Pediatric and Neonatal Patients Flashcards

A 3-year-old weighing 14 kg requires a weight-based dopamine infusion at 5 mcg/kg/min. Using the rule of 6, how many mg of dopamine should be added to 100 mL of D5W?

Answer: 84 mg

Rule of 6: weight (kg) × 6 = mg added to 100 mL; 14 × 6 = 84 mg, giving 1 mcg/kg/min per 1 mL/hr.

During neonatal transport, a 28-week premature infant develops bradycardia to 80 bpm with oxygen saturation dropping to 75%. The FIRST intervention should be:

Answer: Provide positive pressure ventilation with 100% oxygen

Neonatal bradycardia is almost always hypoxia-driven, so the first step is to ensure adequate ventilation with PPV.

A 6-week-old infant presents with bilious vomiting and abdominal distension. Which diagnosis should the flight nurse prioritize as most life-threatening?

Answer: Midgut volvulus

Midgut volvulus causes rapid intestinal ischemia and can be fatal within hours if untreated, making it the most immediately life-threatening cause of bilious vomiting in an infant.

When securing a pediatric endotracheal tube in flight, the flight nurse should verify correct depth using which landmark formula?

Answer: 3 × ETT internal diameter (mm) at the lip

Tube depth (cm at lip) = 3 × internal diameter of the ETT is a reliable bedside formula for pediatric patients.

A 10 kg toddler in hemorrhagic shock receives an initial fluid bolus of 20 mL/kg NS. After two boluses with minimal improvement, what is the next most appropriate intervention?

Answer: Administer 10 mL/kg packed red blood cells

After two crystalloid boluses with inadequate response in hemorrhagic shock, early transfusion with pRBC at 10 mL/kg is indicated.

A 2-year-old ingested a button battery 2 hours ago. X-ray confirms the battery is lodged in the esophagus. The flight nurse should anticipate the need for:

Answer: Emergent endoscopic removal within 2 hours of ingestion

Esophageal button battery ingestion causes rapid liquefactive necrosis and requires emergent endoscopic removal, ideally within 2 hours.

During air transport at altitude, a neonate with a congenital diaphragmatic hernia (CDH) deteriorates. The priority intervention is:

Answer: Insert an orogastric tube to decompress the stomach

Gas in the herniated bowel expands at altitude, worsening lung compression; OG tube decompression reduces bowel distension and improves ventilation.