Chapter 35 - Pediatric Emergencies

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:

• wheezing.

• stridor.

• grunting.

• rhonchi.

Before assessing the respiratory adequacy of a semiconscious infant or child, you must:

• routinely suction the mouth to remove oral secretions.

• ensure that the airway is patent and clear of obstructions.

• ensure that his or her head is in a hyperextended position.

• insert a nasopharyngeal or oropharyngeal airway adjunct.

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by:

• assuming a tripod position.

• grunting.

• retracting the intercostal muscles.

• wheezing.

An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious but clearly restless. Her heart rate is 130 beats/min, and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should:

• begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min.

• be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.

• continue high-flow oxygen therapy, contact medical control, and request permission to administer nebulized albuterol treatment.

• begin immediate ventilation assistance and ensure that you squeeze the bag forcefully to open her bronchioles.

A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:

• place the child in a supine position and perform abdominal thrusts.

• carefully look into his mouth and remove the object if you see it.

• encourage him to cough, give oxygen as tolerated, and transport.

• deliver a series of five back blows and then reassess his condition.

A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant’s mother tells you that he has not had a soiled diaper in over 12 hours. The infant’s heart rate is 140 beats/min, and his anterior fontanelle appears to be slightly sunken. You should suspect:

• severe dehydration.

• hypovolemic shock.

• mild dehydration.

• moderate dehydration.

A 4-year-old, 16-kg female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and has skin burns around her mouth. You should:

• administer 16 g of activated charcoal.

• monitor her airway and give oxygen.

• place her supine and elevate her legs.

• determine why the ingestion occurred.

Which of the following statements regarding a pediatric patient’s anatomy is correct?

• The tracheal rings of a child are more rigid than an adult’s tracheal rings.

• Children have a larger, rounder occiput compared to adults.

• A child’s tongue is proportionately smaller than an adult’s tongue.

• The child’s epiglottis is less floppy and smaller than an adult’s epiglottis.

A common cause of shock in an infant is:

• cardiovascular disease.

• a cardiac dysrhythmia.

• excessive tachycardia.

• dehydration from vomiting and diarrhea.

Early signs of respiratory distress in the pediatric patient include all of the following, except:

• retractions.

• abnormal airway noise.

• cyanosis.

• tachypnea.