Ch 27 -28 PEDS (FINALS❗️)
The nurse shows slides of red blood cells from a child with sickle cell disease, noting that in addition to their sickle shape, the cells contain the abnormal element of_______________
Hemoglobin S
A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?
Hemosiderosis
The nurse, assessing an elevated erythrocyte sedimentation rate (ESR) for an infant with gastroenteritis, recognizes that this confirms the ____________ process that is part of this disease
inflammatory
A 6-year-old with leukemia asks, "Who will take care of me in heaven?" What is the best response by the nurse?
"Who do you think will take care of you?"
Which statement by a mother may indicate a cause for her 9-month-old's iron deficiency anemia?
"Formula is so expensive. We switched to regular milk right away."
Which statement made by a parent alert the nurse to the need for additional education about poison prevention?
"I keep a bottle of syrup of ipecac handy"
Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?
"It is important for my child to drink plenty of fluids."
A child has been diagnosed with ascariasis (roundworm). Which statement made by her mother that may suggest a cause for her condition?
"My child often goes out to the garden and pulls up a carrot to eat."
The nurse finds an adolescent with Hodgkin's disease crying. The adolescent says, "I am so scared." What is the most appropriate nursing response to this comment?
"Tell me what's got you scared."
The nurse is caring for an 18 pound child who has had one stool of diarrhea. The nurse knows that the child needs to consume how many milliliters of oral fluid to make up for the fluid loss?
81
What is the treatment of choice for a child with intussusception?
A barium enema
Why are infants more vulnerable to fluid and electrolyte imbalance is than adults?
A greater percentage of body water in infants is extracellular
Parents ask the nurse how their infant developed a Meckel's diverticulum. What condition, will the nurse explain, is present causing this diagnosis?
A pouch forms when the vitelline duct fails to disappear.
A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. What acid-base imbalance would the nurse expect to occur from this persistent vomiting?
Alkalosis
Following surgery for pyloric stenosis, an infant awoke from anesthesia hungry and crying. What is the most appropriate nursing action?
Allow 1 ounce of glucose water at frequent intervals.
The nurse is speaking to the parent of a 3-year-old child who has mild diarrhea. What dietary modification would the nurse advise?
An oral rehydrating solution, such as Pedialyte
On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm3. What is the priority nursing intervention?
Assessing neurological status
What should be included in the nursing care of a 12 year old child receiving radiation therapy for Hodgkin's disease? (Select all that apply)
Application of sunblock Appetite stimulation Conservation of energy conservation Provision for expressions of anger
What will the nurse teach the parents of a child with a low platelet count to avoid?
Aspirin
What would the nurse expect to find in a child admitted to the hospital for non-organic failure to thrive?
Be limp like a rag doll
What does the nurse expect the appearance of the stools of a child with celiac disease to be?
Bulky, frothy
What interventions will the nurse perform when feeding a child with pyloric stenosis? (Select all that apply)
Burp the infant before and during feeding Give the feeding slowly Re-feed if the infant vomits
The nurse explains that because ____________ beverages cause diuresis, they are not good choices for fluid replacement in a child who is dehydrated
Caffeinated
To prevent ___________, the nurse warms the blood that is to be given as a transfusion through a central line
Cardiac arrhythmias
The nurse remind parents of a child allergic to cow's milk that they should avoid foods that list _________ as part of their contents
Casein
Which finding in a newborn is suggestive of tracheoesophageal fistula?
Choking on the first feeding
What is the result of a deficiency of factor IX?
Christmas disease
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse?
Clamp off blood and keep line open with normal saline.
What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?
Clean teeth with a soft toothbrush.
The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron?
Cream of Wheat
What description of a child's stool characteristic leads the nurse to suspect intussusception?
Currant jelly
The nurse explains that Rickets, a deficiency disease that causes bone deformities, is caused by the in adequate supply of vitamin________
D
A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease?
Each child has a one in four chance of having the disease and a two in four chance of being a carrier.
The nurse confirms that sickle cell trait can be distinguished from sickle cell disease by a lab test called_____________
Electrophoresis
A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated?
Heart failure
What important focus of nursing care for the dying child and the family should the nurse implement?
Families should be made aware that hearing is the last sense to stop functioning before death
What should the nurse closely assess in a child receiving a transfusion?
Fever
A child is brought into the ED with suspected appendicitis. What signs and symptoms does the nurse expect to assess? (Select all that apply)
Guarding Rebound tenderness Pain on lifting thigh when supine
What are the classic symptoms of thalassemia major (coolies anemia)? (Select all that apply)
Hepatomegaly Jaundice Protruding teeth Pathological fractures
Hernias are successfully repaired by the surgical operation called a______________
Herniorrhaphy
An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this?
III
A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?
If bleeding occurs, apply pressure, ice, elevate, and rest the extremity.
