Pediatrics: Respiratory Distress and Bronchiolitis

Central Cyanosis

• Defined as a blue discoloration of the torso and extremities, indicating hypoxia
• May occur in newborns with normal breathing and pulse rates
• Treatment involves providing blow-by oxygen, warm blankets, and skin-to-skin contact if possible
• If the patient is apneic or has a pulse rate less than 100, start Positive Pressure Ventilation (PPV)

Bronchiolitis

• Defined as an inflammation or swelling of the small airways in the lower respiratory tract due to viral infection
• Can be difficult to differentiate from asthma, but the patient's age is a key clue (children under 1 year old are more likely to have bronchiolitis)
• Common symptoms include wheezing, tachypnea, retractions, and mild hypoxia

Pregnancy and Childbirth

• A woman can become pregnant after starting her menstrual cycle
• Premature newborns are at increased risk for heart defects, low birth weight, and lung issues
• Common causes of premature birth include maternal narcotic use and multiple pregnancies
• Normal heart rate for teenagers is 60-100 beats per minute
• Normal gestation period is 40 weeks

Pediatrics and Neonate Care

• Fluid dosage for pediatrics: 20ml/kg
• Fluid dosage for neonates: 10ml/kg
• Assessment differs from adults in that pain is assessed last in pediatric patients
• Having parents nearby can help comfort inconsolable pediatric patients

Cardiomyopathy in Pregnancy

• Defined as a form of heart failure that occurs in the last trimester of pregnancy or postpartum
• Risk factors include obesity, multiple pregnancies, and African American descent
• Symptoms include smoking, alcoholism, poor nourishment, persistent hypertension, pulmonary edema, pedal edema, hypotension, diaphoresis, and tachycardia

Eclampsia

• High-risk patients include those under 18 and over 35
• Assessment findings include ketones in the urine, pedal edema, headache, and dizziness
• Symptoms include hypertension and seizures

Pneumothorax in Infants

• Causes include meconium inhalation, infection, or aggressive PPV
• Symptoms include non-responsiveness to PPV, unilateral absent breath sounds, and shifted heart tones on the left side

Newborn Care

• During delivery, support the head and do not pull
• Check for a nuchal cord and gently guide the head to deliver the shoulders
• Dry and suction the baby's nose and mouth with sterile gauze and bulb syringe
• Cut the cord 4 inches from the baby's navel, 2 inches from that, and cut in between when no longer pulsating

Ventilation Issues in Newborns

• Most common issue: ineffective BVM seal and head position
• Other possible causes: secretions, pneumothorax, and equipment malfunction

Bradycardia in Newborns

• Most common cause: hypoxia, which responds well to PPV
• Other possible causes: hypovolemia, hyperthermia, pneumothorax, head injury, maternal drug use, hypothyroidism, and acidosis

Thermoregulation

• Defined as the process by which the body maintains temperature through heat gain and loss
• Important in newborn care to prevent hypothermia and hypothermia-related complications