CPN Procedures Practice Questions (70 Flashcards)

Per 2026 guidelines, for patients weighing 2.1–12.7 kg, the recommended volume is 3–5 mL per culture bottle. Sensitivity increases with volume; however, total blood volume removed must not exceed 1%–5% of the patient's total blood volume within 24 hours. **CPN Tip:** The PNCB emphasizes weight-based volumes rather than a standard 10mL adult dose. If only one bottle is drawn, it should be the aerobic bottle, as most pediatric pathogens are aerobic.

Air trapping (obstructive emphysema) on the affected side. Rationale: A foreign body often creates a ball-valve effect where air enters during inspiration but cannot exit during expiration. On an expiratory film, the affected lung remains hyperinflated (radiolucent) while the healthy lung deflates. Exam Tip: PNCB emphasizes that a normal CXR does NOT rule out FBA. Look for asymmetrical air trapping as the key radiographic indicator.

This is an early sign of compensated hypovolemic shock, likely from internal bleeding. Children maintain blood pressure through intense vasoconstriction and tachycardia until they have lost ~25-30% of their circulating volume. Tachycardia is the most sensitive early indicator of distress post-procedure. Immediate assessment of the site and distal pulses is required.

Double chemotherapy-rated gloves and a non-permeable, lint-free gown are required even for oral administration or when handling hazardous medications (splitting/crushing). If a liquid form is unavailable and a tablet must be crushed, it must be done within a plastic bag or a negative-pressure hood to prevent aerosolization. Rationale: Significant toxicity can occur via skin absorption or inhalation of powder. PNCB focuses on Standard Precautions for Hazardous Drugs regardless of the route (IV, oral, or topical). Always educate parents on using gloves for home administration.

Buck Traction: Skin traction used for short-term immobilization (e.g., pre-op for hip/femur) with the leg in a straight line. Russell Traction: Uses a sling under the knee to provide a vertical lift, allowing for hip and knee flexion. This provides more pull and better alignment for femur fractures. PNCB Tip: Russell traction involves two lines of pull (horizontal and vertical), whereas Buck is simpler and unidirectional.