Pediatric Emergency Care: Airway, Breathing, and Circulation Management, Exams of Nursing

Download Pediatric Emergency Care: Airway, Breathing, and Circulation Management and more Exams Nursing in PDF only on Docsity! ENPC FINAL EXAM LATEST 2025 REAL EXAM 150 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) | AGRADE When a poison has been ingested by a child, the parents should be instructed to do which of the following first? a) Induce vomiting. b) Call the local poison control center. c) Administer an emetic. d) Get to an emergency facility. - ANSWER- Call the local poison control center. Correct RATIONALE: Not all poisons should be vomited. Strong acids, for example, could cause as much destruction of tissue being vomited as being swallowed. The poison control center will provide the most accurate information on the next steps for the patient. Assessment of a child reveals a tension pneumothorax. The nurse would prepare the child for which of the following? a) Needle thoracotomy b) Suctioning c) Intubation d) Defibrillation - ANSWER- Needle thoracotomy Correct RATIONALE: A needle thoracotomy is indicated for tension pneumothorax to relieve the air collected in the space. Intubation is indicated for apnea and in situations in which the airway cannot be maintained. Suctioning would be indicated for excessive airway secretions that influence airway patency. Defibrillation is used to stimulate or alter the heart's electrical rhythm. A 6-year-old girl who is being treated for shock is pulseless with an irregular heart rate of 32 BPM. Choose the priority intervention: a) Administer doses defibrillator shocks in a row b) Initiate cardiac compressions c) Give three doses of epinephrine d) Defibrillate once followed by three cycles of cardiopulmonary resuscitation (CPR) - ANSWER- Initiate cardiac compressions Correct RATIONALE: The American Heart Association (AHA) emphasizes the importance of cardiac compressions in pulseless clients with arrhythmias, making this the priority intervention in this situation. Current AHA recommendations are for defibrillation to be administered once followed by five cycles of CPR. The AHA now recommends against using multiple doses of epinephrine because they have not been shown to be helpful and may actually cause harm to the child. A 3-year-old girl had a near-drowning incident when she fell into a wading pool. Which intervention would be of the highest priority? a) Inserting a nasogastric tube to decompress stomach b) Assuring the child stays still during an X-ray c) Suctioning the upper airway to ensure airway patency d) Covering the child with warming blankets - ANSWER- Suctioning the upper airway to ensure airway patency Correct RATIONALE: Due to the potentially devastating effects of drowning-related hypoxia on a child's brain, airway interventions must be initiated immediately. The child's airway should be suctioned to ensure patency. Other interventions such as covering the child with blankets, inserting a nasogastric tube, and assuring that the child remains still during X-ray are interventions that are appropriate once airway patency is achieved and maintained. The nurse is preparing an in-service program on pediatric cardiopulmonary resuscitation. The nurse would include a discussion that cardiopulmonary arrest in infants and children is most likely the result of which of the following? a) Underlying heart disease b) Respiratory failure c) Neurologic trauma d) Lethal arrhythmia - ANSWER- Respiratory failure A 16-year-old boy is brought to the emergency department with a head injury. The nurse knows that adolescents are vulnerable to injuries related to which of the following? a) Play-related injuries b) Falls from beds c) Automobile accidents d) Falls from staircases - ANSWER- Automobile accidents Correct RATIONALE: Adolescents are prone to injuries related to activities that involve high risk, such as driving. Adolescents tend to be impulsive and take unnecessary risks as a result of peer pressure. Falling from the bed is common in infants. Play-related injuries are commonly seen in school-aged children, and falling from staircases is a common injury among toddlers. Administration of which medication reverses histamine release and hypotension that are seen in anaphylaxis? a) Atropine b) Epinephrine c) Benadryl d) Zantac - ANSWER- Epinephrine Correct RATIONALE: Epinephrine reverses histamine release and hypotension due to anaphylaxis. A nurse is caring for a stable toddler diagnosed with accidental poisoning due to the ingestion of