Nokea
A 3-year-old female presents with respiratory distress. She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves:
- A. gently restraining her and assisting with ventilations.
- B. ventilations with a flow-restricted, oxygen-powered device.
- C. a non-rebreathing mask with the flow rate set at 6 to 8 L/min.
- D. asking the mother to hold an oxygen mask near her face.
Correct Answer: C
Rationale: In a pediatric patient with respiratory distress, a non-rebreathing mask with a flow rate set at 6 to 8 L/min is the most effective way to deliver oxygen. This method ensures a high concentration of oxygen is delivered to the child, aiding in improving oxygen saturation levels. In this scenario, the mother can assist in holding the mask to maintain comfort and cooperation in the child while ensuring proper oxygen delivery.
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When performing CPR on an infant with suspected sudden infant death syndrome (SIDS), an important aspect to consider is:
- A. Focusing all of your attention on the infant, with minimal parental interaction.
- B. Carefully inspecting the environment in which the infant was found.
- C. Understanding that most infants with SIDS can be successfully resuscitated.
- D. Encouraging the presence of the parents during your resuscitation attempt.
Correct Answer: B
Rationale: When dealing with a suspected case of SIDS, it is crucial to carefully inspect the environment in which the infant was found. This inspection can provide valuable information that may help determine the cause and support further investigation into the incident. By examining the surroundings, potential hazards or clues related to the sudden event may be identified, aiding in understanding the circumstances and potentially preventing similar incidents in the future.
After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of:
- A. 10 to 12 breaths/min.
- B. 12 to 20 breaths/min.
- C. 6 to 8 breaths/min.
- D. 8 to 10 breaths/min.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-old child?
- A. Capillary refill time
- B. Presence of peripheral pulses
- C. Skin color and temperature
- D. Systolic blood pressure
Correct Answer: D
Rationale: Systolic blood pressure is the least reliable parameter when assessing perfusion status in a 2-year-old child. In young children, blood pressure measurements can be variable, affected by factors like anxiety or crying. Capillary refill time, presence of peripheral pulses, and skin color and temperature are more reliable indicators of perfusion status in this age group.
A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should:
- A. administer 1 g/kg of activated charcoal.
- B. give 15 mL of ipecac and contact medical control.
- C. contact poison control and give him oxygen.
- D. give oxygen and perform a head-to-toe exam.
Correct Answer: C
Rationale: When a child ingests a harmful substance like drain cleaner and remains alert with a patent airway and adequate breathing, the initial steps involve contacting poison control to guide further management. In this scenario, providing oxygen to support respiratory function is essential until definitive care is established. Activated charcoal and ipecac are not recommended in the management of ingested caustic substances like drain cleaner. Performing a head-to-toe exam can wait until the child's immediate respiratory needs are addressed and the poison control center has provided guidance on further management.
You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should:
- A. provide supportive care and transport.
- B. give him acetaminophen or ibuprofen.
- C. begin rapid cooling measures at once.
- D. allow the mother to take her child to the doctor.
Correct Answer: A
Rationale: After a febrile seizure, the recommended course of action is to provide supportive care and transport the child to a medical facility. Supportive care may include ensuring a safe environment, monitoring the child, and seeking medical evaluation to determine the underlying cause of the seizure and appropriate management.