module 3

Question 1

Respiratory distress in children arises from

Answer 1

derangement in pulmonary gas exchange and is identified by increased work of breathing, indicating that the child is actively compensating for the disturbance.

Question 2

Why do Children rely heavily on rate of respiration for compensation?

Answer 2

This is because they are unable to increase respiration depth due to small lung volumes and the flattened diaphragm’s inability to move downward against the abdomen

Question 3

Over time, increases in the work of breathing significantly increases what?

Answer 3

The metabolic rate and oxygen demand of the child, resulting in respiratory muscle fatigue and decreased respiratory effort as respiratory failure progresses.

Question 4

o Prolonged inspiration occurs with

Answer 4

upper airway obstruction

Question 5

o Prolonged expiration occurs with

Answer 5

lower airway obstruction

Question 6

dyspnoea

Answer 6

distress during breathing

Question 7

hyperpnoea

Answer 7

increased depth

Question 8

seesaw (paradoxic) respirations

Answer 8

chest falls on inspiration and rises on expiration

Question 9

retractions of the upper chest are associated with

Answer 9

with upper airway compromise.

Question 10

retractions of the lower chest usually suggest

Answer 10

lower airway compromise

Question 11

head bobbing or extension of the neck on
inspiration is a clinical manifestation of
infants in respiratory distress. Why does it occur

Answer 11

The inability of the underdeveloped sternocleidomastoid muscle to effectively support the effort of breathing results in an infant’s head moving forward and back with each breath

Question 12

inspiratory stridor is associated with

Answer 12

upper airway disease

Question 13

expiratory wheeze is associated with

Answer 13

lower airway disease

Question 14

Why does grunting occur

Answer 14

It is heard at the end of expiration as the body attempts to generate positive-end pressure within the alveoli to prevent collapse.

Question 15

Tachycardia is a compensatory mechanism that presents in hypoxic states to provide….
If not resolved, prolonged hypoxia can result in bradycardia, which is a signal that the child has

Answer 15

adequate systemic oxygenation.

exhausted all compensatory efforts and an arrest situation is pending.

Question 16

cause of crackles and sound

Answer 16

Air passing through airways with fluid in them or opening up of collapsed alveoli.
Non-continuous sounds, low-medium pitch.

Question 17

cause of wheeze and sound

Answer 17

Movement of air through narrowed airways.

High pitched musical sound

Question 18

cause of pleural rub and sound

Answer 18

Friction caused by inflamed pleura.

Loud, low pitched

Question 19

pH meaning and normal values

Answer 19

(hydrogen ion concentration)

7.35 - 7.45

Question 20

pCO2 meaning and normal values

Answer 20

(partial pressure of carbon dioxide)

35 - 45 mm Hg

Question 21

pO2 meaning and normal values

Answer 21

(partial pressure of oxygen)

80 - 100 mm Hg

Question 22

HCO3 meaning and normal values

Answer 22

(bicarbonate ion concentration)

22 - 28 mmol/L

Question 23

. The first heart sound is the lubb sound. What does it signify

Answer 23

it signifies closure of the AV valves (particularly the mitral valve) after ventricular systole. is louder than the second sound

Question 24

The second heart sound is the dubb sound, it signifies the

Answer 24

closure of the semilunar valves at the beginning of ventricular diastole

Question 25

The third heart sound: signifies

Answer 25

rapid filling of the ventricles during diastole

is not usually heard

Question 26

The fourth heart sound is the result of

Answer 26

atrial contraction occurs just before the 1st heart sound

Question 27

Pallor is usually the first sign of

Answer 27

poor skin or mucous membrane perfusion in infants/young children. It may also be evident in conditions where haemoglobin levels are low.

Question 28

Mottling is another sign of

Answer 28

poor perfusion commonly seen in the paediatric population and is caused by constriction of the blood vessels to the skin.

Question 29

Prolonged capillary refill may be an indication of

Answer 29

systemic hypoperfusion as a result of low cardiac output.

Question 30

what should a Fontanelle be like

Answer 30

Should be firm, flat and pulsatile

Question 31

Sunken fontanelle: indicates

Answer 31

possible fluid volume deficit

Question 32

Bulging: indicates

Answer 32

possible fluid volume overload

Question 33

gcs 13 to 15 =

Answer 33

mild head injury

Question 34

gcs 9 to 12 =

Answer 34

moderate head injury

Question 35

gcs Less than 8 =

Answer 35

severe head injury

Question 36

What is Nociceptive pain

Answer 36

arises from actual or threatened damage to non-neural tissue and is the result of activation of nociceptors in the skin and deep tissues which respond to noxious stimuli.

Question 37

Nociceptive pain can be divided into somatic (superficial and deep), and visceral

Answer 37

Somatic pain:
o arises from bone, joint, muscle, skin or connective tissue, tends to be localised, constant pain that is usually described as sharp, aching or throbbing

Visceral pain:
o arises from visceral organs such as gastrointestinal tract and pancreas, tends to be vague in distribution, and is usually described as deep, aching, squeezing

Question 38

Neuralgia:

Answer 38

pain in the distribution of a nerve or nerves

Question 39

Neuropathic pain:

Answer 39

pain caused by a lesion or disease of the somatosensory nervous system which can be localised to the peripheral or central nervous systems E.G. phantom limb pain,

Question 40

FLACC

Answer 40

Face 
Legs 
Activity
Cry
Consoloability

Question 41

Fevers occur because of.. and antipyretic medication is used and works how?

Answer 41

In fever, the production of prostaglandin is increased in response to viral or bacterial pyrogens. This stimulates the hypothalamus to raise the set point of body temperature. Both paracetamol and ibuprofen reduce the production of prostaglandin leading to lowering of the set point and resolution of the fever.