Pediatric Physical Assessment
ABG's
Cardiovascular Monitoring
X-Rays
Non-invasive Monitoring
100
Signs of Respiratory Distress in a child?
What is head bobbing, nasal flaring, and grunting.
100
Name the puncture sites for obtaining arterial blood samples from a pediatric patient?
What is the radial artery, dorsalis pedis or posterior tibial artery.
Note: The brachial and femoral artery must be avoided.
100
To obtain accurate hemodynamic values, where must the transducer system be positioned?
What is at the level of the atria and pulmonary artery, called the phlebostatic axis.
100
What can lateral decubitus view be used to evaluate?
What is suspected foreign body aspiration, pleural effusion and a pneumothorax.
100
What clinical parameter is critically important to monitor when mechanical ventilation is administered and why?
What is blood pressure because increasing intrathoracic pressure (by increasing positive end expiratory pressure, for example) can reduce venous return, resulting in decreased blood pressure.
200
While auscultating a young child’s breath sounds, the therapist hears bilateral fine crackles, which can be produced by the what condition?
Pulmonary Edema
200
Name some factors that would adversely affect the correlation between arterial puncture measurements and those from a capillary sample.
What is hypotension, hypothermia, hypovolemia, and lack of perfusion.
200
What is one of the most common arrhythmias observed as a complication from the insertion of a pulmonary artery catheter?
What is Premature ventricular contraction or ventricular tachycardia.
200
While viewing a lateral view of a neck radiograph of an 18-month-old child, a therapist notices thumb print sign. Which condition does this child likely have?
What is Epiglottitis.
200
A therapist is monitoring a child on the mechanical ventilator who is hemodynamically stable. The PetCO2 is 48 mm Hg. If accurate, what should be the PaCO2?
What is 43 to 48 mm Hg. Normally, PetCO2 is 2 to 5 mm Hg below PaCO2.
300
After placing a stethoscope over a small child’s trachea, the therapist hears expiratory stridor, which is consistent with which condition?
What is Tracheomalacia.
300
What can cause methemoglobinemia?
What is Inhalation of Nitric Oxide.
300
How would tricuspid stenosis be expected to influence a patient’s CVP value?
What is increase it above normal.
300
A therapist is viewing frontal and lateral neck X-rays of a 12-month-old child and notices what is described as the “steeple” sign: subglottic narrowing below the vocal cords and an overdistended hypopharynx. Which condition does this child likely have?
What is Croup.
300
What is the purpose of indirect calorimetry?
What is to calculate energy expenditure by measuring VO2 and VCO2.
400
Tactile fremitus may be increased over areas of the chest wall corresponding with which condition?
What is pulmonary consolidation.
400
What are some of the factors that can cause a right shift in the oxyhemoglobin dissociation curve?
What is decreased pH, increased PCO2, increased temperature & increased 2,3-DPG.
400
A patient has a systolic blood pressure of 100 mm Hg and a diastolic pressure of 75 mm Hg. What is this patient’s mean arterial pressure?
What is 83 mm Hg.
Formula: MAP = [(2 × diastolic) + systolic]/3
400
A therapist is examining an AP chest radiograph of a neonate and notices a structure projecting away from the mediastinum toward the right upper lung. This structure looks like a sail with a sharp inferior margin and lateral margins with wavy contours. What structure is the therapist observing?
What is the Thymus.
400
While working in the PICU with a mechanically ventilated child who is being monitored for PetCO2, the therapist observes the following capnogram. What interpretation should the therapist make of this capnogram?
What is the patient is rebreathing his own exhaled gas.
500
A young patient is experiencing the following symptoms: Persistent coughing with copious, thick yellowish-green secretions, wheezing and shortness breath. The mother stated that the child has been seen frequently for bacterial infections of the lung and has been struggling to gain weight. What could be the potential diagnosis?
Cystic Fibrosis
500
patients can have a
reduced oxygen content even though the PaO2 may
be normal
A left-shifted oxyhemoglobin dissociation curve
What condition causes patients to have a
reduced oxygen content even though their PaO2 may be normal and also causes a left shift in the oxygen dissociation curve that further compounds tissue hypoxia?
What is Carboxyhemoglobinemia.
500
Calculate a patient’s total arterial oxygen content given the following data:
- Arterial oxygen tension (PaO2), 100 mm Hg
- Arterial carbon dioxide tension (PaCO2), 45 mm Hg
- Arterial oxygen saturation (SaO2), 97.5%
- Hemoglobin concentration ([Hb]), 15 g/dL
- Cardiac output, 4.5 L/minute
- Stroke volume, 55 mL/beat
What is 19.9 vol%
The formula for calculating the total arterial oxygen content (CaO2) is as follows: O2 delivery = O2 content = (Hb × 1.34 × SaO2) + (PaO2 × 0.003).
500
The therapist is examining a chest x-ray and notices upper lobe predominant “tram-track” reticular opacities, atelectasis, scarring, hyperinflation, and right ventricular enlargement. Which condition does this child likely have?
What is Cystic Fibrosis.
500
The following capnogram was obtained from a child receiving mechanical ventilation. How should the therapist evaluate this capnogram?
What is airway obstruction.