pediatric perfusion and PPH

A client in the intensive care unit is diagnosed with hypovolemic shock based on a blood pressure of 88/53 mm Hg, heart rate of 122 beats/min, respiratory rate of 26 breaths/min. Given these vital signs, what urine output should the nurse expect? Increased to 60+ mL/hr with dilute urine. Client's normal amount with dark, concentrated urine. Maintained between 30 to 50 mL/hour with no sediment in the bag. Decreased below 30 mL/hr with decrease glomerular filtration rate (GFR).

Decreased below 30 mL/hr with decrease glomerular filtration rate (GFR).

The nurse is collecting data on a 5-year-old child admitted with the diagnosis of congestive heart failure. Which clinical manifestation observed during the physical assessment would be consistent with this diagnosis? Scissoring of the legs with toes pointed down Jerking movements of the arms and legs Failure to gain weight Spooning of the finger nails

Failure to gain weight

A school nurse is caring for a child with a severe sore throat and fever. What is the nurse's best recommendation to the parent? Give acetaminophen for the fever and pain, and have the child rest. Have the child drink fluids that contain electrolytes. Have the child be seen by the primary care provider. Have the child go to the emergency room.

Have the child be seen by the primary care provider.

The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Fahrenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which complication? Atelectasis Osteomyelitis Hypovolemic shock Urinary retention

Hypovolemic shock

A nurse is caring for an infant who is in critical condition. The nurse notes that the child weighs 11 lb (5 kg) and has had a blood loss of 100 mL. Assessment reveals a decreased urine output, mild tachycardia, and restlessness. Which of the following should be the priority action for the nurse to take? IV administration of lactated Ringer's insertion of a Foley indwelling catheter application of telemetry monitoring neurologic assessment with the Glasgow Coma Scale

IV administration of lactated Ringer's

The parents of a 13-year-old boy with a sore throat for a week, vomiting for two days, swollen lymph glands, and stiff achy joints is now seeking antibiotic treatment after herbal remedies were unsuccessful. Throat cultures reveal infection with group A streptococci. This child is at high risk for development of which cardiac complicaton? Infective endocarditis Myocarditis Vasculitis Mitral valve stenosis

Mitral valve stenosis

A mother is asking for more information about her infant's patent ductus arteriosus (PDA). What would be included in the education? Your child may need multiple surgeries to correct this defect. An IV for fluids will be started immediately. This type of defect is caused by having a genetic predisposition for it. This is caused by an opening that usually closes by 1 week of age.

This is caused by an opening that usually closes by 1 week of age.

Which factor puts a client on her first postpartum day at risk for hemorrhage? moderate amount of lochia rubra thrombophlebitis uterine atony hemoglobin level of 12 g/dl

uterine atony

A client has come to the office for her first postpartum visit. On evaluating her blood work, the nurse would be concerned if the hematocrit is noted to have: slightly increased. acutely decreased. slightly decreased. acutely increased.

acutely decreased.

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? "To prevent another episode, she'll need preventive antibiotic therapy for at least 5 years." "We can stop the penicillin when her symptoms disappear." "She needs to take the drug for the full 14 days." "If she needs dental surgery, we might need additional medication."

"We can stop the penicillin when her symptoms disappear."

A nurse is providing care to a postpartum woman. The woman gave birth vaginally at 2 a.m. The nurse would anticipate the need to catheterize the client if she does not void by which time? 9:00 a.m. 7:45 a.m. 3:30 a.m. 5:15 a.m.

9:00 a.m.

In an acute care setting, the nurse is assessing an unstable client. When prioritizing the client's care, the nurse should recognize that the client is at risk for hypovolemic shock in which of the following circumstances? Blood pressure regulation becomes irregular. The client experiences tachycardia and a bounding pulse. Fluid volume circulating in the blood vessels decreases. There is an uncontrolled increase in cardiac output.

Fluid volume circulating in the blood vessels decreases.

The nurse is monitoring a client who has given birth and is now bonding with her infant. Which finding should the nurse prioritize and report immediately for intervention? The mother is unable to void after 4 hours. Placental separation 15 minutes after birth Maternal tachycardia and falling blood pressure Dark red lochia

Maternal tachycardia and falling blood pressure

A client arrives via ambulance with a suspected pelvic fracture from a motor vehicle collision. The client's vital signs are: blood pressure 85/50 mm Hg, heart rate 120 beats/min, respiratory rate 22 breaths/min, and an oxygen saturation of 98% on room air. The client is afebrile. The health care provider has written several prescriptions. What is the nurse's priority action? Send client to diagnostic imaging for pelvic x-ray. Obtain STAT hemoglobin and group and match. Administer 5 mg morphine intravenously. Draw blood cultures and white blood cell count.