How has synthetic recombinant anti-hemophilic factor improved the management of hemophilia? (Select all that apply)
Illuminates the need for frequent transfusion Can be administered by family at home Reduce his cost of care of the hemophiliac Reduce his risk of HIV and hepatitis A and B transmission
A school age child is living with a chronic disease process how would the nurse anticipate chronic illness will affect growth and development? (Select all that apply)
Impaired sense of belonging Decreased the feelings of independence
A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow?
Increased susceptibility to infection
The nurse is presenting information on the congenital disorder of hemophilia A. What fact will the nurse include?
It is transmitted by symptom-free females.
What instruction will the nurse give to parents about preventing the spread and reinfection of pinworms?
Keep children's nails short.
An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCo2 40, HC03-21. how does the nurse interpret these values?
Metabolic acidosis
A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). What does the nurse expect this child to receive following gastric lavage?
N-acetylcysteine
The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?
Peripheral neuropathy
The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding? (Select all that apply)
Petichiae Purpura Ecchymosis Hematoma
A mother reports that her child has been scratching the anal area and complaining of itching. What does the nurse suspect based on this information?
Pinworms
The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?
Platelet count of 25,000/mm3
Which is the most appropriate intervention for a 3-month-old infant who has gastroesophageal reflux?
Position the infant in the crib on his or her abdomen, with the head elevated.
A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. What will be the nurses's priority goal of the infant's care?
Prevent fluid and electrolyte imbalance.
The nurse is interviewing parents of an infant with pyloric stenosis. What would the nurse expect the parents to report?
Projectile vomiting
The nurse is teaching a parent about pyrvinium (Povan). What would be included in regard to potential side effects?
Red stool
What assessment would lead a nurse to suspect hirschsprung's disease in a one month old infant? (Select all that apply)
Ribbon like stools Fever Failure to thrive Vomiting Diminished peristalsis
The nurse has reviewed it dietary restrictions for celiac disease with concerned parents. Which grain will the nurse explain can be eaten with celiac disease?
Rice
The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child?
Risk for infection
The nurse explains that medically excepted definition of constipation is fewer than ____________ bowel movements in a two week.
Seven
Why would the nurse orange the family of a dying 12-year-old boy to include his eight-year-old sister in Care? (Select all that apply
She will feel less neglected by the parents, She can make amends for past hostilities to her brother she can express her feelings through Care She can experience being supportive of her parents and brother
An infant is admitted to the hospital with severe isotonic dehydration. For what is this child at the highest risk?
Shock
A frightened mother calls the pediatrician's office because her child swallowed dishwashing detergent. What is the most appropriate action?
Take the child to the local emergency department.
Which nursing interventions will be implemented for the mother of a 10-month-old infant with nonorganic failure to thrive?
Teaching the mother about the developmental milestones to expect in the next few months
The nurse is dealing with a preschool-age child with a life-threatening illness. What should the nurse remember the child's concept of death is at this age?
That a person becomes alive again soon after death
Why are rapid respirations a possible cause of dehydration?
They cause evaporation of fluid on the mucous membranes.
Which assessment with the nurse report to the physician immediately?
Two month old with a urine output of 150 ML in 24 hours
The nurse is instructing a mother how to administer oral nice Staten suspension prescribe to treat thrush. What will the nurse include?
Use a sterile applicator to swab the medication on the oral mucosa
The family have a child receiving chemotherapy for leukemia should be taught to focus on which aspects of the child's care? (Select all that apply)
Using a support group Stimulating appetite Maintain an adequate hydration Reporting exposure to infectious diseases
A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing?
Vaso-occlusive
The nurse explains that the COPP medical regimen for the treatment of Hodgkin's disease uses a combination of which drugs? (Select all that apply)
Vincristine Cyclophosphamide Prednisone Procarbazine a hydrochloride
On the second day of hospitalization for a 3-month-old brought in for treatment for gastroenteritis, the nurse makes all of the assessments listed below. Which assessment finding indicates ineffectiveness of treatment?
Weight loss of 4 ounces
Parents have adopted a child with the diagnosis of Kwashiorkor. What is most likely to be observed when assessing this child? (Select all that apply)
White streak in hair Edematous abdomen Slowed growth
A mother reports that her 2-year-old child experiences constipation frequently. Which food would the nurse recommend to include in the child's diet?
Whole-grain cereal
What will the nurse administer with ferrous sulfate drops when providing them to a child on the pediatric unit?
With orange juice
What signs indicates moderate dehydration? (Select all that apply)
a. 10% weight loss b. Dry mucous membranes c. Normal anterior fontanel
The nurse is planning a parent education program about lead poisoning prevention. What will be included in regarding primary sources of lead in the community?
deteriorating paint in older buildings.
The rate of RBC production is regulated by
erythropoietin
Which statement by a mother may indicate a cause of her sons vitamin C deficiency?
we get our fruits from homemade preserves ( vitamin c is destroyed by heat)
