Grayson Pals Chapter 1

Front 1

During the primary assessment evaluate the _____?

Back 1

ABCDEs

Front 2

Conduct a ______ and _____ assessment of the general appearance in the first few seconds of the pt assessment

Back 2

Visual and auditory

Front 3

Once the child's condition has been stabilized, proceed with the _____ and _____ assessment

Back 3

Secondary and tertiary

Front 4

Central apnea is characterized by _____?

Back 4

absence of inspiratory muscle activity

Front 5

Respiratory rate is best evaluated before your _____?

Back 5

hands on assessment

Front 6

RR of Toddlers 1 to 3 yr

Back 6

24-40

Front 7

RR of preschoolers

Back 7

22 - 34

Front 8

You can decide what you need to do and implement the action or treatment at the end of this phase.

Back 8

primary assessment

Front 9

This assessment included vital signs and O2 saturation.

Back 9

Primary

Front 10

Here you assess cardiopulmonary and neurologic function to categorise a childs condition.

Back 10

primary

Front 11

This assessment is hands on

Back 11

primary

Front 12

The _____ assessment uses the ABCDE approach and means _____?

Back 12

primary
Airway, breathing, circulation, disability, exposure

Front 13

Activating the ERS, starting CPR, obtaining the defibrillator, place pt on monitor, giving O2, and starting treatment fall under what step of the ACDA?

Back 13

Act

Front 14

In the ACDA the D stands for _____ and means what?

Back 14

Decide. Decide what to do based on your assessment and initial categorization of the clinical condition. Base these on your scope of practice.

Front 15

In the ACDA attempt to categorize the clinical condition by _____ and _____.

Back 15

type and severity

Front 16

Laboratory, radiorgaphic, and other advanced tests that help to establish a child's physiologic condition and diagnosis.

Back 16

Tertiary assessment (falls under the systemic approach)

Front 17

Under the systematic approach, the secondary assessment, you should do what?

Back 17

Focused medical and SAMPLE and a head to toe exam.

Front 18

A rapid hands-on ABCDE approach to evaluate cardiopulmonary and neurologic function. Includes vital signs and pulse ox

Back 18

The primary assessment of the systematic approach.

Front 19

The general assessment is what?

Back 19

A rapid, visual, and auditory assessment of a child's overall appearance, work of breathing and circulation.

Front 20

The 4 parts of the pediatric assessment?

Back 20

General
Primary
Secondary
Tertiary

Front 21

The 4 parts of the APPROACH to pediatric assessment.

Back 21

ACDA (assess, categorize, decide, act)

Front 22

Cardiac arrest in children is rarely sudden cardiac arrest, instead it is most often _____?

Back 22

asphyxial

Front 23

Clinical signs of cardiac arrest

Back 23

apnea, or agonal gasps
no palpable pulses
unresponsive

Front 24

For VF/VT after 1 shock give _____?

Back 24

epinephrine 0.01 ml/kg 1 to 10,000 q 3 to 5 min

Front 25

antiarrhythmics used for pals CPR

Back 25

amiodarone 5mg/kg
lidocaine 1mg/kg

Front 26

The 5 drugs used to treat tachyarrhythmias.

Back 26

adenosine: 0.1 mg/kg 2ns dose x2
amiodarone: 5 mg/kg (max 300)
lidocaine: 1 mg/kg
procainamide: 15 mg/kg
sodium bicarb:1 mEq/kg

Front 27

Respiratory distress is a clinical state characterized by ____?

Back 27

increased respiratory rate and effort. And may include sounds, skin color, and mental status.

Front 28

Respiratory failure is characterized by _____?

Back 28

inadequate oxygenation, ventilation or both.

Front 29

A true diagnosis of respiratory failure may require _____?

Back 29

laboratory testing

Front 30

RR for toddler

Back 30

24-40

Front 31

RR for preschool

Back 31

22-34

Front 32

RR for school age

Back 32

18-30

Front 33

RR for adolescent

Back 33

12 to 16

Front 34

_____ is the term used for tachypnea without the signs of increased respiratory rate.

Back 34

quiet tachypnea

Front 35

Quiet tachypnea results from an attempt to _____?

Back 35

maintain normal blood PH

Front 36

Quiet tachypnea commonly results from nonpulmonary conditions like ?

Back 36

high fever, pain, mild metabolic acidosis, sepsis

Front 37

central apnea is characterized by ?

Back 37

absence of inspiratory muscle activity or suppression of the brain or spinal cord

Front 38

An absence of airflow with no inspiratory muscle activity or a suppression of the spinal cord

Back 38

central apnea

Front 39

obstructive apnea

Back 39

inspirstory muscle activity without airflow

Front 40

Inspiratory muscle movement without airflow is called?

Back 40

obstructive apnea

Front 41

mixed apnea is characterized by?

Back 41

mixed central and obstructive apnea

Front 42

mixed apnea is?

Back 42

a combo of both obstructive and central apnea.

Front 43

signs of increased respiratory effort include?

Back 43

nasal flaring, chest retractions, head bobbing or seesaw respirations

Front 44

_____ is a serious sign and may indicate respiratory distress or respiratory failure.

Back 44

Grunting

Front 45

seesaw breathing usually indicates _____ airway obstruction.

