N138 Midterm 2 Exam Questions with Complete
Solutions!!
Peds Labs
Na
K
Fe
PO4
Sweat Cl for CF - ANSWER Na: 138-145
K: 3.5-5
Iron: 50-120
PO4: 2.4-4.1
Sweat Cl: CF>60
Peds Labs
RBC
MCV
WBC
Bands - ANSWER RBC: 4.5-5.5 million
MCV: 77-95
WBC: 4.5-13.5
Bands:3-5%
Peds Labs
Hgb
Hct
,Creatinine - ANSWER Hgb: 12-16
Hct: 35-45%
Creatinine: 0.3-0.7
Respiratory assessment - ANSWER -LOC (irritable, lethargic)
-Vital Signs (RR, HR,temp)
-Color (pink, pale, cyanotic)
-Inspection (chest expansion, WOB)
-Auscultation (stridor, wheeze)
-Pulse oximeter
S/S of hypoxia - ANSWER -restlessness
-diaphoretic
-tripod
-retractions
-flaccid body
-nasal flaring
-grunting
-Look at whole chest to look for retractions (chest, xyphoid, suprasternal)
-Kids tend to cough up mucus and then swallow it, look for cough and swallowing
Late Signs of Resp. Distress - ANSWER - skin color changes
- apnea/irregular respirations
- change in LOC
- bradycardia
,Resp Distress vs Resp Failure - ANSWER • Respiratory distress:
- Increased work of breathing
• Respiratory failure:
- Inadequate oxygenation or ventilation
- Most common pathway to cardiac arrest
Why are respiratory problems in children more serious than in adults? - ANSWER
Smaller airway size in children
(trachea=little finger diameter)
Small amount of swelling = large increase in resistance
If there is edema or mucus, it could completely block the child's airway!!!
O2 sat problems - ANSWER -If O2 sat alarms, always look at Pt FIRST!
-Make sure you see good pleth wave
-95% O2 sat is worrisome, should be higher, look to see if HR is increasing, having
trouble breathing
O2 sat probe placement - ANSWER -Want 2 parts to be directly across from each other,
use finger, foot, ear
-Make sure to rotate site so that skin won't get burned.
-Check skin underneath probe, easy place for bacteria, staph infections
Oxygen delivery in kids - ANSWER Humidified
Use least invasive method first so child doesn't freak out
, Use what the child tolerates!
If kid is crying, it's okay, that means they are deep breathing the O2
• Methods of Delivery
- Blow-by (paper cup to blow out O2)
- Nasal Cannula
- Non/partial rebreather
- Face mask
(Blended O2/mist is rarely used)
H1N1 - ANSWER In children, emergency warning signs that need urgent medical
attention include:
• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
Runny Nose in Kids - ANSWER -germs are spread when kids wipe snot with hand and
then go play
-contact isolation, wash hands, clean toys
-kids will have a line across nose from wiping snot up with hand and creating a crease
Solutions!!
Peds Labs
Na
K
Fe
PO4
Sweat Cl for CF - ANSWER Na: 138-145
K: 3.5-5
Iron: 50-120
PO4: 2.4-4.1
Sweat Cl: CF>60
Peds Labs
RBC
MCV
WBC
Bands - ANSWER RBC: 4.5-5.5 million
MCV: 77-95
WBC: 4.5-13.5
Bands:3-5%
Peds Labs
Hgb
Hct
,Creatinine - ANSWER Hgb: 12-16
Hct: 35-45%
Creatinine: 0.3-0.7
Respiratory assessment - ANSWER -LOC (irritable, lethargic)
-Vital Signs (RR, HR,temp)
-Color (pink, pale, cyanotic)
-Inspection (chest expansion, WOB)
-Auscultation (stridor, wheeze)
-Pulse oximeter
S/S of hypoxia - ANSWER -restlessness
-diaphoretic
-tripod
-retractions
-flaccid body
-nasal flaring
-grunting
-Look at whole chest to look for retractions (chest, xyphoid, suprasternal)
-Kids tend to cough up mucus and then swallow it, look for cough and swallowing
Late Signs of Resp. Distress - ANSWER - skin color changes
- apnea/irregular respirations
- change in LOC
- bradycardia
,Resp Distress vs Resp Failure - ANSWER • Respiratory distress:
- Increased work of breathing
• Respiratory failure:
- Inadequate oxygenation or ventilation
- Most common pathway to cardiac arrest
Why are respiratory problems in children more serious than in adults? - ANSWER
Smaller airway size in children
(trachea=little finger diameter)
Small amount of swelling = large increase in resistance
If there is edema or mucus, it could completely block the child's airway!!!
O2 sat problems - ANSWER -If O2 sat alarms, always look at Pt FIRST!
-Make sure you see good pleth wave
-95% O2 sat is worrisome, should be higher, look to see if HR is increasing, having
trouble breathing
O2 sat probe placement - ANSWER -Want 2 parts to be directly across from each other,
use finger, foot, ear
-Make sure to rotate site so that skin won't get burned.
-Check skin underneath probe, easy place for bacteria, staph infections
Oxygen delivery in kids - ANSWER Humidified
Use least invasive method first so child doesn't freak out
, Use what the child tolerates!
If kid is crying, it's okay, that means they are deep breathing the O2
• Methods of Delivery
- Blow-by (paper cup to blow out O2)
- Nasal Cannula
- Non/partial rebreather
- Face mask
(Blended O2/mist is rarely used)
H1N1 - ANSWER In children, emergency warning signs that need urgent medical
attention include:
• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
Runny Nose in Kids - ANSWER -germs are spread when kids wipe snot with hand and
then go play
-contact isolation, wash hands, clean toys
-kids will have a line across nose from wiping snot up with hand and creating a crease
