CPEN UPDATED EVALUATION EXAM QUESTIONS AND
ANSWERS RATED A+
✔✔Types of seizures partial - ✔✔Simple Partial: no impairment in LOC, 10-20sec, w/o
postictal
Complex Partial: impairment in LOC, more than 30 sec., postictal
✔✔Generalized Seizures - ✔✔Absence(petit mal): staring, slight loss of muscle tone
Tonic/Clonic- + LOC, postictal
Myoclonic: brief sudden massive muscle contractions, whole or part body, possible LOC
Atonic: sudden loss of muscle tone, fall to the ground, dec LOC
Tonic: 10 sec, tonic contractions, dec LOC, fall, postictal
✔✔Shunt Dysfunction - ✔✔Tachy, inc RR then slowed, inc HR for younger children, inc
BP: Cushing triad
Fever!!!- infection
Know baseline
Sundowning, dec LOC
Inc HOB, head midline
✔✔Traumatic Brain Injury - ✔✔Elevate HOB 30 degrees, head midline, immobilize C
spine
Watch for Cushing's triad(brady, HTN, alt in resp)
CO2 30-35
Unilateral dilation: herniation
✔✔Basilar skull fracture - ✔✔Significant force, Hemotympanum, raccoon eyes, battle
sign , otorrhea/rhinorrhea
Sedate, intubate, osmotic(mannitol)
Do not give ketamine, inc ICP
Normal ICP is 10
✔✔Epidural Hematoma - ✔✔arterial bleed, middle meningeal artery, quick deteriorate
rapidly, surgery
Bleeds quickly, + LOC, alert but not normal
Blown and pin pt pupils- herniation
✔✔Subdural Hematoma - ✔✔Venous bleed, slower onset of symptoms
Shaken Baby
✔✔TBI interventions - ✔✔Fracture: great deal of force
Babinski: normal for 2yo and younger
Brudzinski: meningeal sign, knee/hip flex when neck is flexed
Kernig: meningeal sign, leg flexs at hip and pt cannot extend
Doll's eye: eyes move in the opposite direction
, Cold Calories: eyes move toward the ear stimulated with cold water
✔✔Spinal Cord Trauma - ✔✔Steroids are beneficial
✔✔Spinal Cord Trauma Peds - ✔✔Lap belt: worn around the abdomen rather than
pelvis, frontal impact causes mid-lumbar (2nd-4th fx) aka Chance Fx. Internal bleeding
✔✔Autonomic Dysreflexia - ✔✔Life Threatening- after acute phase of SCI
Over rxn of sympathetic nervous system- full bladder, full rectum, decubitus
HA, inc BP, sweating, flushing
Elevate HOB, relieve cause, gang blockers
✔✔Compartment Syndrome - ✔✔dec vascular perfusion after cast placement
position at level of heart, no ice
Cut cast
✔✔Slipped Capital Femoral Epiphysis - ✔✔Slippage of the proximal femoral epiphysis
on the femoral neck
Adolescent males who are inactive and over weight
✔✔Muscular dystrophy - ✔✔inherited
muscle weakness and atrophy
Duchenne most common type
✔✔Juvenile Rheumatoid Arthritis - ✔✔unk triggers
overgrowth of articular cartilage causing joint destruction
✔✔Osgood Schlatter disease - ✔✔inflammation of the tibia tubercle
Overuse by active adolescents
✔✔ Peds Assessment Triangle - ✔✔Apperance, WOB, and circulation
No touch
✔✔3 S's - ✔✔Sick: nothing abmornal
Sicker: acute disruption
Sickest: 2 or more disruptions
✔✔Urgent vs. Emergent - ✔✔U: need care within 24 hrs
E: threats to life, limb, or eyesight
✔✔4 components of Peds Triage - ✔✔PAT, initial assessment, triage hx, acuity
✔✔Gastric Lavage - ✔✔Needs to be done within 1 hr
