Complete Solutions
Atrioventricular Septal Defect (AVSD):
a. Definition: absence of atrioventricular septum, resulting in a
single common atrial ventricular chamber. most common CHD
in Trisomy 21 (Down syndrome)
b. X-ray: N/A
c. Treatment: Diuretics/digoxin, low SpO2/little oxygen, surgery
Atrial Septal Defect (ASD):
a. Definition: failure of the foreman ovale to close or failure of
the atrial septum to develop correctly.
c. At birth: normal
d. Symptoms start later: heart failure, failure to thrive,
difficulty feeding, turns blue occasionally
e. X-ray: N/A
f. Treatment: oxygen, surgery
Coarctation of Aorta POSTDUCTAL TYPE:
a. Definition: stenosis, or narrowing of the aorta distal to the
ductus arteriosus.
b. Cyanosis? NO
c. Other symptoms: pulse/BP higher in upper extremities than
lower extremities, pulmonary hypertension/edema
,d. X-ray: N/A
e. Treatment: digitalis, prostaglandins, surgery
Coarctation of Aorta PREDUCTAL TYPE:
a. Definition: stenosis, or narrowing of the aorta proximal to the
entrance of the ductus arteriosus.
b. Cyanosis? YES
c. Other symptoms: pulse/BP higher in upper extremities than
lower extremities
d. X-ray: N/A
e. Treatment: prostaglandins, surgery
During mass casualty what is your role? What are the triage
system color codes?
You should have established call in list.
Triage system color codes:
Red: needs immediate assistance, but has chance of survival
Yellow: requires observation, but stable for the moment
Green: will require medical care at some point, but can wait
White: does not need medical care
Black: deceased, or has injuries so extensive, they will not
survive
Detail the set up and use of a disposable drainage unit for a chest
tube:
,1. Set up like three bottle system
2. Approx. 2cm of water in water-seal chamber
a. Water moves 2-6cmH2O AKA intrapleural pressure
a. On vent - water rises away from patient on insp and toward
patient on exp
b. Off vent - water rises toward patient on insp and away from
patient on exp
3. Approx. 20cm of water in suction-control chamber (height of
water=suction pressure) - bubbling normal
4. Replace when full
Describe rigid vs flexible bronchoscopes. In what situations
should each be used?
Rigid: hollow metal tube that also functions as an airway.
Preferred scope for *therapeutic indications (i.e. foreign
body)*. Used in OR.
Flexible: rubber scope, with fiber optic bundles as a light source.
Preferred scope for *diagnostic indications (i.e. lavage,
evaluation, aspiration, inhalation)*. Used in ICU/outpatient.
A pediatric patient is developing respiratory distress syndrome.
The physician wants the patient's PaO2 increased. You cannot
increase FiO2 and the patient's blood pressure deteriorates with
further PEEP. What should you do?
Administer fluid challenge
, What are the four critical life functions?
1. Ventilation
2. Oxygenation
3. Circulation
4. Perfusion
What assessments would measure how well a patient is
ventilating?
PaCO2, PeCO2, RR, Vt, BS, chest movement
How would you know if a patient has a problem with
oxygenation?
*HR*, SpO2, PaO2, color
What is the most common problem in neonates and children?
Oxygenation
What factors in maternal history would indicate a high-risk
pregnancy?
Alc or drug use, conditions (DM, HBP, young or advanced
maternal age), poor prenatal care, issues with previous
pregnancies
Para means
Pregnancies (any gestation) including current
Gravida means