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Pediatric triangle - Answer appearance
work of breathing
circulation to skin
General appearance considerations - Answer Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry
Work of breathing: - Answer Increased work of breathing evidenced by tachypnea,
stridor, grunting, retractions, accessory musles, nasal flaring, head bobbing, abnormal
positioning
Circulation to Skin - Answer Observe palor
mottling
cyanosis
Sick, Sicker, Sickest - Answer Sick: no disruption of any component of PAT but
caregivers are concerned
Sicker: one component of PAT is a concern
Sickest 2+ concerns of PAT
2 leading causes of altered mental status in kids - Answer hypoxia
hypoglycemia
Blood pressure norms - Answer Hypotension: Less than 70 + (2 x age in years)
Widening pulse pressure = increased ICP
Narrowing pulse pressure = hypovolemic shock
Crying child - Answer Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag
Respiratory distress indicated by: - Answer increased heart rate
skin color changes
incrased work of breathing
wheezing
diaphoresis
,ENPC 2022 Study Guide With Complete
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abnormal airwa sounds
Respiratory failure signs - Answer fatigue and become lethargic
hypoxia
hypercarbia
General airway interventions - Answer Allow child to stay in most comfortable position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation
Croup - Answer 1-3 days of nasal congestion and fever with sudden onset of barky
cough
Treatment: dexamethasone and nebulized epi
Discharge Teaching: oral hydration, get child to cool air or steamy bathroom
Asthma interventions - Answer albuterol, duo neb and oral steroid
Bronchiolitis/RSV - Answer Assessment: 1-3 days nasal congestion fever, cough,
respiratory distress with wheezing and crackles. Dehydration and tachypnea
interventions: nasla suctioning, fluids
sever: heated, high flow nasal cannula O2
Discharge: lasts 2-3 weeks; nasal suctioning; monitor hydration
treating hypoglycemia - Answer obtain glucose for anyone who is not awake and alert
treat kids with 2-4ml/kg of D25W
When to perform blood glucose test? - Answer When the child is not awake and alert or
AMS is suspected
Preventing Secondary brain injury in TBI - Answer prevent hypotension and hypoxia
cuffed vs uncuffed tube - Answer uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5
fluid bolus formula - Answer infant: 10ml/kg
kid: 20ml/kg
normal vitals - Answer pg 52
, ENPC 2022 Study Guide With Complete
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blood glucose normal ages 5-11 - Answer 72-140
Cardiac Assessment - Answer Trend pulse and pulse pressure
palapate upper and lower extremity pulses
symptoms of CHF - Answer poor feeding, irritability, fatigue easily with rapid resp rate,
increased work of breathing
Ass and Interventions similar to adults
Myocarditis Assessment and treatment - Answer Assess: consider in anyone with
recent viral infection; SOB and crackles; dysrhthmias; heart failure; syncope; elevated
liver enzymes
Treat: diuretics; BP support; ECMO; transplant
Hypovolemic Shock - Answer Tachycardia, tacypnea; AMS; slight increaes in diastolic
pressure
Intervention: Stop bleed; give fluids and RBC; balanced therapy; offer pedialyte if not
NPO
Cardiogenic shock - Answer Intervention: expert consult; supportive care to decrease
O2 and metabolism demands; slow fluids; treat hpotension while decreasing afterload;
vagal maneuver; vasopressors
Obstructive Shock - Answer Assessment: Cardiac tamponade- muffled heart sounds
and pulsluss paradoxus; tension pneumo- asymmetrical chest rise and fall
Intervention: pericardiocentesis; needle thoracentesis; antigoagulation or surgical
intervention; treat ductal dependent lesion
Anaphylactic Shock - Answer remove pathogen
fluids
epi
Neurogenic - Answer spinal motion restriction
vasopressors
warming measures
Septic - Answer Fluids
antibiotics
vasopressors