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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.

Read the first 7 Shock Management flashcards as text

  1. A 2-year-old is brought in with vomiting and diarrhea for 3 days. HR is 175, CRT is 5 sec, skin turgor is poor, and mucous membranes are dry. What is the primary shock type?

    Answer: Hypovolemic shock

    Prolonged vomiting and diarrhea cause volume depletion leading to hypovolemic shock, the most common type of shock in children.

  2. Which PALS endpoint of resuscitation indicates that shock has been adequately treated?

    Answer: Heart rate, CRT, mental status, and urine output normalized

    PALS targets normalization of clinical perfusion markers — heart rate, CRT < 2 sec, mental status, and urine output ≥ 1 mL/kg/hr.

  3. During a trauma resuscitation, massive hemothorax is identified. After chest tube placement drains 500 mL of blood, the child remains in shock. What is the next intervention?

    Answer: Administer blood products and prepare for operative intervention

    Persistent hemorrhagic shock after initial chest tube output requires blood product resuscitation and surgical hemorrhage control.

  4. A 5-year-old post-cardiac surgery develops Beck's triad (hypotension, muffled heart sounds, JVD). Which diagnosis and treatment are correct?

    Answer: Cardiac tamponade — pericardiocentesis

    Beck's triad is pathognomonic for cardiac tamponade, which causes obstructive shock relieved by pericardiocentesis.

  5. In a pediatric patient with distributive shock from anaphylaxis, what is the FIRST drug to administer?

    Answer: IM epinephrine 0.01 mg/kg (max 0.5 mg)

    IM epinephrine is the first-line treatment for anaphylaxis, reversing bronchospasm and vasodilation before antihistamines or steroids.

  6. When titrating dopamine for a child in cold septic shock, which dose range provides predominantly beta-1 inotropic effects?

    Answer: 5–10 mcg/kg/min (beta-1 predominant)

    At 5–10 mcg/kg/min, dopamine primarily stimulates beta-1 receptors, increasing heart rate and contractility.

  7. A child in shock has ScvO2 of 52% despite normal BP and heart rate after fluid resuscitation. What does this indicate and what should be done?

    Answer: Inadequate oxygen delivery — consider transfusion or inotrope

    ScvO2 < 70% indicates increased oxygen extraction due to inadequate delivery; hemoglobin optimization or inotropic support is needed.