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ENPC 2022 Study Guide with Complete Solution

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Pediatric triangle appearance work of breathing circulation to skin General appearance considerations Tone Interactiveness: drawn to sounds or people. Wants to play Consolability Look/Gaze Speech/cry Work of breathing: Increased work of breathing evidenced by tachypnea, stridor, grunting, ...

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  • January 19, 2024
  • 22
  • 2023/2024
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ENPC 2022 Study Guide with Complete Solution

Pediatric triangle ✔✔appearance
work of breathing
circulation to skin


General appearance considerations ✔✔Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry


Work of breathing: ✔✔Increased work of breathing evidenced by tachypnea, stridor, grunting,
retractions, accessory musles, nasal flaring, head bobbing, abnormal positioning


Circulation to Skin ✔✔Observe palor
mottling
cyanosis


Sick, Sicker, Sickest ✔✔Sick: no disruption of any component of PAT but caregivers are
concerned


Sicker: one component of PAT is a concern


Sickest 2+ concerns of PAT


2 leading causes of altered mental status in kids ✔✔hypoxia
hypoglycemia


Blood pressure norms ✔✔Hypotension: Less than 70 + (2 x age in years)

,Widening pulse pressure = increased ICP


Narrowing pulse pressure = hypovolemic shock


Crying child ✔✔Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag


Respiratory distress indicated by: ✔✔increased heart rate
skin color changes
incrased work of breathing
wheezing
diaphoresis
abnormal airwa sounds


Respiratory failure signs ✔✔fatigue and become lethargic
hypoxia
hypercarbia


General airway interventions ✔✔Allow child to stay in most comfortable position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation


Croup ✔✔1-3 days of nasal congestion and fever with sudden onset of barky cough


Treatment: dexamethasone and nebulized epi


Discharge Teaching: oral hydration, get child to cool air or steamy bathroom

, Asthma interventions ✔✔albuterol, duo neb and oral steroid


Bronchiolitis/RSV ✔✔Assessment: 1-3 days nasal congestion fever, cough, respiratory distress
with wheezing and crackles. Dehydration and tachypnea


interventions: nasla suctioning, fluids
sever: heated, high flow nasal cannula O2


Discharge: lasts 2-3 weeks; nasal suctioning; monitor hydration


treating hypoglycemia ✔✔obtain glucose for anyone who is not awake and alert


treat kids with 2-4ml/kg of D25W


When to perform blood glucose test? ✔✔When the child is not awake and alert or AMS is
suspected


Preventing Secondary brain injury in TBI ✔✔prevent hypotension and hypoxia


cuffed vs uncuffed tube ✔✔uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5


fluid bolus formula ✔✔infant: 10ml/kg
kid: 20ml/kg


normal vitals ✔✔pg 52


blood glucose normal ages 5-11 ✔✔72-140

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