Pediatric Critical Care Transport: Comprehensive Guide, Exams of Nursing

Download Pediatric Critical Care Transport: Comprehensive Guide and more Exams Nursing in PDF only on Docsity! PNCCT EXAM 2024\2025 PNCCT EXAM 2024\2025 WITH GUARANTEED ACCURATE ANSWERS |VERIFIED What type of equipment would be needed during pediatric and neonatal transport? - Accurate Answers✔✔✔ Pumps that can do decimal points, Ventilators that can perform pressure ventilations, pediatric restraints, isolette, and thermoregulation equipment. What are some aspects of a pediatric assessment that should be performed by the cct provider? - Accurate Answers✔✔✔ Toe-Head assessment, AMPLE history, and immunization record How do CCT providers obtain consent while dealing with pediatric patients? - Accurate Answers✔✔✔ Implied consent for emergency care, parents for non-emergency procedures, and social services for children in state custody. What will be noted on an x-ray of a child with croup? - Accurate Answers✔✔✔ Steeple sign How do you decide the appropriate ETT size for a pediatric patient? - Accurate Answers✔✔✔ ETT= (Patient's age in years +16)/4 How do you decide the appropriate ETT size for a neonate patient? - Accurate Answers✔✔✔ ETT= Patients gestational weeks/10 What drugs are contraindicated in sepsis? - Accurate Answers✔✔✔ Etomidate, ibuprofen How do you establish the appropriate fluid administration in pediatrics? - Accurate Answers✔✔✔ 4cc/kg for the first 10 kg, 2 cc/kg for the second 10 kg, and 1 cc/kg for each additional kg. 4-2-1 rule What type of maintenance fluid do neonates receive? - Accurate Answers✔✔✔ Dextrose 10% What do the majority of pediatric's receive as maintenance fluid? - Accurate Answers✔✔✔ Dextrose 5% What pediatric patients do not receive dextrose as a maintenance fluid? - Accurate Answers✔✔✔ Head injuries, hyperglycemia, and metabolic disorders What is retropharangeal abscess? - Accurate Answers✔✔✔ A collection of pus in the tissue in the back of the throat. What are some signs and symptoms of an upper airway obstruction? - Accurate Answers✔✔✔ Stridor, drooling, poor chest rise, altered mental status, What does grunting indicate? - Accurate Answers✔✔✔ Alveolar collapse, auto-peep What does nasal flaring indicate? - Accurate Answers✔✔✔ hypoxemia How does bronchiolitis present? - Accurate Answers✔✔✔ Apnea, bradycardia, desaturation, cough, secretions, tachycardia, tachypnea, crackles, wheezing, increased WOB, cyanosis What is the treatment for bronchiolitis? - Accurate Answers✔✔✔ Albuterol & SQ/IM Epi How does Reactive Airway Disease present? - Accurate Answers✔✔✔ Wheezing, Decreased peak flows,coughing, tachypnea, tachycardia, nasal flaring, retractions, grunting, pallor, cyanosis How do you manage RAD? - Accurate Answers✔✔✔ identify & remove asthma triggers, heliox, CPAP/BiPAP, Anesthetic gases, Meds: Albuterol, Atrovent, Solumedrol, Magnesium Sulfate, Epinephrine, Terbutaline How does pneumonia present? - Accurate Answers✔✔✔ cough, increased secretions, tachycardia, tachypnea, crackles, wheezing, increased work of breathing, + cultures, Infltrates on CXR, Respiratory acidosis What is the management of pneumonia? - Accurate Answers✔✔✔ O2% @ 95%, abuterol, pulmonary toilet, antibiotics, CPAP, intubation What characteristics are found with bronchospasms? - Accurate Answers✔✔✔ wheezing may not be heard, forced or prolonged expiratory phase. What ventilator settings affect ventilation and can reduce hypercarbia? - Accurate Answers✔✔✔ RR, TV, E time, & PIP What are standard ventilatory rates for pads and neonates? - Accurate Answers✔✔✔ peds: 20-30, neonates: 40-60 How do you calculate tidal volume? - Accurate Answers✔✔✔ 6-10 cc/kg What are standard PIP settings for peds, neonates, and premies? - Accurate Answers✔✔✔ peds: 20-30, neonates: 15-25, premies: <15 What ventilators parameters regulate oxygenation? - Accurate Answers✔✔✔ I time, RR, PEEP, FiO2, PIP, tV What are potential complications with ventilators? - Accurate Answers✔✔✔ pulmonary hypertension, barotrauma, and inappropriate tube size What is DIC? - Accurate Answers✔✔✔ bleeding and clotting at the same time What is hemolytic uremic syndrome? - Accurate Answers✔✔✔ Presents with blood in the urine, protein urea, bloody diarrhea, and may show hyperkalemia on the ECG What is the fluid management for HUS? - Accurate Answers✔✔✔ fluid restrictions What happens to the WBC during an infection? - Accurate Answers✔✔✔ may be increased or decreased What populations may have an elevated hemoglobin? - Accurate Answers✔✔✔ Polycythemia, lung disease, and heart disease What should the CCT provider consider