Deck 41: The Critically Ill Child

Question 1

____ is inadequate perfusion of nutrients, fluids, and removal of waste products from the tissues.

A) Hypoxemia
B) Hypovolemia
C) Hypoperfusion
D) Hypokalemia

Answer 1

Hypoperfusion

Question 2

All children, regardless of age, should look toward or make eye contact with the Paramedic as she approaches.

Answer 2

True

Question 3

Supraventrical tachycardia often presents with a rate above 200 for children and 260 for infants.

Answer 3

False

Question 4

Children compensate for hypoperfusion by constricting their blood vessels and increasing their heart rate.

Question 5

Literature suggests a family presence during resuscitation could be beneficial to both the family and the healthcare team.

Question 6

A heart rate of ____ bpm or below is often not tolerated in the younger pediatric patient and will cause severe hypoperfusion.

A) 60
B) 70
C) 80
D) 90

Question 7

____ is the development of cyanosis in the peripheral parts of the body such as the nail beds, palms of the hands, and soles of the feet.

A) Rosacea
B) Acrocyanosis
C) Discyanosis
D) Eczema

Question 8

Asking the patient to bear down as if having a bowel movement, preferably against a closed glottis, will increase the patient's vagal tone on the heart.

Question 9

Supraglottic devices may not be used in patients who are obtunded and without a gag reflex.

Question 10

Abnormal heart rhythms or arrest caused by blunt trauma to the chest is called ____.

A) torsades de pointes
B) cordis commotio
C) Long QT syndrome
D) tamponade

Question 11

____ is a terminal rhythm indicating that the electrical system has been completely exhausted.

A) Atrial fibrillation
B) Atrial flutter
C) Ventricle fibrillation
D) Asystole

Question 12

Ventricular tachycardia and fibrillation are common rhythm disorders in pediatric patients.

Question 13

____ tachycardia is a narrow complex tachycardia of atrial origin that occurs due to an accelerated rate of firing from the SA node or rogue atrial cell.

A) Sinus
B) Ventricle
C) Supraventricular
D) Atrial

Question 14

No single chief concern indicates to the Paramedic that a child is critically ill.

Question 15

____ is the most frequent cause of bradydysrhythmias in children.

A) Dehydration
B) Hypoxemia
C) Infection
D) Low blood sugar

Question 16

Pediatric patients are less sensitive to changes in oxygenation and ventilation than adults.

Question 17

Respiratory failure is best addressed by early assisted ventilations using a bag-valve mask.

Question 18

The primary cause of cardiac arrest in the pediatric patient is ____.

A) respiratory failure
B) circulatory failure
C) neurological failure
D) symptomatic bradycardia

Question 19

Any fever, defined as a body temperature above at least ____ in an infant younger than 30 to 60 days old, is a significant concern.

A) 98.7°F
B) 99.2°F
C) 100.4°F
D) 102.2°F

Question 20

____ is the absence of heart activity characterized by unconsciousness, apnea, and pulselessness.

A) Hypoperfusion
B) Cardiac arrest
C) Shock
D) Bradycardia

Question 21

____ is the first-line fluid used in fluid resuscitation for the critically ill child.

A) Insulin
B) Normal saline
C) Sodium
D) Epinephrine

Question 22

The most common cause of death in children younger than six months of age is ____.

A) sudden infant death syndrome
B) abuse
C) birth defects
D) trauma

Question 23

____________________ is the absence of a pulse with organized activity on cardiac monitoring.

Question 24

____________________ is a subset of ventricular tachycardia with alternating amplitudes above and below the isoelectric line resulting from multiple irritable foci in the ventricles, essentially producing a multiform ventricular tachycardia.

Question 25

SVT refractory may respond to ____, as it offers the chemical equivalent of defibrillation.

A) glycogen
B) atropine
C) sertraline
D) adenosine

Question 26

Treatment of sinus tachycardia with poor perfusion consists of ____________________ and addressing the underlying cause of the tachycardia.

Question 27

If the patient in pediatric pulseless cardiopulmonary arrest has a shockable rhythm, the Paramedic's first step is to administer a single shock at an energy level of ____ joules/kg.

A) 1
B) 2
C) 3
D) 4

Question 28

Respiratory ____________________ are a common cause of respiratory failure and include pneumonia, bronchiolitis, and other viral causes.

Question 29

After administrating a shock to the patient in pediatric pulseless cardiopulmonary arrest, the Paramedic should complete ____ cycles of CPR and then perform a simultaneous rhythm and pulse check.

A) two
B) five
C) seven
D) ten

Question 30

The Paramedic can use a quick method to determine the low normal systolic blood pressure for children by doubling the patient's age in years and adding that to ____.

A) 50
B) 60
C) 70
D) 80

Question 31

Surgical and percutaneous cricothyrotomy intubation techniques are contraindicated in children who are younger than ____ due to significant tracheal stenosis that can occur.

A) 10
B) 12
C) 14
D) 18

Question 32

If a vasopressor medication is required for a pediatric patient with poor perfusion, ____ is the initial drug of choice.

A) prednisone
B) fluoxetine
C) epinephrine
D) propranolol

Question 33

____ remains the most common cause of death in children six months and older.

A) Abuse
B) Trauma
C) Cancer
D) Respiratory distress

Question 34

Specific ____________________ have been implicated as the cause of Long QT syndrome.

Question 35

If the child's fontanel is depressed (i.e., the skin sinks below the level of the surrounding bone at the fontanel), the child is ____.

A) hypothermic
B) hypovolemic
C) hypoglycemic
D) hypoxic