Ch 4 Respiratory disorders lz peds exam 3

Which statement by the parents of a toddler with repeated otitis media indicates they need additional teaching?

"My child will have fewer ear infections if he has his tonsils removed."

Which child is at highest risk for requiring hospitalization to treat respiratory syncytial virus (RSV)?

1. A 2-month-old who was born at 32 weeks.

Which should the nurse instruct children to do to stop the spread of influenza in the classroom?

3. Wash their hands after sneezing.

48. What should be the nurse's first action with a child who has a high fever, dysphagia, drooling, tachycardia, and tachypnea?

4. Lateral neck radiographs..

Which should be included in instructions to the parent of a child prescribed amoxicillin to treat an ear infection?

3. "Administer the amoxicillin until all the medication is gone."

Which child diagnosed with pneumonia would benefit most from hospitalization?

3. 15-year-old who has been vomiting for 3 days and has a fever of 38.5°C (101.3°F).

Which is diagnostic for epiglottitis?

3. Lateral neck x-ray of the soft tissue.

Which information will be most helpful in teaching parents about the primary prevention of foreign body aspiration?

3. Most common objects that toddlers aspirate.

28. Who is at the highest priority to receive the flu vaccine?.

A healthy 8-month-old who attends day care.

A 7-month-old has a low-grade fever, nasal congestion, and a mild cough. What should the nursing care management of this child include?

Instilling saline nose drops and bulb suctioning.

How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)? The values indicate the child is

Not compliant with taking her enzymes.

The parent of an infant with cystic fibrosis (CF) asks the nurse how to meet the child's increased nutritional needs. Which is the nurse's best suggestion?

"You may need to change your child to a higher-calorie formula."

Which breathing exercises should the nurse have an asthmatic 3-year-old child do to increase her expiratory phase?

3. Blowing a pinwheel

38. A parent asks the nurse how it will be determined if their child has respiratory syncytial virus (RSV). Which is the nurse's best response?

3. "We will swab your child's nose and send that specimen for testing."

The parent of a child with cystic fibrosis (CF) is excited about the possibility of the child receiving a double lung transplant. What should the parent understand?

The transplant will not cure the child of CF but will allow the child to have a longer life.

24. A parent asks how to care for a child at home who has the diagnosis of viral tonsillitis. Which is the nurse's best response?

"You can give your child Tylenol every 4 to 6 hours as needed for pain."

How will a child with respiratory distress and stridor and who is diagnosed with RSV be treated?

3. Nebulized racemic epinephrine.

Which would the nurse explain to parents about the inheritance of cystic fibrosis?

The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.

Which child would benefit most from having ear tubes placed?

A 2-year-old who has had five previous ear infections.

Which position would be most comfortable for a child with left-sided pneumonia?

Left side.

An infant is not sleeping well, crying frequently, has yellow drainage from the ear, and is diagnosed with an ear infection. Which nursing objective is the priority for the family?

Providing pain relief for the child.

A school-age child is admitted to the hospital for a tonsillectomy. During the nurse's post-operative assessment, the child's parent tells the nurse that the child is in pain. Which of the following observations would be of most concern to the nurse?

The child is swallowing excessively.

The nurse is reviewing discharge instructions with the parents of a child who had a tonsillectomy 24 hours ago. The parents tell the nurse that the child is a big eater, and they want to know what foods to give the child for the next 24 hours. What is the nurse's best response?

"The child's diet should be restricted to soft foods."

Which is the nurse's best response to parents who ask what impact asthma will have on the child's future in sports?

"The earlier a child is diagnosed with asthma, the more significant the symptoms."

What is the most important piece of information that the nurse must ask the parent of a child in status asthmaticus?

"When was your child's last dose of medication?"

What does the therapeutic management of cystic fibrosis (CF) patients include? Select all that apply.

*Providing a high-protein, high-calorie diet. *Encouraging exercise *Minimizing pulmonary complication. *Encouraging medication compliance.

Which would be an early sign of respiratory distress in a 2-month-old?

2. Tachypnea.

Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath?

3. Albuterol.

Which statement by the parent of a child using an albuterol inhaler leads the nurse to believe that further education is needed on how to administer the medication?

1. "I should administer two quick puffs of the albuterol inhaler using a spacer."

Which statement indicates the parent needs further teaching on how to prevent his other children from contracting respiratory syncytial virus (RSV)?

1. "I should make sure that both my children receive Synagis (palivizumab) injections for the remainder of this year."

