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Parents of a 7 year old who is undergoing chemotherapy report the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the following: Difficulty to arouse, pale. HR is 160/min, RR is 30/min, and BP is 76/45. CAP refill is 5 to 6 sec, temp is 103 F. What is the most appropriate intervention? - Obtain vascular access and administer 20mL/kg of isotonic crystalloid over 5 to 10 minutes Which of the following is a characteristic of respiratory failure? - Inadequate oxygenation and/or ventilation An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention? - Administer (Racemic) Epinephrine An 8 year old child presents with history of vomiting and diarrhea. The child has the following vital signs: HR 168/min, RR of 15/min, BP of 90/60, and a temp of 98.6 F. CAP refill is 4 sec. After 2 IV boluses of NS, the child has the following Vitals: HR 130/min, RR 16/min, BP 94/62, CAP refill less than 2 sec, temp of 98.6 F. Urine output is 1 to 2 mL/kg. The Child is still lethargic. What diagnostic tests or information should be obtained first? - Glucose A115 year old boy presents with acute onset of severe respiratory distress, with retractions and an 02 Sat of about 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His HR is 140/min, his BP is 84/60, and hi CAP refill time is 3 sec. What is the most appropriate intervention? - Perform needle decompression on the left chest For a 6 Month Old infant with Supraventricular Tachycardia and adequate perfusion, which of the following is the preferred vagal maneuver? - Ice to face During resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1mg/kg to be given IO. What should the team member do? - Respectfully ask the team leader to clarify the dose (closed loop communication) A 2 week old infant presents with irritability and a history of poor feeding. BP is 55/40. What term describes this infant's blood pressure? - Hypotensive A3 year old child was recently diagnosed with leukemia and has been treated with chemotherapy. The child presents with lethargy and a high fever. HR is 195/min, RR is 36/min, BP is 85/40, and CAP refill time is less than 2 seconds. What is the child's most likely condition? -— Septic shock A 10 year old child had a sudden witness's cardiac arrest and received immediate by standard CPR and defibrillation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive and has an advanced airway in place. There is no history of trauma or signs of shock. What is the target range for oxygen saturation for this child? - 94% to 99% Which of the following is most likely to produce a prolonged expiratory phase and wheezing? -— Lower airway obstruction A4 year old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following is most likely to be abnormal? — Control of breathing A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the correct compression-to-ventilation ratio when 2 or more healthcare providers are present to perform CPR? - mlb=z A/7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention? - Synchronized shock with 0.5 to 1 J/kg While you are performing CPR on an infant in cardiac arrest at a doctor's office, a second rescuer arrives with an AED. Which of the following best describes the use of an AED on this infant? - If pediatric pads are unavailable, it is acceptable to use adult pads A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's HR decreases from 150/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. What intervention is most appropriate? - Provide rescue breaths at a rate of 12 to 20/min What is the recommended location to check for a pulse in a 3-month-old infant? - Brachial A6 month old infant is unresponsive and not breathing. What is the maximum time that should be spent trying to palpate the pulse before starting CPR? - 10 Seconds Place an Intraosseous line An alert 2-year-old child with an increased work of breathing and pink color is being evaluated. HR is 110/min, and RR is 30/min. What would best describe this patient's condition? - Respiratory Distress What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease? - Decreased Oxygen saturation 
