maternity chapter 26, 27, 28 & 29

What is the classic symptom of idiopathic (immunological) thrombocytopenia purpura (ITP)?

bruising

What is a characteristic manifestation of Hodgkin's disease?

enlarged lymph nodes

Prevention of rheumatic fever can best be accomplished by:

having sore throats cultured as soon as possible.

The pathologic disturbance of pyloric stenosis results from:

hypertrophy of the pyloric muscle

The administration of prednisone to children with nephrosis creates the problem of:

increased risk of infection

What will the nurse administer with ferrous sulfate drops when providng them to a child on the pediatric unit?

orange juice

What is the approximate bladder capacity of a 4-year-old child?

6 oz Bladder capacity for child is Age + 2

How are pinworms diagnosed?

A "Scotch tape test" in the early morning

What does the nurse expect the appearance of the stools of a child with celiac disease to be?

Bulky, frothy

Which finding in a newborn is suggestive of tracheoesphageal 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 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 monitor for in a child receiving a transfusion?

Fever

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

A child is admitted to the hospital with dehydration. The physician orders potassium to be added to the child's IV. What is the nurse's priority assessment?

Genitourinary status

A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated?

Heart failure

A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?

Hemosiderosis

A newborn does not pass meconium within the first 48 hours after birth. Which diagnosis does the nurse suspect?

Hirschsprung's disease

A child who has had heart surgery returns to the pediatric unit with a chest tube and drainage bottles in place. What is a priority nursing responsibility when caring for a child with chest tubes?

Keep the drainage bottles below the chest level at all times.

What are the priority nursing actions when administering Diuril (chlorothiazide) to a child diagnosed with congestive heart failure (CHF)?

Monitor serum electrolytes and daily weight

Which is the earliest sign of esophageal atresia?

Mother develops unexplained polyhydramnios.

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

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 (Mucomyst)

The nurse caring for a child receiving chemotherapy, notes that the child's abdomen is firm and lightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?

Peripheral neuropathy

Which term is a narrowing of the preputial opening of the foreskin, which prevents the foreskin from being retracted over the penis.

Phimosis

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

A 7 month old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. What will be the nurse's priority goal of the infant's care

Prevent fluid and electrolyte imbalances

What clinical manifestation is most suggestive of pyloric stenosis?

Projectile vomiting

The nurse is interviewing parents of an infant with pyloric stenosis. What would the nurse expect the parents to report?

Projectile vomitting

When administering digoxin (Lanoxin) to an infant, the medication should be withheld and the health care provider notified if the:

Pulse rate is below 100 beats/min

The nurse is caring for a child receiving digoxin (Lanoxin) for the diagnosis of heart failure. Which manifestation does the nurse recognize as a cardinal sign of digoxin toxicity?

Sudden change in pulse

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 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

Which disorder causes unoxygenated blood to enter the systemic arterial circulation?

Tetralogy of Fallot

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

Which observation indicates that an infant with congestive heart failure (CHF) is carefully following the prescribed medical regimen?

The child exhibits normal weight for age.

What should the nurse include when educating parents regarding care of their child following a lymphangiogram?

The skin and urine may take on a bluish color.

Why are rapid respirations a possible cause of dehydration?

They cause evaporation of fluid on the mucous membranes

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

What may be included in the treatment of salicylate poisoning?

Vitamin K

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

Daily weights are obtained in children with nephrosis to monitor:

changes in the amount of edema

What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?

clean teeth with a soft toothbrush

Which menu selections are best for a child diagnosed with celiac disease?

corn tortilla and fresh fruit

What instruction will the nurse give to parents about preventing the spread and reinfection of pinworms?

keep children's nails short

An infant with tetralogy of Fallot is experiencing a tet spell involving cyanosis and dyspnea. In which position should the infant be placed?

knee chest

What is the most common form of childhood cancer?

leukemia

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?

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

A child who is in a vasoocclusive crisis caused by sickle cell anemia is experiencing acute pain. The nurse understands that Demerol (meperidine) is not an appropriate pain medication to administer to this child because it:

may induce seizures

Thalassemia major (Cooley's anemia) is treated primarily with:

multiple blood transfusion

A priority nursing responsibility in the care of a child with Wilms' tumor is to

omit abdominal palpation during daily assessments.

The nurse is assessing a child admitted with possible Kawasaki disease. A characteristic sign or symptom that the nurse should observe and document would be:

peeling skin on fingers

Which is the most appropriate intervention for a 3 month old infant who has gastroesophageal reflux (GERD)

position the infant in the crib on their abdomen, with head elevated

An infant is admitted to the hospital with severe isotonic dehydration. For what is this child at highest risk?

