Normal HR awake for an infant. - 100-180
Normal HR sleeping for an infant. - 75-160
Normal RR for an infant. - 30-60
Systolic hypotension for an infant. - <70
When assessing the vital signs of a 10 month old, which of the following vitals would be alarming to the
nurse?
a. Heart rate awake...
NUR 425 Exam 4 Normal HR awake for an infant. - 100-180 Normal HR sleeping for an infant. - 75-160 Normal RR for an infant. - 30-60 Systolic hypotension for an infant. - <70 When assessing the vital signs of a 10 month old, which of the following vitals would be alarming to the nurse? a. Heart rate awake 160 BPM. b. Respirations 44 BPM. c. Heart rate sleeping 92 BPM. d. Blood pressure 68/40. - D (A systolic less than 70 is hypotension) Normal HR awake for a toddler. - 100-150 Normal HR sleeping for a toddler. - 75-150 Normal RR for a toddler. - 24-40 Systolic hypotension in a toddler, preschooler, and school age. - <70 + (2 x age) When assessing the vital signs of a two year old, which of the following vitals would be alarming to the nurse? a. HR sleeping 60 BPM. b. HR awake 102 BPM. c. RR 32 BPM. d. BP 76/44. - A (HR sleeping should be 75 -150.) Normal HR awake for a preschooler (3 -6 years) - 60-150 Normal HR sleeping for a preschooler. (3 -6 yrs) - 60-90 Normal RR for a preschooler. (3 -6 yrs) - 22-34 When assessing the vital signs of a 5 year old, which of the following vitals would be alarming to the nurse? a. HR awake 172 BPM. b. HR sleeping 85 BPM. c. RR 30 BPM. d. BP 100/62. - A (HR awake should be 60 -150) Normal HR awake for school -age. (6 -10 yrs) - 60-110 Normal HR sleeping for school -age. (6 -10 yrs) - 60-90 Normal RR for school -age. (6 -10 yrs) - 18-30 When assessing the vital signs of a 10 year old, which of the following vitals would be alarming to the nurse? a. HR awake 100 BPM. b. HR sleeping 75 BPM. c. RR 14 BPM. d. BP 92/68. - C (Normal RR 18 -30) Normal HR awake for pre -teen/teenagers (>10 years old) - 50-110 Normal HR sleeping for pre -teen/teenagers (>10 years old) - 50-90 Normal RR for pre -teen/teenagers (>10 years old) - 12-16 Systolic hypotension in for pre -teen/teenagers (>10 years old) - <90 When assessing the vital signs of a 14 year old, which of the following vitals would be alarming to the nurse? a. HR awake 90 BPM. b. HR sleeping 40 BPM. c. RR 14 BPM. d. BP 98/68 - B (HR sleeping 50 -90) List some characteristics of the pediatric respiratory system that differs from an adults. - -
Metabolic rate if 2x of an adults, pt. needs more oxygen and glucose to function -Higher RR -Nose breathers (Keep nasal cavity clear of secretions!) -Short neck and trachea -Lungs are high in compliance, meaning they fill and collapse very easily -Cartilaginous larynx (collapses easily because of this) -Large tongue compared to mouth size -Airway is funnel shaped -Epiglottis is higher in neck than in adults, and longer and floppier -Ribs are made of cartilage, so pt. depends on the diaphragm to breathe (If too much pressure on diaphragm, this can impede respiratory effort) -Fewer alveoli, less surface area for gas exchange -Ribs are horizontal -Fewer muscles are functional in airway (Less able to compensate for edema, spasm, and trauma) -Childs eustachian tube is shorter, wider and straighter -Premature cilia in airway -Lots of soft tissue in airway -Walls of alveoli are thicker -Increased compliance in chest wall -Increased potential for atelectasis -Blunted ventilatory response in newborns List some ways the characteristics of the pediatric respiratory system can affect respiratory function. - -ET tubes can become dislodged easily due to short neck and trachea -Infants breathe through their nose so if they have mucus or secretions in their nasal cavity they may have difficulty breathing -Their mouth is small so they do not usually breathe through their mouth -High risk of right mainstream intubation -Tonsils grow during childhood and swell during infection in an already small airway, so it may cause obstruction of the upper airway -Their larynx is easily collapsable due to it being cartilage, especially if their neck is flexed, possibly causing an obstruction -They have a large tongue which takes up a lot of space in their small airway -The epiglottis is more vulnerable to swelling which may result in obstruction and aspiration -Less surface area for gas exchange due to fewer alveoli Where should you auscultate for breath sounds in the pediatric patient? - Midaxillary space
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