Pediatrics- EMT Chapter 32 Quiz

Infants

-First year of life -anterior fontanelle -lack communication -flexible bones -fastest HR & RR, lowest BP calls: SIDS, seizures, bronchiolitis, RSV, choking, dehydration, rashes

Circulatory system pediatric

-Infants can beat 160 beats/min or more (primary method used to compensate for decreased perfusion) - ability of children to constrict blood vessels also helps them compensate for decreased perfusion ** they'll be able to sustain it longer good system

Sudden Infant Death Syndrome (SIDS)

-Leading cause of death in infants younger than 1 years old -attempt CPR if no signs of death -allow family to spend time with infant, and use infant's name

Shaken baby syndrome

-bleeding within the head and damage to the cervical spine -shaking tears blood vessels in the brain, resulting in bleeding around the brain -pressure from blood results i an increase in cranial pressure leading to coma and/or death

Cardiopulmonary Arrest

-in peds associated with respiratory failure and arrest -adults become hypoxic, heart get irritable, and sudden cardiac death comes from arrhythmia -children become hypoxic and their heart slows down, becoming more bradycardic

Apparent Life Threatening Events (ALTE)

-infants who are not breathing, cyanotic, and unresponsive sometimes resume breathing and color with stimulation -Respond and found infant fine classic ALTE is characterized by: cyanosis, apnea, distinct changes in muscle tone, choking or gagging

Airway pediatric

-larger, round occiput - proportionately larger tongue -long, floppy, U shaped epiglottis -less well-developed rings of cartilage in trachea -narrowing, funnel shaped upper airway

Integumentary system

-thinner skin and less subcutaneous fat -larger fluid and heat losses due to higher ratio of body surface area -burns easier

If a nasopharyngeal airway is too long, it may: a.) result in tachycardia b.) push the tongue anteriorly c.) stimulate the vagus nerve d.) become obstructed by mucus

.stimulate the vagus nerve..

Toddles

1-3 years old -stranger anxiety, may need toy or blanket -walking, talking

Adolescents

12-18 years old -similar to adults, still children on emotional level

Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock. a.) 5% b.) 15% c.) 25% d.) 35%

25%

Preschool-Age children

3-6 years old -understand directions and can show painful areas -regular food (airway obstructions) fearful-rich fantasy life

A child may begin to show signs of separation anxiety as early as: a.) 6 months b.) 12 months c.) 18 months d.) 24 months

6 months

Febrile seizures are MOST common in children between: a.) 3 months and 4 years b.) 6 months and 6 years c.) 8 months and 8 years d.) 18 months and 10 years

6 months and 6 years

Seizures

6 months- 6 years old doesn't have to be a very high temp but a sudden rise.

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than: a.) 4 years b.) 6 years c.) 8 years d.) 10 years

6 years

School-Age

6-12 years old -familiar with physical examinations -direct questions -act like more adults -peer pressure

The normal respiratory rate for a newborn should not exceed ________ breaths/min. a.) 50 b.) 60 c.) 70 d.) 80

60

With regard to the legal implications of child abuse: a.) child abuse must be reported only if it can be proven b.) EMTs must report all suspected cases of child abuse c.) you should document your perceptions on the run form d.) a supervisor can forbid you from reporting possible abuse

EMTs must report all suspected cases of child abuse

Circulatory system contd

Less blood circulating (so slow signs of shock) the'll go into shock more quickly with less blood less

Which of the following statements regarding a 3-month-old infant is correct? a.) the infant is unable to turn his or her head and focus b.) the infant should be aroused easily from a sleeping state c.) at this age, the infant typically sleeps for up to 8 hours a day d.) a 3-month-old infant can distinguish a parent from a stranger

a 3-month-old infant can distinguish a parent from a stranger

An infant with severe dehydration would be expected to present with: a.) excessive tearing b.) moist oral mucosa c.) bulging fontanelles d.) absent urine output

absent urine output

A normal level of consciousness in an infant or child is characterized by: a.) normal interactiveness, awareness to time, and pink skin color b.) awareness to place, pink and dry skin, and consistent eye contact c.) crying or combativeness, good muscle tone, and awareness to time d.) age-appropriate behavior, good muscle tone, and good eye contact

age-appropriate behavior, good muscle tone, and good eye contact

During the attempted resuscitation of an infant with suspected SIDS: a.) discourage the family from observing b.) allow the family to observe if they wish c.) a law enforcement officer must be present d.) give detailed updates to the infant's parents

allow the family to observe if they wish

The purpose of the pediatric assessment triangle (PAT) is to: a.) determine if the child's vital signs are within the age-appropriate limits b.) allow you to rapidly and visually form a general impression of the child c.) facilitate a rapid head-to-toe assessment of the child visualization only d.) gather critical date by performing a rapid hands-on-assessment of the child

