Knapp CH 1: Bronchiolitis and CH2: Asthma

a nurse is teachign parents of an infant with bronchiolitis how to bulb suction. which statement should be included a. feed the infant 20 minutes prior to stuctioning b. place the infant in a head down position c. suciton as often as the infant seems to need it d. repeat the suctioning process several times until most of the mucus is removed

D

in preparation for discharge, the nurse teaches the mother of an infant diagnosed with bronchiolitis about the condition and its treatment. which statement by the mother indicates successful teaching a.i need to be sure to take my childs temperature every day b. i hope i do not get a cold from my child c. next time my child gets a cold i need to listen to his chest d. i need to wash my hands more often

D

2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation? A. Reverse isolation B. Airborne isolation C. Contact Precautions D. Standard Precautions

ANS: C RSV is transmitted through droplets. In addition to Standard Precautions and hand washing, Contact Precautions are required. Caregivers must use gloves and gowns when entering the room. Care is taken not to touch their own eyes or mucous membranes with a contaminated gloved hand. Children are placed in a private room or in a room with other children with RSV infections. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other children need to be protected from exposure to the virus. The virus is not airborne.

4. What is a common trigger for asthma attacks in children? A. Febrile episodes B. Dehydration C. Exercise D. Seizures

ANS: C Exercise is one of the most common triggers for asthma attacks, particularly in school-age children. Febrile episodes are consistent with other problems, for example, seizures. Dehydration occurs as a result of diarrhea; it does not trigger asthma attacks. Viral infections are triggers for asthma. Seizures can result from a too-rapid intravenous infusion of theophyllinea therapy for asthma.

a nurse is explaning bronchioltis to the parents of an infant admitted with the condition. which is the best information for the nurse to provide a. it is a seasonal viral illness that causes inflammation and obstruction of the small airways b. causes decreased mucus secretion which causes air trapping and lobular collapse c. affects premature infants because they lack surfactant d. caused by a bacteria that causes epithelial necrosis and damage to the cilia

A

the nurse is planning care for an infant with bronchiolitis who requires monitoring for dehydration. what is the most important intervention for the nurse to provide a. daily weight b. blood levels every 4 hours c. urinalysis every 8 hours d. weighing each diaper

A

Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV)? a. Activity Intolerance b. Decreased Cardiac Output c. Pain, Acute d. Tissue Perfusion, Ineffective (peripheral)

A Activity intolerance is a problem because of the imbalance between oxygen supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this respiratory-disease process.

3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration This suggests what condition? A. Asthma B. Pneumonia C. Bronchiolitis D. Foreign body in trachea

A Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset, fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stridor.

6.Following parental teaching, the nurse is evaluating the parents understanding of environmental control for their childs asthma management. Which statement by the parents indicates appropriate understanding of the teaching? A. We will replace the carpet in our childs bedroom with tile. B. Were glad the dog can continue to sleep in our childs room. C. Well be sure to use the fireplace often to keep the house warm in the winter. D. Well keep the plants in our childs room dusted.

ANS 1 Control of dust in the childs bedroom is an important aspect of environmental control for asthma management. When possible, pets and plants should not be kept in the home. Smoke from fireplacesshould be eliminated.

Parents of a child admitted with respiratory distress are concerned because the child wont lie down and wants to sit in a chair leaning forward. Which response by the nurse is the most appropriate? A. This helps the child feel in control of his situation. B. The child needs to be encouraged to lie flat in bed. C. This position helps keep the airway open. D. This confirms the child has asthma.

ANS C Leaning forward helps keep the airway open. The child is not in control justbecause he is leaning forward. Lying flat in bed will increase the respiratory distress. Thisposition does not confirm asthma.

The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding suggests that the childs condition is worsening? A. Hypoventilation B. Thirst C. Bradycardia D. Clubbing

ANS: A The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability, and increased heart and respiratory rate. As the child tires from the increased work of breathing hypoventilation occurs leading to increased carbon dioxide levels. The nurse would be alert for signs of hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sign of hypoxia; tachycardia is. Clubbing develops over a period of months in response to hypoxia. The presence of clubbing does not indicate the childs condition is worsening.

1. Which finding is expected when assessing a child hospitalized for asthma? a. Inspiratory stridor b. Harsh, barky cough c. Wheezing d. Rhinorrhea

ANS: C Wheezing is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of croup. A harsh, barky cough is characteristic of croup. Rhinorrhea is not associated with asthma.

Which intervention is appropriate for the infant hospitalized with bronchiolitis? A. Position on the side with neck slightly flexed. B. Administer antibiotics as ordered. C. Restrict oral and parenteral fluids if tachypneic. D. Give cool, humidified oxygen.

ANS: D Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree angle and the neck slightly extended to maintain an open airway and decrease pressure on the diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a secondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is tachypneic, fluids are given parenterally to prevent dehydration.

5.The practitioner changes the medications for the child with asthma to salmeterol (Serevent). The mother asks the nurse what this drug will do. The nurse explains that salmeterol (Serevent) is used to treat asthma because the drug produces which characteristic? A. Decreases inflammation B. Decreases mucous production C. Controls allergic rhinitis D. Dilates the bronchioles

ANS: D Rationale: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating. Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines control allergic rhinitis.

3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes these symptoms are characteristic of which respiratory condition? A. Allergic rhinitis B. Bronchitis C. Asthma D. Sinusitis

ANS: D Sinusitis is characterized by signs and symptoms of a cold that do not improve after 14 days, a low-grade fever, nasal congestion and purulent nasal discharge, headache, tenderness, a feeling of fullness over the affected sinuses, halitosis, and a cough that increases when the child is lying down.The classic symptoms of allergic rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and palate, and sneezing. Symptoms occur as long as the child is exposed to the allergen. Bronchitis is characterized by a gradual onset of rhinitis and a cough that is initially nonproductive but may change to a loose cough. The manifestations of asthma may vary, with wheezing being a classic sign. The symptomspresented in the question do not suggest asthma.

the nurse is planning care for an infant with bronchiolitis. what is the nurses priority intervention for this child a. position the infant with the head elevated b. monitor intake and output c. assess respiratory status frequently d. incorporate parents into the childs care

C

the nurse is teaching home care to the parents of a child with bronchiolitis. what is the most important information for the nurse to provide a. place the child in a prone position for comfort b. use warm mist to replace insensible fluid loss c. recognize the signs of increasing respiratory distress d. engage the child in many activities to prevent developmental delay

C

An infant is being treated at home for bronchiolitis. what should the nurse teach the parent about home care. select all that apply a. offering small amounts of fluids frequently b. allowing the infant to sleep prone c. calling the clinic if the infant vomits d. writing down how much the infant drinks e. performing chest physiotherapy every 4 hours f. watching for difficulty breathing

a. offering small amounts of fluids frequently f. watching for difficulty breathing

the nurse is caring for a 7mo with bronchiolitis. which symptoms would the nurse expect to find during his assessment. select all that apply a. wheezing b. rr of 46 c. HR of 128 d. RR of 68 e. hr of 82 f. poor feeding

a. wheezing c. HR of 128 d. RR of 68 f. poor feeding

the nurse in the ER is caring for a toddler with dx of bronchiolitis. which sign/symptom should this nurse anticipate during his assessment. select all that apply a. heart rate of 157 b. temp of 101.8 c. subcostal retractions d. poor feeding e. diarrhea

c. subcostal retractions d. poor feeding