C-NPT: Metabolic | Endocrine

 A 6-year-old’s current ABGs are: pH 7.37, PaCO₂ 58, HCO3^– 23, base deficit -2, PaO₂ 106. What is your interpretation?

A 1-year-old has a diagnosis of left upper lobe pneumonia. Current vitals: BP 70/36, HR 138, RR 48, SpO₂ 87%, and T 102.1°F.  Current ABG: pH 7.20, PaCO₂ 68, HCO3^– 32, PaO₂ 50.  This presentation will result in which of the following changes?

A 12-year-old patient has a current pH of 7.52. Their previous pH was 7.41, and their potassium (K⁺) was 4.7 mEq/L. The expected current K+ is approximately what?

A 13-year-old patient has a history of insulin-dependent diabetes and recently admitted to a local ICU. The family states that they have had a cold over the past week and have become more lethargic over the last 24 hours. Lab results are as follows: Na⁺ 150, Cl^– 103, glucose 504, WBC 12.3, bands 14%, leukocytes represent 68%. The most likely cause of this patient’s DKA state is:

A 14-year-old patient is currently being treated for diabetic ketoacidosis (DKA). There is a noted decrease in mental status with associated lethargy, and their Glasgow coma scale (GCS) score is now 7, dropping from the previous 14. The neurological changes would most likely indicate which situation?

A 15-year-old with a past medical history of type I diabetes mellitus is very lethargic and only responsive to painful stimuli. The family states that the patient has been dealing with viral gastroenteritis for the past 24 hours. When reviewing lab results, what would initially be expected?

A 3-hour-old neonate is found to be polycythemic. What is the likely cause?

A 3-year-old patient’s current ABGs are:

pH 7.30, PaCO₂24, PaO₂62, HCO3^–16.  What is your interpretation?

A 5-year-old pediatric patient with a recent craniotomy is currently awake, alert and answering questions appropriately. There are no signs of neurological deficits. Vitals are currently: BP 112/76, HR 88, RR 22, SpO₂ 97% on 2L NC, glucose 96 mg/dL. Since the craniotomy, they have been urinating approximately 50 mL/hr. Within the last couple of hours, urine output has increased to 350 mL/hr and has a specific gravity of 1.001. What condition is suspected?

A 6-year-old patient treated for diabetic ketoacidosis (DKA) is showing signs of deterioration. Which of the following assessment findings would confirm this suspicion?

A 6-year-old patient’s current ABGs are:

pH 7.55, PaCO₂ 30, PaO₂ 56, HCO3^– 25.  What is your interpretation?

A 9-year-old patient is ordered to have consistent nasogastric (NG) suctioning.  Based on this, you would expect what acid-base disorder?

A change in HCO3^– of 10 mEq/L, will change the pH __________ in the same direction?

A key component used in the management of both diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) in the pediatric population is?

A patient is demonstrating an increase in venous oxygen saturation (SvO₂) and a decrease in oxygen consumption (VO₂) and pH. What type of shock is suspected?

A patient experiencing an aplastic sickle cell crisis typically presents with pallor, tachycardia, weakness, and fatigue as well as:

An 11-year-old patient is suffering from malignant hyperthermia. Malignant hyperthermia is a result of what?

An 8-year-old patient’s initial ABG values were: pH 7.25, PaCO₂ 51, PaO₂ 104, HCO3^– 27, SpO₂ 97%, EtCO₂ 54. They have been on the transport ventilator during the one-hour flight.  Now the EtCO₂ is showing 34.  What would you anticipate the pH to be?

An effect to which of the following would NOT result in a shift on the oxyhemoglobin dissociation curve?

Based upon the diagnosis of diabetes insipidus in a 5-year-old pediatric patient, what lab findings are anticipated?

Causes of metabolic alkalosis include all of the following EXCEPT:

During the treatment of diabetic ketoacidosis (DKA) in a pediatric patient, at what glucose level would you start a dextrose maintenance infusion?

Fluid loss in an already dehydrated patient will most critically increase serum levels of which of the following?

In a salicylate overdose, the primary acid-base disturbance is __________ followed by __________?

Myoglobinuria, if left untreated, will result in what critical condition?

Protracted vomiting typically results in what acid-base imbalance?

Regarding the diabetic ketoacidosis (DKA) patient, glucose should be decreased based on the following protocol?

Systemic inflammatory response syndrome (SIRS) can lead to multi-organ dysfunction.  Which of the following organs is involved first?

The main focus when treating a patient with disseminated intravascular coagulation (DIC) is to:

The primary treatment in reversing malignant hyperthermia is what medication?

The team is transporting a 2-year-old presenting with fever, hyperglycemia, and lethargy for the past three hours. Vital signs are as follows: BP 72/42, HR 146, and RR 32. Upon assessment, there is dry mucous membranes and capillary refill of 4 seconds. Current labs are: K⁺ 3.0 mEq/L, glucose 485 mg/dL. ABGs: pH 7.1, PaCO₂ 22, HCO3^– 17, PaO₂ 98. Which of the following types of fluids is most appropriate initially for this patient?

What is the best treatment choice in someone with diabetes insipidus (DI)?

What is the leading cause of neonatal sepsis?

What is the priority when treating respiratory acidosis?

When administering packed red blood cells, you can expect an approximate rise in hemoglobin (Hgb) and hematocrit (Hct) of __________ for each unit of blood?

When treating a pediatric patient with suspected diabetic ketoacidosis, what value can help differentiate the diagnosis of diabetic ketoacidosis (DKA) from a hyperosmolar hyperglycemic state (HHS)?

Which lab finding would be most indicative of diabetes insipidus?

Which of the following blood gas results would have you preparing to intubate and ventilate the multisystem trauma pediatric patient?

Which of the following is not a treatment strategy when dealing with rhabdomyolysis and myoglobinuria in the pediatric population?

Which of the following laboratory findings is expected in a patient with a diagnosis of syndrome of inappropriate anti-diuretic hormone (SIADH)?

You are transporting a 3-year-old, 15 kg patient involved in a motor vehicle collision (MVC) which is on a ventilator with the following settings: SIMV 20, V_t 60, FiO₂ 1.0, PEEP 5, PIP 22, P_plat 19. ABG results are: pH 7.01, PaCO₂ 70, HCO3^– 14, PaO₂ 280, BE -8.  What is the arterial blood gas interpretation?