Vital Signs by Age
What is the normal temperature, pulse, respiratory rate, and blood pressure for an infant?
Temperature = 97.7-99.3 (axillary)
Pulse = 80-150
RR = 25-55
BP = 65-100/45-65
at what age do the anterior fontanels close?
12-24 months
What are the early and late signs of Malignant Hyperthermia?
What would the treatment be?
Early = increased ETCO2, tachycardia, tachypnea, acidosis, and masseter spasm/trismus
Late = hyperthermia, trunk/limb rigidity, myoglobinuria
Treatment = Stop triggering agents, Hyperventilate/100% oxygen, Dantrolene (helps relax muscles), Bicarbonate (helps with acidosis), glucose and insulin, IV fluids and cooling the pt, and fluid output monitoring, fast heart
Primary Intention
wound is closed, surgical incision, hematoma, epithelialization (process of repairing damaged epithelial tissue by covering new epithelial cells), heals quickly, fine scar (NO GRANULATION)
what is the daily fluid requirements by body weight?
<10kg
10-20kg
>20kg
<10kg = 100mL/kg
10-20kg = 1000mL + 50mL /kg for each additional kilogram between 10-20
>20kg = 1500mL + 20mL/kg for each additional kg over 20
What is the normal temperature, pulse, respiratory rate, and blood pressure for a toddler
Temp = 97.5 - 98.6 (axillary)
Pulse = 70-110
RR = 20-30
BP = 90-105/55-70
at what age does the posterior fontanel close?
2-3 months
what are some peripheral nerve blocks?
as nurses, can we help assist?
Fentanyl and midazolam
Yes
Secondary Intention
wound edges not approximated
healing from the bottom up
wounds with tissue loss or contamination
GRANULATION, tissue contraction, epithelialization
slow to heal, larger scar
what disease is more prominent in African Americans?
sickle cell disease
**note = HTN, kidney disease, cancer, HIV, AIDS, asthma
What is the normal temperature, pulse, respiratory rate, and blood pressure for a preschooler?
Temp = 97.5 - 98.6 (axillary) *hint same as toddler
Pulse = 65-110
RR = 20-25
BP = 95-110/60-75
What causes bulging fontanels?
increased intracranial pressure
what is this?
surgery performed in body cavity or body area through one or more endoscopes, can correct problems, remove organs, and take tissue for biopsy, or reroute blood vessels
Minimally Invasive Surgery
Examples = arthroscopy, tubal ligation, hysterectomy, lung lobectomy, coronary artery bypass, cholecystectomy
CONTRAINDICATED IN PATIENTS WITH obestiy or osteoporosis.
wound left open for a few days, then surgically closed
wounds that are contaminated and need monitoring for infection
wound closure delayed until risk of infection resolved/decreased
what are the five domains of SDOH (social determinants of health)
- Education Access and Quality
- Health Care Access and Quality
- Neighborhood and Built Environment
- Social and Community Context
What is the normal temperature, pulse, respiratory rate, and blood pressure for a school-age child?
Temp = 97.5-98.6 (oral) **hint same as toddler and preschool - but use oral temp
Pulse = 60-95
RR = 14-22
BP = 100-120/60-75
what causes depressed fontanels?
dehydration
what are some duties of an OR Nurse (AKA Circulator)
get equipment as needed
patient advocate
coordinates with OR team = initiate time out, make sure everyone is where they need to be
maintains standards = monitor, gauze counts, sterile field
what size syringe and gauge would you use for wound irrigation
35mL syringe and 19-gauge
- soft angiocatheter to maintain safe pressure
at what age does chest x-rays become a preop testing for surgery?
4 years and up
What is the normal temperature, pulse, respiratory rate, and blood pressure for an adolescent
Pulse = 55-85
RR = 12-18
BP = 110-135/65-85
what is the minimun urine output by age-group?
Infants and toddlers
Preschoolers and young school-age
School-age children and adolescents
Infants and Toddlers min urine output = 2-3mL
Preschoolers and young school-age = 1-2mL
School-age and adolescents = 0.5-1mL
Difference in General Anesthesia, Conscious Sedation, and Local Anesthesia
Conscious Sedation = used for procedures like colonoscopy, nerve blocks like Fentanyl or Versed used, ability to move on their own (nurse can administer must be trained)
Local Anesthesia = certain area of the body is numb, completely awake - does not affect judgement
which white blood cell is seen on the CBC with differential that is in the later stages of inflammation and increases with allergic response
Eosinophils
Difference between wound dehiscence and wound evisceration?
Wound Dehiscence = wound no longer approximated and wound pulled apart (put sterile gauze over top, and call provider)
Wound Evisceration = organ is protruding (call provider right away)