Heartcode PALS (Correctly Solved)
The infant is placed on the ambulance stretcher and responds with a groan when stimulated and has a temperature of 36.3 C (97.3 F) correct answers -Monitor and support ABCs
-Establish IV/IO access
-Monitor heart rate, blood pressure, and pulse oximetry
-Call for assistance if needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled, glucose is 97 mg/dL and capillary refill time is 5 seconds. What are the warning signs that the patient is progressing from compensated shock to hypotensive shock? correct answers -Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified as ___________ shock. correct answers Hypotensive
What should be included in the initial treatment for this patient? correct answers -Rapid fluid bolus administration
-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most appropriate way to rapidly determine her weight and calculate correct medication? correct answers Measure her by using color-coded length-based tape
You measure the infant to be 7 kg and prepare to administer a fluid bolus of what type? correct answers Normal saline 20 mL/kg
What is the most appropriate method of delivering rapid fluid boluses to this patient? correct answers A syringe and 3-way stopcock After the first fluid bolus is administered, the child is reassessed and her vital signs are HR 167, BP 58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale and she is still lethargic and weak.
What should be the next intervention? correct answers Deliver a second fluid bolus of 20 mL/kg and reassess
When should vasoactive therapy be considered be considered in managing distributive shock? correct answers If the child remains hypotensive and poorly perfused despite rapid bolus fluid administration
How does the clinical presentation of distributive shock compare with hypovolemic shock? correct answers Distributive shock has more variable presentation than that of hypovolemic shock
For general shock management, administer an isotonic crytalloid bolus of __ mL/kg over __ to __ minutes correct answers For general shock management, administer an isotonic crytalloid bolus of 20 mL/kg over 5 to 20 minutes
What signs distinguish anaphylactic shock from other types of shock? correct answers -
Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
in a child with anaphylactic shock, what is the most appropriate initial treatment? correct answers IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock? correct answers Seconds to minutes
What should you evaluate to recognize septic shock? correct answers -Temp
-Heart rate
The infant is placed on the ambulance stretcher and responds with a groan when stimulated and has a temperature of 36.3 C (97.3 F) correct answers -Monitor and support ABCs
-Establish IV/IO access
-Monitor heart rate, blood pressure, and pulse oximetry
-Call for assistance if needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled, glucose is 97 mg/dL and capillary refill time is 5 seconds. What are the warning signs that the patient is progressing from compensated shock to hypotensive shock? correct answers -Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified as ___________ shock. correct answers Hypotensive
What should be included in the initial treatment for this patient? correct answers -Rapid fluid bolus administration
-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most appropriate way to rapidly determine her weight and calculate correct medication? correct answers Measure her by using color-coded length-based tape
You measure the infant to be 7 kg and prepare to administer a fluid bolus of what type? correct answers Normal saline 20 mL/kg
What is the most appropriate method of delivering rapid fluid boluses to this patient? correct answers A syringe and 3-way stopcock After the first fluid bolus is administered, the child is reassessed and her vital signs are HR 167, BP 58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale and she is still lethargic and weak.
What should be the next intervention? correct answers Deliver a second fluid bolus of 20 mL/kg and reassess
When should vasoactive therapy be considered be considered in managing distributive shock? correct answers If the child remains hypotensive and poorly perfused despite rapid bolus fluid administration
How does the clinical presentation of distributive shock compare with hypovolemic shock? correct answers Distributive shock has more variable presentation than that of hypovolemic shock
For general shock management, administer an isotonic crytalloid bolus of __ mL/kg over __ to __ minutes correct answers For general shock management, administer an isotonic crytalloid bolus of 20 mL/kg over 5 to 20 minutes
What signs distinguish anaphylactic shock from other types of shock? correct answers -
Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
in a child with anaphylactic shock, what is the most appropriate initial treatment? correct answers IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock? correct answers Seconds to minutes
What should you evaluate to recognize septic shock? correct answers -Temp
-Heart rate
