Exam #3 part 2
A group of students are reviewing information about gallbladder disease in children. The students demonstrate a need for additional review when they state:
. cholesterol gallstones are more frequently found in males
After teaching the parents of a child diagnosed with celiac disease about nutrition, the nurse determines that the teaching was effective when the parents identify which foods as appropriate for their child? Select all answers that apply.
B)Peanut butter C)Carbonated drinks D)Shellfish E)Jelly Foods allowed in a gluten-free diet include peanut butter, carbonated drinks, shellfish, and jelly. Wheat germ and flavored yogurt should be avoided.
The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality?
Currant jelly-like
A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which finding?
Decreased platelets and leukocytosis
An 8-month-old infant is brought to the clinic for evaluation. The mother tells the nurse that she has noticed some white patches on the infant's tongue that look like curdled milk after breastfeeding. The nurse suspects oral candidiasis (thrush). Which question would the nurse use to help confirm this suspicion?
"Are you having breast pain when you nurse the baby?
1. Lower endoscopy, what will a nurse teach the patient?
- Bowel cleansing
1. Signs of moderate dehydration
- Decreased tears - Decreased cap refill - Decreased urine output - Sunken fontanels
1. S/S of UTI in children?
- Elevated temp
1. A nurse can see the urethra opening on the dorsal side of the penis. How would this be documented?
- Epispadias (on the top)
A NB has not passed meconium, what is the possible problem the NB may have?
- Imperforate anus: birth defect improperly developed anus or Hirschsprung Disease
1. Iv pyelogram (substance used in some DX procedures to help parts of the body show up better on x-rays or other imaging test), what needs to be done before the test?
- Makre sure the client is NOT allergic to shellfish or iodine
A child has periorbital edema, weight gain, not feeling well, and anorexia. What disease process does this child have
- Nephrotic Syndrome (fluid overload) - Labs: Proteinuria and BUN
1. Why are toddlers more prone to UTIs?
- Shorter urethra
1. What is the TX for hydrocele (fluid-filled sac in the scrotum)
- Should resolve spontaneously within one year
After teaching the parents of a 6-year-old how to administer an enema, the nurse determines that the teaching was successful when they state that they will give how much solution to their child?
500-1000 For a school-age child, typically 500 to 1,000 mL of enema solution is given. For an infant, 250 mL or less is used; for a toddler or preschooler, 250 to 500 mL is used.
The nurse is assessing a child with acute poststreptococcal glomerulonephritis. What would the nurse expect to assess? Select all that apply.
Abdominal pain Hypertension Crackles
A child is scheduled for a lower endoscopy. What would the nurse include in the child's plan of care in preparation for this test?
Administering the prescribed bowel cleansing regimen
What can be seen with several gastrointestinal disorders, such as inflammatory bowel disease.
Bloody stools
A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test?
Checking with the parents for any allergies
The nurse is caring for a client with hemolytic-uremic syndrome (HUS). The client is demonstrating oliguria. What does the nurse expect to find when reviewing the client's records?
Elevated BUN and creatinine levels
A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause?
Escherichia coli(E. coli)
The nurse is providing care to a child with celiac disease. What will the stool look like
Greasy stools
The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find?
Hard, moveable, olive-shaped mass in the right upper quadrant
The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents?
Having a wound, ostomy, and continence meet with them.
The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which response from the mother indicates a need for further teaching?
I should position him on his abdomen with knees bent."
The nurse is providing care to a child with pancreatitis. When reviewing the child's laboratory test results, what would the nurse expect to find? Select all that apply.
Leukocytosis ) Elevated serum amylase levels
A nurse is caring for a 14-year-old girl scheduled for a barium swallow/upper gastrointestinal (GI) series. Before providing instructions, what would be the priority?
Screening the girl for pregnancy.
. What is gastroschisis?
When the intestine is outside of the abdomen and has NO sac covering it
1. Which organism is found in a culture of a patient with a UTI?
e coli
Does circumcision put a child at risk for UTI?
no
Severe dehydration in a child
skin tenting, Dusky extremities hypotension.
Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?
sunken fontanels
A 15-year-old boy comes to the emergency department accompanied by his parents. The boy reports an abrupt onset of sudden pain on the right side of his scrotum. When asked to rate his pain on a scale of 1 to 10, with 10 being the most severe, the boy states, "It's a 12." Further assessment reveals a blue-black swelling on the affected side. The nurse suspects testicular torsion and immediately notifies the physician because:
the condition is a surgical emergency
While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate?
A girl's urethra is closer to the rectal opening"
The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find?
Decreased blood urea nitrogen (BUN)
When examining the abdomen of a child, which technique would the nurse use last?
Palpation.
1. 14-year-old boy has a sudden onset of pain in the scrotum. What is this an example of?
- Testicular torsion What will the client need? - surgery
The nurse is determining maintenance fluid requirements for a child who weighs 25 kg. How much fluid would the child need per day?
1600 mL Using the following formula of: 100 mL/kg for the first 10 kg 50 mL/kg for the next 10 kg 20 mL/kg for the remaining kg The child would require (100 × 10) + (50 × 10) + (20 × 5) = 1,000 + 500 + 100 = 1,600 mL in 24 hours.
1. What should a nurse teach a child about a renal U/S?
- Will not hurt - Cold jelly
1. How does infants vs. adults vary through insensible fluid loss and hoe their body compensates?
- infants are more prone to insensible fluid loss b/c thinner skin, body surface area, higher metabolic rate - Children have a proportionally higher body water - Fever in children: increases dehydration, have more fever with illnesses and maybe higher - Kidneys in children: renal immaturity does not allow the kidneys to concentrate urine
A nurse is conducting a physical examination of an infant and observes the urethral opening on the dorsal side of the penis. The nurse documents this finding as:
. epispadias
The nurse is preparing to administer intravenous fluids to manage a child with dehydration. The medical record indicates the child weighs 60 pounds (27.2 kg). How many milliliters will initially be administered? Record your answer using two decimal places.
545.45 Nursing goals for the infant or child with dehydration are aimed at restoring fluid volume and preventing progression to hypovolemia. Provide oral rehydration to children for mild to moderate states of dehydration. Children with severe dehydration should receive intravenous fluids. Initially, administer 20 mL/kg of normal saline or lactated Ringer, and then reassess the hydration status.
