ENPC 5th edition(Emergency Nursing Pediatric Course 5th Edition)
Neonate characteristics: - ANS Birth to 4 weeks
If preterm neonate until original due date plus 28 days
Loses 5-10% weight by 3-4th day of life
Flexion normal posture
Limited glycogen store
Nose breathers
Infant characterist...
ENPC 5th edition (Emergency nursing
pediatric course 5th Edition)
Neonate characteristics: - ANS Birth to 4 weeks
If preterm neonate until original due date plus 28 days
Loses 5-10% weight by 3-4th day of life
Flexion normal posture
Limited glycogen store
Nose breathers
Infant characteristics: - ANS Nose breather until 6months
And muscle to breathe
Metabolic rate 2x adult (increased need for oxygen and glucose)
Toddler characteristics: - ANS Babinski réflex normal until walking
Plantar réflex at 2 years
And muscles to breathe
Most common cause of bradycardia in peds - ANS hypoxia
When to begin chest compressions in peds - ANS when HR is below 60bpm
Suctioning the neonate - ANS increases the risk for decreased cerebral blood flow
decreased pulmonary oxygenation
bradycardia
suction mouth then nose
Neonate first minute emphasis - ANS ventilation not intubation
Lower glucose levels in Neonate - ANS associated with potential for brain injury
, stress of respiratory and circulatory efforts metabolize existing glucose
D10 IV for glucose <40mg/dL
normal heel stick at birth 30 mg/dL
normal heel stick at 24h 45 mg/dL
Neonatal CHD - ANS compare pulse ox from right hand to either foot (difference >3%
suggest dx)
considered in infant presenting with respiratory distress or shock (with absence of fever)
s/s include shock, cyanosis, tachypnea, or pulmonary edema
Neonatal cyanosis - ANS look inside the mouth at gum line for purple/blue color of
tongue and gums - central
look for hands and feet to change color - peripheral
Respiratory Distress in peds patient - ANS characterized by increased respiratory rate
increased heart rate
skin color changes
increased WOB (grunting, nasal flaring, head bobbing, accessory muscle use)
wheezing
diaphoresis
abnormal upper airway (sounds such as stridor)
change in mentation (irritable or agitated)
Laryngotracheobronchitis (Croup) - ANS viral illness that account 90% peds stridor
inflammation, exudates and edema of larynx l/d narrowing of upper airway
tx with dexamethasone and racemic epi (nebulized epinephrine)
tx with antipyretics for fever
Pertussis (whooping cough) - ANS acute bacterial infection of the respiratory tract that
is highly contagious
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