cleaning solution. What must be included in teaching parents about how to protect a toddler from accidental poisoning? a) Label poisonous solutions. b) Do not leave the toddler alone. c) Closely monitor the toddler's activity. d) Keep cleaning solutions locked up. - ANSWER- Keep cleaning solutions locked up. Correct RATIONALE: The parents should keep cleaning solutions locked up to protect the toddler from accidental poisoning. Accidental poisonings usually occur among toddlers and commonly involve substances located in bathrooms or kitchens. Labeling poisonous substances may not help as toddlers are unable to read. Not leaving the child alone and closely monitoring the child are important, but not feasible all the time. The effect of the bite of a rattlesnake, copperhead, or cottonmouth moccasin (all pit vipers) is the almost immediate failure of the blood coagulation system. a) False b) True - ANSWER- True A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding which of the following? a) Putting child safety locks on kitchen cabinets b) Placing house plants out of reach of children c) Putting medicine away where children cannot reach it d) Removal or covering of flaking paint on the walls of the home - ANSWER- Removal or covering of flaking paint on the walls of the home Correct RATIONALE: The usual sources of ingested lead are paint chips or paint dust, home-glazed pottery, or fumes from burning or swallowed batteries. A child with a blood lead level over 5 μg/dL needs to be rescreened to confirm the level and then active interventions begun to prevent further lead exposure such as removal of the child from the environment containing the lead source or removal of the source of lead from the child's environment. Removal of the lead source is not an easy task in homes because simple repainting or wallpapering does not necessarily remove the source of peeling paint adequately. After some months, the new paint will begin to peel because of the defective paint underneath. The walls must therefore be covered by paneling or dry wall or other solid protective material. The other answers refer to safety measures to prevent other types of poisoning, such as from household cleaners, medicine, and plants. Which finding from the history of a child with extensive burns would make you most alert to assess for respiratory complications? a) Firemen found the child sobbing silently. b) The child's clothing was burned. c) The child was trapped in a closed burning bedroom. d) The fire was caused by burning weeds. - ANSWER- The child was trapped in a closed burning bedroom. Correct RATIONALE: When a child is confined in a closed space during a fire, he or she can inhale a great deal of smoke, causing respiratory tract burns or irritation. The nurse is assessing the neurologic status of an 11-month-old girl. Which finding would be cause for concern? a) Palpation of the head reveals a closed posterior fontanel. b) The child is crying and looking around fearfully. c) The child's eyes remain closed unless she is spoken to. d) Inspection shows a sluggish pupillary reaction. - ANSWER- Inspection shows a sluggish pupillary reaction. Correct RATIONALE: A sluggish pupillary reaction may occur with increased intracranial pressure, which would be cause for concern. A closed posterior fontanel in an 11-month-old would be a normal finding. Crying and looking around are encouraging signs indicating improved neurologic status. Opening the eyes when being spoken to is an encouraging sign. When assessing a child with a traumatic injury, which of the following would be the priority assessment? a) Airway patency and airflow b) Breathing effectiveness and breath sounds c) Level of consciousness and papillary reaction d) Pulse rate and skin color - ANSWER- Airway patency and airflow Correct RATIONALE: When assessing the child with a traumatic injury, the ABCs are assessed first: assess the patency of the airway and establish the effectiveness of breathing, d) Have the child sit up straight in a chair. - ANSWER- Administer 100% oxygen by mask. Explanation: Management of the near-drowning victim focuses on assessing his airway, breathing, and circulation (ABCs) and correcting hypoxemia. Administering oxygen is the primary intervention to assist breathing. It is best to let the child assume the most comfortable position for him. Checking capillary refill time helps determine ineffective tissue perfusion. Providing sedation is an intervention for pain that will be assessed after effective breathing is established. An 