ENPC HOME EXAM, HOME
INSPECTOR,HOME AILE,HOME HEALTH
EXAM QUESTIONS
Tachycardia = an _______ sign of shock
Early
What is a late sign of circulatory compromise in children?
Hypotension
Children can remain normotensive until about _____ percent of blood volume is
lost
25%
What are two intervention you should always be doing?
Applying oxygen
Checking bedside blood glucose
How long should the car seat be rear facing?
Until at least one year of age
_____ model parents behavior with toys
Toddlers
Age 3 to 5:
Preschoolers
Magical and it logical thinkers
Take things literally
What are common fears of the preschooler?
Pain
Darkness
Body mutilation
Being alone
Ages 5 to 11:
School age kids
Beers include separation from parents, loss of control, and physical disability
11 to 18 years old:
Body a parent is the most important thing
,What is one of the critical public health issues in today society?
Childhood obesity
At how many years old can a child start using the faces pain scale?
Three years old
What is there an emphasis on during the prioritization of the patient?
Safety
I focused assessment is what type of information?
Objective
I focused history is what type of information?
Subjective
The pediatric assessment triangle a.k.a. the across the room assessment of a
patient looks at what three things?
General appearance
Work of breathing
Circulation to the skin
How long should the pediatric assessment triangle take?
About 3 to 5 seconds
What does the general appearance section include:
Interaction
Muscle tone
Consolabilty
Look or gaze
Speech or cry
Work of breathing— a good indicator of oxygenation and ventilation. What should
you look for in this assessment?
Abnormal airway sounds
Coughing
Abnormal positioning
Retractions/nasal flaring
Rate and depth of respirations
Circulation to the skin:
Skin reflects perfusion status
Inspect the color of central areas such as lips and mucous membranes
Assessed for pallor, molting, or cyanosis
Is the patient flushed or diaphoretic
,What are the three patient categories for the pediatric assessment triangle?
Sick
Sicker
Sickest
If all three components of the PAT are stable know what will the patient be ranked
as?
Sick
If there is disruption in one of the areas of the PAT what will the patient be
ranked?
Sicker
If there is Disruption in two or more components of the PAT what ranking will the
patient receive?
Sickest
If a patient is identified as sickest what is indicated?
Rapid resuscitation
And a child what event typically leads to a code?
Typically a respiratory event leads to a cardiac event
What is the priority with any trauma or suspected drama?
Stabilize the C-spine and stop any bleeding
What maneuver is used to open the jaw in a trauma patient?
Jaw thrust maneuver
When is the nasal pharyngeal airway indicated?
In a semi conscious or conscious patient
Where is the nasopharyngeal airway contra indicated?
In trauma patients
What type of airway should be used for a trauma patient?
Oral pharyngeal airways and be prepared for intubation with RSI if oral pharyngeal
airway is unsuccessful
After you have bagged the patient, the patients oxygen saturations and
respiratory effort including respiratory rate have not improved, what is your next
step?
Prepare to Intubate
Less than eight intubate
, When will you start CPR?
When the heart rate is less than 60 bpm and the patient is symptomatic you should start
CPR
How do you calculate the normal systolic blood pressure for a child?
90 + 2x the age in years
How to calculate minimum acceptable SBP:
70 + 2x age in years
What are you going to use for your history during the assessment?
CIAMPEDS
What should the urinary output be for an infant?
2 ml/ kg / hour
What should the normal urinary output be for an adolescent
1-1.5 ml/kg / hour
What is the most common cause of arrest in pediatric patients?
Respiratory arrest
What is the second most common cause of arrest in a pediatric patient?
Shock
_____ is the inadequate delivery of oxygen and nutrients necessary for normal
tissue and cellular function. It is the in balance between supply and demand at
the cellular level.
Shock
Anytime a patient presents with Shock what is the first intervention that we
should do?
Place them on oxygen
What happens in the body during shock?
Plasma leakage/fluid shifts. This results in puffy kids. DIC, inflammatory responses,
intracellular acidosis, ards, and MODS are also seen in shock
What type of fluid should you give a patient with hypovolemic shock due to
Burns?
Lactated ringer fluid replacement using the Parkland formula.
What is seen in early Shock?
In early Shock or warm Shock there is flash cab refill. Look for bounding pulses fever
and flushed skin
What medication is used to correct SVT?
Adenosine
What are some different types of obstructive shock?
Pneumothorax - you will want to do needle aspiration that the second intercostal space
in the midclavicular line and you want to always place a chest tube after
PDA - start this patient on prostaglandins. Do not give this patient any Motrin as it can
help the PDA to close.
