Nursing Care of Children
A toddler is getting the MMR (measles, mumps, rubella) immunization. What statement by the parent is correct about relieving some of the toddlers pain?
"I can give my child acetaminophen for discomfort associated with the immunization"
A nurse is teaching parents of a 4 month old who has GERD. which of the following statements by the parent indicates an understanding of the teaching?
"I will add 1 teaspoon of rice cereal per ounce to my baby's formula" -the parents can give thickened feedings with rice cereal to help decrease the reflux.
A nurse is teaching parents of a 10 year old child who has iron deficiency anemia. What indicates understanding by the parents for how to take the medication?
"I will administer the iron tablet with orange juice" -intake of citrus juices with the iron will increase the iron's absorption.
A nurse is providing postoperative teaching for the parent of a 3-month old infant who is recovering from an umbilical hernia repair. Which of the following statements by the parent indicates and understanding of the teaching? "I will expect the site to bulge when my baby cries." "I will place a belly band around my child's abdomen." "I will fold my baby's diaper away from the incision." "I will bathe my child in the bath tub daily."
"I will fold my baby's diaper away from the incision." MY ANSWER To prevent infection, the parent should be able to verbalize and demonstrate proper folding of the diaper to protect the surgical incision from contamination.
A nurse in the ED is caring for a 12 year old who has ingested bleach. what statement by the nurse indicates understanding of this ingestion?
"Injury by a corrosive liquid is more extensive than by a corrosive soild"
A nurse is teaching the parents of a child who has rheumatic fever. Which of the following statements by a parent indicates an understanding of the teaching?
"My child may take aspirin for his joint pain."Children who have rheumatic fever might take salicylates (aspirin) to control the inflammatory process that occurs in the joints. "My child will need a blood transfusion prior to discharge."A child who has rheumatic fever does not require blood transfusions, because the child does not have blood loss from this disorder. "I will need to wear a gown when in my child's room."A child who has rheumatic fever only needs standard isolation precautions because rheumatic fever is an immune response that occurs after an infection with group A β-hemolytic streptococci. "I will apply lotion to my child's peeling hands."Kawasaki disease causes peeling hands and rheumatic fever does not.
A child who has cerebral palsy. The nurse should teach what?
"Your child will need a botulinum toxin A injection to help with muscle spasticity"
A nurse is teaching the parents of a child who has Cerebral Palsy. Which of the following statements should the nurse make? "Your child will be unable to eat by mouth." "Your child will be unable to participate in recreational activities." "Your child will need a botulinum toxin A injection to help with muscle spasticity." "Your child will need throw rugs placed over non-carpeted areas."
"Your child will need a botulinum toxin A injection to help with muscle spasticity." MY ANSWER Children who have cerebral palsy have spasticity in their muscles. The child can receive botulinum toxin type A injections into affected muscles, which aid in reducing the spasticity.
A nurse is teaching the parents of an infant who has congenital hypothyroidism. Which of the following statements should the nurse make? "Your child will need to take estrogen daily when she reaches puberty." "Your child will need monthly blood coagulation studies." "Your child will need surgery to remove the diseased thyroid." "Your child will need to take thyroid hormone replacement for her entire life."
"Your child will need to take thyroid hormone replacement for her entire life." MY ANSWER In congenital hypothyroidism, the child does not manufacture an adequate amount of thyroid hormone to maintain the appropriate metabolic rate. The child will require life-long thyroid hormonal replacement for normal growth and development.
A nurse is teaching the parent of a 12 month old infant about nutrition. Which of the following statements by the parent indicates a need for further teaching?
"my infant drinks at least 2 quarts of skim milk each day" -As the infant transitions into toddler hood, whole milk intake should average 24 to 30 oz per day. Too much milk can affect intake of solid foods and result in iron deficiency anemia. Skim milk is not recommended until after age 2.
What is a good answer to a parent saying "why does my child's abdomen stick out?" "You should give your child a stool softener daily." "Toddlers gain weight at a rapid pace." "You should have your child assessed for a spinal deformity." "Toddlers do not have well-developed abdominal muscles."
