NURSING > QUESTIONS & ANSWERS > PALS - Team Response Scenario: Noah Johnson COMPLETE SOLUTION 2022 (All)

PALS - Team Response Scenario: Noah Johnson COMPLETE SOLUTION 2022

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PALS - Team Response Scenario: Noah Johnson COMPLETE SOLUTION 2022 Following the pediatric assessment triangle (PAT), record the findings from the rapid assessment of Noah. - ✔✔There are no signs of airway compromise and Noah is alert and acting appropriately, but he is obviously tachypneic, which is evidence of abnormal breathing. He is quite diaphoretic and told Ann that his heart feels like it is beating out of his chest. These findings indicate abnormal circulation. Next, we'll move to the primary assessment to find out more. Which of the following are included in the primary assessment of Noah? - ✔✔1. 12-lead ECG 2. Radial pulse 3. Pulse ox 4. Blood pressure 5. Respiratory rate As the team continues assessing Noah, which additional piece of equipment should be prepared to use? - ✔✔Nasal cannula In observing this ECG reading, you note which wave form is not clearly identifiable? - ✔✔The unidentifiable P wave in this reading means Noah is in SVT. Next, observe his condition and consider this as you continue providing care. Based on the ECG findings and Noah's current condition, what is the team's immediate next action? - ✔✔Instruct Noah to perform a vagal maneuver by instructing him to "bear down" as if trying to pass a bowel movement for 20 seconds. The vagal maneuver was unsuccessful. The medication team member has started an IV using an IV set with a 3-way stopcock on Noah's left antecubital space. The doctor asks the team to prepare the medication that should be administered at this time. What is the correct medication and dose to prepare based on Noah's weight of 72.7 pounds? - ✔✔Adenosine, 3.3mg IV - it should be administered at 0.1 mg/kg. After 2 minutes, there is no additional decrease in Noah's heart rate and the rhythm remains in SVT. The nurse prepares to give an additional dose of adenosine. The vial reads 12 mg/4mL. How many mL would the nurse administer based on Noah's weight of 72.7 pounds? - ✔✔The second dose of adenosine should be administered at 0.2 mg/kg. (2.2 mL) After the second dose of adenosine, there is still no additional decrease in Noah's heart rate or change in heart rhythm; it is 188 bpm in SVT. The healthcare provider consults a pediatric cardiac intensivist who says to proceed with pharmacologic cardioversion. What is the correct medication to prepare? - ✔✔Amiodarone since 2 doses of adenosine is max What is the correct dose of amiodarone to use? - ✔✔5 mg/kg IV Over what time period should the amiodarone 5 mg/kg IV be administered? - ✔✔20-60 minutes Noah's heart rate and rhythm remains in SVT at 163 bpm. However, the nurse verbally reports that his blood pressure is dropping, he looks dusky (pale) and diaphoretic and his level of consciousness is decreasing. The medication team member suggests administering a third dose of adenosine. What is the correct course of action? - ✔✔Review the SVT protocol with the team members, consult with the pediatric cardiologist, and decide to initiate synchronized electrical cardioversion

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