Nokea
What is the MOST common cause of shock in infants and children?
- A. Severe allergic reaction
- B. Dehydration
- C. Accidental poisoning
- D. Cardiac failure
Correct Answer: B
Rationale: Dehydration is the most common cause of shock in infants and children. In children, the body's fluid reserves are smaller compared to adults, making them more susceptible to dehydration, which can lead to shock if not promptly addressed. Severe allergic reactions, accidental poisoning, and cardiac failure can also cause shock, but dehydration is the most frequent cause in this age group.
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You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred?
- A. Poison oak exposure
- B. Allergic reaction
- C. Heat illness
- D. Acute asthma attack
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When inserting an oropharyngeal airway in a small child, what is the preferred method?
- A. Insert the airway with the curvature towards the roof of the mouth and then rotate it 180 degrees.
- B. Insert the airway as you would in an adult, but use an airway that is one size smaller than usual.
- C. Depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue.
- D. Open the airway with the tongue-jaw lift maneuver and insert the airway until slight resistance is met.
Correct Answer: C
Rationale: When inserting an oropharyngeal airway in a small child, it is crucial to depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. This technique helps in maintaining an open airway and preventing obstruction by the tongue. Placing the airway with the curve facing the roof of the mouth or using a smaller size is not recommended for small children, as it may not effectively keep the airway patent. The tongue-jaw lift maneuver is not the preferred method for inserting an oropharyngeal airway in small children.
A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should:
- A. Ventilate through the tracheostomy tube.
- B. Place an oxygen mask over the tracheostomy tube.
- C. Remove the tracheostomy tube and clean it.
- D. Carefully suction the tracheostomy tube.
Correct Answer: D
Rationale: In this scenario, the 4-year-old boy with a tracheostomy tube is showing signs of respiratory distress, including intercostal retractions, a low heart rate, and decreased oxygen saturation. The gurgling sound indicates a possible airway obstruction. Correctly, the immediate action should be to carefully suction the tracheostomy tube. Suctioning can help clear any secretions or obstructions, thus improving the child's ability to breathe effectively. Ventilating through the tube, placing an oxygen mask over it, or removing and cleaning the tube would not address the potential obstruction and could worsen the respiratory distress.
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.
A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for:
- A. hypotension.
- B. combativeness.
- C. convulsions.
- D. respiratory distress.
Correct Answer: C
Rationale: In a 7-year-old child with altered mental status, high fever, and a generalized rash, the most critical concern is the potential for convulsions. These symptoms could indicate a serious underlying condition, such as a febrile seizure or another type of seizure activity. Monitoring for convulsions is crucial during transport to ensure prompt intervention if they occur, as seizures can lead to additional complications and require immediate management.