Deck 45: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children

Question 1

Hypotension may not be observed in a child until the fluid loss approximates ___% of body weight.

A) 10
B) 15
C) 20
D) 25

Answer 1

15

Question 2

In cardiogenic shock,why do hepatomegaly and periorbital edema occur?

A) Because there is mass vasodilation due to chemical mediators released from the myocardium
B) Because there is low cardiac output causing a high central venous pressure
C) Because the tissue damage to the myocardium causes increased capillary permeability
D) Because low perfusion of the kidneys has stimulated the renin-angiotensin-aldosterone system to retain sodium and water

Answer 2

Because there is low cardiac output causing a high central venous pressure

Question 3

Approximately 80% of all nosocomial infections in children are a result of:

A) gram-positive and gram-negative bacteriA.
B) viruses.
C) fungi.
D) rickettsia.

Answer 3

gram-positive and gram-negative bacteriA.

Question 4

Children younger than 2 years have a significantly higher risk for associated morbidity and mortality after thermal injury.

Question 5

Which statement is false about how the body compensates for cardiogenic shock in a child?

A) Splanchnic arteries are constricted to divert blood from the skin,kidneys,and gut to the heart and brain.
B) Peripheral blood vessels are constricted to raise blood pressure.
C) Adrenergic responses produce tachycardia to increase cardiac output.
D) The renin-angiotensin-aldosterone system retains water to increase blood volume.

Question 6

Why is the cardiac output more closely related to heart rate in children than in adults?

A) Because the stroke volume is smaller in children than in adults
B) Because the capillary refill in children is shorter than adults
C) Because children have a higher percentage body water than adults
D) Because the myocardium in the child is thinner that an adult

Question 7

Hyperglycemia (glucose > 150 mg/dl)has been linked with poor survival in children with trauma or shock.

Question 8

Infants are at increased risk for a precipitous drop in core body temperature caused by an inability to regulate heat loss by shivering.

Question 9

Reperfusion injury is stimulated by the generation of highly reactive free oxygen radicals and superoxide.

Question 10

Excessive skin blood flow may be present in _____ shock.

A) hemorrhagic
B) septic
C) neurogenic
D) cardiogenic

Question 11

Shock is present in children when there are signs of poor systemic perfusion with normal,low,or high blood pressure.

Question 12

When an infant or child is greater than ___% dehydrated,hypotension occurs.

A) 2
B) 5
C) 7
D) 10

Question 13

Considering a normal capillary refill time for infants and children is 1.5 to 2 seconds,a refill time of 3 seconds is associated with a greater than ____% dehydration.

A) 2
B) 5
C) 10
D) 15

Question 14

The most common type of shock in children is:

A) hypovolemic.
B) cardiogenic.
C) neurogenic.
D) septic.

Question 15

The most common type of burn injury in very young children is flame injury.

Question 16

Scar tissue is metabolically inactive and avascular.

Question 17

Hypotension is a late sign of shock in children.

Question 18

The most common cause of bradycardia in young children is:

A) cardiogenic shock.
B) neurogenic shock.
C) dehydration.
D) hypoxia.

Question 19

Viruses,fungi,or rickettsial microorganisms cause about 40% of nosocomial infections in children.

Question 20

The same standard rule of nines used for fluid resuscitation in adults is also used for children.

Question 21

MATCHING
Match the terms with the corresponding descriptions.
Involve flammable liquids such as gasoline

A)Scald burns
B)Contact burns
C)Flame burns
D)Electrical burns
E)Chemical burns

Question 22

To determine a child's response to fluid therapy for shock,the nurse should monitor:

A) hematocrit and hemoglobin levels.
B) urine output and specific gravity.
C) blood pressure and pulse.
D) arterial blood gases and heart rate.

Question 23

MATCHING
Match the terms with the corresponding descriptions.
Caused by hot grease

A)Scald burns
B)Contact burns
C)Flame burns
D)Electrical burns
E)Chemical burns

Question 24

Which cytokines are anti-inflammatory mediators?

A) Interleukin 1 (IL-1),interleukin 6 (IL-6),and tumor necrosis factor alpha (TNF-)
B) Interleukin 8 (IL-8),interleukin 12 (IL-12),and platelet activating factor (PAF)
C) Interleukin-24 (Il-24),arachidonic acid metabolites,and nitric oxide
D) Interleukin-4 (Il-4),interleukin 11 (Il-11),and colony-stimulating factor (CSF)

Question 25

MATCHING
Match the terms with the corresponding descriptions.
Results from direct contact with high and low voltage current

A)Scald burns
B)Contact burns
C)Flame burns
D)Electrical burns
E)Chemical burns

Question 26

In children in shock,crystalloids and colloids are generally administered in boluses of ___ ml/kg.

A) 5
B) 10
C) 15
D) 20

Question 27

MATCHING
Match the terms with the corresponding descriptions.
Corrosive agent

A)Scald burns
B)Contact burns
C)Flame burns
D)Electrical burns
E)Chemical burns

Question 28

The most sensitive indicator of inadequate systemic perfusion in children is:

A) metabolic acidosis.
B) hypoxia.
C) urine output.
D) dysrhythmias.

Question 29

What causes renal failure after electrical burns in children?

A) Cytokines released after the damaged tissue
B) Immature kidneys unable to compensate for the electrical burn
C) Reduction in cardiac output
D) Myoglobin released from damaged muscles

Question 30

The severity of burn injury is assessed by:

A) amount of fluid lost.
B) circumference of the burn injury.
C) depth of the burn injury.
D) injury to other body systems.

Question 31

Children are at high risk for pulmonary complications because of:

A) immature lungs.
B) anatomic differences in their airways.
C) decreased immunity.
D) high incidences of pneumonia.

Question 32

_____ injury is cellular injury caused by the restoration of physiologic concentrations of oxygen to cells that have been exposed to injurious but nonlethal hypoxic conditions.

A) Hypoxic
B) Hyperoxygenation
C) Reperfusion
D) Ischemic

Question 33

Children younger than _____ years of age lack the ability to concentrate urine.

A) 2
B) 4
C) 6
D) 8

Question 34

When circulatory collapse prevents using the intravenous route for burn fluid resuscitation in children,fluids may be given via _____ cannulation.

A) interdermal
B) intraarterial
C) intraosseous
D) gastrointestinal

Question 35

Compared with the ebb phase,what are characteristics of the catabolic flow phase in metabolism after a burn injury in a child?

A) Reduced oxygen consumption
B) Elevation of catecholamines
C) Impaired circulation
D) Cellular shock

Question 36

MATCHING
Match the terms with the corresponding descriptions.
Cigarette burns and curling irons

A)Scald burns
B)Contact burns
C)Flame burns
D)Electrical burns
E)Chemical burns