"toddlers do not have well-developed abdominal muscles"
(MMR) is given when?
12-15 months of age
A nurse is performing a physical assessment on a 6 month old infant. What reflex should the nurse expect to find?
Babinski -elicited by stroking the bottom of the foot and causing the toes to fan and the big tow to dorsiflex.
A nurse is admitting a child who has acute lymphocytic leukemia. Which lab value should the nurse expect?
RBC 2.5 million/uL -a child with acute lyphocytic leukemia has a low RBC
Overdose on acetaminphen. What should the nurse prepare to give? Digoxin immune fab Acetylcysteine Naloxone Vitamin K
Acetylcysteine Acetylcysteine is the antidote for acetaminophen overdose or poisoning.
A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has a current blood glucose level of 250 mg/dL. What action should the nurse take?
Administer 5% dextrose in 0.9% sodium chloride by continuous IV infusion. -When BG is 250-300. -Goal is to maintain BG between 120-240. -If dextrose is not added, hypoglycemia might occur.
A 4 month old has otitis media and a fever of 101 F. What medication should be given?
Amoxicillin
A nurse is caring for a child who has epistaxis. Which of the following actions should the nurse take?
Apply continuous pressure to the child's nose for at least 10 mins
A nurse is caring for a child who has Tetralogy of Fallot. Which lab value should the nurse expect to find? Platelet count of 20,000/mm3 WBC 4,000/mm3 Thyroid stimulating hormone 7.0 microunits/mL RBC 6.8 million/uL
RBC 6.8 million/uL -a child who has Tetralogy of Fallot causes cyanosis; therefore, the body responds by increasing RBC production in an attempt to supply oxygen to all body parts.
A nurse is caring for a child who has acute glomerulonephritis. What action should the nurse take?
Check the child's blood pressure every 4 hours -to monitor for hypertension
What food is the most common food allergy in children?
Cow's milk
A nurse is caring for a toddler who has asthma. The parents are concerned about the toddler's reaction to the hospitalization. Which of the following actions should the nurse take to decrease the child's Anxiety? Provide privacy. Give the child a thorough explanation before providing care. Encourage rooming-in. Tell the child you will help fix her.
Encourage rooming-in. MY ANSWER Rooming-in is the most effective means of providing emotional support for a toddler. The family's presence provides a sense of security that increases the child's ability to cope in an unfamiliar environment.
A 3 year old child had a blood lead level of 3 mcg/dL. When teaching the parents about the correlation of nutrition with lead poisoning, what information is appropriate for the nurse to include?
Ensure the child's dietary intake of calcium and iron is adequate. -to reduce the absorption and effects of the lead.
A nurse is caring for an 8 year old who has sickle cell anemia. What action should the nurse take to help with hydration.
Give the child flavored popsicles -maintaining hydration with a child who has sickle cell anemia is important to prevent sickling
Which immunization should a nurse give to a 2 month old infant.?
Haemophilus influenzae type (B) and polio virus (IPV)
What should the nurse report to the provider about a 5 month old infant during a well-child visit?
Head lags when pulled from a lying to sitting position. -At the age 5 months, the infant should have no head lag when pulled to a sitting position.
A nurse is assessing a 9 month old infant during a well-child visit. What finding indicates that the infant has developmental delay?
Inability to vocalize vowel sounds -the infant should begin vocalizing vowel sounds at the age of 7 months, and by the age of 10 months, be able to say at least one word
What is a toddlers action during separation anxiety stage of despair?
Inactive and thumb sucking -a child who is thumb sucking and refusing to eat or drink is displaying manifestation of the second stage of separation anxiety which is despair
An 18 year old patient is moving into the dorms. What immunization should he get prior to moving into campus dormitory?
Meningococcal polysaccharide -To prevent infection by certain groups of meningococcal bacteria.
A nurse is caring for a 2 day old infant who has a myelomeningocele. What action should the nurse take?
Monitor the infant's head circumference. -infants who have myelomeningocele have an increased risk for hydrocephalus.
