Delirium
Airway
Tools
Emergencies
Everything in between
100

What approach is best for pediatric patient's following anesthesia?

Hands off approach - lower incidence of emergence delirium

100

What is the most common arrest in PACU?

Respiratory, often treated quickly and recognized so promptly that no arrest record recquired

100

A tool created for children to help them communicate their pain.

What is Wong-Baker pain scale

100

A life threatening pharmacogenetic reaction that occurs on administration of general anesthesia, characterized by hypermetabolism.  This results in dangerously high body temp, muscle rigidity/spasms and rapid heart rate.

What is malignant hyperthermia.

100

Pediatric patients are generally not considered febrile until they reach a temperature of 100.4F or higher.  True or false.

True

200

In what age does pediatric emergence delirium occur most frequently?

What is 2 to 5 years.

200

The narrowest part of the upper airway in a pre-pubertal child.

What is the cricoid cartilage?

200

These are some examples: Distractions, popsicles, tylenol, opioids.

What are examples of pain interventions for peds.

200

The forceful closure of vocal cords preventing respiration that can occur in stage 2 of anesthesia, when the airway is unprotected.

What is laryngospasm

200

Bradycardia in children is most often the result of this.

What is hypoxia.

300

What type of anesthesia is more effective in preventing emergence delirium?

Total Intravenous Anesthesia (TIVA) - gas has increased risk 

300

Child shows signs of fatigue, weak cry, cricoid tug, grunting.

What are the signs and symptoms of respiratory distress.

300

This can be used to evaluate emergence delirium.

Pediatric Anesthesia Emergence Delirium (PAED) scale - eye contact/purposeful/aware/restless/inconsolable

300

A noxious stimulus that can result in increased ICP, pain, emesis, hypoxemia, hypertension, and cardiac dysrhythmias.

What is direct laryngoscopy.

300

Restlessness is one of the first signs of this.

What is hyoxia/hypoxemia.

400

What other medications can help prevent pediatric emergence delirium?

Clonidine, Precedex, Ketamine, Opiods

400
Child shows stridor, hoarseness and increased work of breathing during inspiratory phase.

What are the signs and symptoms of upper airway obstruction in peds.

400

There are multiple interventions that can be utilized pre- and post-op for children who are anxious.  List 3

Distraction, weighted blanket, parent/guardian presence, medication.

400

Angioedema, stridor, wheezing, and shock develop within minutes to hours.

What is anaphylaxis.

400

This is the initial nursing action for a laryngospasm event.

What is positive pressure ventilation while calling for help, anticipate need for succinylcholine.

500

Child appears confused, he's crying & screaming & kicking.  He doesn't respond to verbal cues nor opens his eyes......

What are the signs and symptoms of emergence delirium.

500

These are two anatomical airway differences in pediatric patients vs adult patients.

What are shorter neck & trachea; smaller mandible, nares, airway diameter; floppier airway

500

There are 4 stages of anesthesia: Stage 1 - analgesia; Stage 2 - delirium; Stage 3 - surgical anesthesia; Stage 4 - respiratory arrest.  The stage that includes loss of consciousness, irregular respirations and increase potential for laryngospasm is this stage.

What is stage 2.

500

A previously healthy 5 year old presents with a heart rate of 55 in the PACU.  Your immediate action should be what?

Assess patient for adequate oxygenation and ventilation.

500

This inhaled medication is commonly used for stridor or airway edema in pediatric patients.

What is racemic epinephrine.

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