14175209
Descripción
Fichas por Elizabeth Then, actualizado hace más de 1 año
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Creado por Elizabeth Then
hace más de 6 años
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| Pregunta | Respuesta |
| Neurological system | tightly packed epithelial cells blood - brain barrier to prevent most proteins and polarised molecules from entering the brain lipidssoluble molecules can pass through the blood- brain easily, most chemicals are kept out |
| Neurological system continued | protective blood brain barrier not developed in children ie morphine can cause resp depression, more dramatic in children |
| Cardiavascular system | standard blood volume is: neonate - 85-90mls/kg child 75-80ml/kg adult 70-75ml/kg |
| Cardiovascular system continues | heart less development, increase strength of contraction increase in heart rate and contractile force peripheral vasoconstriction occurs earlier - less effective in circulating blood volume hypotension last sign in children stroke volume decreases as blood volume decreases |
| Body composition | relative to their size, consist up to 70% water water - soluble drugs more dilute in a child dehydration can quickly affect how drugs are transported by blood stream most is extracellular fluid fluid loss rapid |
| Respiratory system | small airway - excessive secretions and inflammation promote brochodilation supplemental oxygen higher oxygen consumption rate hypoxemia - major sign of bradycardia |
| Gastrointestinal system | small - infant holds 90mls, 1 year 360 mls oral drugs reduce oral food intake absorption of drugs are faster |
| Endocrine system | smaller glycogen stores, increases glucose demand predisposes to hypoglycaemia, and glucagon may be less effective convert and remove drugs more slowly - newborn metabolism elevated |
| Renal system | normal urine output is 2m/kg/hr cannot conserve fluids well increase waste-production rate higher urine production rate |
| Drug administration | smaller but more frequent doses doses are weight based if unknown use a height |
| Fluid administration | prefer IV fluids containing dextrose due to increased metabolic rate and demand |
| Pain management | begins with oxygen paracetemol is most common fentanyl can cause chest rigidity , morphine resp distress in high doses |
| Medication errors | APINCH - classify medications according to risk active failures - unsafe acts committed by staff in direct contact latent conditions - arise made by designers, management, error waiting to happen |
| Medication errors: actions | actions should include: address underlying cause use numerous risk reduction use strategies that have impact on management assess effectiveness be sustainable |
| IM medication | vastus lateralis site for infants and children less than 2 years more than 2 years ventral gluteal |
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