Random from CPEN Practice Test 1 Solved 100% Correct!!

Random from CPEN Practice Test 1 Solved 100% Correct!! plague (yersinia pestis) - fever - bloody sputum - clinical pneumonia -- early sign - sepsis + DIC -- late sign anthrax (bacillius anthracis) - fever - headache - dyspnea - cough - N/V - chest/abd pain botulism (clostridium botulinum) -descending flaccid paralysis - cranial nerve palsy - normal mentation smallpox (variola) - fever - vesiculopustular leisons in face + trunk Dextrose 5% not used to tx hypoglycemia in kids Dextrose 10% tx hypoglycemia in neonates Dextrose 25% tx hypoglycemia in 1month to 2years old Dextrose 50% tx hypoglycemia in 2 years old & older in compartment syndrome, do you elevate extremity above the heart or at the level of the heart keep limb at leave of heart b/c if you elevate, you're reducing blood flow and w/ compartment syndrome, you are already worried about reduced blood flow femur factures are (name 4 things) 1. can cause significant blood loss 2. cause hemorrhagic shock 3. painful 4. presents w/ external rotation Oxygen supplement helps a sickle cell anemia pt by ease WOB oxygen baseline for sickle cell anemia pts are generally lower d/t sickling of RBC so important to measure their O2 Jaw thrust maneuver is used in traumatic injury / spinal injury is suspected protects the spine head tilt maneuver is used in non-trauma patients (when spine injury is NOT suspected) normal liver palpable up to how many cms below costal margin up to 2cm below costal margin Sickle cell disease is most susceptible to what 2 things? 1. acute chest syndrome (ACS) stration crisis (firm/enlarged spleen) - LUQ pain sequestration crisis tx 1. PRBC 2. oxygen (tx inadequate tissue oxygenation) What heart sounds are heard w/ cardiogenic shock? muffled heart sounds what can cause a blunt carotid artery injury? cervical seat belt abrasion s/s of blunt carotid artery injury - unilateral weakness - unremarkable CT of head - carotid bruit - normal mental status s/s of intrabdominal hemorrhage - hypovolemic shock (hypotensive) - altered mental status - tachycardia - pallor Henoch-Schonlein Purpura - generalized vasculitis - presents usually in lower extremities (including butt) - bloody stools - abd pain, D/V when can henoch-schonlein purpura occur after a recent URI FLACC highest score is ____ w/ _____ categories highest score 10 5 categories face 0 = no particular expression 1 = occasional grimace, frown, withdrawn, disinterested 2= frequent to constant frown, clenched jaw, quivering chin legs 0= normal/relaxed 1= uneasy, restless, tense 2= kicking or legs drawn up activity 0= lying quietly, normal position, moves easily 1= squirming, shifting back & forth, tense 2= arched, rigid, jerking cry 0= no crying 1= moans or occasional whimper 2=crying steadily, screams or sobs, frequent complaining consolibility 0=content, relaxed 1= reassured by occasional touch, hug, or being talked to, distractable 2=difficult to console/comfort do not give what type of drugs to sickle cell disease patients NSAIDS - they can impair kidney function and accelerate kidney damage anticonvulsant meds have shown to increase the risk of what violence or aggressive behaviors s/s of epiglottitis - drooling - inability to swallow - retractions - stridor epiglottitis can be caused by HIB (take HIB vaccine) s/s of croup - inspiratory stridor (s in inspir for s=tridor) - expiratory wheeze - barking cough - retractions - fever birth weight doubles 6 months birth weight triples 12 months birth weight quadruples 30 to 36 months preferred IO site proximal tibia skeletal survey will help reveal fractures and healing fractures generally used when suspected child abuse/suspicious fall/fall if babinski reflex is NOT observed in children under 2 year old, what do you suspect? so what exam is required? lesion on the spine CT scan of lower spine how much drainage per hour would require blood transfusion in a hemothorax greater than 2mL/kg per hour PICC lines: dislodge clots causes what - pulmonary embolism - respiratory distress - would not cause swelling or pallor PICC lines: air embolism causes what - air lodged in the pulmonary vasculature - respiratory distress phlebitis is noticed immediately, not over time ~ 20 mins PICC lines: catheter rupture can be caused by what? - flushing w/ less than 5mL syringe PICC lines: why does flushing w/ syringe less than 5mLs lead to possible catheter rupture? smaller syringe has higher infusion pressure so it increases risk of catheter rupture PICC lines: catheter rupture s/s - pallor - swelling at the rupture site ruptured catheter causes fluid to leak into subcutaneous tissue Apply a magnet to a pacemaker will put the pacemaker into a fixed rate, asynchronous node, and helps determine if pacemaker battery replacement is needed or if there is malfunction stable SVT tx adenosine unstable SVT tx synchronized cardioversion using the defib monitor must search for highest R wave deflection on the QRS complex start w/ how many joules in synchronized cardioversion? 0.5 joules/kg symptomatic bradycardia tx pacer mode ~ requires transcutaneous pacing pulseless VT or ventricular fibrillation (vfib) tx defibrillation mode (unsynchronized shock required) complex laceration repairs that require plastic surgeries are... areas that contain cartilage (e.g. ears) how do you clean a human bite soap & water and apply guaze as needed need soap & water b/c human dental place and gingiva harbor bacteria a LMA (laryngeal mask airway) is used when... (name 2) 1. ET intubation fails 2. ventilation is difficult initial choice to ensure patency of airway - name 2 1. nasopharyngeal airway 2. orophargyneal airway when is a nasopharyngeal airway contraindicated? head or brain trauma when is an oropharyngeal airway contraindicated? when pt is conscious effects of using prostaglandins to keep PDA open include which 5 adverse effects 1. hypoglycemia 2. hypotension (known to vasodilate) 3. flushed skin 4. apnea 5. positive pressure ventilation so give the least needed possible bilious emesis seen in volvulus what causes scaphoid abdomen & barrel chest seen in diaphragmatic hernia pyloric stenosis common in what age 3-5 weeks of life what does pyloric stenosis cause? small mass in hypertrophic pylorus causing obstruction at outflow of stomach what are s/s of pyloric stensis? name 3 - projectile vomiting - small oval mass in LUQ (olive) - dehydration d/t malabsorption - 4-6 weeks s/s of intussusception..name 4 - jelly currant stools (blood in stool) - bilious emesis - sausage shaped mass - 6-12 months 4 s/s of trichomonas vaginitis - dysuria - thick, frothy, green vaginal discharge - foul odor - abd pain 3 s/s of candida vulvovaginitis - itching - burning - white curd like discharge what is the most common cause of bradycardia in kids? hypoxia what is the insulin dosage in a DKA pt? 0.1 units /kg/hour pericarditis can occur after what? upper respiratory illness from as long as 2 weeks ago pericarditis makes what heart sounds? squeaky heart sounds cardiogenic shock heart sounds muffled heart sounds Do not give NSAIDS to which sick patients? Oncology Blunt carotid artery injury s/s.. name 3 - carotid bruit - unilateral weakness - unremarkable CT What is Henoch Schonlen Purpura (HSP)? Generalized vasculitis that occurs after recent upper respiratory tract infection S/s of Henonch Schonlen Purpura? - bloody stools - fecal occult blood + - D/V/ abd pain - swelling of dorsal hands/feet/ankles What type of pain medicine is NOT suitable for sickle cell disease? why? Ibuprofen can impair kidneys Which type of medications has been shown to increase risk of violence/aggressive behaviors? Certain anticonvulsant meds If babinski reflex is absent in a child under 2 y/o, what does this mean? what diagnostic exam is needed? maybe lesion on spine CT scan of lower spine What 2 foods can cause clostridum botulinum? 1. Honey 2. Corn syrup When suctioning tracheostomy, how far should you go to avoid bleeding? less than 0.5cm beyond the end of the tube Saline drops prior to suctioning tracheostomy does what? - does not cause bleeding - ineffective b/c it lengthens recovery time and exacerbate desaturation associated w/ suctioning If an IO site does not work/infiltrated, what is the next thing that should be done? remove IO device What damage does an infiltrated IO cause?