PALS ARRHYTHMIAS EXAM
QUESTIONS AND ANSWERS
1. Whenever a child has an abnormal heart rate or rhythm, you
must quickly determine?: Determine if the arrhythmia is causing hemodynamic instability
or other signs of deterioration.
2. What are the signs of instability in a patient with arrhythmias?:
Respiratory distress or failure
Shock with poor end-organ perfusion, may occur with or without hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
sudden collapse
3. Priorities in initially managing arrhythmias are?: The same as they are for
all critically ill children: Support ABC and treat underlying cause
4. Bradycardia: A heart rate that is slow in comparison with a normal heart rate range for the childs
age, level of activity and clinical condition
,5. What is the leading cause of symptomatic bradycardia in children?:
Tissue hypoxia
6. Symptomatic Bradycardia: Heart rate below 60/min associated with cardiopulmonary
compromise
7. Cardiopulmonary compromise: * Hypotension
* Acutely altered mental status
* Signs of shock
8. Bradycardia is an ominous sign of?: Sign of impending cardiac arrest in infants
and children. Especially if hypotension or poor tissue perfusion is present
9. Children with severe cardiovascular compromise from pulmonary
embolism, what treatment should be considered?: Fibrinolytic agents
10. What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise?: Bag mask ventilation with 100% O2
11. Fibrinolytic agents: tissue plasminogen activator, streptokinase, reteplase
Tenecteplase
12. Primary bradycardia: A result of congenital or acquired heart conditions
13. Causes of primary bradycardia: Congenital abnormality of the heart
, pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
14. Secondary bradycardia: Result of noncardiac conditions that alter the normal function
of the heart (Slow sinus node pacemaker or slow conduction)
15. secondary bradycardia
causes: Hypoxia Acidosis
Hypotension
Hypothermia
Drug effects
16. ECG characteristics of
Bradycardia HR
P wave
QRS complex
Pwave and QRS complex: HR Slow compared with normal heart rate
for age P wave May or may not be visible
QRS complex Narrow or wide
Pwave and QRS complex: may be unrelated
QUESTIONS AND ANSWERS
1. Whenever a child has an abnormal heart rate or rhythm, you
must quickly determine?: Determine if the arrhythmia is causing hemodynamic instability
or other signs of deterioration.
2. What are the signs of instability in a patient with arrhythmias?:
Respiratory distress or failure
Shock with poor end-organ perfusion, may occur with or without hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
sudden collapse
3. Priorities in initially managing arrhythmias are?: The same as they are for
all critically ill children: Support ABC and treat underlying cause
4. Bradycardia: A heart rate that is slow in comparison with a normal heart rate range for the childs
age, level of activity and clinical condition
,5. What is the leading cause of symptomatic bradycardia in children?:
Tissue hypoxia
6. Symptomatic Bradycardia: Heart rate below 60/min associated with cardiopulmonary
compromise
7. Cardiopulmonary compromise: * Hypotension
* Acutely altered mental status
* Signs of shock
8. Bradycardia is an ominous sign of?: Sign of impending cardiac arrest in infants
and children. Especially if hypotension or poor tissue perfusion is present
9. Children with severe cardiovascular compromise from pulmonary
embolism, what treatment should be considered?: Fibrinolytic agents
10. What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise?: Bag mask ventilation with 100% O2
11. Fibrinolytic agents: tissue plasminogen activator, streptokinase, reteplase
Tenecteplase
12. Primary bradycardia: A result of congenital or acquired heart conditions
13. Causes of primary bradycardia: Congenital abnormality of the heart
, pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
14. Secondary bradycardia: Result of noncardiac conditions that alter the normal function
of the heart (Slow sinus node pacemaker or slow conduction)
15. secondary bradycardia
causes: Hypoxia Acidosis
Hypotension
Hypothermia
Drug effects
16. ECG characteristics of
Bradycardia HR
P wave
QRS complex
Pwave and QRS complex: HR Slow compared with normal heart rate
for age P wave May or may not be visible
QRS complex Narrow or wide
Pwave and QRS complex: may be unrelated
