You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is
responsive, but she does not feel well and appears to be flushed. Her
temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min,
blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
Your assessment reveals mild increase in work of breathing and bounding pulses.
The child is receiving 100% oxygen by nonrebreathing mask.
Laboratory studies document lactic acidosis. On the basis of the patient's clinical
assessment and history, what type of shock does this patient most likely have? -
ANSWERS-Distributive, septic
You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is
responsive, but she does not feel well and appears to be flushed. Her
temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min,
blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
Your assessment reveals mild increase in work of breathing and bounding pulses.
The child is receiving 100% oxygen by nonrebreathing mask.
What assessment finding is most important in your determination of the severity
of the patient's
condition? - ANSWERS-Blood pressure
You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is
responsive, but she does not feel well and appears to be flushed. Her
temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min,
blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
, Your assessment reveals mild increase in work of breathing and bounding pulses.
The child is receiving 100% oxygen by nonrebreathing mask.
What is the most appropriate amount to administer for the first normal saline
fluid bolus? - ANSWERS-10-20 ml/kg
You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is
responsive, but she does not feel well and appears to be flushed. Her
temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min,
blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
Your assessment reveals mild increase in work of breathing and bounding pulses.
The child is receiving 100% oxygen by nonrebreathing mask.
In addition to oxygen administration and appropriate fluid resuscitation, what
additional early intervention should you provide to this patient? - ANSWERS-
Antibiotic administration
A 10-year-old child is brought to the emergency department for fever and cough.
You obtain an oxygen saturation on the child. What oxygen saturation would
indicate that immediate intervention is needed? - ANSWERS-88% on 4 L/min of
nasal oxygen
An unresponsive 14-year-old girl is pale and cool to the touch. Her blood pressure
is 70/45 mm Hg, heart rate is 190/min, and respiratory rate is 12/min. The Spoz is
not detectable. Capillary refill time is 5 seconds. An IV is in place. The cardiac
monitor displays the rhythm shown here. - ANSWERS-Supraventricular
tachycardia
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