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ENPC Pre-Course Study Guide
Questions and Answers 2024/
What are the most common pediatric presentations where you work? RSV,pneumonia, diarrhea, malnutrition, appendicitis, sports injuries, car accidents, self harm risk, epilepsy What health promotion initiatives are needed in your area? HEADS-ED screening tool Nutrition Activity Home safety Personal safety Health safety Physical activity How can health promotion and injury prevention topics be incorporated into routine assessment and care of pediatric patients in the ED? Pediatric Readiness 7 areas include: administration and coordination of pediatric care in the ED, competencies, quality improvement, policies, protocols, medication safety, support services, equipment and supplies How do you incorporate patient and family centered care concepts into pediatric patients? PFCC Core concepts include: Dignity and respect, information sharing, participation, collaboration Does your facility have a pediatric emergency care coordinator?
Yes What opportunities exist at your facility to improve pediatric readiness and care for pediatric patients? Pediatric trauma Pediatric facility recognition programs Prehospital Pediatric readiness project Does your facility receive children needing higher level of care, or does your facility typically transfer children requiring higher level of care? Are there formal agreements in place? Children that need higher level of care are transferred to PICU. A set of vital signs and transfer form must be completed. In most cases, consent for minors must be obtained by a parent or legal guardian. Are there any exceptions to this rule in your state? What is the policy for obtaining consent? Emancipated Minors can consent without a parent or legal guardian in the following cases: Contraception Emancipation Marital status Minor has a child Military service Pregnant Prenatal care Sexual health Substance abuse How can understanding stages of development help you when caring for peds patients of various ages? Piagets Cognitive Development Eriksons Psychosocial Development What are some signs of pain that can be observed in children who are nonverbal? FLACC NIPS Wong Baker FACES Why is it important to incorporate caregivers in the assessment and care for pediatric patients?
What assessment findings in the neonate may indicate hypoglycemia? Sweating POOR FEEDING Weak or high pitched cry Hypotonia What assessment findings in a neonate would indicate congenital heart disease? Shock, pulmonary edema, irritability, decreased activity, crying during feedings, decrease in appetite, and poor weight gain, fast or irregular breathing, blue or purple discoloration of skin, heart murmur, hepatomegaly What equipment does your facility have for newborn stabilization and care? What are safe haven laws or other options for safe newborn surrender in your country? Unharmed newborn infant surrenders to healthcare facility without repercussions to the parent What is the definition of shock? Describe. Inadequate tissue perfusion How can you differentiate compensated, decompensated/hypotensive, and irreversible shock? Compensated: blood is shunted to vital organs, causing cool extremities, decreased urine output, and ELEVATED LACTATE LEVEL Decompensated: weak peripheral pulses, altered mental status Irreversible: mottled skin, bradycardia, unresponsiveness List three pediatric differences relevant to shock. Describe the clinical significance of each difference How can a lactate level be used to identify and manage shock? What are the four types of shock, name one cause for each type Hypovolemic: fluid volume depletion Obstructive: pump/pipe obstruction Cardiogenic: heart failure Distributive: systemic vasodilation Name one goal directed therapy for each shock. Hypovolemic: prevent fluid loss Cardiogenic: Cardiology consult
Obstructive: prostaglandin E infusion Distributive: IM epi, spinal motion restriction, 20 mL/kg bolus What are the most likely causes for pediatric cardiac arrest? Think H's and T's You find a child who is unresponsive with no signs of normal breathing and no palpable pulse. What are your initial actions? Begin CPR, chest compressions Do you have a pediatric resuscitation teams? Who responds? What are three ways to differentiate respiratory distress and respiratory failure in the pediatric patient? What assessment findings can be used to differentiate between between the following common pediatric respiratory illnesses? What are the three important discharge teaching topics for children with asthma? Chest radiographs are not obtained as often in pediatric patients as adults. Why do you think that is the case? What standardized scoring systems are used at your facility to assess severity of respiratory illness in pediatric patients? What protocols are available at your facility for care of pediatric patients with respiratory illness? What age specific developmental characteristics put children at increased risk for injury? What additional information would he helpful for predicting the types and severity of injuries for the following complaints? Fall, MVA, Bicycle crash What are the dangers of logrolling a patient with an unstable spine or pelvic injury? What discharge education is provided for a child with a mild traumatic brain injury? What are the car seat laws in your area? Does your facility have a process for providing car seats to families when theirs are damaged in MVCs? Does your facility have pediatric cervical collars and pelvic binders? In what patient populations is the presence of a fever an urgent concern? What are some red flags that cause increased concern in the pediatric patient with a fever? What type of characteristics can help distinguish a febrile seizure from other types? What methods are used at your facility to measure temperature in peds patients? Does your facility have a protocol for identifying and managing pediatric sepsis?
Does your facility have any processes in place for identification and reporting of suspected human trafficking? What is your process for reporting child maltreatment? Describe an interaction with a patient or family member that resulted in escalation/agitation/violence Describe a de-escalation situation What resources are available to help cope with compassion fatigue? Are you comfortable relying on families as experts for their children with special healthcare needs? What medical devices have you encountered while caring for children with special healthcare needs? What medical devices have you encountered while caring for children with special healthcare needs? What is the difference between person first and identity first language? What documentation influences how you think about the patient or family before you even meet them?
