PEARS Managing Shock Emergencies 2

Question 1

A 3-year-old presents with HR 160, BP 70/40, cool mottled extremities, and delayed capillary refill after a dog bite. Which type of shock is most likely?

Accepted Answer

Hypovolemic shock

Answer

Blood loss from trauma causes hypovolemic shock, characterized by tachycardia, hypotension, and poor perfusion.

Question 2

During management of a child in hypovolemic shock, when should you reassess perfusion after an IV fluid bolus?

Accepted Answer

Immediately after the bolus is complete

Answer

Reassessment should occur immediately after each fluid bolus to determine the child's response and need for additional therapy.

Question 3

A child in septic shock fails to improve after 60 mL/kg of isotonic fluid. What is the most appropriate next intervention?

Accepted Answer

Begin vasoactive drug therapy

Answer

Fluid-refractory septic shock requires vasoactive agents such as dopamine or epinephrine to restore perfusion.

Question 4

Which vasoactive drug is first-line for cold (low cardiac output) septic shock in children?

Accepted Answer

Epinephrine

Answer

Epinephrine is preferred for cold septic shock because it increases cardiac output and has inotropic properties.

Question 5

A 5-year-old with known peanut allergy suddenly develops urticaria, stridor, and hypotension. What is the priority intervention?

Accepted Answer

Intramuscular epinephrine 0.01 mg/kg

Answer

IM epinephrine is the first-line treatment for anaphylactic shock and must be given immediately.

(PEARS) Pediatric Emergency Assessment, Recognition, and Stabilization Practice Test

(PEARS) Pediatric Emergency Assessment, Recognition, and Stabilization Practice Test

PEARS Managing Shock Emergencies 2