Term
| What are Common Causes of Respiratory Arrest in Children? |
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Definition
Having smaller airways than adults
Having underdeveloped immune systems
Lacking coordination
Being susceptible to choking on food and small objects
Being susceptible to sudden infant death syndrome |
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Term
| What are the Drugs Administered Through Tracheal Tube? |
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Definition
L: lidocaine
E: epinephrine
A: atropine
N: naloxone |
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Term
| What is the Nursing Management of a Child With a Pediatric Emergency? |
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Definition
Maintaining a patent airway
Providing supplemental oxygen
Monitoring for changes in status
Assisting ventilation
Offering support and education to the child and family |
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Term
| What are Airway and Ventilation Methods? |
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Definition
Anesthesia bag or flow-inflating ventilation system
Bag-valve-mask device or manual resuscitator
Laryngeal mask airway
Tracheal intubation |
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Term
The nurse assisting a child in respiratory distress inserts the rubber connecting tube of an inflatable silicone mask blindly into the airway to form a seal. What method of resuscitation is being performed by the nurse?
a. anesthesia bag
b. flow-inflating ventilation system
c. bag-valve-mask device
d. laryngeal mask airway |
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Definition
d. laryngeal mask airway. Using this method, the nurse inserts the rubber connecting tube of an inflatable silicone mask blindly into the airway to form a seal.
Rationale: Using an anesthesia bag or flow-inflating ventilation system involves a small collapsible bag that consists of a reservoir bag, an overflow port, and a fresh gas inflow port. A bag-valve-mask device is a self-inflating oxygen delivery bag that does not need a source of oxygen for resuscitation and ventilation. |
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Term
| What are the Forms of Vascular Access? |
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Definition
Peripheral IV route
Central IV route
Saphenous vein
Intraosseous access |
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Term
Is the following statement true or false?
The nurse accessing a vein to manage a child while CPR is in progress uses the recommended route, the saphenous vein. |
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Definition
False. The femoral route is best for obtaining central venous access while CPR is in progress.
Rationale: The femoral route is best for obtaining central venous access while CPR is in progress because the insertion procedure will not interfere with life-saving interventions involving the airway and cardiac compressions. The saphenous vein (found in the ankle) is an alternative route for venous access that is obtained using a surgical incision. |
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Term
| What are ABCs of Life Support? |
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Definition
Airway
Breathing
Circulation |
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Term
| What is the Neurologic Assessment of a Child With a Pediatric Emergency? |
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Definition
Evaluate sensorium in an older child.
Evaluate interest in environment in an infant.
Evaluate the child’s head.
Assess the eyes.
Evaluate the child’s face.
Evaluate spontaneous movement of extremities.
May use Pediatric Glasgow Coma Scale |
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Term
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Definition
| Shock is the result of dramatic respiratory or hemodynamic compromise. |
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Term
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Definition
| Impaired cardiac output, impaired systemic vascular resistance (SVR), or a combination of both causes shock. |
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Term
| How does shock differ in children and adults? |
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Definition
| Infants and young children differ from adults in that their cardiac output depends on their heart rate, not their stroke volume. |
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Term
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Definition
| The most common types of shock are hypovolemic, septic, cardiogenic, and distributive. |
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Term
| What are Common Types of Emergencies in Children? |
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Definition
Respiratory arrest
Shock
Cardiac arrhythmias and arrest
Near drowning
Poisoning
Traumatic injury |
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Term
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Definition
Tachypnea
Increased respiratory rate |
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Term
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Definition
Hypoventilation
Decrease in depth and rate of respiration |
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Term
| What is periodic breathing? |
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Definition
Periodic breathing
Regular breathing with occasional short pauses |
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Term
The nurse is caring for a child with respiratory distress who is being treated with narcotics for pain related to leukemia. For what condition should the nurse monitor in this child?
a. hyperventilation
b. hypoventilation
c. tachypnea
d. periodic breathing |
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Definition
b. hypoventilation. A child who is being treated with narcotics for pain related to leukemia should be monitored for hypoventilation.
