Pediatric Cardiac Arrest Exam Questions with Correct Answers
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Course
Cardiac Arrest
Institution
Cardiac Arrest
Pediatric Cardiac Arrest Signs, Symptoms - Answer-Signs/Symptoms:
The most common recognizable signs of cardiac arrest include unresponsiveness, no breathing or only gasping, and no pulse. A pulse check should be attempted for no longer than 10 seconds and should not delay the initiation of CPR.
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Pediatric Cardiac Arrest Exam Questions
with Correct Answers
Pediatric Cardiac Arrest Signs, Symptoms - Answer-Signs/Symptoms:
The most common recognizable signs of cardiac arrest include unresponsiveness, no
breathing or only gasping, and no pulse. A pulse check should be attempted for no
longer than 10 seconds and should not delay the initiation of CPR.
In light of the progressive nature of most pediatric cardiac arrest events, there will
usually be impending signs of cardiac arrest.
These impending signs of cardiac arrest can be categorized using the ABCDE acronym.
A: airway (obstruction, complete or severe)
B: breathing (apnea, significantly increased work of breathing, bradypnea)
C: circulation (weak or absent pulses, poor perfusion, hypotension, bradycardia)
D: disability (decreased level of consciousness, unresponsiveness)
E: exposure (significant hypothermia, significant bleeding, petechiae, or purpura
consistent with septic shock or coagulation problems)
Hydrogen Ion (Acidosis): - Answer-To determine if the patient has respiratory acidosis,
an arterial blood gas evaluation must be performed. Prevent and treat respiratory
acidosis by providing adequate ventilation. Prevent metabolic acidosis by giving the
patient sodium bicarbonate.
Most common cause of Pediatric Cardiac arrest - Answer-Cardiac arrest in children can
occur suddenly; however, it is usually the end result of progressive tissue hypoxia and
acidosis caused by respiratory failure and/or shock.
Although rarer, sudden cardiac arrest does occur in children. When it does occur, it is
often associated with athletic activity.
When cardiac arrest is associated with respiratory distress/failure or shock, the rhythms
typically associated with the arrest include : - Answer-asystole, PEA, ventricular
fibrillation, and pulseless ventricular tachycardia.
Asystole: - Answer-ECG tracing that is usually a flatline on the monitor. During asystole,
there is no blood flow to the brain and other vital organs. This results in a very poor
outcome if resuscitation is successful. Review asystole page here.
, Asystole - Answer-During asystole, there is no blood flow to the brain and other vital
organs. This results in very poor outcomes if resuscitation is successful.
If asystole is visualized on the monitor, you should ensure that all leads are connected
properly. If all leads are properly connected, you should rapidly assess for any
underlying causes for the asystole.
As with pulseless electrical activity (PEA), asystole can have possible underlying
causes which can be remembered using the H's and T's mnemonic.
(PALS H & T's are covered thoroughly in another area.)
Hypovolemia - Answer-the loss of fluid volume in the circulatory system, can be a major
contributing cause to cardiac arrest.
Looking for obvious blood loss in the patient with pulseless arrest is the first step in
determining if the arrest is related to hypovolemia. After CPR, the most important
intervention is obtaining intravenous access/IO access. A fluid challenge (fluid bolus)
may also help determine if the arrest is related to hypovolemia.
(See also .)Hypovolemic Shock Page
Hypovolemic Shock Page - Answer-...
Hypoxia: - Answer-deprivation of adequate oxygen supply, can be a significant
contributing cause to cardiac arrest.
You must ensure that the patient's airway is open and that the patient has chest rise
and fall and bilateral breath sounds with ventilation. Also, ensure that your oxygen
source is connected properly. (See Respiratory Distress/Failure Page)
Respiratory Distress/Failure - Answer-...
Hyper/Hypokalemia: - Answer-Both a high potassium level and a low potassium level
can contribute to cardiac arrest. The major sign of hyperkalemia, high serum potassium,
is taller and peaked T-waves. Also, a widening of the QRS-wave may be seen. This can
be treated with a variety of interventions which include sodium bicarbonate (IV),
glucose+insulin, calcium chloride (IV), Kayexalate, dialysis, and possibly albuterol. All of
these will help reduce serum potassium levels.(See Hyperkalemia and Cardiac Arrest
Page)
major signs of hypokalemia - Answer-low serum potassium, are flattened T-waves,
prominent U-waves, and possibly a widened QRS complex. Treatment of hypokalemia
involves rapid but controlled infusion of potassium. Giving IV potassium has risks.
Always follow the appropriate infusion standards. Never give undiluted intravenous
potassium.
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