Back 45

upper

Front 46

normal tidal volume is _____?

Back 46

5 to 7 mm/kg

Front 47

In the child with apparently normal or increased respiratory effort, diminished distal air entry suggests __________?

Back 47

airflow obstruction or lung tissue disease.

Front 48

significant airway abnormalties may be missed in the _____ child.

Back 48

obese

Front 49

RR X tidal volume =

Back 49

minute volume

Front 50

A course high pitched breathing sound.

Back 50

stridor

Front 51

Stridor sounds like

Back 51

a course high pitched sound. Typically heard on inspiration.

Front 52

Stridor is a sign of ____ airway obstruction.

Back 52

upper

Front 53

a sound that may indicate critical airway obstruction requiring immediate intervention

Back 53

stridor

Front 54

A low pitched sound heard on expiration.

Back 54

grunting

Front 55

Grunting occurs as the child exhales against a partially closed _____

Back 55

Glottis

Front 56

A sound that may indicate lung tissue disease of the small airway or alveolar collapse

Back 56

Grunting

Front 57

An upper airway sound heard due to airway secretions, vomit or blood.

Back 57

Gurgling

Front 58

A high pitched or low pitched whistling or sighing sound most often heard during expiration.

Back 58

Wheezing

Front 59

This sound indicates lower (intrathoracic) airway obstruction, especially of the smaller airway.

Back 59

Wheezing

Front 60

inspiratory wheezing suggests _____?

Back 60

a foreign body or other obstruction in the trachea or upper airway.

Front 61

A sharp crackling sound heard on inspiration may be wet or dry.

Back 61

Crackles (railes)

Front 62

A sound that indicates accumulation of alveolar fluid.

Back 62

crackles (railes)

Front 63

Dry crackles are most often heard with _____?

Back 63

atelectasis and interstitial lung disease.

Front 64

If the heart rate displayed on the pulse oximeter is not the same as that of the monitor the reading is _____?

Back 64

not reliable

Front 65

If a child is _____ saturation may be 100% but O2 delivery may be low.

Back 65

anemic

Front 66

Assessment of circulation includes evaluation of _____ and _____

Back 66

cardiovascular function and end organ function.

Front 67

Cardiovascular function is assessed by evaluation of the __________?

Back 67

skin color and temp.
heart rate
heart rhythm
BP
pulse
cap refill

Front 68

End organ function is assessed by the evaluation of the _____?

Back 68

brain perfusion (mental status)
skin profusion
renal perfusion

Front 69

The most common cause of bradycardia in the child

Back 69

hypoxia

Front 70

Hypotension may occur with ____ to ____ % of blood loss

Back 70

20 to 25%

Front 71

Hypotension may be a sign of septic shock due to _-___-?

Back 71

vasodilation

Front 72

Pulsus paradoxus can occur in children with _____ or _____?

Back 72

severe asthma or pericardial tamponade

Front 73

Brain perfusion signs consist of?

Back 73

level of consciousness
muscle tone
pupillary response

Front 74

Sudden and severe cerebral hypoxia may present with these neurologic signs.

Back 74

loss of muscle tone
seizures
pupillary dilation
unconsciousness

Front 75

Alterations in neurologic signs may be caused by conditions other than cerebral hypoxia name them.

Back 75

drugs,
ICP
metabolic conditions

Front 76

Petechiae appear as tiny dots and suggest a _________?

Back 76

low platelet count

Front 77

Purpura (discolorations caused from bleeding of capillaires and small vessels) appear as larger spots and may represent ______?

Back 77

septic shock

Front 78

Cyanosit is not apparent untill at least _____ d/dl of hemoglobin is desaturated.

Back 78

5

Front 79

Children with different _____ levels will be cyanotic at different levels O2 levels

Back 79

hemoglobin

Front 80

increased urine output may be due to _____?

Back 80

high glucose (hyperglycemia)

Front 81

A quick evaluation of the cerebral cortex and brain-stem is known as _____?

Back 81

The disability assessment

Front 82

The disability assessment consists of a quick assessment of ____?

Back 82

nervous system ( brain-stem and cerebral cortex)

Front 83

The Disability assessment should be done after the _____?

Back 83

primary assessment

Front 84

At the end of the primary assessment do the _____ assessment

Back 84

Disability assessment

Front 85

The _____ assessment establishes the childs level of sonsciousness.

Back 85

Disability

Front 86

The disability assessment consists of evaluating the ?

Back 86

AVPU pediatric response scale
GCS (Glasgow coma scale)
Pupillary response to light

Front 87

To rapidly evaluate the cerebral cortex function use the ______ scale

Back 87

AVPU

Front 88

The AVPU scale evaluates the _____?

Back 88

Cerebral cortex

Front 89

The most widely used method of defining a childs level of consciousness and neurologic status is ______?

Back 89

GCS

Front 90

The GCS is used to assess the ____

Back 90

Level of consciousness and neurologic function

Front 91

Pupil response to light is a good indicator of ____?

