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Heart code PALS QUESTIONS AND ANSWERS FULLY SOLVED
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Exam of 11 pages for the course Heart code at Heart code (Heart code PALS)
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Heart code PALSThe infant is placed on the ambulance stretcher and responds with a groan when
stimulated and has a temperature of 36.3 C (97.3 F) - answer-Monitor and support
ABCs
-Establish IV/IO access
-Monitor heart rate, blood pressure, and pulse oximetry
-Call for assistance if needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled,
glucose is 97 mg/dL and capillary refill time is 5 seconds. What are the warning signs
that the patient is progressing from compensated shock to hypotensive shock? -
answer-Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified
as ___________ shock. - answer Hypotensive
What should be included in the initial treatment for this patient? - answer-Rapid fluid
bolus administration
-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most appropriate
way to rapidly determine her weight and calculate correct medication? - answerMeasure
her by using color-coded length-based tape
You measure the infant to be 7 kg and prepare to administer a fluid bolus of what type?
- answerNormal saline 20 mL/kg
What is the most appropriate method of delivering rapid fluid boluses to this patient? -
answerA syringe and 3-way stopcock
After the first fluid bolus is administered, the child is reassessed and her vital signs are
HR 167, BP 58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale
and she is still lethargic and weak.
What should be the next intervention? - answerDeliver a second fluid bolus of 20 mL/kg
and reassess
When should vasoactive therapy be considered be considered in managing distributive
shock? - answerIf the child remains hypotensive and poorly perfused despite rapid
bolus fluid administration
, How does the clinical presentation of distributive shock compare with hypovolemic
shock? - answerDistributive shock has more variable presentation than that of
hypovolemic shock
For general shock management, administer an isotonic crytalloid bolus of __ mL/kg over
__ to __ minutes - answerFor general shock management, administer an isotonic
crytalloid bolus of 20 mL/kg over 5 to 20 minutes
What signs distinguish anaphylactic shock from other types of shock? - answer-
Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
in a child with anaphylactic shock, what is the most appropriate initial treatment? -
answerIM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock? -
answerSeconds to minutes
What should you evaluate to recognize septic shock? - answer-Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
When should antibiotics be administered in septic shock? - answerWithin the first hour
What are the initial assessment findings for septic shock? - answer-Fever
-Hypothermia
-Normal, elevated or decreased WBC
For septic shock, how soon should fluid resuscitation begin? - answerWithin 10 to 15
minutes after recognizing shock
What is the recommendation for fluid bolus of isotonic crystalloids in cardiogenic shock?
- answer5 to 10 mL/kg over 10 to 20 minutes
What is the focus of the initial management of distributive shock? - answer-Correcting
hypovolemia
-Filling expanded dilated vascular space
-Expanding intravascular volume
What are causes of obstructive shock? - answer-Pulmonary embolus
-Tension pneumothorax
-Congenital heart defects
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