Completado STN special pop

Compared with the more common hemoglobin transfusion threshold of 9.5 g/dL, which of the following hemoglobin values has been shown to have no deleterious effects for the hemodynamically stable child? 6 g/dL. 9 g/dL. 8 g/dL. 7 g/dL.

7 g/dL. It has been demonstrated that in hemodynamically stable critically ill children there were no adverse events associated with transfusing a children at a hemoglobin level of 7 g/dL when compared to threshold hemoglobin of 9.5 g/dL.

Young children have a larger head in proportion to the rest of their body. In light of this, which statements are true? -A young child is likely to sustain a head strike when falling from a medium or high height. -The large head causes the child to have a lower center of gravity. -The child's head/body proportion becomes the same as an adult's by age 10. -None of the above.

A young child is likely to sustain a head strike when falling from a medium or high height. Head is proportionally larger in young children resulting in a higher frequency of blunt brain injuries in this age group.

Pt is arriving who suffered burns to 40% of his body from an intense enclosed storage shed fire. Based on this history of exposure, what condition is automatically assumed in this pt? -Carbon monoxide poisoning. -Associated head injury. -40% Full-thickness burns. -Rhabdomyolysis.

Carbon monoxide poisoning. Always assume carbon monoxide (CO) exposure in patients who were burned in enclosed areas.

A 1 5 y/o male is found unconscious in a swimming pool. He arrives intubated in full spine-immobilization. His airway is clear; respiratory efforts are spontaneous-16 breaths; BP 78/50 mmHg; HR 49 bpm. Early management must include which condition? -Pneumothorax. -Electrolyte imbalance. -Toxic ingestion. -Cervical spine injury.

Cervical spine injury. Diving injuries must always be suspected in near-drowning patients. His bradycardia in the presence of hypotension is suspicious for neurogenic hypotension, which is caused by loss of vasomotor tone and lack of reflex tachycardia.

In addition to physical assessment, which of the following is the BEST lab test to assist in the decision to order a packed red blood cell transfusion for a child, post trauma with a hemoglobin of 8 gm/dL? -Ferritin I. -Potassium. -Lactate. -Ammonia.

Lactate. Elevated Lactate is a marker indicating poor tissue perfusion. In trauma patients, elevated lactate and base deficit have been associated with the development of multiple organ dysfunction syndrome (MODS) and poor outcome.

What can one anticipate immediately after a major burn? -Decreased peripheral vascular resistance. -Massive fluid shifts resulting in hypotension. -Decreased blood viscosity. -Multiple organ failure.

Massive fluid shifts resulting in hypotension. A marked increase in peripheral vascular resistance accompanied by a decrease in cardiac output is one of the earliest manifestations of the systemic effects of thermal injury, resulting in fluid shifts.

CT contrast in the older patient should be used judiciously due to: -Potential for renal insufficiency or renal disease. -Contrast should not be used in the older population. -Does not provide assistance in diagnostic testing. -May cause drowsiness resulting in post-procedure fall.

renal insufficiency or renal disease. Both a steady decline in functioning nephrons and renal perfusion occurs with the aging process.

Pt arrives after receiving burns to her arms and hands following a fire in her small apartment. The patient is talking clearly; without respiratory distress; and pulse oximetry on room air is 98%. What intervention is necessary? -No other interventions are necessary at this time. -Administration of oxygen via nasal cannula at 6L/min. -The patient needs humidified oxygen via a non rebreather mask with continuous monitoring. -The patient needs immediate endotracheal intubation.

humidified oxygen via a non rebreather mask with continuous monitoring. Suspect inhalation injury for burn patients involved in smoke related fires. Patients exposed to smoke should all be treated with humidified , supplemental oxygen. Early intubation is indicated whenever there are physical findings of airway injury.

A 35 year old patient arrives to your emergency department with 57% total body surface area burns due to electrical injury and dark colored urine. Important considerations for this patient include all of following except: -Monitor EKG for dysrhythmias. -Monitor for compartment syndrome. -Fluid resuscitation with goal of 30mI/hour of urine output. -Observe for hemoglobinuria.

