ENPC 2022 Study Guide with Complete Solution
Pediatric triangle ✔✔appearance
work of breathing
circulation to skin
General appearance considerations ✔✔Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry
Work of breathing: ✔✔Increased work of breathing evidenced by tachypnea, stridor, grunting,
retractions, accessory musles, nasal flaring, head bobbing, abnormal positioning
Circulation to Skin ✔✔Observe palor
mottling
cyanosis
Sick, Sicker, Sickest ✔✔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 ✔✔hypoxia
hypoglycemia
Blood pressure norms ✔✔Hypotension: Less than 70 + (2 x age in years)
,Widening pulse pressure = increased ICP
Narrowing pulse pressure = hypovolemic shock
Crying child ✔✔Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag
Respiratory distress indicated by: ✔✔increased heart rate
skin color changes
incrased work of breathing
wheezing
diaphoresis
abnormal airwa sounds
Respiratory failure signs ✔✔fatigue and become lethargic
hypoxia
hypercarbia
General airway interventions ✔✔Allow child to stay in most comfortable position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation
Croup ✔✔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 ✔✔albuterol, duo neb and oral steroid
Bronchiolitis/RSV ✔✔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 ✔✔obtain glucose for anyone who is not awake and alert
treat kids with 2-4ml/kg of D25W
When to perform blood glucose test? ✔✔When the child is not awake and alert or AMS is
suspected
Preventing Secondary brain injury in TBI ✔✔prevent hypotension and hypoxia
cuffed vs uncuffed tube ✔✔uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5
fluid bolus formula ✔✔infant: 10ml/kg
kid: 20ml/kg
normal vitals ✔✔pg 52
blood glucose normal ages 5-11 ✔✔72-140
Pediatric triangle ✔✔appearance
work of breathing
circulation to skin
General appearance considerations ✔✔Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry
Work of breathing: ✔✔Increased work of breathing evidenced by tachypnea, stridor, grunting,
retractions, accessory musles, nasal flaring, head bobbing, abnormal positioning
Circulation to Skin ✔✔Observe palor
mottling
cyanosis
Sick, Sicker, Sickest ✔✔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 ✔✔hypoxia
hypoglycemia
Blood pressure norms ✔✔Hypotension: Less than 70 + (2 x age in years)
,Widening pulse pressure = increased ICP
Narrowing pulse pressure = hypovolemic shock
Crying child ✔✔Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag
Respiratory distress indicated by: ✔✔increased heart rate
skin color changes
incrased work of breathing
wheezing
diaphoresis
abnormal airwa sounds
Respiratory failure signs ✔✔fatigue and become lethargic
hypoxia
hypercarbia
General airway interventions ✔✔Allow child to stay in most comfortable position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation
Croup ✔✔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 ✔✔albuterol, duo neb and oral steroid
Bronchiolitis/RSV ✔✔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 ✔✔obtain glucose for anyone who is not awake and alert
treat kids with 2-4ml/kg of D25W
When to perform blood glucose test? ✔✔When the child is not awake and alert or AMS is
suspected
Preventing Secondary brain injury in TBI ✔✔prevent hypotension and hypoxia
cuffed vs uncuffed tube ✔✔uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5
fluid bolus formula ✔✔infant: 10ml/kg
kid: 20ml/kg
normal vitals ✔✔pg 52
blood glucose normal ages 5-11 ✔✔72-140
