PALS - Team Response Final Scenario- Sophia Giamanti (Questions and Answers) 100% A+ 2023

PALS - Team Response Final Scenario- Sophia Giamanti (Questions and Answers) 100% A+ 2023 Which of the following should Jeremy do immediately after checking for responsiveness using the shout-tap-shout sequence? - CORRECT ANSWER-The first step is simultaneously assessing for breathing and a central pulse for at least 5 seconds, but less than 10. After determining that the infant is not breathing and does not have a pulse, which of the following should the nurses start immediately? - CORRECT ANSWER-Immediate care consists of performing high-quality CPR and administration of 100% oxygen via BVM The cardiac monitor reveals the patient's rhythm is asystole. Which of the following should be included in the treatment? - CORRECT ANSWER-1. Continue high-quality CPR. 2. Provide ventilations with high flow 100% O2 via BVM. 3. Consider/maintain an advanced airway. 4. Administer epinephrine. After reviewing her chart, Marco notes Sophia's weight is 8 kg. Which of the following doses of epinephrine IO should he administer to Sophia? - CORRECT ANSWER-The correct dose is 0.1 mL/kg of the 1:10,000 solution, which would be 0.8 mL for Sophia. Joanne knows that the compressions are effective as evidenced by an ETCO2 value range of what? - CORRECT ANSWER-ETCO2 values between 15 to 20 mmHg indicate effective compressions during a resuscitation attempt. The team knows it is appropriate to give a second dose of epinephrine at what time interval? - CORRECT ANSWER-Epinephrine should be administered every 3 to 5 minutes during cardiac arrest. The infant's rhythm has changed, but it is still unorganized. Which of the following rhythms does this image show? - CORRECT ANSWER-The rhythm is ventricular fibrillation. What is the immediate next step for this cardiac rhythm? - CORRECT ANSWER-Ventricular fibrillation is a shockable rhythm. The team should defibrillate immediately at a dose of 2 J/kg for an initial shock. What is the appropriate dose that should be administered to Sophia for a second shock? Enter your answer in joules. - CORRECT ANSWER-The correct dose for a second shock is 4 J/kg. The PICU team understands that this spike in ETCO2 mmHg level likely indicates what? - CORRECT ANSWER-The spike in ETCO2 level indicates ROSC. Jenny adjusts the settings for the ventilator knowing which of the following are appropriate interventions to optimize oxygenation and ventilation after cardiac arrest? - CORRECT ANSWER-The respiratory therapist should maintain oxygen saturation greater than 94% but less than 100% and maintain normocapnia. It is important to use the lowest possible tidal volume to do this and avoid hyperventilating the patient. Assessment findings reveal that Sophia's rectal temperature is elevated to 100.4° F (38° C). Which treatment options are appropriate? - CORRECT ANSWER-The team should treat the fever right away by administering an antipyretic or using active cooling. Based on these assessment findings, which initial intervention should Marco implement? - CORRECT ANSWER-Administer a fluid bolus. After the initial fluid bolus, Marco notes Sophia's CVP reading is 6. Which action should he take? - CORRECT ANSWER-The team should administer a second fluid bolus due to the lower than desired CVP reading. Marco knows that it is important to treat hyperglycemia post cardiac arrest when the glucose levels reach which of the following? - CORRECT ANSWER-Hyperglycemia is necessary to treat when the levels are greater than 144 mg/dL. In this case, treatment is not necessary. Which is the primary goal and focus of post-cardiac arrest care? - CORRECT ANSWER-Preservation of neurologic function In children and infants, cardiac arrest most often arises from which complication? - CORRECT ANSWER-Respiratory failure Which medications may be used in the cardiac arrest care of a patient with a "shockable" rhythm? - CORRECT ANSWER-1. Amiodarone 2. Epinephrine 3. Magnesium Sulfate 4. Lidocaine Which finding indicates adequate end-organ and tissue perfusion? - CORRECT ANSWER-Urine output greater than 1 mL/kg/h A patient admitted to the pediatric emergency department is in cardiac arrest. The rhythm on the defibrillator monitor is ventricular fibrillation (VF). Which energy dose should the team leader order to administer an initial shock? - CORRECT ANSWER-2 J/kg Which statement correctly describes the completion of the primary assessment of a patient in cardiac arrest? - CORRECT ANSWER-The primary assessment should be delayed in order to provide prompt, life-saving measures. A healthcare provider suspects that hyperkalemia may be the cause of the patient's cardiac arrest. Which should the provider order to confirm hyperkalemia? - CORRECT ANSWER-Serum electrolyte panel The healthcare provider notes that an infant receiving post-cardiac arrest care has an increase in temperature. The provider understands treatment should be initiated if the temperature rises at least which amount above normal? - CORRECT ANSWER-1 degree increase The healthcare provider understands that an ischemia/reperfusion response during post-cardiac arrest syndrome (PCAS) is similar to which kind of shock? - CORRECT ANSWER-Septic Which ECG rhythm is identified in the following image? - CORRECT ANSWER-Polymorphic ventricular tachycardia (torsades de pointes) looks like scribbed signature mountain/upside down mountains The PALS team is actively attempting to resuscitate a 9-kg infant in cardiac arrest. The team leader instructs the monitor team member to administer a second defibrillation. How many joules should the team member administer? - CORRECT ANSWER-36 joules: 1. Activate emergency medical services, call a pediatric "code blue", obtain AED or defibrillator 2. Is the rhythm shockable? Rhythm IS shockable (ventricular fibrillation or unstable ventricular tachycardia) 1. Administer shock at 2 Joules/kg 2. Administer high-quality CPR for 2 minutes 3. Check rhythm If not shockable, move to asystole/PEA rhythm protocol If shockable, continue 4. Administer shock at 4 Joules/kg 5. Administer epinephrine 0.01 mg/kg IV or 0.1 mg/kg per ETT every 3-5 minutes 6. Administer high-quality CPR for 2 minutes 7. Check rhythm If not shockable, move to asystole/PEA rhythm protocol If shockable, continue 8. Administer shock at >4 Joules/kg 9. Administer amiodarone 5 mg/kg IV (repeat 2 times if needed) or lidocaine 1 mg/kg IV 10. Administer high-quality CPR for 2 minutes 11. Check rhythm If not shockable, move to asystole/PEA rhythm protocol If shockable, repeat steps 8-11 Rhythm IS NOT shockable (asystole or pulseless electrical activity) 1. Administer high-quality CPR for 2 minutes 2. Administer epinephrine 0.01 mg/kg IV or 0.1 mg/kg per ETT every 3-5 minutes 3. Check rhythm If shockable, move to VF/VT rhythm protocol If not shockable, continue 4. Administer high-quality CPR for 2 minutes 5. Check rhythm If shockable, move to VF/VT rhythm protocol If not shockable, continue 6. Administer amiodarone 5 mg/kg IV (repeat 2 times if needed) 7. Administer high-quality CPR for 2 minutes 8. Check rhythm