8-year-old girl with tachycardia is alert, breathing comfortably, and exhibiting signs of adequate tissue perfusion. Which nursing intervention would be most appropriate for this child? a) Administering epinephrine as ordered b) Oxygenating and ventilating the child c) Applying ice to the child's face d) Initiating cardiac compressions - ANSWER- Applying ice to the child's face Explanation: The child is exhibiting compensated supraventricular tachycardia (SVT). Vagal maneuvers such as ice to the face or blowing through a straw that is obstructed are priority interventions for compensated SVT. Oxygenating and ventilating the child as ordered are interventions for bradycardia. Epinephrine is given for bradycardia. Initiating cardiac compressions is the priority intervention for collapsed (pulseless) rhythms. Which of the following nursing diagnoses would be appropriate for teaching interventions for a single mother who leaves her toddler unattended in the bathtub? a) Risk for Falls b) Risk for Imbalanced Body Temperature c) Noncompliance d) Risk for Suffocation - ANSWER- Risk for Suffocation Correct Explanation: Death from drowning occurs from suffocation. Nearly half of all drowning victims are children under the age of 5. Most drowning deaths in young children occur because of inadequate supervision of a bathtub or pool. The nurse has performed an across-the-room assessment of an 8-year-old child and has classified her as emergent. Which of the following signs and symptoms has the nurse seen? a) The child is guarding one hand. b) The child is asleep on the mother's lap. c) The child is scratching a rash. d) There is a blue color to the lips. - ANSWER- There is a blue color to the lips. Correct Explanation: Blue lips is a sign of cyanosis. The child is in respiratory distress and should be cared for on an emergency basis. An injured hand and a rash are not emergencies. The sleeping child could have a fever that may be the result of an underlying pathology; however, this cannot be determined from across the room. The nurse is caring for a 10-month-old infant with signs of respiratory distress. Which is the best way to maintain this child's airway? a) Inserting a small towel under shoulders b) Using the head tilt chin lift technique c) Employing the jaw-thrust maneuver d) Placing the hand under the neck - ANSWER- Inserting a small towel under shoulders Explanation: Inserting a small, folded towel under shoulders best positions the infant's airway in the "sniff" position as is recommended by the American Heart Association (AHA) Basic Cardiac Life Support (BCLS) guidelines. The hand should never be placed under the neck to open the airway. The head tilt chin lift technique and the jaw- thrust maneuver are used with children over the age of 1 year. A child is learning to ride a bicycle. He should be instructed to use a(an) a) Helmet b) Knee pads c) Light d) Wrist guard - ANSWER- Helmet Correct Explanation: Children should wear properly fitted helmets when cycling, riding, or playing contact sports The nurse is assessing the neurologic status of an infant. Which of the following would the nurse identify as a nonreassuring finding? a) Vigorous crying b) Soft flat anterior fontanel c) Lack of interest in surroundings d) Making eye contact with the nurse - ANSWER- Lack of interest in surroundings Correct Explanation: An infant who is not interested in the environment is a cause for concern. Vigorous crying is a reassuring sign. Making eye contact with the nurse is a reassuring finding. A normal anterior fontanel is soft and flat and would be considered a reassuring finding. A 2-year-old boy is in respiratory distress. Which nursing assessment finding would suggest the child aspirated a foreign body? a) Noting absent breath sounds in one lung b) Hearing a hyperresonant sound on percussion c) Hearing dullness when percussing the lungs d) Auscultating a low-pitched, grating breath sound - ANSWER- Noting absent breath sounds in one lung Explanation: Unilateral absent breath sounds are associated with foreign body aspiration. Dullness on percussion over the lung is indicative of fluid consolidation in the lung as with pneumonia. Auscultating a low-pitched, grating breath sound suggests inflammation of the pleura. Hearing a hyperresonant sound on percussion may indicate pneumothorax or asthma. The nurse is ventilating a 9-year-old girl with a bag valve mask. Which action would most likely reduce the effectiveness of ventilation? a) Referring to Broselow tape for bag size b) Setting the oxygen