Pediatric Perianesthesia Nursing Flashcards

A 4-year-old post-tonsillectomy patient is restless and crying in the PACU. Which assessment finding would most indicate emergence delirium rather than pain?

Answer: Inconsolable despite opioid administration

Emergence delirium is characterized by inconsolable agitation that does not respond to comfort measures or analgesics, unlike pain-related crying.

When calculating IV fluid maintenance for a 20 kg pediatric patient using the Holliday-Segar method, what is the correct hourly rate?

Answer: 60 mL/hr

Holliday-Segar: 4 mL/kg/hr for first 10 kg + 2 mL/kg/hr for next 10 kg = 40 + 20 = 60 mL/hr for a 20 kg child.

A 6-year-old child arrives in the PACU after adenoidectomy with a FLACC score of 7. Which analgesic approach is most appropriate as a first step?

Answer: IV opioid titration

A FLACC score of 7 indicates moderate-to-severe pain requiring IV opioid titration for prompt and effective relief.

Which sign is the earliest indicator of respiratory compromise in a 3-year-old child recovering from general anesthesia?

Answer: Increased respiratory rate

Tachypnea is the earliest compensatory response to hypoxia in children; cyanosis and desaturation are late signs.

A parent asks to stay with their child during IV placement before surgery. What is the recommended nursing response?

Answer: Allow parental presence as it reduces child anxiety

Evidence supports parental presence during preoperative procedures as it significantly reduces pediatric anxiety and improves cooperation.

Which factor most increases a child's risk for post-operative nausea and vomiting (PONV) after ambulatory surgery?

Answer: Age over 3 years with history of motion sickness

Children over 3 years with a personal or family history of motion sickness or prior PONV are at highest risk for postoperative nausea and vomiting.

A 9-year-old weighing 30 kg requires morphine for post-op pain. What is the appropriate IV dose range?

Answer: 0.05–0.1 mg/kg (1.5–3 mg)

The standard pediatric IV morphine dose is 0.05–0.1 mg/kg, giving 1.5–3 mg for a 30 kg child, titrated to effect.