with bleeding precautions? - Accurate Answers✔✔✔ frequent needlesticks, venous sticks require 5 What is the management of CHF? - Accurate Answers✔✔✔ CPAP, dieuretics, ACE Inhibitors such as capratril, and milrinone What type of dysrhythmia would be expected with an ASD? - Accurate Answers✔✔✔ Atrial dysrythemias, possible heartblocks What potentially causes ventricular dysrhythmias in peds? - Accurate Answers✔✔✔ VSD, ingestion of toxins, and carsiomyopathy. When is JET present? - Accurate Answers✔✔✔ postoperative patients What is the treatment of JET? - Accurate Answers✔✔✔ Cooling first, Beta blockers such as Esmelol, overdrive pacing. Focus on rate control. What are common causes of sinus tachycardia? - Accurate Answers✔✔✔ fever & dehydration What is unique about SVT in pads? - Accurate Answers✔✔✔ Sweating, poor feeding What is myocarditis? - Accurate Answers✔✔✔ viral infection of the heart that causes decreased cardiac output and ventricular dysrhythmias. What is endocarditis? - Accurate Answers✔✔✔ bacterial infection of the heart causing decreased cardiac output and ventricular dyhrhythmias. What is the formula for cardiac output? - Accurate Answers✔✔✔ CO=HRxSV What mechanism do kids use to compensate? - Accurate Answers✔✔✔ Heart Rate How does patent ductus arterious present? - Accurate Answers✔✔✔ Tachypnea, cough, increased O2%, congestion on chest x-ray, and widening pulse pressures with increased systolic. What are the diagnostics of patent ductus arteriosis? - Accurate Answers✔✔✔ congestion on CXR, echo, LVH on the ECG What is the treatment for patent ductus arterious? - Accurate Answers✔✔✔ Monitor Is & Os, maintain O2%, restrict fluids, and subbacterial endocarditis prophylaxis What occurs during Atrial Septal Defect? - Accurate Answers✔✔✔ Increased pulmonary bloodflow, right ventricular hypertrophy, systolic murmur, and atrial dysrhythmias What is the management of Atrial Septal Defect? - Accurate Answers✔✔✔ 15 lead ECG, chest e-ray, monitor peripheral perfusion, maintain SPO2 of 85%, and treat CHF What happens during a Ventricular Septal Defect? - Accurate Answers✔✔✔ Often associated with other defects, diaphoresis while eating, increased RR. The problem may present after the duct closes. What is the management of ventricular septal defect? - Accurate Answers✔✔✔ Monitor I & O, pain management, treat CHF with digoxin, diuretics, and fluid restriction. What happens during an atrioventricular defect? - Accurate Answers✔✔✔ Often associated with trisomy 21, increased pulmonary blood flow, signs of CHF What is the management of atrioventricular defect? - Accurate Answers✔✔✔ Monitor I & O, Cardiac output, rectal temps, and treat with digoxin & diuretics such as chlorathizide alductone What is coarction of the Aorta? - Accurate Answers✔✔✔ Many have a VSD and associated bicuspid aortic valve. Presents with leg cramp, headache, dizziness, syncope, leg pain, cramps, varying SPO2 What is the management of coarction of the aorta? - Accurate Answers✔✔✔ Manage CHF, administer prostaglandin, consider phenelephrine & milrinone. What are potential side effects of prostaglandin? - Accurate Answers✔✔✔ apnea & hypotension What are complications with small gestational age (SGA) - Accurate Answers✔✔✔ low birth weight, uterine placental insufficiency, hypoglycemia, hypocalcemia, dehydration, & hypercarbia What is the management of respiratory distress syndrome in neonates? - Accurate Answers✔✔✔ surfactant & BPD What is the management of diaphragmatic hernia? - Accurate Answers✔✔✔ do not bag the patient without an ETT in place. What is the management of omphalecele? - Accurate Answers✔✔✔ manage dehydration and hypothermia. What is the management of duodenal atresia? - Accurate Answers✔✔✔ OG tube for decompression How do seizures present in neonates? - Accurate Answers✔✔✔ sudle What is significant about intraventricular hemorrhage in neonates? - Accurate Answers✔✔✔ large volume of blood loss. How quickly can hypernatremia be regulated? - Accurate Answers✔✔✔ 8-14 mEq/day What is the management of hypernatremia? - Accurate Answers✔✔✔ 0.9% NaCl If a patient has low calcium, what will be high? - Accurate Answers✔✔✔ phosphate What is the management for increased ICP? - Accurate Answers✔✔✔ PACO2 of 35, diuretic such as mannitol, hypertonic saline, and barbiturate such as penebarbitol. What should be assessed during altered mental status in infants? - Accurate Answers✔✔✔ sodium, glucose, volume, sepsis, LFT, accidental exposure to toxin. What is SCIWORA? - Accurate Answers✔✔✔ spinal chord injury without radiological abnormality caused by damage to the ligaments.