  • Position of comfort
  • Steroid IV or IM to reduce inflammation (dexamethasone)
  • Nebulized Epinephrine (at 0.25 to 0.5 in 3 ml, 1:1,000)
• Epiglottitis:
  • Transport
  • Position of comfort
  • Supplemental oxygen if tolerated
  • Do not look in mouth or start IV line
  • Prepare BVM and ET tube one to two sizes smaller than anticipated
• Bacterial Tracheitis:
  • Position of comfort
  • Provide supplemental oxygen as tolerated
  • Do not attempt to look in mouth
  • Do not insert an IV line
  • BVM and ET tube one to two sizes smaller than anticipated
• Cardiology and Resuscitation (Peds)*
• Common causes of cardiac arrest:
  • Respiratory arrest
  • Injury, blunt and penetrating
  • Infections of respiratory tract or another organ system
  • Foreign body obstruction
  • Submersion
  • Electrocution
  • Poisoning or drug overdose
  • Sudden infant death syndrome (SIDS)
• Fluid resuscitation dosages:
  • Neonate: 10 ml/kg
  • Newborn and up: 20 ml/kg
• Identify and treat dehydration:
  • Signs and symptoms: dry mucous membranes, tachycardia, sunken fontanelle, sunken eyes, delayed capillary refill, decreased urinary output, absent tears, and weight loss
  • Treatment: IV fluid therapy (normal saline at 10 ml/kg bolus)
• Indications to perform CPR:
  • No pulse
  • Heart rate < 60/min with signs of poor perfusion
  • Pallor, mottling, or cyanosis
  • Apnea
  • Unresponsive with a foreign body obstruction
• Gynecology*
• Signs and symptoms of gynecological infections:
  • Pelvic Inflammatory Disease (PID):
    • Pain that starts during or after normal menstruation
    • Pain localized to right upper quadrant
    • Vaginal discharge
    • Fever and chills
    • Pain or burning during urination (dysuria)
  • Bartholin Abscess:
    • Vulvar pain
    • Pain with intercourse
    • Painful lump in vulvar area
  • Vaginitis:
    • Itching
    • Irritation
    • Discharge
    • Odor
    • Painful intercourse
    • Lower abdominal pain
  • Vaginal Yeast Infections:
    • Itching
    • Burning
    • Soreness in the vagina and around the vulva
    • Vulvar swelling
    • Thick, white vaginal discharge (cottage cheese appearance)
    • Pain during sexual intercourse
    • Burning on urination
  • Vulvovaginitis:
    • Redness
    • Pain
    • Swelling
    • Discharge
    • Burning
    • Itching
  • Cystitis:
    • Suprapubic pain
    • Cloudy urine
    • Urinary frequency
    • Hematuria
    • Dysuria
  • Pyelonephritis:
    • Severely ill
    • Fevers
    • Chills
    • Vomiting
• Signs and symptoms of appendicitis:
  • Early stage:
    • Periumbilical pain
    • Nausea
    • Vomiting
    • Low-grade fever
    • Loss of appetite
  • Ripe stage:
    • Pain in lower right quadrant (McBurney point)
  • Rupture stage:
    • Decrease in pain (decreased pressure)
    • Generalized pain
    • Rebound tenderness
• Treatment of vaginal bleeding:
  • Dysfunctional uterine bleeding:
    • Supportive
    • Position of comfort
    • Dressings or towels to absorb bleeding
  • Traumatic vaginal bleeding:
    • Keep warm
    • Oxygen
    • IV access
    • IV fluids
  • Ectopic Pregnancy:
    • Supplemental oxygen if indicated
    • Give nothing by mouth, including water
    • Left lateral recumbent
    • IV fluid therapy
    • Anticipate vomiting
    • Keep warm
    • Cardiac monitor
    • Transport to nearest facility with surgical capabilities
• Medical (Peds)*
• Identify specific types of seizures:
  • Generalized seizures (involves the entire brain):
    • Tonic-clonic seizure (grand mal)
    • Absence seizure (petit mal)
  • Partial seizures (involves only one part of the brain):
    • Simple partial seizure
    • Complex partial seizure
  • Febrile seizures:
    • Simple febrile seizure
    • Complex febrile seizure
  • Neonatal seizures:
    • Spasms
    • Clonic seizure
    • Tonic seizure
    • Myoclonic seizure
    • Subtle seizure
• Pharmacological treatment for a seizure:
  • Benzodiazepine (anticonvulsant):
    • Lorazepam (Ativan)
    • Diazepam (Valium)
    • Midazolam (Versed)
• Signs and symptoms of meningitis:
  • Fever
  • Lethargy
  • Irritability
  • Poor feeding
  • Bulging fontanel
  • Nuchal rigidity (neck stiffness with movement of neck)
  • Headaches
  • Neck pain
  • Projectile vomiting
  • Photosensitivity
  • Kernig sign and Brudzinski sign

And so on...

Assess your knowledge of epiglottitis, a life-threatening condition in pediatric patients, including its signs, symptoms, and treatment. Test your understanding of this critical condition in pediatric airway management.