allow you to rapidly and visually form a general impression of the child

Signs of a severe airway obstruction in an infant or child include: a.) pink, dry skin b.) crying and anxiety c.) an ineffective cough d.) mild respiratory distress

an ineffective cough

The components of the PAT are: a.) appearance, work of breathing, and skin circulation b.) mental status, heart rate, and systolic blood pressure c.) skin condition, respiratory rate, and level of alertness d.) activity, respiratory quality, and level of consciousness

appearance, work of breathing, and skin circulation

You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should: a.) apply high-flow oxygen via a nonrebreathing mask, perform an in-depth secondary assessment, apply full spinal precautions, and transport b.) insert an oral airway, hyperventilate him with a bag-mask device, apply full spinal precautions, and transport to the closest trauma center c.) apply high-flow oxygen via a nonrebreathing mask, obtain baseline vital signs, apply full spinal precautions, and perform a secondary assessment d.) assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center

assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center

A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: a.) allow the mother to drive her daughter to the hospital b.) attempt cooling measures, offer oxygen, and transport c.) place the child in cold water to attempt to reduce her fever d.) suspect that the child has meningitis and transport at once

attempt cooling measures, offer oxygen, and transport

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: a.) be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital b.) continue high-flow oxygen therapy, contact medial control, and request permission to administer more albuterol c.) begin immediate ventilation assistance and ensure that you squeeze the bag forcefully in order to open her bronchioles d.) 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

When ventilating a pediatric patient with a bag-mask device, the EMT should: a.) block the pop-off valve if needed to achieve adequate chest rise b.) squeeze the bag 40 times/min when ventilating an infant c.) ensure that he or she uses a neonatal device for children younger than 12 months d.) ventilate the child with sharp, quick breaths at the appropriate rate

block the pop-off valve if needed to achieve adequate chest rise

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may: a.) depress the gag reflex b.) cause he child to vomit c.) result in airway swelling d.) result in a soft-tissue injury

cause he child to vomit

Which of the following statements regarding pediatric trauma is correct? a.) children are less likely than adults to be struck by a car b.) a child's head is less frequently injured than an adults c.) children are more likely to experience diving-related injuries d.) inexperience and poor judgment are rare causes of pediatric trauma

children are more likely to experience diving-related injuries

Which of the following statements regarding a pediatric patient's anatomy is correct? a.) the tracheal rings of a child are more rigid than an adults b.) a child's tongue is proportionately smaller than an adult's c.) children have a larger, rounded occiput compared to adults d.) the child's epiglottis is less floppy and smaller than adult's

children have a larger, rounded occiput compared to adults

Dehydration signs and symptoms

decrease in urine output absence of tears sunken or depressed fontanelle changes in LOC and behavior skin tugor: loss fluid in space below skin able to pull out

A common cause of shock in an infant is: a.) a cardiac arrhythmia b.) dehydration from vomiting and diarrhea c.) excessive tachycardia d.) cardiovascular disease

dehydration from vomiting and diarrhea

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with: a.) extreme restlessness b.) drooling or congestion c.) skin that is cool and dry d.) acute respiratory distress

drooling or congestion

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: a.) carefully look into his mouth and remove the object if you see it b.) encourage him to cough, give oxygen as tolerated, and transport c.) deliver a series of five back blows and then reassess his condition d.) place the child in a supine position and perform abdominal thrusts

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

Vital BP

for children 1-10 years old 70+(2x child's age in years)= systolic BP

In most children, febrile seizures are characterized by: a.) a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase b.) unresponsiveness, complete body relaxtion, a fever greater than 105 degrees, and a short postictal phase c.) generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase d.) isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase

generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by: a.) grunting b.) wheezing c.) assuming a tripod position d.) retracting the intercostal muscles

grunting

When a child experiences a blunt injury to the abdomen: a.) he or she can compensate for blood loss better than adults b.) his or her blood pressure falls with as little as 5% blood loss c.) your assessment will most often reveal bruising to the abdomen d.) delayed capillary refill indicates a state of decompensated shock

he or she can compensate for blood loss better than adults

All of the following are normal findings in an infant or child, EXPECT: a.) quiet breathing b.) fear or anxiety c.) belly breathing d.) head bobbing

head bobbing

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the: a.) intercostal muscles are not well developed b.) rib cage is rigid and provides little flexibility c.) abdominal organs force the diaphragm upward d.) upper airway is smaller and easily collapsible

intercostal muscles are not well developed

Febrile seizures in a child: a.) typically last less than 30 minutes b.) occur after a week of a febrile illness c.) are usually caused by viral meningitis d.) may indicate a serious underlying illness

may indicate a serious underlying illness

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? a.) certain cases of SIDS are predictable and therefore preventable b.) SIDS is most commonly the result of an overwhelming infection c.) most cases of SIDS occur in infants younger than 6 months d.) the cause of death following SIDS can be established by autopsy

most cases of SIDS occur in infants younger than 6 months

Infants are ________ breathers rate obstructions

nose 20-60 breaths/minute easily obstructed by secretions, blood, or swelling. Airway size of straw

