Pediatric Perianesthesia Nursing Flashcards

A 4-year-old weighing 16 kg is to receive ketamine for procedural sedation. What is the appropriate IV sedation dose?

Answer: 1–2 mg/kg (16–32 mg)

IV ketamine for procedural sedation in children is dosed at 1–2 mg/kg; the dissociative state provides analgesia and sedation while maintaining airway reflexes.

Which discharge criterion specifically addresses readiness for home after ambulatory anesthesia in a pediatric patient?

Answer: Modified Aldrete score ≥9 or PADSS ≥18 with stable vital signs

Most ambulatory centers use a Modified Aldrete score ≥9 or PADSS ≥18 as objective discharge criteria, combined with clinical assessment of the child.

A 3-year-old in the PACU develops total laryngospasm. After calling for help, what is the immediate nursing priority?

Answer: Apply firm jaw thrust and positive pressure ventilation with 100% O2

Immediate management of laryngospasm begins with jaw thrust and gentle positive pressure ventilation with 100% O2 to break the spasm before escalating to succinylcholine.

Which preoperative fasting guideline (NPO) applies to a healthy 5-year-old scheduled for elective ambulatory surgery?

Answer: Clear liquids up to 2 hours, breast milk up to 4 hours, solids up to 6 hours before surgery

ASA fasting guidelines: clear liquids 2h, breast milk 4h, formula/non-human milk/solids 6h, and fatty meals 8h before elective anesthesia.

A toddler's caregiver reports the child has a loose tooth. What is the priority perianesthesia concern?

Answer: Risk of aspiration of a dislodged tooth during intubation or emergence

A loose tooth creates a significant aspiration risk during airway management; the anesthesia team must be notified immediately for risk-benefit assessment and airway planning.

Which behavioral sign in the PACU most reliably indicates adequate pain control in a non-verbal 18-month-old?

Answer: Calm facial expression, relaxed body posture, and ability to be comforted

In non-verbal toddlers, behavioral indicators such as calm expression, relaxed posture, and consolability are the most reliable signs of adequate pain management.

A 6-year-old with a history of severe needle phobia is scheduled for ambulatory surgery. Which premedication is most commonly used to reduce preoperative anxiety in pediatric patients?

Answer: Oral midazolam 0.5 mg/kg (max 15 mg) given 20–30 minutes before induction

Oral midazolam 0.5 mg/kg (max 15 mg) given 20–30 minutes before induction is the most widely used and effective pediatric anxiolytic premedication.