flow rate at 15 L/minute c) Pressing down on the mask below the mouth d) Checking the tail for free fl ow of oxygen - ANSWER- Setting the oxygen flow rate at 15 L/minute Correct The nurse has administered IV adenosine as ordered to a child with supraventricular tachycardia. Which action would the nurse do next? a) Monitor for ventricular arrhythmias. b) Set up a continuous infusion for administration of adenosine. c) Administer a rapid generous saline flush. d) Give five positive-pressure ventilations. - ANSWER- Administer a rapid generous saline flush. Correct Explanation: Administration of IV adenosine should be followed immediately by a rapid generous saline flush. Adenosine is given rapidly over 1 to 2 seconds and repeated every 1 to 2 minutes to a maximum dose of 0.3 mg/kg. Five positive-pressure ventilations are given after atropine, which is diluted with 3 to 5 mL of normal saline, is given via the tracheal route. After giving adenosine, the nurse would monitor for shortness of breath, dyspnea, and a worsening of asthma. Monitoring for ventricular arrhythmias is necessary when giving dobutamine, dopamine, and epinephrine. After assessing a child's airway, breathing, and circulation (ABCs), which of the following would the nurse do next? a) Remove the child's clothing. b) Obtain a full set of vital signs. c) Assess level of consciousness. d) Provide pain management. - ANSWER- Assess level of consciousness. Correct Explanation: Once the ABCs are completed, the nurse's next step is to assess the child's level of consciousness or disability. This would be followed by removing the child's clothing and diaper (exposure) to assess for underlying signs of illness or injury. Next, full vital signs are taken while facilitating the family presence, followed by giving comfort by managing pain and providing emotional support. The acronym ABCDEFG is a useful reminder of the order of assessment: airway, breathing, circulation, disability, exposure, full vital signs and facilitating family, and giving comfort. The nurse is preparing to insert an oropharyngeal airway. Which action would be most appropriate to determine the proper size? a) Measuring from the tip of the nose to earlobe to middle of xiphoid process b) Measuring distance from end of nose to tragus of ear c) Placing the airway next to the cheek with tip pointing down d) Inspecting the child's fifth digit to estimate the diameter - ANSWER- Placing the airway next to the cheek with tip pointing down Explanation: The nurse determines the correct size by placing it next to the child's cheek with the tip pointing down. An airway that is too large will extend past the angle of the child's mandible and can obstruct the glottic opening when inserted. Measuring the distance from the end of the nose to the tragus of the ear is appropriate for a nasopharyngeal airway. Looking at the child's fifth digit reflects the approximate diameter of the nasopharyngeal airway. Measuring from the tip of the nose to the earlobe to the middle area between the xiphoid process and umbilicus is used to determine the length of a nasogastric tube. The nurse is attempting to establish peripheral vascular access in child requiring pediatric advanced life support. The decision to use the intraosseous route would be made if the nurse were unsuccessful after how many attempts within 90 seconds? a) Two b) Four c) Three d) Five - ANSWER- Three Explanation: No more than three attempts should be made within 90 seconds to obtain peripheral vascular access. A home care nurse provides health education to parents regarding the care of their toddler. Which of the following precautions should the nurse suggest the parents take to protect the toddler from drowning? 1) Teach the toddler water is bad 2) Tell the toddler to stay away from the pool 3) Avoid unattended baths for the toddler. - ANSWER- Avoid unattended baths for the toddler. Correct Explanation: The parents should not leave the toddler for an unattended bath. Toddlers are naturally inquisitive, and instructing them to stay away from the pool or teaching them that water is dangerous is insufficient to ensure safety. The nurse is examining a 10-month-old girl who has fallen from the back porch. Which assessment will directly follow evaluation of the "ABCs?" a) Palpating the abdomen for soreness b) Palpating the anterior fontanel c) Auscultating for bowel sounds d) Observing skin color and perfusion - ANSWER- Palpating the anterior fontanel Correct Explanation: Once the ABCs have been evaluated, the nurse will