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Shock Management Flashcards

7 cards from real PALS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A newborn with ductal-dependent congenital heart disease develops cardiogenic shock at day 3 of life. Which medication is critical to administer?

    Answer: Prostaglandin E1 (alprostadil)

    Prostaglandin E1 keeps the ductus arteriosus open in ductal-dependent lesions, maintaining pulmonary or systemic blood flow.

  2. During resuscitation of a child in shock, which lab value most directly assesses tissue oxygen delivery and adequacy of perfusion?

    Answer: Lactate level

    Elevated serum lactate indicates anaerobic metabolism from inadequate oxygen delivery to tissues, reflecting shock severity.

  3. A 7-year-old with acute myocarditis develops cardiogenic shock with severe hypotension despite dobutamine. Which therapy should be added next?

    Answer: Norepinephrine to support blood pressure

    Norepinephrine provides vasopressor support to maintain perfusion pressure when cardiogenic shock is severe and inotropes alone are insufficient.

  4. Which parameter best indicates ADEQUATE fluid resuscitation response in a child with hypovolemic shock?

    Answer: Decrease in heart rate toward normal range

    Return of heart rate toward age-appropriate normal is a key clinical indicator that perfusion and volume status are improving.

  5. A child with hemorrhagic shock due to trauma requires packed red blood cells. What is the recommended initial PRBC dose in pediatric patients?

    Answer: 10 mL/kg over 30–60 minutes

    10 mL/kg of PRBC over 30–60 minutes is the standard pediatric transfusion dose for hemorrhagic or anemia-related shock.

  6. In neurogenic shock following spinal cord injury, which hemodynamic pattern is expected?

    Answer: Bradycardia and low SVR

    Loss of sympathetic tone in neurogenic shock causes bradycardia and vasodilation (low SVR), distinguishing it from other shock types.

  7. A child receiving epinephrine infusion for fluid-refractory cold septic shock develops worsening extremity ischemia. Which action is most appropriate?

    Answer: Add vasopressin and reduce epinephrine

    Vasopressin can be added as a catecholamine-sparing agent, allowing reduction of epinephrine and decreasing peripheral vasoconstriction.