EXAM ACTUAL COMPLETE REAL EXAM 230 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
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steps in resuscitation of the neonate
Dry, warm, position to open airway, suction mouth then nose
Tactile stimulation (HR<100 or apnea/IR breath rub back and
put) Oxygen near the face
Bag valve mask - unresponsive to tactile stim within a few sec (40-60bpm)
reposition head, reapply mask, suction again prn, if no response in 30 sec
Intubate - if HR < 60 after PPV for 30 sec, then
Chest compressions - 3:1 ratio (90 compressions / 30 breaths)
Drugs - epinephrine 0.1-0.3ml/kg of 1:10,000, through et tube or (preferably)
through umbilical venous line, volume loss give 10ml/kg NS
pulmonary contusion
Chest pain
bruising over
sternum
Progressive
dyspnea
decreased breath sounds on one
side rales
low sats despite being on o2
hemoptysis
irregular pulse-dysrthymia
,ruptured diaphragm
abd contents herniate into the thoracic cavity compressing the lung
s/s: dyspnea, dysphagia, abd pain, sharp epigastric or chest pain
radiating to L shoulder (Kehr sign), bowel sounds heard in the lung fields
on injured side, decreased breath sounds on injured side.
Tracheobronchial injury
1. hemoptysis
2. subcutaneous emphysema
3. air leak (PNEUMOTHORAX) + PNEUMEDIASTINUM even after
chest tube placement***
- advance ETT below level of injury into Right mainstem
esophageal perforation
-fever
-hematemesis
Fat embolus
can form when a long bone is fractured and fat cells from yellow bone
marrow are released into the blood
-fever
-rash after fracture
Blood loss from humerus fracture
750 ml
,blood loss from femur fracture
1500 ml
PAWP (pulmonary artery wedge pressure)
- Looks at the left side of the heart
- If elevated can indicate pulmonary congestion, CHF, cardiogenic shock
- Do not keep wedged for more than 30 seconds
- Make sure balloon is deflated and have patient cough forcefully
-Normal: 8-12
Adult ETT depth
3 x ETT size or average 19.23 cm
Peds ETT depth
10 + age in years (cm)
Neonate ETT depth
6 + wt in kg (cm)
Adjust vent to change Co2
adjust rate and tidal volume
, Adjust vent to change oxygenation
adjust PEEP, PAP
infant rule of nines
Head and neck -
21% Each arm -
10%
chest/stomach -
13%
back - 13%
butt/genitals -
6% each leg -
13.5%
Sodium Bicarbonate
-acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
Digoxin
-cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml