Systematic Approach Flashcard 2
Rationale
D. Rationale: Whenever the provider has identified a life-threatening condition, they must first activate the emergency response system and begin lifesaving interventions. However, if the patient is not in a life-threatening situation, the provider goes ahead to perform the secondary assessments and diagnostic assessments.
Question
What must a healthcare provider do once they determine a patient has a life-threatening condition?
a. Check for pulse and breathing
b. Give rescue breaths
c. Perform high-quality CPR
d. Activate the emergency response system
Answer
d. Activate the emergency response system
Rationale
A. Rationale: The primary assessment algorithm involves Airway-Breathing-Circulation-Disability-Exposure (A-B-C-D-E). Exposure pertains to performing a focused physical examination of the seriously ill child. If appropriate, you may remove the patient’s clothing one area at a time and then cover it after your assessment. Observe the head, torso, and extremities for any injuries, bleeding, burns, or unusual markings.
Question
When evaluating an acutely critically ill child, you must check for spinal injuries, the presence of skin discoloration, and any bone deformities. Assessment of these possible clinical conditions involves which part of the primary evaluation?
a. Exposure
b. Disability
c. Circulation
d. Breathing
Answer
a. Exposure
Rationale
B Rationale: Performing the head tilt-chin lift maneuver (or jaw-thrust maneuver for patients with a spinal injury) is a recommended, noninvasive technique to open the airway in cardiac arrest patients or unconscious patients. The head tilt-chin lift maneuver prevents the tongue from falling back into the posterior oropharynx and causing an obstruction, effectively opening the airway.
Question
Which of the following interventions is a noninvasive technique to open the airway of an unconscious pediatric patient or a pediatric patient in cardiac arrest?
a. Insert a nasopharyngeal airway
b. Perform the head tilt-chin lift maneuver
c. Place the patient in the recovery position
d. Perform the Heimlich maneuver
Answer
b. Perform the head tilt-chin lift maneuver
Rationale
C. Rationale: A patient in hypovolemic shock, a life-threatening condition, has poor perfusion to the tissues due to severe dehydration from incessant diarrhea or vomiting. A patient with significant volume loss will present with weak pulses, tachycardia, tachypnea (probably from metabolic acidosis), hypotension, and dry skin and mucosa. These signs and symptoms are detectable in the circulation assessment of the A-B-C-D-E surveys.
Question
You are caring for a 3-year-old boy in hypovolemic shock secondary to severe dehydration from acute gastroenteritis. He presents with dry buccal mucosa, pallor, and tachypnea. The signs and symptoms of shock as a life-threatening condition are observed when the healthcare provider has assessed a patient through which one of the following primary assessment surveys?
a. Airway
b. Breathing
c. Circulation
d. Exposure
Answer
c. Circulation