pedi Ch 28
The nurse is preparing to admit a 3-year-old child with acute spasmodic laryngitis. What clinical features of hepatitis B should the nurse recognize? (Select all that apply.)
Croupy cough Tendency to recur Occurs sudden, often at night
An infant has been diagnosed with staphylococcal pneumonia. Nursing care of the child with pneumonia includes which intervention?
Administration of antibiotics
The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. What statement by the parent indicates a correct understanding of the teaching?
"I can use an ice collar on my child for pain control along with analgesics."
A school-age child has asthma. The nurse should teach the child that if a peak expiratory flow rate is in the yellow zone, this means that the asthma control is what?
50% to 79% of a personal best and needs an increase in the usual therapy.
A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests what condition?
Asthma
A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?
Before chest physiotherapy (CPT)
Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39° C (102.2° F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication?
Benzocaine ear drops for topical pain relief
The nurse is preparing to admit a 7-year-old child with pulmonary edema. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Diaphoresis Pink frothy sputum Respiratory crackles
In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind?
Diet should be high in calories, proteins, and unrestricted fats
A 5-year-old child is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process?
Fever, cough, and chest pain
A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition?
Foreign body in the nose
A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true?
May cause voice alterations
Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF?
Mechanical obstruction caused by increased viscosity of mucous gland secretions
What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)?
Meconium ileus
A school-age child with cystic fibrosis takes four enzyme capsules with meals. The child is having four or five bowel movements per day. The nurse's action in regard to the pancreatic enzymes is based on the knowledge that the dosage is what?
Needs to be increased to decrease the number of bowel movements per day
The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these signs and symptoms are suggestive of what condition?
Pneumothorax
An infant with a congenital heart defect is to receive a dose of palivizumab (Synagis). What is the purpose of this?
Prevent RSV infection .
The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6° F). The nurse suspects mild croup and should recommend which intervention?
Provide fluids that the child likes and use comfort measures.
What do the initial signs of respiratory syncytial virus (RSV) infection in an infant include?
Rhinorrhea, wheezing, and fever
The nurse is caring for a newborn with suspected congenital diaphragmatic hernia. What of the following findings would the nurse expect to observe? (Select all that apply.)
Scaphoid abdomen Mediastinal shift Moderate respiratory distress
What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?
Short-acting B2 agonists
What tests aid in the diagnosis of cystic fibrosis (CF)?
Sweat test, stool for fat, chest radiography
A 3-month-old infant is admitted to the pediatric unit for treatment of bronchiolitis. The infant's vital signs are T, 101.6° F; P, 106 beats/min apical; and R, 70 breaths/min. The infant is irritable and fussy and coughs frequently. IV fluids are given via a peripheral venipuncture. Fluids by mouth were initially contraindicated for what reason?
Tachypnea
A child has a streptococcal throat infection and is being treated with antibiotics. What should the nurse teach the parents to prevent infection of others?
The child can return to school after taking antibiotics for 24 hours.
Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections?
They are safer
What statement is the most descriptive of asthma?
There is heightened airway reactivity
A child with asthma is having pulmonary function tests. What rationale explains the purpose of the peak expiratory flow rate?
To assess severity of asthma
The nurse is interpreting a tuberculin skin test. If the nurse finds a result of an induration 5 mm or larger, in which child should the nurse document this finding as positive? (Select all that apply.)
A child receiving immunosuppressive therapy A child with a human immunodeficiency virus (HIV) infection A child living in close contact with a known contagious case of tuberculosis
The clinic nurse is administering influenza vaccinations. Which children should not receive the live attenuated influenza vaccine (LAIV)? (Select all that apply.)
A child with asthma A child with diabetes A child with cancer receiving chemotherapy
A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup?
A cool mist vaporizer at the bedside can help prevent this type of croup.
Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms?
A feeling of fullness in the ear
It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition?
Acute rheumatic fever
An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent?
Administer all of the prescribed medication
What condition is the leading cause of chronic illness in children?
Asthma
An infant's parents ask the nurse about preventing otitis media (OM). What information should be provided?