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to: a.) monitor the child's heart rate b.) observe the child's skin color c.) monitor the pulse oximeter reading d.) observe the chest for adequate rise

observe the chest for adequate rise

When assessing an infant's ventilation status, you should: a.) observe the chest for rise and fall b.) rule out hypoxia if cyanosis is absent c.) palpate the abdomen for rise and fall d.) give oxygen if the Sp02 is less than 90%

palpate the abdomen for rise and fall

Critical burns in child include: a.) any superficial or partial-thickness burn that involves the legs or arms b.) partial-thickness burns covering more than 20% of the body surface c.) second-degree burns covering more than 10% of the body surface d.) superficial burns covering more than 10% to 15% of the body surface

partial-thickness burns covering more than 20% of the body surface

A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should: a.) perform abdominal thrusts b.) visualize the child's airway c.) perform a blind finger sweep d.) give oxygen and transport at once

perform abdominal thrusts

Before positioning an infant or child's airway, you should: a.) put padding behind his or her head b.) thoroughly suction his or her airway c.) rule out an injury to the spinal cord d.) place him or her on a firm surface

place him or her on a firm surface

When administering oxygen to a frightened child, it would be MOST appropriate to: a.) place oxygen tubing through a hole in a paper cup b.) tightly secure the oxygen mask straps to the face c.) have a parent restrain the child as you give oxygen d.) use a nasal cannula instead of a nonrebreathing mask

place oxygen tubing through a hole in a paper cup

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are: a.) proportionately larger and situated more anteriorly b.) more vascular despite the fact that they are proportionately smaller c.) spaced further apart, which causes them to shift following trauma d.) lower in the abdominal cavity, where the muscles are not as strong

proportionately larger and situated more anteriorly

neglect

refusal or failure to provide life necessities

Cardiac arrest in the pediatric population is MOST commonly the result of: a.) a complete airway obstruction b.) respiratory or circulatory failure c.) a congenital cardiovascular defect d.) lethal cardiac rhythm disturbances

respiratory or circulatory failure

Airway obstruction

s/s: not able to talk, weak ineffective cough, leads to blue -infections can cause obstruction -croup is an infection in the airway below he level of the vocal cords -epiglottis is an infection of the soft tissue above the level of the vocal rods s/s: drooling, more serious, stridor, possible neb treatment, 02 humidified 02

When immobilizing an injured child in a pediatric immobilization device, you should: a.) secure the head before the torso b.) slide the device under the child c.) pad underneath the child's head d.) secure the torso before the head

secure the torso before the head

Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient? a.) sexual activity b.) past medical history c.) change in bladder habits d.) duration of symptoms

sexual activity

Bruising to the ____________ is LEAST suggestive of child abuse. a.) shins b.) back c.) face d.) buttocks

shins

Respiratory Emergencies

signs and symptoms of increased work of breathing: -nasal flaring -grunting -wheezing, stridor -accessory muscle use -retractions/movement of child's flexible rib cage

You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is unresponsive and there are no signs of breathing. You should: a.) begin immediate rescue breathing b.) stabilize his head and check for a pulse c.) perform a head tilt-chin lift maneuver d.) open his airway and look in his mouth

stabilize his head and check for a pulse

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: a.) stridor b.) rhonchi c.) grunting d.) wheezing

stridor

Signs and symptoms of meningitis in the infant or child include all of the following, EXPECT: a.) sunken fontanelles b.) headache and fever c.) a stiff or painful neck d.) an altered mental status

sunken fontanelles

Greenstick fractures occur in infants and children because: a.) the growth plate is commonly injured b.) their bones are more brittle than an adult's c.) their bones bend more easily than an adult's d.) twisting injuries are more common in children

their bones bend more easily than an adult's

The signs and symptoms of poisoning in children: a.) vary widely, depending on the child's age and weight b.) are more obvious than in the adult population c.) usually present within the first 10 minutes of ingestion d.) are most severe if the child ingested a poisonous substance

vary widely, depending on the child's age and weight

The MOST common cause of dehydration in pediatric patients is: a.) high fever b.) internal blood loss c.) vomiting and diarrhea d.) refusal to drink fluids

vomiting and diarrhea

Signs of an upper airway obstruction in an infant or child include all of the following, EXPECT: a.) wheezing b.) a weak cough c.) a cough that resembles the bark of a seal d.) stridorous breathing

wheezing

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence? a.) what time did the ingestion occur? b.) have you noticed any signs or symptoms? c.) why did your child ingest the poison? d.) do you know what substance was ingested?

why did your child ingest the poison?