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ENPC 2022 QUESTIONS AND ANSWERS
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ENPC 2022 QUESTIONS AND ANSWERS
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ENPC 2022 QUESTIONS AND ANSWERSPediatric triangle Ans - appearance
work of breathing
circulation to skin
General appearance considerations Ans - Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry
Work of breathing: Ans - Increased work of breathing evidenced by
tachypnea, stridor, grunting, retractions, accessory musles, nasal flaring,
head bobbing, abnormal positioning
Circulation to Skin Ans - Observe palor
mottling
cyanosis
Sick, Sicker, Sickest Ans - 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 Ans - hypoxia
hypoglycemia
Blood pressure norms Ans - Hypotension: Less than 70 + (2 x age in
years)
Widening pulse pressure = increased ICP
Narrowing pulse pressure = hypovolemic shock
Crying child Ans - Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag
Respiratory distress indicated by: Ans - increased heart rate
skin color changes
,incrased work of breathing
wheezing
diaphoresis
abnormal airwa sounds
Respiratory failure signs Ans - fatigue and become lethargic
hypoxia
hypercarbia
General airway interventions Ans - Allow child to stay in most comfortable
position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation
Croup Ans - 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 Ans - albuterol, duo neb and oral steroid
Bronchiolitis/RSV Ans - 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 Ans - obtain glucose for anyone who is not awake
and alert
treat kids with 2-4ml/kg of D25W
When to perform blood glucose test? Ans - When the child is not awake
and alert or AMS is suspected
Preventing Secondary brain injury in TBI Ans - prevent hypotension and
hypoxia
cuffed vs uncuffed tube Ans - uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5
, fluid bolus formula Ans - infant: 10ml/kg
kid: 20ml/kg
normal vitals Ans - pg 52
blood glucose normal ages 5-11 Ans - 72-140
Cardiac Assessment Ans - Trend pulse and pulse pressure
palapate upper and lower extremity pulses
symptoms of CHF Ans - poor feeding, irritability, fatigue easily with rapid
resp rate, increased work of breathing
Ass and Interventions similar to adults
Myocarditis Assessment and treatment Ans - 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 Ans - Tachycardia, tacypnea; AMS; slight increaes in
diastolic pressure
Intervention: Stop bleed; give fluids and RBC; balanced therapy; offer
pedialyte if not NPO
Cardiogenic shock Ans - Intervention: expert consult; supportive care to
decrease O2 and metabolism demands; slow fluids; treat hpotension while
decreasing afterload; vagal maneuver; vasopressors
Obstructive Shock Ans - 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 Ans - remove pathogen
fluids
epi
Neurogenic Ans - spinal motion restriction
vasopressors
warming measures
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