Rationale: Hypoventilation, a decrease in the depth and rate of respirations, is noted in very ill children or children who have central respiratory depression secondary to narcotics. Tachypnea (increased respiratory rate) is often noted in children in respiratory distress. If the child is a young infant (younger than 2 months) or premature, periodic breathing may occur. |
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Term
| What are the Causes of Sudden Cardiac Arrest in Children? |
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Definition
Electrolyte abnormalities
Toxic drug ingestion
History of a serious primary congenital or acquired cardiac defect
Potentially lethal arrhythmias, such as prolonged QT syndrome
Hyper- or hypotrophic cardiomyopathy
Traumatic cardiac injury or a sharp blow to the chest, known as commotio cordis |
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Term
| What are the Standard Laboratory Tests Obtained in the Emergency Room? |
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Definition
Arterial blood gases (ABGs), obtained initially and then serially to assess for changes
Electrolytes and glucose levels
Complete blood count (CBC)
Blood cultures
Urinalysis
Toxicology panel if ingestion is suspected |
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Term
| What labs are done with respiratory status? |
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Definition
Arterial or capillary blood gases: hypoxemia, hypercarbia, altered pH
Chest radiograph: alterations in normal anatomy or lung expansion, or evidence of pneumonia, tumor, or foreign body
Metal detector: evidence of metallic foreign body |
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Term
| What is the AHA adult chain of survival? |
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Definition
1. Early emergency medical system (EMS) activation
2. Early cardiopulmonary resuscitation (CPR)
3. Early defibrillation
4. Early access to advanced care |
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Term
| What is the AHA Pediatric chain of survival? |
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Definition
1. Prevention of cardiac arrest and injuries
2. Early CPR
3. Early access to emergency response system
4. Early advanced care |
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Term
| What is the infant ratio of breaths to compressions? |
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Definition
30 compressions to 2 breaths
2 fingers placed one finger breadth below nipple line |
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Term
| What is the child ratio of breaths to compressions? |
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Definition
30 compressions to 2 breaths
Heel of hand/2 hands pressing on the sternum at the nipple line |
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Term
| What is infant 2 person CPR? |
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Definition
15 compressions to 2 breaths
Two thumbs encircling the chest at nipple line |
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Term
| What is child 2 person CPR? |
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Definition
15 compressions to 2 breaths
Heel of one hand or 2 hands pressing on the sternum at nipple line |
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Term
T OR F?
The nurse performing CPR on an infant by herself correctly applies 15 compressions to 2 breaths. |
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Definition
False. The nurse performing CPR on an infant by herself correctly applies 30 compressions to 2 breaths.
Rationale: For two-person CPR, the nurse would apply 15 compressions to 2 breaths. |
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Term
| What are the AHA Guideline Changes for Chest Compression? |
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Definition
Rescuers must provide compressions of adequate rate and depth.
Chest recoil should be allowed.
Minimal interruption of chest compressions should be the goal.
For infant CPR, two-person infant CPR can be performed by encircling the chest with two thumbs and simultaneously using the hands to provide a thoracic squeeze.
For two-person CPR, no pauses should occur for ventilation, with the compressing health care professional giving continuous compressions. |
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Term
| What is DOPE for Troubleshooting Status of Intubated Child? |
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Definition
Displacement: the tracheal tube is displaced from the trachea.
Obstruction: the tracheal tube is obstructed (e.g., with a mucous plug).
Pneumothorax: usually a pneumothorax results in a sudden change in the child’s assessment.
Equipment failure: disconnected oxygen supply, leak in the ventilator circuit, loss of power |
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Term
| What are the Alterations Occurring With Particular Ingestions? |
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Definition
Hyper- or hypotension
Hyper- or hypothermia
Respiratory depression or hyperventilation
Miosis (pupillary contraction) or mydriasis (pupillary dilatation) |
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