Systematic Approach Flashcard 1

C. Rationale: The airway-breathing-circulation-disability-exposure approach relates to the primary assessment of a patient and includes the taking of vital signs. The diagnostic assessment involves ancillary techniques and radiologic imaging modalities, while the secondary assessment involves a brief history taking and physical exam.

B. Rationale: The American Heart Association PALS Systematic Approach to the Critically Ill Child algorithm includes the Evaluate-Identify-Intervene approach to addressing the acutely critically ill child. Once the provider sees that the patient does not need advanced life support, they must then prevent the worsening of the patient’s condition and progression to cardiac arrest or respiratory arrest. During the identify phase, the clinician gauges the disease severity. If it is respiratory, the clinician must pinpoint the cause of the problem, such as an upper or lower airway obstruction, interstitial disease, or a disorder in the respiratory centers. The clinician must then decide, based on the evaluation phase, whether the patient is in respiratory distress or respiratory failure. Alternatively, if the problem is due to circulation, it may be secondary to hypovolemic shock, distributive shock, cardiogenic shock, or obstructive shock.

A. Rationale: Performing the primary assessment evaluates for the presence of a life-threatening condition. The airway-breathing-circulation-disability-exposure (A-B-C-D-E) approach guides healthcare providers to a diagnosis. The D, or Disability, mainly pertains to an acutely critically ill child’s neurologic function. Altered mental status is a sign of an acute life-threatening condition. Nail clubbing is a manifestation of chronic hypoxia in pediatric patients with congenital heart disease. Yellowish discoloration of the sclera pertains to jaundice, which is also either a manifestation of acute or chronic liver disease, but this is not a sign of a life-threatening condition.

A. Rationale: An alternative to intravenous cannulation is intraosseous cannulation, which can be used to gain vascular access for IV fluid therapy and medication therapy. The marrow provides a non collapsible entry point to the systemic venous system.

D. Rationale: Part of the American Heart Association PALS Systematic Approach to the Critically Ill Child algorithm is the evaluate-identify-intervene approach to guide healthcare workers on the diagnosis and treatment of the acutely critically ill child and prevent disease progression into cardiopulmonary arrest. The intervene part of the algorithm is a call to action on the necessary treatment modalities in different situations. These include maintaining a patent airway, activating the emergency response system, performing CPR, and administering fluids and medications.

C. Rationale: The A, B, C, D, and E survey corresponds to Airway, Breathing, Circulation, Disability, and Exposure. These are part of the primary assessment to evaluate a critically ill pediatric patient that may have a life-threatening condition.

C. Rationale: The Pediatric Assessment Triangle is a vital tool to give rescuers an initial impression of the critically ill child. It includes the child’s appearance, work of breathing, and circulation. The Pediatric Assessment Triangle assists rescuers in assessing whether or not the child has a life-threatening condition.

D. Rationale: A focused history involves finding pertinent information about the incident and the child’s present condition to find explanations for the current problem. To guide the history taking, use the SAMPLE mnemonic: Signs and symptoms, Allergies, Medications, Past medical history, Last meal, and Events. The heart rate, blood pressure, and temperature are part of the primary assessment.

C. Rationale: Central apnea is a neurologic condition in which the failure of respiratory centers of a patient causes the complete cessation of breathing.

B. Rationale: The normal respiratory rate of an infant is 30 to 53 breaths per minute. A toddler has a normal respiratory rate of 22 to 37 breaths per minute, a preschooler has a normal respiratory rate of 20 to 28 breaths per minute, and a school-aged child has a normal respiratory rate of 18 to 25 breaths per minute.