Components in the prioritization of pediatric emergency care (4) - Answer- PAT, Focused Assessment (objective information), Focused pediatric
... [Show More] Hx(subjective information), assignment of an acuity rating decision
Pediatric Assessment Triangle : (3) components - Answer- Appearance. Work of Breathing. Circulation to the skin. This forms the "general impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
PQRST for Pain - Answer- (pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
What age is the respiratory system considered fully developed? - Answer- 8 years old
6P's Assessment for Musculoskeletal Trauma - Answer- (pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
Burn Transfer Criteria - Answer- 1. Partial thickness >10% of BSA
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
6. Burn injury in pt with preexisting medical disorders that could complicate tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or mortality.
8. Burned children in hospital wo qualified equipment or personnel to care for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
Infants are obligate nose breathers. If nose is obstructed ___________ - Answer- mouth then suction nose
Neutropenic pt with a temperature - Answer- Don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable Rashes of concern - Answer- Meningocoxcemia
Petiachia/Purpura
Normal Urine Output for child - Answer- 1 to 2ml / Kg / Hr
Oral Rehydration for 9month old with mild dehydration. - Answer- Glucose and sodium solution, every 2 to 5min with 5 to 10ml
6week old infant, no medical hx. eating poorly, vomiting, "hard to wake up", responsive to pain. Anterior fontanel bulging, tachypnic. Diagnostic evaluation expected? - Answer- Skeletal survey
Possible shaken baby syndrome
Minimal Acceptable BP's - Answer- Newborn = 60
Infant = 70
Child = 70 + (2 x age in yrs)
Decompensated shock in children #1 sign - Answer- Hypotension
TBI considerations - Answer- MD has to say when they can return, not the pt or caregiver.
Should be a "gradual return to play"
Bradycardia pharm treatment - Answer- Epinephrine (1:10,000), 0.01mg/kg every 3-5min
A preschooler has a small laceration that required 2 stitches. The nurse covers the wound with a bandage knowing that it will comfort the child to have it covered. What is the developmental reason for this intervention?
A. Preschoolers are magical thinkers and imagine bandages keep their insides from coming out
B. Preschoolers fear physical disability and believe a bandage will prevent disability
C. Preschoolers explore orally and will likely chew or suck on the stitches if left uncovered
D. Preschoolers are concerned with body image and don't want to appear different than peers - Answer- A. Magical thinkers
An 11-year-old presents to the emergency department with a complaint of hitting his head while playing soccer. The nurse enters the room and performs an across-the-room assessment. He is staring at the wall. He has no increased work of breathing, and his color is pink. Using the pediatric assessment triangle (PAT), what classification will the nurse assign?
A. Well
B. Sick
C. Sicker
D. Sickest - Answer- B. Sicker
A 2-year-old has a suspected cervical spinal injury. In order to ensure neutral spinal alignment, padding should be placed under which area?
A. Shoulders
B. Head
C. Neck
D. Waist - Answer- A. Shoulders
The nurse is planning to begin oral rehydration therapy for a 9-month-old with mild dehydration. She provides the caregivers with a glucose and sodium solution and instructs them to administer small amounts:
A. Every 2 to 5 minutes
B. Every 10 to 12 minutes
C. Every 15 minutes
D. Every 30 minutes - Answer- A. 2-5
Caregivers bring in their 3-week-old neonate and describe nonbilious vomiting after every feeding that is becoming more forceful over the past 24 hours. The last time he vomited the vomitus hit a chair 2 feet away. They say he cries, roots, and sucks vigorously on his pacifier right after vomiting as though still hungry. He is not experiencing any diarrhea. What condition is the most likely cause of these signs and symptoms?
A. Intussusception
B. Volvulus
C. Gastroenteritis
D. Pyloric stenosis - Answer- D. Pyloric Stenosis
Which of the following screening statements/questions is most appropriate in assessing an adolescent for dating violence?
A. "What triggers violence you've experienced from your partner?"
B. "Does your partner feel entitled to sex even if you say 'no'?"
C. "Tell me about a time when you've felt unsafe in your relationship."
D. "Do you feel if you tried harder to please, your partner will not become violent?" - Answer- C. Tell me
Which sign distinguishes compensated shock from decompensated shock in the pediatric patient?
A. Peripheral pulses
B. Blood pressure
C. Capillary refill
D. Level of consciousness - Answer- B BP
A 15-year-old with a history of schizophrenia is taking risperidone (Risperdal) and lithium (Eskalith). She presents with dystonia, akinesia, a shuffling gait, muscle rigidity, and tremors. What does the nurse suspect is the cause of these signs and symptoms?
A. Extrapyramidal symptoms
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome
D. Serotonin syndrome - Answer- A. EPS
Two ambulances collide in front of the hospital. The victims include three pediatric victims. Using the JumpSTART triage system, which category assignment will the nurse give to a 2-year-old who is lying on the ground, alert and crying with spontaneous respirations of 36 breaths/minute and present peripheral pulses?
