OB/Peds Chapter 29
An 8 year old is hospitalized with pneumonia related to cystic fibrosis. What nursing assignment would be best so that a trusting relationship can be established with the child?
It would be best to have one nurse assigned to the patient as much as possible.
The nurse is working with a group of caregivers of children in a community setting. The topic of hospitalization and the effects of hospitalization on the child are being discussed. Which statement made by the caregivers supports the most effective way for children to be educated about hospitals?
"We are going to take our child to an open house at the hospital so she can see the pediatric unit."
The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. What would be the best teaching method for this child and his family?
Provide a trial period of home care.
The nurse is preparing a 4-year-old girl for a lumbar puncture. The child is extremely fearful and crying. The nurse needs to quickly gain the child's cooperation so the procedure can move forward as ordered. Which approach by the nurse should be used?
Engage the mother in therapeutic hugging.
The nurse is admitting a 14-year-old girl for a tonsillectomy and is preparing her for the procedure. Which of the following is the best statement or question?
"Are you wondering about anything related to your tonsillectomy?"
The nurse is caring for a preschooler who requires postsurgical breathing exercises. Which approach will best elicit the child's cooperation?
"Let's see who can blow these cotton balls off the table first."
A 10 year old is scheduled for an appendectomy in 6 hours. The child is placed on NPO status and wants to know why he cannot have anything to eat or drink. What is the best explanation by the nurse?
"We cannot give you anything to eat or drink before your procedure because we do not want you to get an upset stomach."
Which patient does the nurse understand would be the best candidate for patient-controlled analgesia (PCA)?
A 7 year old who understands that when the button is pushed he will get medication to help relieve pain
A 5 month old is hospitalized for dehydration. What can the nurse make with items found on the unit for an activity to distract the child?
A mobile using gauze and tongue blades
The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client?
Determine how much the child knows and is capable of understanding.
The nurse is caring for a technology-dependent school-age child in his home. Which action best builds a trusting relationship?
Discussing care and treatment with the parent and child together
The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. What would be the best intervention?
Enlist the aid of a child life specialist.
The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which would be a priority intervention to help satisfy this preschool child's basic needs?
Explain necessary procedures in simple language that she will understand.
The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the priority nursing intervention?
Explain to the boy that he must keep his leg very still.
A nurse is admitting a 7-year-old to the pediatric unit of the hospital. While the nurse is showing the child and parents the room and explaining where things are, the child becomes upset and frightened. What is the best action by the nurse?
Go slowly with the acquaintance process.
For the nurse to avoid the transmission of microorganisms, what is the best method of prevention?
Hand washing
The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which behaviors of the child would alert the nurse that he is in the second stage of separation anxiety?
He sits quietly and is uninterested in playing and eating.
A nurse is admitting a 7 year old to the hospital. The child's parents will be unable to stay with him. What can the nurse do to help the child meet his developmental, emotional, and intellectual needs?
Make a referral to the child-life program.
The toddler needs elbow restraints to keep his hands away from a facial wound. What will the nurse do to best ensure their safe use?
Remove one restraint at a time on a regular basis to check for skin irritation.
The nurse is providing home care for a 4-year-old girl with a chronic respiratory illness. What would be a case management activity?
Scheduling intravenous and respiratory therapy services needed by the child
After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify what as a characteristic of therapeutic play?
Use of a highly structured format
A 6-year-old needs to cough and deep breathe following surgery. To accomplish this, the nurse will:
blow a pinwheel and bubbles with the child.
The nurse who wishes to be as supportive as possible to the hospitalized preschooler makes great effort to avoid threatening the 4-year-old's:
body integrity.
A nurse asks a 5 year old to use a color scale during a pain assessment. The nurse gives the child crayons and the child picks a red crayon to indicate the pain level. This indicates that the child is experiencing which level of pain?
most pain
A 5-year-old whose mother is rooming-in during the child's hospitalization will feel more:
secure.
The nurse is talking with the parents of a hospitalized child who has three siblings at home being cared for by the grandparents. The main idea the nurse wants the parents to understand is that siblings may experience:
stress equal to that of the affected child.
A nurse getting ready to conduct preoperative teaching with a 9-year-old realizes that the best method when teaching young clients is to:
use short sessions.
A nurse caring for a 5-year-old who had abdominal surgery yesterday is trying to teach the child how to take deep breaths. The best way that the nurse can accomplish this is by:
using a pinwheel.
Which of the following is the best technique for preventing the spread of infection in hospitalized patients?
washing hands between each patient
The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which measures might the nurse consider when caring for this child?
• Avoid leaving small objects that can be swallowed in the bed. • Encourage parents to stay to prevent separation anxiety.
An adolescent would benefit from being out of his hospital room. What can the nurse do to promote this?
• Challenge the adolescent to a video game in the recreation area. • Invite the adolescent to meet with other teens for lunch in a common space.
The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which actions would help reduce her stress related to the procedure?