Obtain STAT hemoglobin and group and match.

The nurse is caring for a 6-year-old with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority? Administer propranolol (0.1 mg/kg IV). Use a calm, comforting approach. Provide supplemental oxygen. Place the child in a knee-to-chest position.

Place the child in a knee-to-chest position.

The nurse is caring for a client who is developing hypovolemic shock from a duodenal ulcer bleed. What is the first intervention the nurse can provide to facilitate blood flow to the brain? Administer a crystalloid solution. Prepare the client for an endoscopy. Place the client in a modified Trendelenburg position. Test the client for blood in the stool.

Place the client in a modified Trendelenburg position.

A nurse is caring for a client with a new diagnosis of rheumatic fever. What is the highestpriority goal of treatment during the acute phase? Promote nutrition Prevent cardiac complications Reduce inflammation Eliminate the infection

Prevent cardiac complications

A child has been admitted to the inpatient unit to rule out acute Kawasaki disease. A series of laboratory tests have been ordered. Which findings are consistent with this disease? Select all that apply. Negative C reactive protein levels Elevated erythrocyte sedimentation rate (ESR) Reduced platelet levels Reduced white blood cell count Reduced hemoglobin levels

Reduced hemoglobin levels Elevated erythrocyte sedimentation rate (ESR)

A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant? Severe staphylococcal infection Croup Medullary sponge kidney Rheumatic fever

Rheumatic fever

A teenager is seen in the emergency room with reports of a sore throat, headache, fever, abdominal pain, and swollen glands. His mother tells the nurse that he was seen 3 weeks before in the clinic and treated with antibiotics for strep throat. He was better for a few days but now he seems to have gotten worse in the last 2 days. What should the nurse suspect is wrong with this client? Mononucleosis Meningitis Flu Rheumatic fever

Rheumatic fever

A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result would be most important for the nurse to monitor? Serum sodium level Oxygen saturation level Erythrocyte sedimentation rate Serum potassium level

Serum potassium level

A mother asks why her infant with a cyanotic heart defect turns blue. What is the nurse's best explanation? This is considered a medical emergency and the infant needs immediate surgery. This is due to a decreased amount of oxygen to the peripheral tissue. This is a sign of heart failure. This is due to the lack of oxygen to the brain.

This is due to a decreased amount of oxygen to the peripheral tissue.

Parents are told that their infant has a heart defect with a left-to-right shunt. What is the best way for the nurse to explain this type of shunting to the parents? This type of shunting causes a decrease of blood to the lungs. This type of shunting causes an increase of blood to the systemic circulation. This type of shunting causes an increase of blood to the lungs. This type of shunting causes a decrease of blood to the brain.

This type of shunting causes an increase of blood to the lungs.

Which assessment finding would be suggestive of adequate tissue perfusion in a client who has experienced a postpartum hemorrhage? Oxygen saturation of 94% Urinary output of 60 cc's over the last hour Cool, clammy skin Capillary refill of 4 seconds

Urinary output of 60 cc's over the last hour

The nurse in a rural nursing outpost will be receiving a client in hypovolemic shock due to a massive postpartum hemorrhage after her home birth. What principle should guide the nurse's administration of intravenous fluid? Whatever fluid is most readily available in the clinic should be given, due to the nature of the emergency Dextran should be given because it increases intravascular volume and counteracts coagulopathy Lactated Ringer's solution is ideal because it increases volume, buffers acidosis, and is the best choice for clients with liver failure 5% albumin is preferred because it is inexpensive and is always readily available

Whatever fluid is most readily available in the clinic should be given, due to the nature of the emergency

A 10-year-old child is admitted to the hospital with a temperature of 104°F (40°C) and is difficult to arouse. The child has history of Varicella two weeks ago. Reye's syndrome is suspected. Which objective data is supportive of the diagnosis? Select all that apply. coma an abnormal liver biopsy dysuria vomiting disorientation client states, "I have a headache."

an abnormal liver biopsy vomiting coma disorientation

Seven hours ago, a multigravida woman gave birth to a male infant weighing 4,133 g. She has voided once and calls for a nurse to check because she states that she feels "really wet" now. Upon examination, her perineal pad is saturated. The immediate nursing action is to: inspect the perineum for lacerations. assess and massage the fundus. increase the flow of an IV. call the primary care provider or the nurse-midwife.

assess and massage the fundus.