A. Green
B. Yellow
C. Red
D. Black - Answer- Yellow
A nurse providing crisis intervention to the family of a seriously ill child can best keep the family informed of the child's condition by:
A. Placing them in a secluded room.
B. Referring to their child as "the patient".
C. Telling the family how they should feel.
D. Appointing one staff member to communicate with them. - Answer- D. Appointing one staff member to communicate with them.
A 16-month-old child was an unrestrained front seat passenger in a motor vehicle crash. The chest x-ray reveals multiple rib fractures. These findings suggest what type of injury?
A. Minor surface injury.
B. Significant underlying injury.
C. Significant surface injury.
D. Minor underlying injury. - Answer- B. Significant underlying injury.
Which piece of information is most important to know prior to transferring a patient to another facility?
A. Documentation of the family's health insurance coverage.
B. Pertinent family health history.
C. Confirmation of acceptance from the receiving hospital.
D. Confirmation of a medical diagnosis. - Answer- C. Confirmation of acceptance from the receiving hospital.
A 10-year-old child who was struck by a car has a distended, tense abdomen. The child's heart rate is 144 beats/minute, respirations 24 breaths/minute, and blood pressure 120/80 mm Hg. Capillary refill is more than 3 seconds, and skin is pale and cool. The patient's signs and symptoms suggest:
A. Obstructive shock.
B. Distributive shock.
C. Hypovolemic shock.
D. Cardiogenic shock. - Answer- C. Hypovolemic shock.
What is the preferred sit for intraosseous access in the infant?
A. Lateral malleolus
B. Iliac crest
C. Proximal femur
D. Proximal tibia - Answer- D. Proximal tibia
An 8-month-old infant with pneumonia has severe intercostal and substernal retractions, weak muscle tone, lethargy, and gray skin color. The infant's condition does not improve after bag-mask ventilation. The next step in treatment is most likely to be:
A. Administration of epinephrine.
B. Supplemental warming measures.
C. Rapid sequence intubation.
D. Administration of albuterol. - Answer- C. Rapid sequence intubation.
Which combination of medications is best to have prepared for a pediatric resuscitation?
A. Dopamine and sodium bicarbonate.
B. Epinephrine and glucose.
C. Naloxone and lidocaine.
D. Pentothal and vecuronium. - Answer- B. Epinephrine and glucose.
Which intervention should be performed next if tactile stimulation, positioning, drying, and blow-by oxygen administration do not increase a newborn's heart rate?
A. Chest compressions.
B. Umbilical vein cannulation.
C. Endotracheal intubation.
D. Bag-mask ventilation. - Answer- D. Bag-mask ventilation.
A 10-kg child has deep partial-thickness burns over 35% of the total body surface area. Which evaluation parameter indicates that fluid resuscitation is adequate?
A. Heart rate of 160 beats/minute.
B. Respiratory rate of 34 breaths/minute.
C. Blood pressure of 80/60 mm Hg.
D. Urine output of 11 ml/hour. - Answer- D. Urine output of 11 ml/hour.
A 7-year-old female sustains a minor head injury and did not lose consciousness. She does not respond to commands and groans in response to questions. Which action will quickly determine if her behavior indicates a serious head injury?
A. Review her medical record for pre-existing developmental problems.
B. Obtain a head computerized tomography scan.
C. Conduct a developmental screening test.
D. Ask the parents if her behavior is unusual. - Answer- D. Ask the parents if her behavior is unusual.
An 8-month-old child presents with purpura, irritability, and a rectal temperature of 39.4�C (102.9�F). An intervention of high priority is:
A. Encouraging the caregiver to hold and comfort the child.
B. Monitoring for signs and symptoms of increased intracranial pressure (ICP).
C. Collecting urine for toxicology screen.
D. Encouraging oral fluids and food. - Answer- B. Monitoring for signs and symptoms of increased intracranial pressure (ICP).
The Pediatric Assessment Triangle is used to:
A. Identify all life-threatening conditions that the child presents with.
B. Perform a complete head-to-toe assessment on the child.
C. Assess the status of the child's airway only upon arrive in the ED.
D. Determine the severity of the child's illness or injury using the "across-the-room" assessment. - Answer- D. Determine the severity of the child's illness or injury using the "across-the-room" assessment.
A 6- week-old infant is pale, has marked substernal retractions, expiratory grunting, and poor muscle tone. The emergency nurse should first:
A. Obtain IV.
B. Apply a pulse ox.
C. Prepare a chest x-ray.
D. Administer 100% oxygen. - Answer- D. Administer 100% oxygen.
The best method to open the airway in an injured child is:
A. Placing the head and neck in hyperextension.
B. Using the jaw thrust maneuver.
C. Placing the head and neck in flexion.
D. Using the head tilt maneuver. - Answer- B. Using the jaw thrust maneuver.
A 3-year-old is transported by prehospital personn [Show Less]