Helpful if med slow gastric motility
ANSWERS RATED A+
✔✔Types of seizures partial - ✔✔Simple Partial: no impairment in LOC, 10-20sec, w/o
postictal
Complex Partial: impairment in LOC, more than 30 sec., postictal
✔✔Generalized Seizures - ✔✔Absence(petit mal): staring, slight loss of muscle tone
Tonic/Clonic- + LOC, postictal
Myoclonic: brief sudden massive muscle contractions, whole or part body, possible LOC
Atonic: sudden loss of muscle tone, fall to the ground, dec LOC
Tonic: 10 sec, tonic contractions, dec LOC, fall, postictal
✔✔Shunt Dysfunction - ✔✔Tachy, inc RR then slowed, inc HR for younger children, inc
BP: Cushing triad
Fever!!!- infection
Know baseline
Sundowning, dec LOC
Inc HOB, head midline
✔✔Traumatic Brain Injury - ✔✔Elevate HOB 30 degrees, head midline, immobilize C
spine
Watch for Cushing's triad(brady, HTN, alt in resp)
CO2 30-35
Unilateral dilation: herniation
✔✔Basilar skull fracture - ✔✔Significant force, Hemotympanum, raccoon eyes, battle
sign , otorrhea/rhinorrhea
Sedate, intubate, osmotic(mannitol)
Do not give ketamine, inc ICP
Normal ICP is 10
✔✔Epidural Hematoma - ✔✔arterial bleed, middle meningeal artery, quick deteriorate
rapidly, surgery
Bleeds quickly, + LOC, alert but not normal
Blown and pin pt pupils- herniation
✔✔Subdural Hematoma - ✔✔Venous bleed, slower onset of symptoms
Shaken Baby
✔✔TBI interventions - ✔✔Fracture: great deal of force
Babinski: normal for 2yo and younger
Brudzinski: meningeal sign, knee/hip flex when neck is flexed
Kernig: meningeal sign, leg flexs at hip and pt cannot extend
Doll's eye: eyes move in the opposite direction
, Cold Calories: eyes move toward the ear stimulated with cold water
✔✔Spinal Cord Trauma - ✔✔Steroids are beneficial
✔✔Spinal Cord Trauma Peds - ✔✔Lap belt: worn around the abdomen rather than
pelvis, frontal impact causes mid-lumbar (2nd-4th fx) aka Chance Fx. Internal bleeding
✔✔Autonomic Dysreflexia - ✔✔Life Threatening- after acute phase of SCI
Over rxn of sympathetic nervous system- full bladder, full rectum, decubitus
HA, inc BP, sweating, flushing
Elevate HOB, relieve cause, gang blockers
✔✔Compartment Syndrome - ✔✔dec vascular perfusion after cast placement
position at level of heart, no ice
Cut cast
✔✔Slipped Capital Femoral Epiphysis - ✔✔Slippage of the proximal femoral epiphysis
on the femoral neck
Adolescent males who are inactive and over weight
✔✔Muscular dystrophy - ✔✔inherited
muscle weakness and atrophy
Duchenne most common type
✔✔Juvenile Rheumatoid Arthritis - ✔✔unk triggers
overgrowth of articular cartilage causing joint destruction
✔✔Osgood Schlatter disease - ✔✔inflammation of the tibia tubercle
Overuse by active adolescents
✔✔ Peds Assessment Triangle - ✔✔Apperance, WOB, and circulation
No touch
✔✔3 S's - ✔✔Sick: nothing abmornal
Sicker: acute disruption
Sickest: 2 or more disruptions
✔✔Urgent vs. Emergent - ✔✔U: need care within 24 hrs
E: threats to life, limb, or eyesight
✔✔4 components of Peds Triage - ✔✔PAT, initial assessment, triage hx, acuity
✔✔Gastric Lavage - ✔✔Needs to be done within 1 hr
Helpful if med slow gastric motility