move on to "D" and assess for disability by palpating the anterior fontanel for signs of increased intracranial pressure. Observing skin color and perfusion is part of evaluating circulation. Palpating the abdomen for soreness and auscultating for bowel sounds would be part of the full-body examination that follows assessing for disability. A 7-year-old boy is brought to the emergency room by his parents following an accident in which he was struck in the back of the head with a baseball bat. The nurse is assessing him. Which of the following would indicate increased intracranial pressure in this child? a) Decrease in pulse and temperature and increase in respiratory rate and pulse pressure b) Decrease in temperature and pulse pressure and increase in pulse and respiratory rate c) Decrease in pulse and pulse pressure and increase in temperature and respiratory rate d) Decrease in pulse and respiratory rate and increase in temperature and pulse pressure - ANSWER- Decrease in pulse and respiratory rate and increase in temperature and pulse pressure Explanation: All children with head trauma require a neurologic assessment as soon as they are seen and again at frequent intervals to detect signs and symptoms of increased intracranial pressure (ICP) as increasing pressure puts stress on the respiratory, cardiac, and temperature centers, causing dysfunction in these areas. The mark of increased pressure is a decrease in pulse and respiratory rate and an increase in temperature and pulse pressure (the distance between the diastolic and systolic A 14-year-old girl arrives at the hospital in a comatose state. Her father, who found her comatose in her room, tells you that she has an opiate addiction. Which of the following would confirm that the coma was caused by opiate intoxication? a) Both pupils are pinpoints b) Both pupils are dilated c) One pupil dilated and the other normal d) One pupil dilated and the other deviated downward - ANSWER- Both pupils are pinpoints Correct Explanation: Observe the child's eyes for signs of dilated pupils from increased ICP. If both pupils are dilated, irreversible brainstem damage is suggested, although such a finding may also be present with poisoning with an atropine-like drug. Pinpoint pupils suggest barbiturate or opiate intoxication. One pupil dilated or the eye deviated downward or laterally more than the other suggests third cranial nerve compression or a tentorial tear (laceration of the membrane between the cerebellum and cerebrum) with herniation of the temporal lobe into the torn membrane. A 3-year-old child has sustained injuries from a fall. Once the airway is secured, which of the following interventions would be next? a) Stabilize the cervical spine. b) Set up antecubital IV access. c) Administer 100% oxygen. d) Check mouth for debris. - ANSWER- Stabilize the cervical spine. Correct Explanation: If head or spine injuries are suspected, then after the airway is opened, the cervical spine must be stabilized to prevent damage. Checking the mouth for debris is part of securing an airway. Administering oxygen and IV access occur after the C-spine is stabilized. A 6-year-old girl who is being treated for shock is pulseless with an irregular heart rate of 32 BPM. Choose the priority intervention: a) Defibrillate once followed by three cycles of cardiopulmonary resuscitation (CPR) b) Initiate cardiac compressions c) Administer doses defibrillator shocks in a row d) Give three doses of epinephrine - ANSWER- Initiate cardiac compressions Explanation: The American Heart Association (AHA) emphasizes the importance of cardiac compressions in pulseless clients with arrhythmias, making this the priority intervention in this situation. Current AHA recommendations are for defibrillation to be administered once followed by five cycles of CPR. The AHA now recommends against using multiple doses of epinephrine because they have not been shown to be helpful and may actually cause harm to the child. The nurse is caring for a 4-year-old boy who is receiving mechanical ventilation. Which is the priority intervention when moving this child? a) Monitoring the pulse oximeter for oxygen saturation b) Checking the CO2 monitor for a yellow display c) Watching for disconnections in the breathing circuit d) Auscultating the lungs for equal air entry - ANSWER- Checking the CO2 monitor for a yellow display Explanation: Exhaled CO2 monitoring is recommended when a child has been intubated. It provides quick, visual assurance that the tracheal tube remains in place and