Components in the prioritization of pediatric emergency care (4) - ANS PAT, Focused Assessment
(objective information), Focused pediatric Hx(subjective information), assignment of an acuity
rating decision
Pediatric Assessment Triangle : (3) components - ANS Appearance. Work of Breathing.
Circulation to the skin. This forms the "general impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
PQRST for Pain - ANS (pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
What age is the respiratory system considered fully developed? - ANS 8 years old
6P's Assessment for Musculoskeletal Trauma - ANS (pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Paresthesia
Paralysis
Poikilothermia
Burn Transfer Criteria - ANS 1. Partial thickness >10% of BSA
2. Face, hands, feet, genitalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
6. Burn injury in pt with preexisting medical disorders that could complicate tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or
mortality.
8. Burned children in hospital wo qualified equipment or personnel to care for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
Infants are obligate nose breathers. If nose is obstructed ___________ - ANS mouth then suction
nose
Neutropenic pt with a temperature - ANS Don't take rectal temp.
No invasive procedures if not necessary.
, Non Blanchable Rashes of concern - ANS Meningococcemia
Petechiae/Purpura
Normal Urine Output for child - ANS 1 to 2 ml / Kg / Hr
Oral Rehydration for 9 month old with mild dehydration. - ANS Glucose and sodium solution,
every 2 to 5 min with 5 to 10 ml
6 week old infant, no medical hx. eating poorly, vomiting, "hard to wake up", responsive to pain.
Anterior fontanel bulging, tachypnic. Diagnostic evaluation expected? - ANS Skeletal survey
Possible shaken baby syndrome
Minimal Acceptable BP's - ANS Newborn = 60
Infant = 70
Child = 70 + (2 x age in yrs)
Decompensated shock in children #1 sign - ANS Hypotension
TBI considerations - ANS MD has to say when they can return, not the pt or caregiver.
Should be a "gradual return to play"
Bradycardia pharm treatment - ANS Epinephrine (1:10,000), 0.01mg/kg every 3-5 min
A preschooler has a small laceration that requires 2 stitches. The nurse covers the wound with a
bandage knowing that it will comfort the child to have it covered. What is the developmental
reason for this intervention?
A. Preschoolers are magical thinkers and imagine bandages keep their insides from coming out
B. Preschoolers fear physical disability and believe a bandage will prevent disability
C. Preschoolers explore orally and will likely chew or suck on the stitches if left uncovered
D. Preschoolers are concerned with body image and don't want to appear different than peers -
ANS A. Magical thinkers
An 11-year-old presents to the emergency department with a complaint of hitting his head while
playing soccer. The nurse enters the room and performs an across-the-room assessment. He is
staring at the wall. He has no increased work of breathing, and his color is pink. Using the
pediatric assessment triangle (PAT), what classification will the nurse assign?
A. Well
B. Sick
C. Sicker
D. Sickest - ANS B. Sicker
A 2-year-old has a suspected cervical spinal injury. In order to ensure neutral spinal alignment,
padding should be placed under which area?
A. Shoulders
B. Head
C. Neck
D. Waist - ANS A. Shoulders
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