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Questions and Answers
What is a common sign of internal bleeding in pediatric patients?
What is a common sign of internal bleeding in pediatric patients?
What should be prioritized in first aid care for a child with internal bleeding?
What should be prioritized in first aid care for a child with internal bleeding?
Which of the following is NOT a potential complication of blood administration in pediatric patients?
Which of the following is NOT a potential complication of blood administration in pediatric patients?
In which position should a pediatric patient be placed to manage shock effectively?
In which position should a pediatric patient be placed to manage shock effectively?
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Which symptom might indicate changes in a child's status due to internal bleeding?
Which symptom might indicate changes in a child's status due to internal bleeding?
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What is the least important assessment priority in a pediatric emergency situation?
What is the least important assessment priority in a pediatric emergency situation?
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What components are included in the Pediatric Assessment Triangle (PAT)?
What components are included in the Pediatric Assessment Triangle (PAT)?
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Which tool is used to estimate a child's weight for medication dosage based on length?
Which tool is used to estimate a child's weight for medication dosage based on length?
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Which medical treatment is typically considered a last resort in emergencies?
Which medical treatment is typically considered a last resort in emergencies?
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What does respiratory failure indicate in pediatric emergencies?
What does respiratory failure indicate in pediatric emergencies?
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What is the purpose of giving comfort measures during a pediatric assessment?
What is the purpose of giving comfort measures during a pediatric assessment?
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What is vital to assess in children potentially experiencing illness, based on caregiver interaction?
What is vital to assess in children potentially experiencing illness, based on caregiver interaction?
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Which diagnostic test is commonly performed to evaluate electrolyte levels in a pediatric emergency?
Which diagnostic test is commonly performed to evaluate electrolyte levels in a pediatric emergency?
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What is the primary concern when administering activated charcoal in a case of poisoning?
What is the primary concern when administering activated charcoal in a case of poisoning?
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Which injury is characterized by skin being broken and the victim at risk for external bleeding?
Which injury is characterized by skin being broken and the victim at risk for external bleeding?
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What should be done immediately for a pediatric patient suspected of having ingested corrosive substances?
What should be done immediately for a pediatric patient suspected of having ingested corrosive substances?
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What is the most common type of shock in pediatric patients?
What is the most common type of shock in pediatric patients?
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In cases of closed injuries, which of the following is NOT a typical type of closed injury?
In cases of closed injuries, which of the following is NOT a typical type of closed injury?
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What is a key nursing management action in the treatment of shock?
What is a key nursing management action in the treatment of shock?
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What is the purpose of gastric lavage in cases of poisoning?
What is the purpose of gastric lavage in cases of poisoning?
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What should be done if an object is impaled in a wound?
What should be done if an object is impaled in a wound?
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Which of the following is the best method for preserving an amputated limb for potential reattachment?
Which of the following is the best method for preserving an amputated limb for potential reattachment?
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Which type of injury results from a sudden blow and may not show external signs?
Which type of injury results from a sudden blow and may not show external signs?
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Which type of shock is characterized by dilation of blood vessels due to a severe infection?
Which type of shock is characterized by dilation of blood vessels due to a severe infection?
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For pediatric patients who have ingested a harmful substance, what is a crucial precaution regarding food intake?
For pediatric patients who have ingested a harmful substance, what is a crucial precaution regarding food intake?
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What is a common complication of animal bites, particularly from cats?
What is a common complication of animal bites, particularly from cats?
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What is the recommended action when a child is pulseless or has a heart rate less than 60 bpm?
What is the recommended action when a child is pulseless or has a heart rate less than 60 bpm?
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What is the initial step in managing a bleeding victim?
What is the initial step in managing a bleeding victim?
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Which of the following statements about pediatric trauma assessment is true?
Which of the following statements about pediatric trauma assessment is true?
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What causes anaphylactic shock?
What causes anaphylactic shock?
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What is a potential consequence of using a tourniquet?
What is a potential consequence of using a tourniquet?
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Which condition is a common cause of pediatric cardiac arrhythmias?
Which condition is a common cause of pediatric cardiac arrhythmias?
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What is the primary cause of death among children aged 1-4 years?
What is the primary cause of death among children aged 1-4 years?
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What is a leading cause of distributive shock?
What is a leading cause of distributive shock?
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In the case of spinal cord injuries, what is the most critical action to take?
In the case of spinal cord injuries, what is the most critical action to take?
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Which pediatric emergency assessment component involves checking for signs of distress such as nasal flaring?
Which pediatric emergency assessment component involves checking for signs of distress such as nasal flaring?
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What is the appropriate use of an AED for children?
What is the appropriate use of an AED for children?
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Which scale is used to assess neurological status in pediatric emergencies?
Which scale is used to assess neurological status in pediatric emergencies?
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When managing a bleeding wound, direct pressure should be applied using which method?
When managing a bleeding wound, direct pressure should be applied using which method?
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What initial action should be taken if the airway is compromised?
What initial action should be taken if the airway is compromised?
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What factor does NOT significantly influence the severity of bleeding?
What factor does NOT significantly influence the severity of bleeding?
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In pediatric emergency assessment, which sign indicates poor perfusion?
In pediatric emergency assessment, which sign indicates poor perfusion?
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What should a nurse assess for under 'Circulation' during a pediatric emergency?
What should a nurse assess for under 'Circulation' during a pediatric emergency?
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What is the recommended action if a child shows signs of respiratory failure during an emergency?
What is the recommended action if a child shows signs of respiratory failure during an emergency?
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Which age group is most affected by intentional self-harm as a leading cause of death?
Which age group is most affected by intentional self-harm as a leading cause of death?
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Study Notes
Pediatric Emergencies
- Leading cause of death in children aged 1-4 is accidents.
