Cystic Fibrosis - evolve Case study (peds exam 1)

what response reflects that the nurse values the principle of beneficence?

" I know this has to be a very scary and difficult time for you. What can I do to help you?"

Based on her previous conversation with Pamela, what is the best response by the nurse?

"I will sit with your child so you and your wife can talk. We have a quiet room you can use that is private and close by."

Which actions should the nurse educator take to address this? SATA

- Instruct the parents to perform chest physiotherapy (CPT) either 2 hours before meals or 2 hours after meals - Aerosolized medications should be administered before CPT - encourage 'blowing' activities such as bubbles or pinwheels

Which documentation further supports the diagnosis of CF SATA

- a history of frequent respiratory infections - bulky, loose stools

If the child attends a daycare center, what should be shared with the daycare workers? SATA

- proper hand washing between care of the other children - isolate the child from any children with upper respiratory infections - correct techniques for performing chest physiotherapy

The nurse identified 'ineffective airway clearance related to excessive pulmonary secretions' as a nursing diagnosis in the child's plan of care. Which statement should the nurse record as the expected outcome for this nursing diagnosis

The child will be able to remove mucus from the airway by coughing

While discussing pancreatic enzymes, the CNS explains that the dosage of the pancreatic enzyme is adjusted according to stool formation, which indicates how well she is digesting her food Which adjustment would the nurse anticipate will be required if she has constipation?

The pancreatic enzymes would be increased with each meal and snack

What laboratory result warrants immediate intervention

WBC count is 20,000/mcL

Which assessment supports the diagnosis of CF

Weight loss and delayed growth despite a hearty appetite

The nurse is a preceptor for a student nurse from the local community college, the student nurse asks the preceptor, " I keep hearing about standards of care. What are standards of care?" Which is the best explanation for the nurse to provide to the student?

standards of care are published statements that describe the level of care that the client can expect from the nurses

Darla's pneumonia resolves. The nurse educator visits with Darla and her parents. The parents share that they are looking forward to a relaxing vacation at the beach this summer. They ask the nurse educator if any special precautions will be necessary for Darla. How should the CF nurse educator respond?

suggest that they add extra salt to Darla's diet and watch for her dehydration

The primary nurse, who is assigned to care for four clients, is working with an unlicensed assistive personnel (UAP) during the 7 pm to 7 am shift. What nursing task can be safely delegated to the UAP?

take vital signs

The CNS asks which immunizations the child has already received. Her mother has a copy of the immunization record and notices the child has not had a second MMR vaccine. The mother asks, 'when should the second MMR be given to her' What information provided by the nurse is correct?

the second immunization is given between ages 4 and 6 years of age

what information will the nurse include when teaching about the sweat test

it is a simple and reliable test that measures the chloride in sweat

Two days later, Darla's condition has improved, but she remains in the hospital for continued IV antibiotic therapy.The primary nurse reports to the charge nurse that the IV antibiotic prescribed for Darla was administered to another child and Darla received the other child's prescribed antibiotic. When the primary nurse realized the mistake, the IV antibiotic was discontinued immediately. Which action should the primary nurse implement first?

assess the client and the child who received the wrong medication

Which instruction should the nurse educator give the clients parents concerning the use of pancreatic enzymes as an oral prescription

ensure that enzymes are administered within 30 minutes of consuming meals and snacks

The primary nurse finds Darla and the play therapist in the therapy room working with fingerpaints, and the nurse is unsure whether she should interrupt to assess Darla's vital signs. She seeks advice from the charge nurse. What action should the charge nurse take?

explain that play therapy is an intervention and should not be interrupted for vital signs

The nurse recognizes that energy needs are increased as a result of malabsorption of nutrients and that extra effort is needed for respirations and frequent pulmonary infections. The nurse teaches the client's parents about pancreatic replacement enzymes. Which of the following statements made by the parents would indicate a correct understanding of the teaching?

pancreatic enzymes are needed to digest fats and proteins

Which action indicates to the nurse educator that the parents need more instruction about the respiratory care of the child with CF complications?

placing the child in a prone position when she is having a dyspneic episode

The nurse shares with the student nurse that the society of pediatric nurses standards of care includes primary, secondary, and tertiary nursing care prevention. the student nurse asks, "What type of care is given in secondary nursing care prevention?' Which statement by the nurse is correct?

" it is care such as the sweat test and DNA testing that the child received"

Which statement by the parents indicates a correct understanding of a proper nutritional protocol of a client with CF? SATA

- her diet should include more calories than an unaffected child - Darla should take vitamin A, D, E, and K supplementation along with her diet - her diet should consist of high fat, high protein, an unrestricted fats

The HCP prescribes gentamicin (Garamycin) 2.5 mg/kg every 8 hours IV to be infused over 30 minutes with a peak and trough at the second dose for treatment of pneumonia. The pharmacy sends 30 mg of the medication in a 50 ml bag of NS to be administered. At what rate should the nurse set the infusion pump? (Enter numerical value only. If rounding is necessary, round to the whole number.)

2.5x 12= 30 50 (amount in bag) x 60 (mins in an hour) = 3000 3000/30 (time given to be administered over)= 100

The CNS refers the parents to the local chapter of the Cystic Fibrosis foundation. Which rationale best supports this decision?

Community resources often provide support groups for parents of children with CF

One year after being discharged from the Children's Medical Center, Darla is brought to the emergency department (ED). Her father reports that Darla started coughing and choking and was unable to catch her breath. She had passed out briefly and he put her in the car and drove straight to the hospital. Darla is admitted into the emergency department. Which intervention should the nurse implement first

administer oxygen 4L/ min via high flow nasal cannula

What is the CNS's responsibility when discussing immunizations?

explain that the client should receive all routine childhood immunizations

The parents have been at the clients bedside since she was admitted to the hospital. The father asks to speak to the nurse outside in the hall. he tells the nurse that the mother is telling everyone that the client is going to be fine and that there has been a mistake and everything will be alright. What action should the nurse take first?

make arrangements to meet privately at the first opportunity