• Introduce her to the health care personnel. • Teach her the steps of the procedure. • Pretend to perform the procedure on her doll.
Microorganisms are sometimes spread by what is called a vehicle. Of the following, which would fit into this category of transmission?
• Microorganisms spread by food • Microorganisms spread by water • Microorganisms spread by blood
The nurse is performing an admission of a 10-year-old boy. Which actions will help the nurse establish a trusting and caring relationship with the child and his family?
• The nurse should initiate introductions. • The nurse should maintain eye contact at the appropriate level. • The nurse should use age-appropriate communication with the child.
An Indian-American 18 month-old patient is anemic. The nurse is aware that this patient's family is vegetarian. What action should the nurse take?
Provide the parents with iron-rich foods taken from vegetarian sources.
The nurse is ordered to apply restraints to a toddler who keeps pulling at the tubes in his arm. Which criteria must occur to ensure proper use of these restraints?
• Use a clove-hitch type of knot to secure the restraints with ties. • Remove the restraint every 2 hours to allow for range of motion and repositioning. • Encourage parent participation, providing continuous explanations about the reasons and time frame for restraints.
A nurse working with a 7-year-old who has had a hernia repair realizes that discharge planning starts at what point?
Immediately upon admission
The nurse is caring for a 6-year-old child following abdominal surgery. Of the following nursing interventions, which is the highest priority?
The nurse uses pain assessment tools.
The nurse referring a child to home care discusses the advantages and disadvantages with the child's family. What are disadvantages of this method of health care?
• The nurse is performing care of the child in the family's home. • The out-of-pocket cost of home care is more expensive. • The technical procedures may be overwhelming for the family. • The financial burden may cause more stress for the family.
A 6-year-old will be hospitalized for a surgical procedure. How can the nurse best ease the stress of hospitalization for this child?
Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.
The nurse is caring for a 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child?
Provide age-appropriate toys and games.
A nurse is preparing to start an intravenous (IV) line on a 5-year-old. Where does the nurse understand the procedure should be performed so that the child's "safe place" will not be disrupted?
The treatment room
A nurse is caring for a child on transmission-based precautions. What interventions can the nurse provide to prevent the child from feeling socially isolated?
• Arrange to spend extra time in the room when performing treatments and procedures. • Encourage family members to spend time with the child and help them with maintaining precautions. • Make sure the child understands the isolation precautions are not a punishment.
When a child is hospitalized and must be away from the caregiver, the child goes through stages of response to the separation. The child who cries and refuses to let the nurse or anyone else comfort them and is continually looking out the door to see if the caregiver is returning is in which stage of separation?
Protest
A nurse is using a doll to explain what will be done when starting an intravenous (IV) line on a 4-year-old. What type of play is this?
Therapeutic play
An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate?
Providing detailed explanations of the procedure at least a week in advance of the procedure
The nurse is providing home care for an 8-year-old girl who is dependent on a ventilator, and for her family. What is a part of case management for the child and family?
Scheduling respite care of the child with a child care provider
A nurse realizes that a child's hospitalization is stressful for the family for which reasons?
• Cause of the illness • The illness's treatment • Guilt about the illness • Past experiences of illness and hospitalizations • Disruption in family life
A 6-year-old with leukemia is placed on reverse isolation. What nursing actions could prevent depression and loneliness in this client?
• Play a game while in the room. • Spend extra time to talk while in the room. • Read a story while in the room.
The nurse is caring for a 10-year-old child admitted for a surgical procedure to be done the next day. The nurse takes the child to a special area in the playroom and lets the child "start" an IV on a stuffed bear. This is an example of:
therapeutic play.
A pediatric nurse caring for an 8 year old who is having pain would use which of the following scales to assess the child's pain?
FACES scale
A nurse is preparing to administer an intravenous (IV) medication to a child but the child is in the playroom in the pediatric unit. What is the best action by the nurse?
The nurse should request that the child come with the nurse to the treatment room to have the medication administered.
The nurse is preparing a nursing care plan for a child hospitalized for cardiac surgery. Which are examples of interventions that nurses perform in the "building a trusting relationship" stage?
• Preparing the child for a procedure by playing games • Explaining in simple terms what will happen during surgery
The nurse is preparing a postsurgical care plan for an infant girl located on a general hospital unit that only occasionally admits children. To ensure the infant's safety, what should the nurse include in the plan?
Place the infant in a room close to the nurses' station.
What is the primary purpose for rooming-in on pediatric units?
Providing security and stability
Development should continue during hospitalization. What play activities will the nurse choose for toddlers to accomplish this?
• Stacking blocks • Pulling a toy train • Putting together a large-piece puzzle
The nurse is caring for a child who has been hospitalized for six days and whose caregivers are unable to stay with the child. The child cried most of the day for the first three days but now is quiet and seems to be accepting the hospitalization and being away from the caregivers. This behavior in the child is an example of which stage of separation?
Despair