ENPC 2023 Study Guide With Complete And Rated 100% Correct Solutions
Pediatric triangle - ANSWER appearance work of breathing circulation to skin General appearance considerations - ANSWER Tone Interactiveness: drawn to sounds or people. Wants to play Consolability Look/Gaze Speech/cry Work of bre...
ENPC TEST 2023 REVIEW WITH
ANSWERS
Pediatric triangle - ANSWER appearance
work of breathing
circulation to skin
General appearance considerations - ANSWER Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry
Work of breathing: - ANSWER Increased work of breathing evidenced by
tachypnea, stridor, grunting, retractions, accessory musles, nasal flaring, head
bobbing, abnormal positioning
Circulation to Skin - ANSWER Observe palor
mottling
cyanosis
Sick, Sicker, Sickest - ANSWER 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 - ANSWER hypoxia
hypoglycemia
Blood pressure norms - ANSWER Hypotension: Less than 70 + (2 x age in years)
Widening pulse pressure = increased ICP
Narrowing pulse pressure = hypovolemic shock
Crying child - ANSWER Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag
Respiratory distress indicated by: - ANSWER increased heart rate
skin color changes
incrased work of breathing
wheezing
diaphoresis
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,ENPC TEST 2023 REVIEW WITH
ANSWERS
abnormal airwa sounds
Respiratory failure signs - ANSWER fatigue and become lethargic
hypoxia
hypercarbia
General airway interventions - ANSWER Allow child to stay in most comfortable
position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation
Croup - ANSWER 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 - ANSWER albuterol, duo neb and oral steroid
Bronchiolitis/RSV - ANSWER Assessment: 1-3 days nasal congestion fever,
cough, respiratory distress with wheezing and crackles. Dehydration and
tachypnea
Discharge: lasts 2-3 weeks; nasal suctioning; monitor hydration
treating hypoglycemia - ANSWER obtain glucose for anyone who is not awake
and alert
treat kids with 2-4ml/kg of D25W
When to perform blood glucose test? - ANSWER When the child is not awake
and alert or AMS is suspected
Preventing Secondary brain injury in TBI - ANSWER prevent hypotension and
hypoxia
cuffed vs uncuffed tube - ANSWER uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5
fluid bolus formula - ANSWER infant: 10ml/kg
kid: 20ml/kg
normal vitals - ANSWER pg 52
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, ENPC TEST 2023 REVIEW WITH
ANSWERS
blood glucose normal ages 5-11 - ANSWER 72-140
Cardiac Assessment - ANSWER Trend pulse and pulse pressure
palapate upper and lower extremity pulses
symptoms of CHF - ANSWER poor feeding, irritability, fatigue easily with rapid
resp rate, increased work of breathing
Ass and Interventions similar to adults
Myocarditis Assessment and treatment - ANSWER 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 - ANSWER Tachycardia, tacypnea; AMS; slight increaes in
diastolic pressure
Intervention: Stop bleed; give fluids and RBC; balanced therapy; offer pedialyte if
not NPO
Cardiogenic shock - ANSWER Intervention: expert consult; supportive care to
decrease O2 and metabolism demands; slow fluids; treat hpotension while
decreasing afterload; vagal maneuver; vasopressors
Obstructive Shock - ANSWER Assessment: Cardiac tamponade- muffled heart
sounds and pulsluss paradoxus; tension pneumo- asymmetrical chest rise and fall
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