Pediatric Nursing Ch 25 PrepU

Place in correct order the steps in the anaphylactic response.

Exposure to allergen Rapid immune response Vasodilation Bronchoconstriction Circulatory collapse

The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant the child gets a rash. It just does not make sense to me." How should the nurse respond?

"Has your child ever been tested for a peanut allergy?"

The nurse is providing education to the parents of a child prescribed oral cyclophosphamide. Which statement by the parent indicates additional teaching is needed?

"I need to give this medication to my child at bedtime."

he nurse is providing education to the parents of a child prescribed oral cyclophosphamide. Which statement by the parent indicates additional teaching is needed?

"I need to give this medication to my child at bedtime."

The nurse is caring for a child with HIV currently taking zidovudine. Which statement by the parent would be the most concerning?

"Zidovudine decreases the chance my child will transmit HIV to others."

The nurse is providing family education about the administration of cyclosporine A. Which response by the family indicates a need for further teaching?

"The medication is best absorbed with the vitamin C in citrus juices."

The nurse is providing discharge teaching to the client with myasthenia gravis. Which statements by the parents of the client demonstrate knowledge of proper care? Select all that apply.

-"If my child shows signs of an upper respiratory infection I will contact our physician right away." -"We love to take family vacations to Florida, but we will have to find a new vacation spot." -"I picked up our child's medical alert bracelet today."

The nurse is reviewing the medical history of a 4-year-old child. What would the nurse identify as potentially indicative of a primary immunodeficiency? Select all that apply.

-Acute otitis media, one episode every 3 to 4 weeks over the past year. -Recurrent deep abscess of the thigh -Oral candidiasis (thrush), persistent over the past 6 to 7 months

The nurse is preparing to administer IVIG to an adolescent. Prior to administration, which baseline lab values does the nurse need to review? Select all that apply.

-BUN -Serum creatinine

A nurse is giving a talk to high school students about preventing the spread of human immunodeficiency virus (HIV). What does the nurse identify as ways in which HIV is spread? Select all that apply.

-Exposure to blood and body fluids through sexual contact -Sharing contaminated needles -Transfusion of contaminated blood -Perinatally from mother to fetus -Through breastfeeding

A nurse is providing care to a child who is HIV positive and prescribed IV zidovudine. Which nursing actions would be appropriate when administering the drug? Select all that apply.

-Infuse the drug over 60 minutes. -Monitor the child for paresthesias. -Give the drug in the morning and after lunch. -Reinforce use of meticulous handwashing.

While obtaining a health history on a 3-year-old child, the nurse finds what information a concern? Select all that apply.

-Parents report the child as an infant had failure to thrive. -Parents report the child has had recurrent bacterial infections. -Parents report the child didn't start walking until 1½ years old. -Parents report the child didn't sit up by herself until 9 months old.

The nurse is preparing an informational brochure about risk factors for immune disorders. Which disease process can indicate a potential underlying immunologic disorder? Select all that apply.

-Persistent oral thrush -Chronic cough -Extensive eczema

The nurse is caring for an infant exposed to HIV. The polymerase chain reaction (PCR) test was negative at birth. The nurse tells the mother that the child should be tested again at what age?

4 to 7 weeks

The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate?

Contact the health care provider to request treatment.

Which nursing action is most appropriate when caring for a child with positive serum IgE antibodies, a white blood cell count of 6,000/mm3, and 10% eosinophils? :

Obtain a careful health history

The nurse is instructing a group of women of childbearing age about human immunodeficiency virus (HIV) during pregnancy. What would be a priority recommendation in this setting?

Screening for HIV

A 6-month-old boy has been admitted to the hospital with severe bloody diarrhea. The nurse notes petechiae and eczema with signs of secondary infection. As the nurse documents the boy's history, the parents report easy bruising and prolonged bleeding after circumcision. Based on these findings, the nurse suspects a diagnosis of:

Wiskott-Aldrich syndrome.

A child is diagnosed with severe combined immunodeficiency syndrome. What would the nurse expect to find when reviewing the child's history and physical examination? You Selected:

chronic diarrhea

The nurse is assessing a child who is experiencing renal complications as a result of lupus. Which finding is of greatest concern?

elevated blood pressure

The nurse is caring for a child with juvenile idiopathic arthritis (JIA). There is involvement of five or more small joints and it is affecting the body symmetrically. This tells the nurse that the child:

has polyarticular JIA.

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens.

humoral; bacterial

The nurse is caring for a child with HIV. The doctor will most likely order which test to monitor the child's progress?

lymphocyte immunophenotyping T-cell quantification

The nurse is preparing to administer intravenous immunoglobulin (IVIG) for a child who has not had an IVIG infusion in over 10 weeks. The nurse knows to first:

premedicate with acetaminophen or diphenhydramine.

The nurse is providing education to a 16-year-old who has recently been diagnosed with myasthenia gravis. Which statement(s) by the adolescent indicates an understanding of the information provided? Select all that apply.

-"It is important I avoid triggers." -"Getting a flu shot will be important." -"I am going to incorporate a short nap into my daily routine."

The nurse is assisting with skin testing on a pediatric client with allergies. What will the nurse do first?

Ensure the child has not taken diphenhydramine in the past week. Correct response:

A child will receive IV immunoglobulin (IVIG). The nurse assesses the child every 15 minutes for the first hour of infusion for symptoms of anaphylaxis. Which symptom(s) would indicate to the nurse that anaphylaxis is occurring? Select all that apply.

-The child's face is flushed. -The child's temperature begins to elevate. -The child appears increasingly anxious. -Inspiratory wheezes are heard on auscultation.