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PALS precourse assessment with complete answers well elaborated -2024
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PALS precourse assessment A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency department by her parents. During your assessment, you find that the infant responds only to painful stimulation. The infant's respiratory rate is 40 breaths per minute, an...

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  • April 15, 2024
  • 4
  • 2023/2024
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PALS precourse assessment

A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency department
by her parents. During your assessment, you find that the infant responds only to painful stimulation. The
infant's respiratory rate is 40 breaths per minute, and central pulses are rapid and weak. The infant has
good bilateral breath sounds, cool extremities, and a capillary refill time of more than 5 seconds. The
infant's blood pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.65 mmol/L). You administer 100%
oxygen via face mask and start an IV. Which treatment is most appropriate for this infant? - Answer-
Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV

A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is
speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged
expiratory time and wheezing. You administer 100% oxygen by a nonrebreathing mask. His spO2 is 92%.
Which med do you prepare to give to this patient? - Answer-Albuterol (duh)

Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds
only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen,
abdominal distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child's heart
rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely palpable. The cardiac
monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency
department, the child is intubated and ventilated with 100% oxygen, and IV access is established. The
heart rate is now 150/min with weak central pulses but no distal pulses. Systolic blood pressure is 74
mmHg. Which intervention should be provided next? - Answer-Rapid bolus of 20ml/kg of isotonic
crystalloid

You are called to help treat an infant with severe symptomatic bradycardia (heart rate 66/min) associated
with respiratory distress. The bradycardia persists despite establishment of an effective airway,
oxygenation, and ventilation. There is no heart block present. Which is the first drug you should
administer? - Answer-Epinephrine

Which statement is correct about the use of calcium chloride in pediatric patients? - Answer-Routine
administration is not indicated during cardiac arrest

Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? - Answer-It is the least desirable route of administration

Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty during inspiration and
pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor) when
agitated; otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild inspiratory
intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal
breath sounds bilaterally. Which is the most appropriate initial intervention for this child? - Answer-
Humidified oxygen as tolerated

You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You
delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4 J/kg shock and resume CPR. Which drug and dose should be administered next? -
Answer-Amiodarone 5 mg/kg IO

Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired
oxygen to a 7yo child? - Answer-Nonrebreathing face mask

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