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In which of the following situations may IO access be used? - correct answers An extremity with slow capillary refill time. A 2 - week old infant is being evaluated irritability and poor feeding. His blood pressure is 55/40 mm Hg and capillary refill time is 5 seconds. Which statement best describes your assessment of this infants blood pressure? - correct answers It is Hypotensive You are caring for patients in the emergency department. Which two year old requires immediate interventions? - correct answers A child who is grunting A 3 year old child is having difficulty breathing. What finding would most likely lead you to expect an upper airway obstruction in this child? - correct answers Increased inspiratory effort with retractions A team member is unable to perform an assigned task because it is beyond the team member's scope of practice. What action should the team member take? - correct answers Ask for a new task or role. You are the team lead during a pediatric resuscitation attempt. Which action is high quality CPR? - correct answers Allow complete chest wall recoil after each compression. A 8 year old child is brought to the emergency department by his mother for difficultly breathing. He has a history is asthma and nut allergies. His mother tells you that he has recently ate a cookie at a family picnic. Which condition is most likely present with this child? - correct answers Upper airy way obstruction
An 8-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. What finding would suggest that immediate intervention is needed? - correct answers Decreased level of consciousness A 6-year-old child is found unresponsive, not breathing, and without a pulse. One healthcare worker leaves to activate the emergency response system and get the resuscitation equipment. You and another healthcare provider immediately begin performing CPR. What compression-to-ventilation - ratio do you use? - correct answers 15: A 3-year-old child is in cardiac arrest, and high-quality CPR is in progress. You are the Team Leader. The first rhythm check reveals the rhythm shown here. Defibrillation is attempted with a shock dose of 2 J/kg. After shock administration, what should you say to your team members? - correct answers Resume compressions You are caring for a 5-year-old boy with a 4-day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His oxygen saturation is 72% on room air and 89% when on a nonrebreathing oxygen mask. He has shallow respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles.
- What assessment finding is consistent with respiratory failure in this child? - correct answers Oxygen Saturation You are caring for a 5-year-old boy with a 4-day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His oxygen saturation is 72% on room air and 89% when on a nonrebreathing oxygen mask. He has shallow respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles.
You respond to an infant who is unresponsive, is not breathing, and does not have a pulse. You do not have a mobile device, and you shout for nearby help but no one arrives. What action should you take next? - correct answers Begin CPR for 2 minutes before leaving to activate the emergency response system What ratio for compressions to breaths should be used for 1-rescuer infant CPR? - correct answers Give 30 compressions to 2 breaths A 3-year-old boy is brought to the emergency department by his mother. He is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk capillary refill. Which immediate life-threatening condition could this child's condition most likely progress to if left untreated? - correct answers Respiratory Failure You are evaluating a 10-year-old child who is febrile and tachycardic. The child's capillary refill time is 5 seconds. What parameter will determine if the child is in compensated shock? - correct answers Blood Pressure An 18-month old has had vomiting and diarrhea for the past 2 days; the mother brings him to the emergency department because he is becoming more lethargic. What diagnostic test should you order first? - correct answers Blood Glucose You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg.
- What assessment finding indicates that the infant has hypotensive shock? - correct answers Blood Pressure You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg. On the basis of this infant's presentation, what type of shock does this infant have? - correct answers Hypovolemic Shock You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg. You have decided that this infant needs fluid resuscitation. How much fluid should you administer? - correct answers 20 ml/kg normal saline What abnormality helps identify children with acute respiratory distress caused by lung tissue disease? - correct answers Crackles You are caring for a 9-month-old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infant's SpOz is 94%. On auscultation, the lungs are clear bilaterally. What is the most likely cause of this infant's respiratory distress? - correct answers Upper airway obstruction
A 7-year-old child in cardiac arrest is brought to the emergency department by ambulance. No palpable pulses are detected. The child's ECG is shown here. How would you characterize this child's rhythm? - correct answers Pulseless electrical activity After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now unresponsive to paintul stimulation. His respirations are shallow, at a rate of 10/min. His oxygen saturation is 94% on 2 L/min of nasal cannula oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. What action should you take next? - correct answers Reposition the patient and insert an oral airway If the patient continues to snore and exhibit poor chest rise and poor air entry bilaterally after your initial intervention, what next step is most appropriate? - correct answers Provide bag-mask ventilation You are performing the airway component of the primary assessment. What finding would lead you to conclude that the child has an upper airway obstruction? - correct answers Inspiratory strides In management of post-cardiac arrest patients, extra care should be taken to avoid reperfusion injury. What should the ideal oxygen saturation range most likely be? - correct answers 94%- 99% You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% oxygen by nonrebreathing mask. Laboratory studies document lactic acidosis. On the basis of the patient's clinical assessment and history, what type of shock does this patient most likely have? - correct answers Distributive, septic You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% oxygen by nonrebreathing mask. What assessment finding is most important in your determination of the severity of the patient's condition? - correct answers Blood pressure You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% oxygen by nonrebreathing mask. What is the most appropriate amount to administer for the first normal saline fluid bolus? - correct answers 10 - 20 ml/kg
The parents of a 7-year-old child who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals that the child is difficult to arouse, and her skin color is pale. The child's heart rate is 160/min, respiratory rate is 38/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and temperature is 39.4°C (103°F). I access has been established, and blood cultures have been obtained. What is the most appropriate intervention? - correct answers Administer 10 to 20 mL/kg of isotonic crystalloid over 5 to 10 minutes An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and Spoz is 60% on room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. - correct answers Sinus Bradycardia An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and Spoz is 60% on room air. He is unresponsive and cyanotic. What action do you take next? - correct answers Provide bag-mask ventilation with 100% oxygen A 3-year-old child is brought to the emergency department by his mother. What is a normal finding for a 3-year-old child? - correct answers Respiratory rate of 24/min A 6-month-old infant is being evaluated for bradycardia. What is the most likely cause of bradycardia? - correct answers Hypoxia