- Children aged 5-9: Accidents, cancer, congenital abnormalities
- Children aged 10-14: Accidents, self-harm, cancer, congenital abnormalities
Pediatric Codes
- Most pediatric codes involve respiratory failure or shock.
- Pediatric nurses are certified in PALS (Pediatrics Advance Life Support) and PEARS (Pediatrics Emergency Assessment, Recognition, and Stabilization).
Pediatric Emergency Assessment (PEARS)
- A - Airway: Ensure the airway is open and clear. Look for obstructions and abnormal sounds. Secure the airway if compromised.
- B - Breathing: Monitor rate/pattern, O2 status, work of breathing, and signs of breathing effort (nasal flaring, accessory muscles). Assess breathing effectiveness by checking rate, effort, and quality. Look for distress signs like retractions, flaring, and cyanosis. Provide oxygen or ventilation support if needed.
- C - Circulation: Check skin color, temperature, capillary refill, heart rate, and pulse strength. If absent, start CPR.
Other Key Information
- Disability (Neurological Status): Assess level of consciousness, activity level, response to the environment, pupils, and altered mental status or seizures. Use the AVPU scale (Alert, Voice, Pain, Unresponsive) or the Glasgow Coma Scale.
- Exposure/Environment: Fully expose the child to identify injuries or signs of illness. Maintain body temperature. Look for rashes, wounds, or abnormalities.
- Pain: Least important assessment because the child is still alive and breathing.
- Pediatric Assessment Triangle (PAT): rapid assessment tool to quickly evaluate the severity of illness or injury (Appearance, Work of Breathing, Circulation).
Common Medical Treatments
- Suctioning, Oxygen, Bag-Valve-Mask Ventilation, Intubation
- IV Fluids, Blood Products – improving circulation
- Cervical Stabilization – to prevent further damage
- Defibrillation – last resort in emergencies
Medication Doses and Equipment Sizes
- Many facilities prepare code reference sheets when a child is admitted and use color coded Broselow tape for weight-based medication dosage.
Respiratory Emergencies
- Respiratory insufficiency: Increased work of breathing, but adequate gas exchange.
- Respiratory failure: Inability to maintain oxygenation of the blood.
- Apnea: Cessation of respirations for more than 20 seconds (can be central or obstructive).
- Respiratory arrest: Complete cessation of respirations
- Airway obstruction: Can be due to aspiration of a foreign body.
- Pediatric intubation: Nurses are vital on the intubation team, aiding in equipment setup, medication administration, suctioning, and ET tube securing.
- Macintosh Blade: C-curve blade, most used for a wider range of patients, useful in adults and children. Directly lifts the epiglottis for good visualization.
- Miller Blade: L-straight blade, often used for pediatric patients or those with a floppy epiglottis. Directly lifts the epiglottis and allows excellent visualization of vocal cords, useful in anatomical situations.
Pediatric Intubation
- Nurses are a vital part of the intubation team, assisting with equipment, medication administration, suctioning, and endotracheal tube placement.
Other Pediatric Respiratory Emergencies
- BRUE (Brief Resolved Unexplained Event): Alarming episode in infants (under 1 year old) involving apnea, color change, muscle tone change, or altered responsiveness. Resolves on its own.
- SIDS (Sudden Infant Death Syndrome): Sudden, unexpected death of an otherwise healthy infant, often during sleep, during the first year of life. Prevention focuses on safe sleep practices.
Pediatric Shock
- An inadequate delivery of blood to cells; left untreated, shock is fatal.
- Progressive, gradual or rapid process that requires immediate recognition and treatment.
Cardiac Arrhythmias and Arrrests
- Common causes include electrolyte abnormalities, toxic drug ingestion, congenital cardiac defects, potential life-threatening arrhythmias (prolonged QT syndrome, Hypertrophic cardiomyopathy), and traumatic cardiac injury.
- Pediatric CPR: Initiate cardiac compressions if child is pulseless or heart rate less than 60 bpm. Use an AED for children under 1 who have sudden, witnessed collapse.
- AHA recommends using an AED for children less than 1 who have no pulse and suffered a sudden, witnessed collapse.
Submersion Injuries
- Third leading cause of preventable deaths.
- Near-drowning/Submersion injuries: Child survives longer than 24 hours, after submersion in water.
- Drowning: Asphyxia and death within 24 hours; primary respiratory impairment.
- Water aspiration leads to poor oxygenation, pulmonary edema, and hypoxemia.
Ingestions & Poisoning
- Ingestion of harmful substances is most common in the home environment.
- Ex. Medications, household chemicals, plants, food, alcohol, drugs.
- Prevention is crucial for children and adolescents.
- Potential symptoms— vomiting, abdominal pain, decreased level of consciousness, seizures, respiratory distress.
Injuries & Trauma
- Common cause of death in children and adolescents (unintentional injuries).
- Closed Injuries: soft tissues damaged beneath the skin (bruises, hematomas).
- Crush Injuries: underlying layers of skin severely damaged.
- Clamping Injuries: severe damage to tissues and blood vessels.
- Open Injuries: Skin is broken (abrasions, lacerations, avulsions, penetrating/punctured wounds)
Impaled Objects
- Do not remove impaled objects unless in an OR.
Bleeding
- Common causes include trauma, falls, accidents, sports injury.
- First aid: Stop the bleeding immediately by applying direct pressure, or elevating the bleeding area.
Internal Bleeding in Pediatric Patients
- Can result from trauma, blunt trauma, fractures, or injuries to vital organs (spleen, liver, kidneys).
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Description
This quiz focuses on key aspects of pediatric emergencies, including the leading causes of death in children, critical pediatric codes, and the PEARS assessment process. Gain insights into airway management, breathing assessment, and circulation evaluation in emergency situations involving children.
