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PALS Final ReviewMikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your emergency
department. Your initial impression from the door does not raise immediate concern. On
your entry to the room, you are able to look at Mikey more closely and notice on
inhalation his nostrils are flaring. This is a sign of: - answerRespiratory distress
The proper site for a peripheral pulse assessment in the infant patient is: -
answerbrachial
You are called to the scene of a 3-year-old patient who was found anxious, *cyanotic*
and lethargic after a fall down a flight of stairs. On assessing the patient, you find vital
signs with a respiratory rate of 30, regular pulse rate of 130, regular capillary refill time
of 4 seconds, and a blood pressure of 102/61. What kind of shock is the patient
experiencing? - answercompensate shock?
A mnemonic that aids in performing a primary assessment is: - answerABCDE
A consideration of treatment for a pediatric patient with acute fulminant myocarditis who
is in cardiac arrest or at a high risk of cardiac arrest is: - answerExtracorporeal
membrane oxygenation (ECMO)
Which of the following is the correct meaning for one of the individual letters in the
AVPU scale? - answerAlert - The child is alert and awake and responds to normal
stimuli based upon age and environment
The recommended route of vascular access on a hypotensive pediatric patient is: -
answercentral IV
You are called to the bedside of a 12-year-old male patient who was admitted after a
week of persistent vomiting, diarrhea and limiting oral intake of both solids and liquids.
The patient's airway is patent, ventilatory rate is within normal limits and the patient's
circulatory status presents with tachycardia, a blood pressure of 70/40 and a capillary
refill time of 5 seconds. The patient is speaking incoherently. The patient has no history
of cardiac problems or congenital defects. The appropriate fluid administration dose for
this patient is: - answer20 ml/kg 0.9% NaCl over 10 minutes
You suspect your 8-year-old female patient of being hypovolemic. Her parents brought
her to the emergency department with persistent vomiting and diarrhea for 5 days. The
patient presents with *mottled skin* and reports of periods where "she just stopped
, breathing!" according to her parents. The patient is being managed with a BVM and
supplemental oxygen. What is the best route of establishing vascular access for the
purpose of fluid resuscitation? - answerIV
Which of the following cannot be administered through an ETT? - answerSodium
bicarbonate
You are examining the rhythm strip of a patient who presents with bradycardia. Which of
the following characteristics may you notice in the rhythm? - answerThe most obvious
sign of bradycardia on an ECG is slow heart rate. The characteristics of P-waves and
the QRS complex may vary. When looking at an EKG, the following characteristics are
seen with bradycardia patients: Slow heart rate, P-waves may not be noticeable, QRS
complex may be wide or narrow, and P-waves and QRS complex may not be related to
bradycardia.
How do children's metabolic rates compare to adults'? - answerhigher
Children's demand for oxygen is ___________ adults. - answergreater
Which of the following must you monitor while fluid resuscitating a patient? -
answerUrine output
What type of pressure is monitored to obtain right ventricular cardiac preload? -
answerCentral venous pressure (CVP)
Define shock: - answerWhen oxygen and nutrient supply to body tissue is insufficient
compared to metabolic tissue needs
Your 5-year-old patient is admitted to the PICU and is being treated by your team for
hypovolemic shock. The team has administered one bolus of 20ml/kg of 0.9% NaCl . On
re-evaluation the patient is alert and anxious with a heart rate of 145 beats per minute, a
blood pressure of 76/48mmHg and a capillary refill time of 4 seconds. Which of the
following is the patient's clinical condition? - answerhypotensive shock
To treat wheezing in a child, which medication is the most appropriate to administer? -
answerAlbuterol
You arrive on scene to assess a 9-year-old boy who was stung by a bee. The patient is
found to be suffering from urticaria and is displaying respiratory distress with a
presentation of nasal flaring, tachypnea and accessory muscle use. The patient's
mother relates he has never had an allergic reaction to a bee sting, but his father is
gravely allergic to bee stings. The patient relates it is hard to breathe. While gathering
your initial set of vital signs you note the patient has a room air SpO2 is 90%. This
finding classifies the patient as: - answerWhen the blood is insufficiently oxygenated,
hypoxemia can occur. Hypoxemia is a decreased saturation of oxyhemoglobin
(oxygenated hemoglobin) in the blood. A noninvasive method of estimating arterial
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