Fluid resuscitation with goal of 30mI/hour of urine output. Presence of pigment in the urine (pink to dark red) indicates underlying muscle damage. The urine output must be maintained between 75-100 ml/hr until it is grossly clear.

An 8 y/o child is brought to the pediatrician. Mom states that the child fell from his bike yesterday. The child complains of abdominal pain. You note that the child is listless, slightly pale, and has a pulse 130. Both you and the pediatrician agree: -To call an ambulance to send the boy to the emergency department of a local trauma center immediately, preferably one with pediatric capabilities. -To send the boy home. Tell the mom he should rest and have fluids. He probably has the flu. -Refer the child to a local surgeon for work-up of a possible acute abdomen. -None of the above.

To call an ambulance to send the boy to the emergency department of a local trauma center immediately, preferably one with pediatric capabilities. Pediatric patients with abdominal trauma who are hemodynamically unstable may have ongoing blood loss from an intra-abdominal organ injury and should seek immediate emergency attention.

A male patient arrives in your emergency department with burns to his face, chest and arms from an explosion in his basement. He complains of shortness of breath and chest pain. What is your priority intervention? -Assess airway. -Immediately prepare for intubation as he most likely has an inhalation injury. -Cover his burns. -Monitor his cardiovascular status.

Assess airway. Lifesaving measures for patients with burn injuries includes establishing airway control, stopping the burning process, and gaining intravenous access.

A patient arrives to the ED after rescue from a house fire. Voice is hoarse. Soot is noted around the lips along with singed eyebrows. Select the priority of care for this patient. -Provide pain control immediately. -Estimate the of total body surface area (T BSA) burned. -Secure a definitive airway. -Begin fluid resuscitation according to the Parkland/Consensus Formula.

Definitive airway. Clinical indications of inhalation injury include: face and/or neck burns, singeing of the eyebrows and nasal vibrissae, carbon deposits in the mouth and/or nose and carbonaceous sputum, acute inflammatory changes in the oropharynx.

A child with head and thoracic trauma who is now stabilized and no longer receiving vasopressors has been on dextrose-containing IV fluids only. What is the BEST method of providing nutritional support? -Jejunal enteral feedings. -Parenteral nutrition. -Gastric enteral feedings. -Continuous intravenous fluid.

Gastric enteral feedings. Once pt is stabilized, enteral nutrition is preferred method of feeding whenever clinically possible. It helps to decrease risk of infection, maintains gut integrity, enhances wound healing, improves the immune response, and blunts inflammatory.

In major burn pt, identify the most accurate indicator to monitor when evaluating if the burn fluid resuscitation is effective within the first 24-48 hours? -Pulse oximetry readings. -Hourly vital signs. -Serial Hematocrits. -Hourly urine outputs.

Hourly urine outputs. Hourly urinary output obtained by use of an indwelling bladder catheter is the most readily available and generally reliable guide to resuscitation adequacy. Adults: Adults: 0.5 ml per Kg per hour (or 30-50 cc/hour), Children weighing less than 30 kg.

A 28 year old pregnant patient (7 months) was a restrained rear seat passenger in a low speed MVC. Initial vital signs: BP 120/70, HR 107 RR 20, GCS 15. Breathe sounds clear. Fetal doppler: 140 beats per minute. Which intervention is most appropriate at this time? -Anticipate an X-ray of the abdomen will be ordered. -Discharge the patient home with supervision by family members. -The trauma team will need to perform an emergent ED cesarean section. -Monitor the patient and fetus for a minimum of 4 hours.

Monitor patient and fetus for a minimum of 4 hours. Primary focus of resuscitation is on the patient and evaluation of fetus is in the secondary examination. Minor trauma to the patient does not rule out injury to the fetus, therefore, it is important to monitor the fetus for 4 hours.

A school-age child had a documented pancreatic injury 3 days ago and the serum Amylase is now 1800 units/L. What is the MOST likely diagnosis? -Abscess. -Fistula. -Hematoma. -Pseudocyst.

Pseudocyst. Children with documented pancreatic injury by CT scan who also have increased amylase levels > 1 1 00 units/L are most likely to have a pseudocyst, which is an abdominal fluid collection following abdominal trauma.