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ENPC 2022 QUESTIONS AND ANSWERS

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ENPC 2022 QUESTIONS AND ANSWERS

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  • October 16, 2022
  • 16
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers
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ENPC 2022 QUESTIONS AND ANSWERS

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

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