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ENPC With Correct Answers
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ENPC Pediatric 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 e...

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  • December 20, 2023
  • 16
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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  • enpc

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ENPC

Pediatric 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

Septic - ANS Fluids
antibiotics
vasopressors

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