that the child is being adequately ventilated. When moving the child, maintaining tube placement would be crucial. The other interventions would also be appropriate but not as essential as monitoring the child's exhaled CO2 level. Unlike the other interventions, exhaled CO2 monitoring can provide an early sign of a problem. The parents of a 7-month-old boy with a broken arm agree on how the accident happened. Which account would lead the nurse to suspect child abuse? a) "He was climbing out of his crib and fell." b) "The gate was open and he fell down three steps." c) "Mom turned and he fell from changing table." d) "He fell out of a shopping cart in the store." - ANSWER- "He was climbing out of his crib and fell." Explanation: The nurse would be suspicious of a 7-month-old climbing out of his crib, since it is not consistent with his developmental stage. Other areas of concern are if the parents have different accounts of the accident and if the injury is not consistent with the type of accident. The nurse has been monitoring the child's vital signs. The child is 7 years old. Calculate the child's minimum acceptable systolic blood pressure. - ANSWER- 84 Use the following formula (according to Pediatric Advance d Life Support (PALS): 70 + (2 times the age in years) Hence, the minimal systolic BP of a 7- year-old is 70 = (2 x 7) = 84. The nurse is assessing the respiratory status and lungs of a 6-year-old child. Which of the following would the nurse report immediately? a) High-pitched breath sounds over the trachea b) Minimal air movement through the lungs c) Low-pitched bronchial sounds over the periphery d) Resonance over the lungs on percussion - ANSWER- Minimal air movement through the lungs Explanation: Minimal or no air movement requires immediate intervention because this child's status is severely compromised. Breath sounds over the trachea typically are high pitched. Breath sounds over the peripheral lung fields are lower pitched. Normally percussion over air-filled lungs reveals resonant sounds. Fever increases the basal metabolic rate resulting in: a) Bradypnea b) Bradycardia c) Tachypnea d) Decreased oxygen demand - ANSWER- Tachypnea Correct Explanation: Fever increases the basal metabolic rate, resulting in tachycardia, tachypnea, and increased oxygen demand. An unconscious client is brought to the emergency department after ingesting too much prescribed medication. Which of the following is the highest priority nursing intervention? a) Establish a patent airway. b) Establish IV access. Explanation: Inserting an oropharyngeal airway will help ensure that the child maintains a patent airway. Placing a towel under the shoulders would be helpful for opening the airway if this child were an infant. A tracheal tube would not be appropriate since the child is breathing spontaneously and able to maintain her ventilatory effort. Repositioning her using the head tilt/chin lift won't help if she can't maintain an airway independently. A child is to undergo synchronized cardioversion. The child weighs 44 lbs. The nurse would expect how many joules to be delivered? a) 10 to 20 joules b) 5 to 10 joules c) 2 to 4 joules d) 30 to 40 joules - ANSWER- 10 to 20 joules Explanation: Energy for cardioversion is delivered at 0.5 to 1 joule/kg. The child weighs 44 lbs or 20 kg. Therefore, the child would receive 10 to 20 joules. Tachycardia = an sign of shock - ANSWER- Early What is a late sign of circulatory compromise in children? - ANSWER- Hypotension Children can remain normotensive until about percent of blood volume is lost - ANSWER- 25% What are two intervention you should always be doing? - ANSWER- Applying oxygen Checking bedside blood glucose How long should the car seat be rear facing? - ANSWER- Until at least one year of age model parents behavior with toys - ANSWER- Toddlers Age 3 to 5: - ANSWER- Preschoolers Magical and it logical thinkers Take things literally What are common fears of the preschooler? - ANSWER- Pain Darkness Body mutilation Being alone Ages 5 to 11: - ANSWER- School age kids Beers include separation from parents, loss of control, and physical disability 11 to 18 years old: - ANSWER- Body a parent is the most important thing What is one of the critical public health issues in today society? - ANSWER- Childhood obesity At how many years old can a child start using the faces pain scale? - ANSWER- Three years old What is there an emphasis on during the prioritization of the patient? - ANSWER- Safety I focused assessment is what type of information? - ANSWER- Objective