Pediatric and Neonatal Patients Flashcards

A 6-year-old with known type 1 diabetes is unresponsive with a blood glucose of 28 mg/dL and no IV access. The most appropriate immediate treatment is:

Answer: Glucagon 1 mg IM

Glucagon 1 mg IM is the appropriate emergency treatment for severe hypoglycemia in a child without IV access.

A neonate is born with gastroschisis. During transport, the exposed bowel should be managed by:

Answer: Covering the bowel with saline-moistened warm gauze and a plastic wrap or bowel bag

Exposed bowel in gastroschisis must be kept moist and warm with saline-moistened gauze and covered with plastic wrap or a bowel bag to prevent heat and fluid loss.

A 16-month-old presents with multiple bruises in various stages of healing, a posterior rib fracture on X-ray, and a history inconsistent with the injury pattern. The flight nurse's priority is:

Answer: Document and notify receiving facility of suspected non-accidental trauma

Posterior rib fractures and inconsistent history are hallmarks of non-accidental trauma; the flight nurse must document findings and notify the receiving team per mandatory reporting obligations.

A 3-year-old weighing 15 kg requires intraosseous (IO) access. After confirming placement, the maximum single fluid bolus volume that should be delivered via IO in this patient is:

Answer: 300 mL (normal saline)

IO bolus dose for pediatric resuscitation is 20 mL/kg; for a 15 kg child that equals 300 mL per bolus.

A term neonate requires PPV during resuscitation. After 30 seconds of PPV with no improvement in heart rate, what is the NEXT step per NRP guidelines?

Answer: Perform MR. SOPA corrective steps (mask adjustment, reposition, suction, open mouth, pressure increase, alternative airway)

If PPV is not producing chest rise or improving heart rate, NRP directs the provider through corrective ventilation steps (MR. SOPA) before escalating to compressions.

A 7-year-old with anaphylaxis from a bee sting has received epinephrine IM and diphenhydramine. During transport, the child becomes hypotensive again. The next intervention should be:

Answer: Repeat epinephrine 0.01 mg/kg IM and start IV fluid bolus 20 mL/kg

Biphasic or refractory anaphylaxis with hypotension requires repeat epinephrine IM plus aggressive IV fluid resuscitation.

When calculating medication doses for a pediatric patient using a length-based resuscitation tape (Broselow tape), which principle is MOST important?

Answer: Use the color zone corresponding to the child's measured length regardless of actual weight

The Broselow tape is length-based and validated for use by color zone; the color zone corresponding to measured length provides weight estimates and pre-calculated doses even if the child appears over- or underweight.