Shock

When the patient experiences apprehension and urticaria while receiving a blood transfusion, the nurse:

stops the transfusion, allows normal saline solution to run slowly, and notifies the charge nurse.

The nurse understands that genitourinary surgery affects growth and development. When caring for a 4-year-old child postoperatively, a priority nursing responsibility would include:

strategies to preserve the child's body image

Between which two ages does the highest incidence of iron-deficiency anemia occur?

9 and 24 months

An 8-year-old boy diagnosed with hemophilia presents at the emergency department with hemarthrosis from a fall on the school playground. What would be included when following a traditional approach to care? (Select all that apply.)

"RICE" Rest Elevation Ice Compression

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 2 in 4 chance of being a carrier

Which symptoms are indicative of rheumatic fever (RF)? (Select all that apply.)

- Abdominal pain - Migratory polyarthritis - Chorea

The nurse is teaching a parent about pyrvinium (Povan). What would be included in regard to potential side effects?

Red stool

Which diagnosis often accompanies cryptorchidism?

Inguinal hernia

A 2½-year-old child is being discharged after a hypospadias repair. Which of the following cautions should the nurse include in the post-op instructions for parents? Select all that apply.

- Avoid straddling the infant on the hip. - Avoid tricycle riding as a play activity.

What is included in preventive teaching for urinary tract infections (UTIs) in girls? (Select all that apply.)

- Avoiding bubble baths - Wiping front to back - Encouraging fluids

The nurse is recording the vital signs of an infant admitted with signs of respiratory distress. Which of the following observations should be reported to the health care provider?

- Blood pressure is lower in the legs than in the arms - Cyanosis of the lips

Which are characteristics of sickle cell anemia? (Select all that apply.)

- Clinical symptoms present around 1 year of life - Chronic anemia - Pale and tires easily - Potentially fatal crises can occur

Which signs indicate congenital cardiac problems? (Select all that apply.)

- Clubbing of fingers - Tachypnea - Pulsations in neck vein - Dyspnea

What signs and symptoms would alert the nurse to the possibility of intussusception? (Select all that apply.)

- Onset is sudden - Kicking and drawing of legs - Bile stained vomit - Currant jelly stools

Which of the following orders written for a child admitted with a diagnosis of sickle cell anemia should the nurse question? Select all that apply.

- Restrict fluids - Administer meperidine (Demerol)

Which defects are associated with tetralogy of Fallot? (Select all that apply.)

- Ventricular septal defect - Dextroposition of the aorta - Pulmonary artery stenosis - Hypertrophy of the right ventricle

The nurse is monitoring a 2-year-old child for signs of dehydration. Which of the following techniques of monitoring body temperature is appropriate? Select all that apply.

- axillary - tympanic - temporal artery

The nurse is caring for a child diagnosed with nephrosis. Symptoms that are characteristic of nephrosis include which of the following? Select all that apply.

- massive proteinurea - edema

Which organism is the most common cause of urinary tract infections in children?

Escherichia coli

What is the treatment of choice for a child with intussusception?

A barium enema

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

What are the stages of dying as detailed by Kubler-Ross (1975)? (Select all that apply.)

Anger Acceptance Bargaining Denial Depression

Which diagnostic test is a standardized diagnostic test for rheumatic fever?

Antistreptolysin O titer

What will the nurse teach the parents of a child with a low platelet count to avoid?

Aspirin

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

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

A child is admitted to the emergency department with suspected intussusception. What significant assessment supports this diagnosis?

Currant jelly stools

What description of a child's stool characteristic leads the nurse to suspect intussusception?

Currant jelly stools

What is the name of the condition in which the urinary meatus is located on the underside of the penis?

Hypospadias

A 16-year-old boy enters the emergency department reporting acute scrotal pain. He is diagnosed with testicular torsion. What treatment for this condition will the nurse expect?

Immediate surgery

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

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

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

The nurse is caring for a 5-year-old child with leukemia admitted to the hospital with the primary diagnosis of pneumonia. What does the nurse suspect as most likely cause of this child's pneumonia?

Neutropenia

A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?

RICE If bleeding occurs, apply pressure, ice, elevation, and rest the extremity

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

Which principle should the nurse teach the parent concerning administering liquid iron preparations to the child with iron-deficiency anemia?

administer between meals

Priority teaching for the parent of a child who has ingested a foreign body includes:

slicing each stool passed to observe for the foreign body.

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?

stage 3