Deck 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children

Question 1

Which behaviors in newborns would support the possibility of shock? (Select all that apply.)

A)Decreased heart rate variability
B)Temperature instability
C)Hyperalertness
D)Increased muscle tone
E)Hypoglycemia

Answer 1

Decreased heart rate variability
Temperature instability
Hypoglycemia

Question 2

A child has septic shock with significant hypovolemia. What interventions should the healthcare professional prepare to complete? (Select all that apply.)

A)Aggressive fluid administration
B)Antibiotic therapy
C)Titration of inotropes
D)Vasopressors
E)Permissive hyperglycemia

Answer 2

Aggressive fluid administration
Antibiotic therapy
Titration of inotropes
Vasopressors

Question 3

The healthcare professional explains to a student that the most serious outcome resulting from limited glycogen stores in children who have been seriously burned is which of these?

A)Poor wound healing
B)Increased morbidity
C)Decreased immunity
D)Loss of adipose tissue stores

Answer 3

Increased morbidity

Question 4

The healthcare professional plans care for a child in shock. What are the primary goals for the treatment of shock?

A)Maximizing oxygen delivery and minimizing oxygen demand
B)Maintaining hydration and adequate urinary output
C)Supporting all facets of the cardiovascular system
D)Maintaining all vital signs within normal functioning ranges

Question 5

Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.

A)2
B)5
C)7
D)10

Question 6

A student asks the healthcare professional to explain reperfusion injuries. What explanation by the professional is best?

A)Tissue damage that can occur with blood transfusions
B)Tissue destruction during rewarming in frostbite
C)Damage from restored blood flow and exposure to oxygen
D)Fluid overload from intravenous therapy that is too rapid

Question 7

What is the most common type of shock in children?

A)Hypovolemic
B)Cardiogenic
C)Neurogenic
D)Septic

Question 8

Which assessment findings would be recognized as late signs of shock in a child? (Select all that apply.)

A)Metabolic (lactic) acidosis
B)Cool skin
C)Bradycardia
D)Prolonged capillary refill
E)Hypotension

Question 9

A 2-year-old is in shock. The healthcare professional assesses the child's heart rate as 52 beats/min. What action by the healthcare professional is most appropriate?

A)Get an ECG.
B)Increase the intravenous rate.
C)Sedate the child.
D)Begin CPR.

Question 10

A 4-year-old child with a burn injury has entered the catabolic flow phase. What assessment would the healthcare provider correlate with this situation?

A)Oxygen saturation normal on room air
B)7 pound weight loss in 1 week
C)Capillary refill <2 sec
D)Blood pressure 89/56 mmHg

Question 11

Which information does the professor teach the class regarding how a child's body compensates for cardiogenic shock? (Select all that apply.)

A)Splanchnic arteries are constricted to divert blood from the skin, kidneys, and gut to the heart and brain.
B)Peripheral blood vessels are constricted to raise blood pressure.
C)Adrenergic responses produce tachycardia to increase cardiac output.
D)The renin-angiotensin-aldosterone system is stimulated when renal function decreases.
E)Compensation prevents the child from developing hepatic or mesenteric failure.

Question 12

Approximately 80% of all hospital-acquired infections in children are a result of which type of organism?

A)Bacteria
B)Viruses
C)Fungi
D)Rickettsia

Question 13

Which information does the student learn regarding multiple organ dysfunction syndrome (MODS)? (Select all that apply.)

A)Diagnosis requires simultaneous failure of at least two organs.
B)Primary MODS occurs immediately after the attributing cause.
C)Secondary MODS occurs within 3 to 7 days of the initial insult.
D)Chronic illness increases a child's risk for MODS.
E)Risk factors for MODS include severe or prolonged shock, sepsis, and trauma.

Question 14

A 33-pound child is in shock. Which fluid bolus should the healthcare professional prepare to administer to this child?

A)Hypotonic fluid, 150 mL
B)Hypotonic fluid, 300 mL
C)Isotonic fluid, 150 mL
D)Isotonic fluid, 300 mL

Question 15

To determine a child's response to fluid therapy for shock, the healthcare professional should monitor which measurements as the priority?

A)Hematocrit and hemoglobin levels
B)Urine output and specific gravity
C)Blood pressure and pulse
D)Arterial blood gases and heart rate

Question 16

A healthcare professional gets an update on four children. Which one should the professional assess as the priority?

A)6-month old, respiratory rate of 42 breaths/min
B)2-year-old, respiratory rate of 39 breaths/min
C)Preschooler, respiratory rate of 26 breaths/min
D)School-aged child, respiratory rate of 38 breaths/min

Question 17

A healthcare professional assesses that a child's capillary refill time is 4 sec. What does the healthcare professional evaluate that finding to mean?

A)The child is in shock.
B)The child must have septic shock.
C)The child has compensated shock.
D)This finding is normal.

Question 18

A child is in cardiogenic shock and the parents ask why the child has hepatomegaly and periorbital edema. What explanation by the healthcare professional is best?

A)Mass vasodilation as a result of chemical mediators released from the myocardium
B)Low cardiac output and systemic venous congestion
C)Tissue damage to the myocardium, causing increased capillary permeability
D)Reduced renal perfusion, stimulating the RAAS system

Question 19

A child has a burn injury. What does the healthcare provider assess for when determining the child's chance of surviving?

A)Immunosuppression
B)Hypermetabolism
C)Inhalation injury
D)Hypertrophic scarring

Question 20

What causes renal failure after electrical burns in children?

A)Cytokines are released after the damaged tissue.
B)Immature kidneys are unable to compensate for the electrical burn.
C)Cardiac output is reduced.
D)Myoglobin is released from damaged muscles.

Question 21

Which cytokines are antiinflammatory mediators? (Select all that apply.)

A)IL-4
B)IL-11
C)Colony-stimulating factor
D)Nitric oxide
E)Arachidonic acid metabolites

Question 22

A healthcare professional is assessing the severity of a burn injury. What factors does the professional include in this assessment? (Select all that apply.)

A)Amount of fluid lost over a 24-hour period
B)Circumference of the burn injury
C)Depth of the burn injury
D)Severity of the injury caused to other body systems
E)Percentage of total body surface area involved

Question 23

A healthcare professional explains that children under 2 years of age have a higher risk for dehydration because of which factors? (Select all that apply.)

A)Inability to concentrate urine
B)Larger TBSA compared to weight than adults
C)Immature kidneys
D)Limited glycogen stores
E)Underdeveloped antiinflammatory mediators