Not smoking around a child can prevent what type of infection?
Otitis media ear infections
A nurse is caring for a child who has an exacerbation of cystic fibrosis. Which of the following laboratory findings should the nurse report to the provider immediately? Blood glucose 140 mg/dL Oxygen saturation 85% RBC 3.2 million/uL Serum sodium 156 mEq/L
Oxygen saturation 85% Having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. An alteration in any of these can indicate a threat to life, and is therefore the nurse's priority concern. When applying the ABC priority-setting framework, airway is always the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second-highest priority in the ABC priority setting framework because adequate ventilatory effort is essential in order for oxygen exchange to occur. Circulation is the third-highest priority,
A nurse is caring for a 6 month old who has intussusception. What action should the nurse take? Prepare to administer high-dose steroids. Give the child magnesium hydroxide PO. Prepare the child for a barium enema. Educate the parents that the child will need a colostomy.
Prepare the child for a barium enema. -might force the bowel to resume a normal configuration.
A nurse is caring for a child who has suspected nephrotic syndrome. What lab value should the nurse expect?
Serum cholesterol 700 mg/dL -A child who has nephrotic syndrome will have high serum cholesterol findings because of the increase in plasma lipids
A nurse is caring for a 4 year old child who has superficial partial-thickness burns over 50% of his body. When planning for the nutritional needs of the child, which of the following actions should the nurse plan to take? Administer pancrelipase to the child prior to each meal. Supplement the child's feedings with enteral feedings. Provide the child with a low-protein meal. Perform dressing changes 10 min prior to the child's meals
Supplement the child's feedings with enteral feedings. A child who has burns in excess of 25% of total body surface area requires enteral supplementation to consume enough calories to heal.
vesicular rash can be from what condition?
Varicella
A Nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements should the nurse make? "If you take too much insulin, drink a sugar-free cola." "You will need to decrease your insulin dosage when you become a teenager." "You can use a vial of insulin for up to 30 days." "Stop taking your insulin if you are vomiting."
You can use a vial of insulin for up to 30 days." The child can use an opened vial of insulin for 28 to 30 days stored at room temperature or in the refrigerator.
A nurse is preparing a school-age child for a tonsillectomy. Which of the following actions should the nurse take? a. Schedule the child for a preoperative visit to the facility. b. Inform the child she will be put to sleep during the procedure. c. Read the child a story about a cartoon character having a similar operation. d. Tell the child the appointment is to have her throat checked.
a. Schedule the child for a preoperative visit to the facility. A preoperative visit to the facility allows the child to observe perioperative processes. This education helps the child feel at ease prior to the surgical procedure.
TDaP- tetanus, diphtheria, and acellular pertussis is given when?
administered at 11-12 years of age
DTap - Diphtheria, tetanus, and pertussis should be given when?
between 4-6 years
A nurse is planning care for a 6 year old child who is receiving chemotherapy. The child has a platelet count of 20,000. what intervention should the nurse include in the plan of care? Provide foods high in iron. Avoid people who have infections. Administer PRN oxygen. Encourage quiet play.
encourage quiet play -will lessen the client's risk for injury, thereby reducing the chance of hemorrhage.
Live attenuated Influenza vaccine is given when?
is not administered to children under 2 years of age
bee stings symptoms of anaphylaxis? Bradycardia Nausea Hypertension Urticaria Stridor
nausea urticaria stridor
Vaircella (VAR) is given when?
not administered to children younger than 12 months
by 30 months the birth weight should have?
quadrupled
When do you give adult tetanus booster?
recommended for wound prophylaxis in children 7 and older. And every 10 years after 18 years of age
Hepatitis A is given when?
series is started at 12 months old
Human papilomavirus (HPV) is given when?
series is started at age 11
A nurse is caring for infants who have congenital heart defects. For which of following defects should the nurse expect to observe cyanosis?
transposition of great arteries -will have severe cyanosis because of the anatomic position of the aorta and pulmonary artery allows venous blood to enter the systemic circulation without oxygenation.
by 12 months the birth weight should have?
tripled