Avoid tobacco smoke
The nurse is preparing to admit a 7-year-old child with acute laryngotracheobronchitis (LTB). What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Brassy cough Low-grade fever Slowly progressive
What consideration is most important in managing tuberculosis (TB) in children?
Chemotherapy
The nurse is preparing a staff education program about pediatric asthma. What concepts should the nurse include when discussing the asthma severity classification system? (Select all that apply.)
Children with mild persistent asthma have signs or symptoms more than two times per week. Children with moderate persistent asthma have some limitations with normal activity. Children with severe persistent asthma have frequent nighttime signs or symptoms.
A tonsillectomy or adenoidectomy is contraindicated in what conditions? (Select all that apply.)
Cleft palate Blood dyscrasias Acute infection at the time of surgery
What statement best represents infectious mononucleosis?
Clinical signs and symptoms and blood tests are both needed to establish the diagnosis.
What medication is contraindicated in children post tonsillectomy and adenoidectomy?
Codeine
The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate what condition?
Complete obstruction
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?
Contact precautions
A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action?
Continue to assess for bleeding
What interventions can the nurse teach parents to do to ease respiratory efforts for a child with a mild respiratory tract infection? (Select all that apply.)
Cool mist Warm mist Steam vaporizer Run a shower of hot water to produce steam
Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which information?
Do not use for more than 3 days
A 3-year-old is brought to the emergency department with symptoms of stridor, fever, restlessness, and drooling. No coughing is observed. Based on these findings, the nurse should be prepared to assist with what action?
Emergency intubation
A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal?
Encourage the child to blow a pinwheel every 6 hours while awake.
A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)?
Greater than 60 mEq/L
A term infant is delivered, and before delivery, the medical team was notified that a congenital diaphragmatic hernia (CDH) was diagnosed on ultrasonography. What should be done immediately at birth if respiratory distress is noted?
Intubate the infant
A child is diagnosed with active pulmonary tuberculosis. What medications does the nurse anticipate to be prescribed for the first 2 months? (Select all that apply.)
Isoniazid (INH) Rifampin (Rifadin) Pyrazinamide (PZA) Ethambutol (Myambutol)
A 6-year-old child is in the hospital for status asthmaticus. Nursing care during this acute period includes which prescribed interventions?
Methylprednisolone (Solumedrol) IV every 12 hours, continuous pulse oximetry, albuterol nebulizer treatments every 4 hours and PRN
The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this child's care?
Monitor arterial blood gases
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. What nursing action should be included in the care of the child?
Monitor pulse oximetry
The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The child's SaO2 saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take?
Notify the health care provider
A 4-year-old girl is brought to the emergency department. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner?
Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.
Pancreatic enzymes are administered to the child with cystic fibrosis. What nursing consideration should be included in the plan of care?
Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
A child is in the hospital for cystic fibrosis. What health care provider's prescription should the nurse clarify before implementing?
Pancreatic enzymes every 6 hours
A child is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which?
Racemic epinephrine and corticosteroids
One of the goals for children with asthma is to maintain the child's normal functioning. What principle of treatment helps to accomplish this goal?
Reduce underlying inflammation
The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition?
Shows signs of an earache
What diagnostic test for allergies involves the injection of specific allergens?
Skin testing
Children who are taking long-term inhaled steroids should be assessed frequently for what potential complication?
Slowed growth
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action?
The mother's presence will reduce anxiety and ease the child's respiratory efforts.
A 3-year-old child is experiencing pain after a tonsillectomy. The child has not taken in any fluids and does not want to drink anything, saying, "My tummy hurts." The following health care prescriptions are available: acetaminophen (Tylenol) PO (orally) or PR (rectally) PRN, ice chips, clear liquids. What should the nurse implement to relieve the child's pain?
Tylenol PR
A family requires home care teaching with regard to preventative measures to use at home to avoid an asthmatic episode. What strategy should the nurse teach?
Use an indoor air purifier with HEPA filter
When caring for a child after a tonsillectomy, what intervention should the nurse do?
Watch for continuous swallowing
A 1-year-old child has acute otitis media (AOM) and is being treated with oral antibiotics. What should the nurse include in the discharge teaching to the infant's parents?
A follow-up visit should be done after all medicine has been given.
