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◉When you evaluate the patient, you find the lungs are clear, skin is
cool and mottled, glucose is 97 mg/dL and capillary refill time is 5
seconds. What are the warning signs that the patient is progressing from
compensated shock to hypotensive shock? Answer: -Hypotension (late
sign)
-Increasing tachycardia
◉The patient still has a blood pressure of 58/38 mm Hg. Her condition
would be classified as ___________ shock. Answer: Hypotensive
◉What should be included in the initial treatment for this patient?
Answer: -Rapid fluid bolus administration
-Establishing IV/IO access
◉The mother does not recall the infant's most recent weight. What is the
most appropriate way to rapidly determine her weight and calculate
,correct medication? Answer: Measure her by using color-coded length-
based tape
◉You measure the infant to be 7 kg and prepare to administer a fluid
bolus of what type? Answer: Normal saline 20 mL/kg
◉What is the most appropriate method of delivering rapid fluid boluses
to this patient? Answer: A syringe and 3-way stopcock
◉After the first fluid bolus is administered, the child is reassessed and
her vital signs are HR 167, BP 58/44 mm Hg, RR 56/min and SpO2
92%. Her skin is still cool and pale and she is still lethargic and weak.
What should be the next intervention? Answer: Deliver a second fluid
bolus of 20 mL/kg and reassess
◉When should vasoactive therapy be considered be considered in
managing distributive shock? Answer: If the child remains hypotensive
and poorly perfused despite rapid bolus fluid administration
◉How does the clinical presentation of distributive shock compare with
hypovolemic shock? Answer: Distributive shock has more variable
presentation than that of hypovolemic shock
, ◉For general shock management, administer an isotonic crytalloid bolus
of __ mL/kg over __ to __ minutes Answer: For general shock
management, administer an isotonic crytalloid bolus of 20 mL/kg over 5
to 20 minutes
◉What signs distinguish anaphylactic shock from other types of shock?
Answer: -Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
◉in a child with anaphylactic shock, what is the most appropriate initial
treatment? Answer: IM epinephrine
◉How soon after exposure do symptoms typically occur in anaphylactic
shock? Answer: Seconds to minutes
◉What should you evaluate to recognize septic shock? Answer: -Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
◉When should antibiotics be administered in septic shock? Answer:
Within the first hour