PALS HEART CODE WITH
CORRECT ANSWERS | GRADED A+
| UPDATED VERSION
QUESTIONS AND ANSWERS
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). ANSWER -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?. ANSWER -
Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified as
___________ shock.. ANSWER Hypotensive
What should be included in the initial treatment for this patient?. ANSWER -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?. ANSWER 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?.
ANSWER Normal saline 20 mL/kg
, What is the most appropriate method of delivering rapid fluid boluses to this patient?.
ANSWER 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?. ANSWER Deliver a second fluid bolus of 20
mL/kg and reassess
When should vasoactive therapy be considered be considered in managing distributive
shock?. ANSWER 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?.
ANSWER 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. ANSWER 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?. ANSWER -
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?.
ANSWER IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock?. ANSWER
Seconds to minutes
What should you evaluate to recognize septic shock?. ANSWER -Temp
CORRECT ANSWERS | GRADED A+
| UPDATED VERSION
QUESTIONS AND ANSWERS
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). ANSWER -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?. ANSWER -
Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified as
___________ shock.. ANSWER Hypotensive
What should be included in the initial treatment for this patient?. ANSWER -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?. ANSWER 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?.
ANSWER Normal saline 20 mL/kg
, What is the most appropriate method of delivering rapid fluid boluses to this patient?.
ANSWER 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?. ANSWER Deliver a second fluid bolus of 20
mL/kg and reassess
When should vasoactive therapy be considered be considered in managing distributive
shock?. ANSWER 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?.
ANSWER 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. ANSWER 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?. ANSWER -
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?.
ANSWER IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock?. ANSWER
Seconds to minutes
What should you evaluate to recognize septic shock?. ANSWER -Temp
