Complete Solutions Graded A+
The in fant is place d on the ambulance st retche r and responds with a g roan when sti mula te d an d
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 oxim etry
-Cal l fo r ass i s t ance i f needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled, glucose is 9 7
mg/ dL and capillary refill time is 5 seconds. What are the warning signs that the patient is
progressing from com pensated shock to hypotensive shock? - Answer: -Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 5 8 mm Hg. Her condition would be classified as
___________ shock. - Answer: Hypotensive
What shoul d be inclu d e d in the initi al treatment fo r this pati ent? - Answer: -Rapid fl
uid bolus
administration
-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most app rop riate way to rapi dly
dete rmine her weight and calcu la te correct medicati on? - Answer: Measure her by using colo r-
coded length - based tape
You measu r e the infant to be 7 kg an d prepa re to a dministe r a flui d bolus of what type? -
Answer: Normal saline 20 mL/kg
What is the most app rop riate metho d of delive r ing rapi d flui d boluses to this pati ent? -
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 shoul d be the next inte rventi on? - Answer: Delive r a secon d flui d bolus of 20 mL/kg
and reassess
When shoul d vasoacti ve the rapy be consi d e r e d be consi d e re d in managing dist ributi ve
shock? - Answer: I f the chi l d remains hypotensive and poor ly perfuse d despi te rapi d bolus
fl u i d administ r ati on
How does the clinical presentation of distributive shock compare with hypovolemic shock? - Answer:
Dist r ibuti ve shock has mo re va riable presentati on than that of hypovolemic shock
For general shock management, administer an isotonic crytalloid bolus of __ mL/kg ove r __ to __
minutes - Answer: For general shock management, administer an isotonic crytalloid bolus of 20 mL/kg
over 5 to 20 minutes
What signs disti nguish anaphylacti c shock f rom othe r 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 shoul d you evaluate to recognize septi c shock? - Answer: -Temp
-Heart rate
-Systemic perfusion
-Blood pressure