Week 7 Chapter 51

Question 1

Risk Factors for Respiratory Arrest in Children vs Adults

Answer 1

Smaller Airways
Underdeveloped immune systems
Lack motor coordination
Susceptible to choking on food and small objects
Higher risk for SIDS

Question 2

Children are at greater risk for near drowning, poisoning, and traumatic injury compared to adults

Most pediatric arrests from respiratory failure or shock

Answer 2

True

Question 3

Children who have cardiopulmonary arrest requiring resuscitative measures rarely fare well explains differences in each chain

Answer 3

True

Question 4

AHA Chain or Survival

Answer 4

Adult
- EMS activation
- CPR
- Early defib
- Early access to advanced care
- Integrated postcardiac arrest care

Child
- Prevention of cardiac arrest and injuries
- Early CPR
- Early access to emergency response system
- PALS
- Integrated postcardiac and arrest care

Question 5

Common Medical Treatments

Answer 5

Suctioning
Oxygen
BVM ventilation
Intubation
Needle Thoracotomy
IV Fluid Therapy
Blood Product Transfusion
Cervical Stabilization
Defib- V Fib and pulseless v tach
- Synchronized Cardioversion- SVTs V Tach with a pulse

Question 6

AED uses only age above 1 and ?

Answer 6

Witnessed collapse

Question 7

Common Laboratory and Diagnostic Tests

Answer 7

Electrolyte and glucose levels
CBC and basic metabolic
Blood cultures
Urinalysis
ABGs
Toxicology panel if needed
ECG
Chest Radiograph

Question 8

Medication SVT

Answer 8

Adenosine

Question 9

V tach and V fib

Answer 9

Amiodarone

Question 10

Sinus Brady, asystole, PEA

Answer 10

Atropine

Question 11

Adrenergic agent

Answer 11

Dobutamine

Question 12

Inotropic agent

Answer 12

Dopamine

Question 13

Vasopressor, inotropic

Answer 13

Epinephrine

Question 14

Antidysrhythmic

Answer 14

Lidocaine

Question 16

Opioid Antagonist

Answer 16

Naloxone

Question 16

Drugs Administered through ETT

Answer 16

LEAN
L- Lidocaine
E- epinephrine
A- Atropine
N- Naloxone

Question 17

ABCs of Life Support

Answer 17

ABC

Secondary Survey
- Disability
- Exposure

Question 18

Increased respiratory rate

Answer 18

Tachypnea

Question 19

Decreased in depth and rate of respiration

Answer 19

Hypoventilation

Question 20

Regular breathing with occasional short pulses

Answer 20

Periodic Breathing

Question 21

Use of intercostal muscles or presence of retractions

Answer 21

Increased work of breathing

Question 22

Airway Devices and Ventilations Methods

Answer 22

Anesthesia bag or flow ventilation system
BVM or manual resuscitator
Laryngeal Mask Airway
Tracheal Intubation

Question 23

Verify tracheal tube placement with

Answer 23

ETCO2
- Yellow color
- Symmetric rise and fall of chest

• Exhaled CO2 monitors as an indication of appropriate ventilation

Question 24

DOPE for Intubation Troubleshooting

Answer 24

D- displacement O- Obstruction P- Pneumothorax E- Equipment failure - Disconnected oxygen supply - Leak in the ventilator circuit - Loss of power

Question 25

Laboratory and Diagnostic Tests when Assessing Respiratory Status

Answer 25

ABGs Pulse Oximetry Chest Radiograph Metal Detector

Question 26

Circulation

Answer 26

HR Pulses Perfusion Blood Pressure Cardiac Rhythm LOC altered Establish Vascular access

Question 27

Forms of vascular access

Answer 27

Peripheral IV route Central IV Route Saphenous Vein Cutdown Intraosseous Access

Question 28

Neurologic Assessment of a Child with a Pediatric Emergency

Answer 28

Level of awareness Evaluate interest in environment Evaluate the child's head Assess the eyes Evaluate the child's face Evaluate Spontaneous movement May use Pediatric Glasgow Coma Scale

Question 29

Common Types of Pediatric Emergencies

Answer 29

Respiratory Arrest Shock Cardiac Arrhythmias Near Drowning Poisoning Traumatic Injury- Leading Cause of death ( unintentional injuries)

Question 30

Normally healthy child suddenly deteriorates without a known cause

Answer 30

Toxic Ingestion

Question 31

Questions for Poisoning

Answer 31

Inquire about approximate time and nature of toxin How was it ingested? Caregiver medication bottle? Older children possible suicide?

Question 32

Alterations Occurring with Toxic Ingestions

Answer 32

Hyper/ Hypo Tension Hyper/ Hypo thermia Resp. Depression or hyperventilation Pupillary Contraction or dilation

Question 33

Types of Shock

Answer 33

Hypovolemic Septic Cardiogenic Distributive

Question 34

S/S of shock

Answer 34

Pallor Hypotension Brady or Tachycardia Resp. Distress Delayed capillary refill Weak Distal pulses

Question 35

Result of dramatic respiratory or hemodynamic compromise Can be compensated or decompensated Caused by impaired cardiac output, SVR or both Depends on their HR

Answer 35

Shock

Question 36

Causes of Sudden Cardiac Arrest in Children

Answer 36

Electrolyte abnormalities Toxic drug ingestion History of serious primary congenital or acquired cardiac defect Potentially lethal arrhythmias such as prolonged QT syndrome Hyper or hypo cardiomyopathy Traumatic Injury

Question 37

Rare exception for children for cardiac arrest

Answer 37

Commotio Cordis

Question 38

Nursing Management of a Child with a Pediatric Emergency

Answer 38

Maintain Airway Provide oxygen Assisting in ventilation Monitoring changes in status Offering support and education to child and family