Tampa nod - you need to pull the fluid off surrounding the heart
INSPECTOR,HOME AILE,HOME HEALTH
EXAM QUESTIONS
Tachycardia = an _______ sign of shock
Early
What is a late sign of circulatory compromise in children?
Hypotension
Children can remain normotensive until about _____ percent of blood volume is
lost
25%
What are two intervention you should always be doing?
Applying oxygen
Checking bedside blood glucose
How long should the car seat be rear facing?
Until at least one year of age
_____ model parents behavior with toys
Toddlers
Age 3 to 5:
Preschoolers
Magical and it logical thinkers
Take things literally
What are common fears of the preschooler?
Pain
Darkness
Body mutilation
Being alone
Ages 5 to 11:
School age kids
Beers include separation from parents, loss of control, and physical disability
11 to 18 years old:
Body a parent is the most important thing
,What is one of the critical public health issues in today society?
Childhood obesity
At how many years old can a child start using the faces pain scale?
Three years old
What is there an emphasis on during the prioritization of the patient?
Safety
I focused assessment is what type of information?
Objective
I focused history is what type of information?
Subjective
The pediatric assessment triangle a.k.a. the across the room assessment of a
patient looks at what three things?
General appearance
Work of breathing
Circulation to the skin
How long should the pediatric assessment triangle take?
About 3 to 5 seconds
What does the general appearance section include:
Interaction
Muscle tone
Consolabilty
Look or gaze
Speech or cry
Work of breathing— a good indicator of oxygenation and ventilation. What should
you look for in this assessment?
Abnormal airway sounds
Coughing
Abnormal positioning
Retractions/nasal flaring
Rate and depth of respirations
Circulation to the skin:
Skin reflects perfusion status
Inspect the color of central areas such as lips and mucous membranes
Assessed for pallor, molting, or cyanosis
Is the patient flushed or diaphoretic
,What are the three patient categories for the pediatric assessment triangle?
Sick
Sicker
Sickest
If all three components of the PAT are stable know what will the patient be ranked
as?
Sick
If there is disruption in one of the areas of the PAT what will the patient be
ranked?
Sicker
If there is Disruption in two or more components of the PAT what ranking will the
patient receive?
Sickest
If a patient is identified as sickest what is indicated?
Rapid resuscitation
And a child what event typically leads to a code?
Typically a respiratory event leads to a cardiac event
What is the priority with any trauma or suspected drama?
Stabilize the C-spine and stop any bleeding
What maneuver is used to open the jaw in a trauma patient?
Jaw thrust maneuver
When is the nasal pharyngeal airway indicated?
In a semi conscious or conscious patient
Where is the nasopharyngeal airway contra indicated?
In trauma patients
What type of airway should be used for a trauma patient?
Oral pharyngeal airways and be prepared for intubation with RSI if oral pharyngeal
airway is unsuccessful
After you have bagged the patient, the patients oxygen saturations and
respiratory effort including respiratory rate have not improved, what is your next
step?
Prepare to Intubate
Less than eight intubate
, When will you start CPR?
When the heart rate is less than 60 bpm and the patient is symptomatic you should start
CPR
How do you calculate the normal systolic blood pressure for a child?
90 + 2x the age in years
How to calculate minimum acceptable SBP:
70 + 2x age in years
What are you going to use for your history during the assessment?
CIAMPEDS
What should the urinary output be for an infant?
2 ml/ kg / hour
What should the normal urinary output be for an adolescent
1-1.5 ml/kg / hour
What is the most common cause of arrest in pediatric patients?
Respiratory arrest
What is the second most common cause of arrest in a pediatric patient?
Shock
_____ is the inadequate delivery of oxygen and nutrients necessary for normal
tissue and cellular function. It is the in balance between supply and demand at
the cellular level.
Shock
Anytime a patient presents with Shock what is the first intervention that we
should do?
Place them on oxygen
What happens in the body during shock?
Plasma leakage/fluid shifts. This results in puffy kids. DIC, inflammatory responses,
intracellular acidosis, ards, and MODS are also seen in shock
What type of fluid should you give a patient with hypovolemic shock due to
Burns?
Lactated ringer fluid replacement using the Parkland formula.
What is seen in early Shock?
In early Shock or warm Shock there is flash cab refill. Look for bounding pulses fever
and flushed skin
What medication is used to correct SVT?
Adenosine
What are some different types of obstructive shock?
Pneumothorax - you will want to do needle aspiration that the second intercostal space
in the midclavicular line and you want to always place a chest tube after
PDA - start this patient on prostaglandins. Do not give this patient any Motrin as it can
help the PDA to close.
Tampa nod - you need to pull the fluid off surrounding the heart