Back 91

brain-stem function

Front 92

The final component of the primary assessment is _____

Back 92

Exposure

Front 93

After the ABCDE assessment move on the the ____ assessment

Back 93

secondary

Front 94

The secondary comes after the _____ assessment.

Back 94

ABCDEF assessment

Front 95

The components of the secondary assessment focus on?

Back 95

Focused history
physical exam

Front 96

The physical exam and focused history are part of the _____ assessment.

Back 96

secondary

Front 97

Use the ____ to identify important aspects of the childs history and presenting complaint

Back 97

SAMPLE

Front 98

The SAMPLE mnemonic is used to identify aspects of _____?

Back 98

focused history

Front 99

The tertiary assessment consists of ancillary studies to detect and identify the presence and severity of _____ and _____?

Back 99

respiratory and circulation abnormalities.

Front 100

To detect and identify the the presence and severity of respiratory and circulatory abnormalities use the _____ assessment.

Back 100

Tertiary

Front 101

The timing of the tertiary tests are dictated by the ___ ____?

Back 101

clinical situation

Front 102

Laboratory studies that help assess the respiratory abnormalities are?

Back 102

arterial blood gas
venous blood gas
hemoglobin concentration

Front 103

Non-laboratory studies to help determine respiratory abnormalities are?

Back 103

Pulse oximetry
CO2 monitoring
Capnography
Chest x-ray
peak expiratory flow rate

Front 104

ABG analysis measure the _____?

Back 104

partial pressure of atrial O2 (PaO2) and carbon dioxide (PaCO2) disolved in the plasma.

Front 105

The partial pressure of atrial O2 (PaO2) and carbon dioxide (PaCO2) disolved in the plasma is measured by the ___?

Back 105

the ABG

Front 106

The PaO2 measures ?

Back 106

Adequacy of oxygenation (of arterial blood not O2 content)

Front 107

The PaCO2 measures?

Back 107

Adequacy of ventilation

Front 108

The adequacy of ventilation is measured by the ?

Back 108

PaCO2

Front 109

The adequacy of oxygenation (of arterial blood not O2 content) is measured by ?

Back 109

PaO2

Front 110

A normal PaO2 does not confirm oxygen content of the blood because?

Back 110

It reflects only the O2 dissolved in the blood plasma

Front 111

Arterial saturation can be calculated by using the?

Back 111

PaO2 and pH

Front 112

PaO2 and pH can determine?

Back 112

arterial oxygenation saturation

Front 113

You would use a Co-oximeter to rule out?

Back 113

carbon dioxide or methemoglobinemia

Front 114

Respiratory failure is traditionally based on ?

Back 114

inadequate oxygenation (hypoxemia) or inadequate ventilation (hypercarbia)

Front 115

A low paO2 on the ABG is?

Back 115

hypoxemia

Front 116

Hypoxmia is diagnosed as ___ on the ABG results

Back 116

low PaO2

Front 117

A high PaCO2 on the ABG is ?

Back 117

Hypercarbia

Front 118

Hypercarbia is diagnosed as ___ on the ABG results

Back 118

High PaCO2

Front 119

A ___ is not requires to identify respiratory failure

Back 119

an ABG

Front 120

A normal PCO2 on the venous blood gas analysis is typically within ___- to ___ mmHg of the arterial PCO2

Back 120

4 to 6 mmHg

Front 121

On the venous blood gas a high PCO2 and a low pH may be due to ____ use

Back 121

tourniqet

Front 122

A ____ specimen is preferable to a _____ specimen for the source of a VBG

Back 122

Central venous

peripheral venous

Front 123

Hemoglobin concentration helps determine adequacy of ____ _____ capacity

Back 123

oxygen carrying

Front 124

Oxygen content is determined largely by the ________?

Back 124

hemoglobin concentration (g/dL) and its saturation with oxygen (SaO2)

Front 125

____ provides a noninvasive estimate of SpO2 of the oxyhemoglobin saturation (SaO2)

Back 125

pulse oximetery

Front 126

Repeat assessments of PaCO2 by ABG analysis can be avoided using this

Back 126

Capnography

Front 127

This type of X-ray will NOT help determine tracheal vs. esophageal placement of the ET tube.

Back 127

anterior-posterior or posterior-anterior

Front 128

Arterial pH and bicarbonate (HCO3) concentrations obtained with ABG's may be useful in the diagnosis of _____?

Back 128

acid-base imbalances

Front 129

Normal venous oxygen saturation (vO2) is approximately ___ to ___ % if arterial oxygen saturation is 100%

Back 129

70 to 75%

Front 130

There should be a __ to __ % absolute difference between the central venous and atrial oxygen saturation.

Back 130

25 to 30%

Front 131

The total serum CO2 is the total amount of carbon dioxide in the blood. It is present in these 3 forms.

Back 131

Bicarbonate (HCO3)
Carbonic acid (H2CO3)
Dissolved CO2

Front 132

Total CO2 can be used to evaluate the severity of an ____________ imbalance and determine whether the etiology is primarily metabolic.

Back 132

acid-base

Front 133

Hemoglobin concentration indicates the what?

Back 133

Oxygen carrying capacity of the blood.