1
PEDIATRIC SHOCK ASSESSMENT AND MANAGEMENT
STUDY GUIDE TIPS 2026 LATEST
Scenario
15-year-old previously well boy is freshly from the PICU, POD #3 from
partial small bowel resection after multiple gunshot wounds to the
abdomen. The nurse pages because his HR has increased in the last
hour from 90 to 130, despite pain score of 1/10 on morphine drip.
On exam, he is afebrile, HR is 140, BP 80/50. Cap refill is >3 seconds
,2
in his cool extremities and pulses are 1+.
What is your assessment? What is your initial management?
,3
Scenario
A mother brings her 4-year-old girl to the pediatrician’s office. The child has a history
of increasing lethargy, fever and dizziness, when she tries to stand up. There is no
history of vomiting or diarrhea. Her intake has been poor over the last 12 hours.
Typical chickenpox lesions developed 5 days ago over the last 18 hours several
lesions on her abdomen have become red tender and swollen. On exam: child is
confused, she responds to your voice and tries to answer questions. But she does
not know where she is and does not seem to understand what people are saying. HR
- 165/min, RR – 60/min, t – 39.3, bp – 90/30, auscultation reveals clear lungs, regular
rapid heart beat with a short systolic murmur. Extremities are warm and bright red,
pulse +, CRT – 1’, St -100% while the child receiving the high flow oxygen.
ABG analyses shows: pH – 7.30, PCO2 – 35, HCO3 – 18, BE – 5, lactate 3.3
mmol/l
, 4
OBJECTIVES
▪ Define shock
▪ Describe key differences between the pediatric and adult circulatory
system and how they affect assessment and treatment of shock in
children
▪ Explain how to assess for pediatric shock
▪ List appropriate interventions for pediatric shock
PEDIATRIC SHOCK ASSESSMENT AND MANAGEMENT
STUDY GUIDE TIPS 2026 LATEST
Scenario
15-year-old previously well boy is freshly from the PICU, POD #3 from
partial small bowel resection after multiple gunshot wounds to the
abdomen. The nurse pages because his HR has increased in the last
hour from 90 to 130, despite pain score of 1/10 on morphine drip.
On exam, he is afebrile, HR is 140, BP 80/50. Cap refill is >3 seconds
,2
in his cool extremities and pulses are 1+.
What is your assessment? What is your initial management?
,3
Scenario
A mother brings her 4-year-old girl to the pediatrician’s office. The child has a history
of increasing lethargy, fever and dizziness, when she tries to stand up. There is no
history of vomiting or diarrhea. Her intake has been poor over the last 12 hours.
Typical chickenpox lesions developed 5 days ago over the last 18 hours several
lesions on her abdomen have become red tender and swollen. On exam: child is
confused, she responds to your voice and tries to answer questions. But she does
not know where she is and does not seem to understand what people are saying. HR
- 165/min, RR – 60/min, t – 39.3, bp – 90/30, auscultation reveals clear lungs, regular
rapid heart beat with a short systolic murmur. Extremities are warm and bright red,
pulse +, CRT – 1’, St -100% while the child receiving the high flow oxygen.
ABG analyses shows: pH – 7.30, PCO2 – 35, HCO3 – 18, BE – 5, lactate 3.3
mmol/l
, 4
OBJECTIVES
▪ Define shock
▪ Describe key differences between the pediatric and adult circulatory
system and how they affect assessment and treatment of shock in
children
▪ Explain how to assess for pediatric shock
▪ List appropriate interventions for pediatric shock
