Pncb Acute Care Exam Questions & Answers Latest

A child presents after a fall from a high ladder, awake and interactive with an initial Glasgow Coma Score (GCS) of 15. However, shortly after admission, the child's GCS acutely declines to 8. Which is the MOST likely diagnosis? A. Diffuse axonal injury B. Epidural hematoma C. Intraventricular hemorrhage D. Subdural hematoma {Ans: B. Epidural hematoma (The typical presentation includes an initial lucid interval but then rapid deterioration occurs as the size of the intracranial hemorrhage enlarges. Headaches with nuchal rigidity & vomiting can also be seen. Diffuse axonal injury usually occurs with motor vehicle collision in which there are rapid acceleration or deceleration forces causing shear trauma. Subdural hematomas are most commonly seen in younger children, especially those who suffer non-accidental trauma. Intraventricular hemorrhage (IVH) is seen in premature infants related to spontaneous bleeding of immature and fragile blood vessels in the subependymal germinal matrix of the premature brain. Presentation is often nonspecific and subtle, with IVH not typically seen after trauma.)}A 3 day old with a lactate of 7 mg/dL is suspected of having an inborn error of metabolism. Concurrently with stabilization of cardiovascular and respiratory functions, which of the following interventions should be the FIRST priority?