Pediatric Perianesthesia Nursing Flashcards

A 5-year-old is brought to the PACU post-myringotomy with signs of upper airway obstruction: snoring, sternal retractions, and SpO2 88%. What is the priority intervention?

Answer: Jaw thrust and airway repositioning

Jaw thrust with airway repositioning is the first-line maneuver to open a partially obstructed pediatric airway before escalating interventions.

Which developmental stage consideration is most important when preparing a 7-year-old for ambulatory surgery?

Answer: Providing honest, simple explanations of what they will see and feel

School-age children benefit from honest, age-appropriate explanations of procedures as they are in a concrete operational stage and understand cause and effect.

Post-tonsillectomy hemorrhage most commonly occurs within which time frame in the ambulatory setting?

Answer: 5–10 days postoperatively

Secondary post-tonsillectomy hemorrhage peaks between days 5–10 when the fibrin eschar separates, and patients may present to ambulatory centers during this period.

Which IV access site is preferred for infants under 6 months in the perianesthesia setting when hand and arm veins are inaccessible?

Answer: Scalp vein

Scalp veins are a viable and commonly used alternative IV site in infants under 6 months when peripheral extremity veins are inaccessible.

A 10-year-old with a known history of malignant hyperthermia (MH) susceptibility undergoes ambulatory surgery. Which anesthetic approach is required?

Answer: Total IV anesthesia (TIVA) with non-triggering agents only

MH-susceptible patients must receive only non-triggering agents (TIVA with propofol/opioids/non-depolarizing NMBAs); all volatile agents and succinylcholine are contraindicated.

Which of the following best describes the Pediatric Anesthesia Emergence Delirium (PAED) scale?

Answer: A 5-item observational tool scored 0–20 assessing eye contact, purposefulness, and awareness of surroundings

The PAED scale scores five behaviors (eye contact, purposeful actions, awareness, restlessness, inconsolability) from 0–4 each, with scores ≥10 indicating delirium.

A 2-year-old child in the PACU develops stridor and a barking cough 30 minutes after extubation. What is the most likely diagnosis?

Answer: Post-extubation croup (subglottic edema)

Barking cough with inspiratory stridor developing 30–60 minutes post-extubation in a toddler is classic post-extubation croup due to subglottic mucosal edema.