The parent of a child with influenza asks the nurse when the child is most infectious. Which is the nurse's best response?

1. "Twenty-four hours before and after the onset of symptoms."

Which is the nurse's best response to the parent of a child diagnosed with epiglottitis who asks what the treatment will be?

1. Complete a course of intravenous antibiotics.

What would the nurse advise the parent of a child with a barky cough that gets worse at night?

1. Take the child outside into the more humid night air for 15 minutes.

30. A 6-week-old is admitted to the hospital with influenza. The child is crying, and the father tells the nurse that his son is hungry. The nurse explains that the baby is not to have anything by mouth. The parent does not understand why the child cannot eat. Which is the nurse's best response to the parent?

2. "The shorter and narrower airway of infants increases their chances of aspiration so your child should not have anything to eat now."

The parent of a child with frequent ear infections asks the nurse if there is anything that can be done to help avoid future ear infections. Which is the nurse's best response?

2. "Your child should be kept away from tobacco smoke."

Which child is in the greatest need of emergency medical treatment?

2. 6-year-old who has high fever, no spontaneous cough, and frog-like croaking.

Which laboratory result will provide the most important information regarding the respiratory status of a child with an acute asthma exacerbation?

2. ABG.

A 3-year-old is brought to the ER with coughing and gagging. The parent reports that the child was eating carrots when she began to gag. Which diagnostic evaluation will be used to determine if the child has aspirated carrots?

2. Bronchoscopy.

Which statement about pneumonia is accurate?

2. Children with bacterial pneumonia are usually sicker than children with viral pneumonia.

The parents of a 6-year-old who has a new diagnosis of asthma ask the nurse what to do to make their home a more allergy-free environment. Which is the nurse's best response?

4. "Avoid purchasing upholstered furniture."

6. A 2-year-old has just been diagnosed with cystic fibrosis (CF). The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse's best response?

4. "You can expect your child to develop wheezing respirations."

Which intervention is most appropriate to teach the mother of a child diagnosed with a URI and a dry hacking cough that prevents him from sleeping?

4. Give 1/2 teaspoon of honey four to five times per day.

Which physical findings would be of most concern in an infant with respiratory distress?

4. Grunting.

The parents of a 5-week-old have just been told that their child has cystic fibrosis (CF). The mother had a sister who died of CF when she was 19 years of age. The parents are sad and ask the nurse about the current projected life expectancy. What is the nurse's best response?

4. The nurse answers their questions briefly, listens to their concerns, and is available later after they've processed the information.

Which child with asthma should the nurse see first?

A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%.

The parent of a child with croup tells the nurse that her other child just had croup and it cleared up in a couple of days without intervention. She asks the nurse why this child is exhibiting worse symptoms and needs to be hospitalized. Which is the nurse's best response?

Children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed."

Which is the nurse's best response to the parent of an infant diagnosed with the first otitis media who wonders about long-term effects?

The child could suffer recurrent ear infections."

The parent of a 4-month-old with cystic fibrosis (CF) asks the nurse what time to begin the child's first chest physiotherapy (CPT) each day. Which is the nurse's best response?

Thirty minutes before feeding the child breakfast.

A child with severe cerebral palsy is admitted to the hospital with aspiration pneumo- nia. What is the most beneficial educational information that the nurse can provide to the parents?

The prevention of aspiration pneumonia.

A 5-year-old is brought to the ER with a temperature of 99.5°F (37.5°C), a barky cough, stridor, and hoarseness. Which nursing intervention should the nurse prepare for?

2. Respiratory treatment of racemic epinephrine.

Which assessment is of greatest concern in a 15-month-old?

2. The child is in the tripod position, has diminished breath sounds, and a muffled cough.

A parent asks the nurse what will need to be done to relieve the constipation of her child who also has cystic fibrosis (CF). Which is the nurse's best response?

3. "Your child will likely be given MiraLAX."

Which is the nurse's best response to a parent who asks what can be done at home to help a child with upper respiratory infection (URI) symptoms and a fever get better?

1. "Give your child small amounts of fluid every hour to prevent dehydration."

A mother is crying and tells the nurse that she should have brought her son in yesterday when he said his throat was sore. Which is the nurse's best response to this parent whose child is diagnosed with epiglottitis and is in severe distress and in need of intubation?

4. "Epiglottitis is rapidly progressive; you could not have predicted his symptoms would worsen so quickly."