I focused history is what type of information? - ANSWER- Subjective The pediatric assessment triangle a.k.a. the across the room assessment of a patient looks at what three things? - ANSWER- General appearance Work of breathing Circulation to the skin How long should the pediatric assessment triangle take? - ANSWER- About 3 to 5 seconds What does the general appearance section include: - ANSWER- Interaction Muscle tone Consolabilty Look or gaze Speech or cry Work of breathing— a good indicator of oxygenation and ventilation. What should you look for in this assessment? - ANSWER- Abnormal airway sounds Coughing Abnormal positioning Retractions/nasal flaring Rate and depth of respirations Circulation to the skin: - ANSWER- Skin reflects perfusion status Inspect the color of central areas such as lips and mucous membranes Assessed for pallor, molting, or cyanosis Is the patient flushed or diaphoretic What are the three patient categories for the pediatric assessment triangle? - ANSWER- Sick Sicker Sickest If all three components of the PAT are stable know what will the patient be ranked as? - ANSWER- Sick PDA - start this patient on prostaglandins. Do not give this patient any Motrin as it can help the PDA to close. Tampa nod - you need to pull the fluid off surrounding the heart PE Congenital heart disease What is the urine output that we I would like to maintain when a patient is in shock? - ANSWER- 1 mL per kilo Monitoring should be done for a patient in shock? - ANSWER- Cardiac monitoring Pulse ox Capnography 12 lead EKG Chest x-ray CT for any trauma Echo Coags, CBC, electrolytes, type and cross, lactate, arterial blood gas, urinalysis, blood and urine culture, and always check glucose What is the goal with septic shock? - ANSWER- The goal is to restore adequate perfusion What is the rate and depth of CPR that should be administered? - ANSWER- The rate of CPR should be 100 to 120 compressions per minute The death should be 1.5 to 2 inches and then 2 to 2.5 depth allow for recoil What will you give to correct hypoglycemia and in a neonate? - ANSWER- Give D 10- 2cc per kilo can be given over one minute What will you give to the patient that is two years or older with hypoglycemia? - ANSWER- You can give D 25. Either 2 to 4 mL per kilo can be given What is the drug of choice for children with bradycardia? - ANSWER- EPI When do you choose atropine for bradycardia and children? - ANSWER- When you suspect that the bradycardia is vagal in nature What is the number one site choice for an IO? - ANSWER- The proximal tibia How can you tell that an I/O is infiltrated? - ANSWER- I feeling underneath of the leg when flushing How long can an I/O same place for? - ANSWER- For 24 hours or until you get another form of access What are the things that you want to consider pre-intubation? - ANSWER- Preoxygenation Atropine, this drug maybe used for patients less than eight years old Prepare for any alternative things that may have to happen such as cric Consider lido What are the complications of intubation? - ANSWER- Pneumothorax Gastric dissension How will you confirm placement of the ET tube? - ANSWER- Auscultation CO2 detector Chest x-ray Capnography If an ET tube fails what are alternative airway solutions? - ANSWER- LMA mask is a true emergency! High fever. Muffled voice. Sore throat. Drooling. Stridor . This is caused by a marvelous influenza B. Often times you will see the thumb sign. For these patients you want to give blow by oxygen as tolerated. Make sure to avoid any invasive procedures until the patient is stabilized, this means no IV or throat exam until the patient's airway is stable. - ANSWER- Needle cricothyrotomy A barky seal like cough, worse at night. Low-grade fever. Steeple sign is seen via x-ray. You will want to inform parents to do coolness, take the child outside or open the freezer. Steam from the shower can also help. Administer steroids for inflammation. Give her Seemic Kathy for relief up to two hours, observation is key. - ANSWER- Croup We should observe a patient that received racemic epi-for at least hours? - ANSWER- 6 pneumonia: - ANSWER- Maybe viral, bacterial, fungal, or parasitic Give antibiotics Most kids are viral Abdominal pain may be present in lower lobe pneumonia Pertussis: - ANSWER- Whooping cough Bacterial - contagious Thank you Bashan is 7 to 10 days Usually worse at night Droplet cautions Erythromycin is the anabiotic of choice The most common cause of pediatric dysrhythmias is an unrecognized or - ANSWER- Respiratory or metabolic compromise