PALS MC Pediatric Sepsis with Septic Shock – FirstAidWeb Certifications

Pediatric Sepsis with Septic Shock

A 4-year-old child is brought to the emergency department with a high fever, tachycardia, and lethargy. The child’s skin is mottled, with a capillary refill time of 4 seconds. They appear hypotensive, with cool extremities and weak peripheral pulses. Respiratory rate is elevated, and oxygen saturation is borderline despite supplemental oxygen. The child shows increasing signs of shock, with deteriorating mental status, requiring immediate fluid resuscitation and initiation of antibiotics to manage septic shock and prevent further progression.

Focus on restoring perfusion and correcting the signs of shock.

A 4-year-old child presents with fever, tachycardia, lethargy, and mottled skin. Capillary refill time is delayed at 4 seconds. What is your next step?

Administer broad-spectrum antibiotics immediately.

Perform endotracheal intubation.

Start dopamine infusion for inotropic support.

Administer a 20 mL/kg fluid bolus of isotonic crystalloid.

Consider that more fluids may be needed in distributive shock.

After administering the first fluid bolus, the child’s perfusion remains poor, and capillary refill time is still delayed. What is your next step?

Start a norepinephrine infusion.

Administer an additional 20 mL/kg fluid bolus.

Provide high-flow oxygen.

Perform a chest x-ray.

If fluids alone are insufficient, what intervention helps restore vascular tone?

Despite fluid resuscitation, the child remains hypotensive. What is the next appropriate intervention?

Start a norepinephrine infusion.

Administer an additional 20 mL/kg fluid bolus.

Provide 100% oxygen via non-rebreather mask.

Administer hydrocortisone.

Focus on what fluid resuscitation directly improves in septic shock.

What is the primary goal of fluid resuscitation in septic shock?

Restore tissue perfusion and oxygen delivery.

Stabilize heart rate to normal levels.

Reduce pulmonary edema.

Decrease the fever and normalize temperature.

Focus on indicators of end-organ perfusion.

After starting norepinephrine, the child’s blood pressure stabilizes but their urine output is low. What should you assess next?

Administer a diuretic to stimulate urine output.

Evaluate lactate levels and capillary refill time.

Increase norepinephrine dosage.

Start a dopamine infusion to augment renal perfusion.

When should antibiotics be administered in sepsis?

Antibiotics are ready to administer. What is the most important consideration for timing?

Administer only after fluid resuscitation is complete.

Administer when vasopressors are no longer required.

Wait until blood cultures are drawn.

Administer within the first hour of recognizing sepsis.

Think about therapies used in refractory septic shock.

The child’s lactate levels remain elevated despite interventions. What additional therapy might be needed?

Increase norepinephrine dosage further.

Administer a diuretic.

Start hydrocortisone therapy.

Provide a transfusion of packed red blood cells.

Consider strategies to minimize lung injury during mechanical ventilation.

The child progresses to respiratory failure and requires intubation. What ventilation strategy is most appropriate?

Avoid PEEP to minimize hemodynamic compromise.

Set high tidal volumes to ensure maximum oxygenation.

Use lung-protective ventilation with low tidal volumes.

Use high respiratory rates to increase minute ventilation.

What is the focus of care after initial resuscitation in sepsis?

After achieving stability, what is the primary goal of post-resuscitation care in sepsis?

Initiate physical therapy as soon as possible.

Monitor and prevent organ dysfunction.

Reduce fluid intake to prevent overload.

Wean off all medications quickly.

Your score is

The average score is 11%

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