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Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn?
- A. Assess the newborn's skin condition and color.
- B. Initiate positive-pressure ventilations.
- C. Start chest compressions and contact medical control.
- D. Provide blow-by oxygen with oxygen tubing.
Correct Answer: B
Rationale: In a newborn with a heart rate below 100 beats/min, the most appropriate initial management is to initiate positive-pressure ventilations. This helps support the newborn's respiratory effort and oxygenation in the setting of a low heart rate, ensuring adequate oxygen supply to vital organs. Assessing the skin condition and color, starting chest compressions, or providing blow-by oxygen are not the priority in this scenario where respiratory support is crucial.
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What is the appropriate treatment for a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color?
- A. Oxygen, back slaps, and transport.
- B. Subdiaphragmatic thrusts until the object is expelled.
- C. Assisted ventilations, back slaps, and transport.
- D. Supplemental oxygen and transport.
Correct Answer: D
Rationale: For a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, the appropriate treatment includes providing supplemental oxygen and arranging for transport to a healthcare facility. Oxygen helps alleviate the respiratory distress, and transport ensures the child receives further evaluation and care by healthcare professionals. Back slaps and subdiaphragmatic thrusts are not recommended for a child with a mild airway obstruction and normal skin color, as these interventions are typically reserved for more severe cases of airway obstruction.
What is the appropriate technique for performing two-rescuer CPR on a 4-year-old child?
- A. 15 compressions to 2 ventilations, compressing the sternum with your thumbs, and delivering at least 100 compressions per minute.
- B. 30 compressions to 2 ventilations, compressing the chest one third the depth of the chest, and delivering each breath over 1 second.
- C. 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.
- D. 30 compressions to 2 ventilations, compressing the sternum with the heel of both hands, and delivering each breath over 1 to 2 seconds.
Correct Answer: C
Rationale: When performing two-rescuer CPR on a 4-year-old child, the appropriate technique involves 15 compressions to 2 ventilations. Compressions should be done by pressing the child's sternum with the heel of your hand. Ventilations should be given until visible chest rise occurs. This technique ensures effective CPR delivery for a child in need of resuscitation.
Which of the following is the MOST detrimental effect of gastric distention in infants and children?
- A. Tracheal rupture.
- B. Less effective chest compressions.
- C. Decreased ventilatory volume.
- D. Acute rupture of the diaphragm.
Correct Answer: C
Rationale: Gastric distention in infants and children can lead to a decrease in ventilatory volume. This occurs because the distended stomach can limit the movement of the diaphragm, reducing its ability to contract and expand the chest cavity effectively. As a result, the amount of air entering and leaving the lungs is decreased, impacting ventilation. Tracheal rupture, acute rupture of the diaphragm, and less effective chest compressions are not typically associated with gastric distention.
A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child's age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury?
- A. Lower leg injury
- B. Head injury
- C. Upper thorax injury
- D. Pelvic injury
Correct Answer: D
Rationale: Given the mechanism of injury and the distance the child was thrown, a primary pelvic injury should be suspected due to the high impact and force. The pelvis is a common site for significant injury in such cases, and the distance the child was thrown indicates a high-energy impact that could lead to pelvic fractures or injuries.
You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should:
- A. reassess the newborn every 5 minutes and transport after the placenta delivers.
- B. keep the newborn warm, give oxygen to the mother if needed, and transport.
- C. massage the lower part of the mother's uterus until the placenta delivers.
- D. give the newborn high-flow oxygen via a non-rebreathing mask and transport.
Correct Answer: B
Rationale: In this scenario, the appropriate action is to keep the newborn warm, ensure the mother receives oxygen if needed, and prepare for transport. The newborn is showing signs of central cyanosis (hands and feet being cyanotic), which can be due to various reasons, including inadequate oxygenation. Therefore, ensuring warmth and possible oxygen to the mother are important. Additionally, monitoring both the mother and baby during transport is crucial for their well-being.