PALS Vascular Access and Fluid Management in Pediatric Emergencies 2

Question 1

What maximum fluid volume (in mL/kg) should be given before reassessing a child in septic shock and considering vasopressors?

Accepted Answer

40–60 mL/kg

Answer

PALS guidelines suggest reassessing and considering vasoactive agents after 40–60 mL/kg of fluid if perfusion has not improved.

Question 2

A child with distributive shock is fluid-resuscitated but becomes hypotensive with signs of fluid overload. Which finding suggests fluid overload?

Accepted Answer

New crackles on lung auscultation and hepatomegaly

Answer

Pulmonary crackles and hepatomegaly indicate excessive fluid accumulation, signaling fluid overload in pediatric patients.

Question 3

Which drug is used as a first-line vasoactive agent for cold septic shock (decreased cardiac output) in children?

Accepted Answer

Epinephrine

Answer

Epinephrine is preferred for cold septic shock because its combined alpha and beta effects increase cardiac output and vascular tone.

Question 4

During IO administration of medications, which action must be performed to ensure drug delivery into the circulation?

Accepted Answer

Flush with 5–10 mL of normal saline after each drug

Answer

Flushing with saline after IO drug administration ensures the medication reaches the systemic circulation from the bone marrow cavity.

Question 5

Which of the following is a contraindication to IO placement at a specific site?

Accepted Answer

Fracture of the bone proximal to the intended site

Answer

A fracture proximal to the IO site is a contraindication because fluids and medications can extravasate through the fracture site into surrounding tissue.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Vascular Access and Fluid Management in Pediatric Emergencies 2