Peds 3

After the nurse explains dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching?

"Our child must maintain these dietary restrictions for life."

The parent of a child with glomerulonephritis asks the nurse why the urine is such a funny color. Which is the nurse's best response?

"There is blood in your child's urine that causes it to be tea-colored."

The parents of a child being evaluated for appendicitis tell the nurse the physician said their child has a positive Rovsing sign. They ask the nurse what this means. Select the nurse's best response.

. "A positive Rovsing sign means the child feels pain in the right side of the abdomen when theLEFT SIDE is palpated."

Which should be included in the plan of care for a 14-month-old whose cleft palate was repaired 12 hours ago? Select all that apply.

1. Allow the infant to have familiar items of comfort such as a favorite stuffed animal and a "sippy" cup. . 3. Administer pain medication on a regular schedule, as opposed to an as-needed schedule.

Which causes the clinical manifestations of hydronephrosis? 1. A structural abnormality in the urinary system causes urine to back up and can cause pressure and cell death. 2. A structural abnormality causes urine to flow too freely through the urinary system, leading to fluid and electrolyte imbalances. 3. Decreased production of urine in one or both kidneys results in an electrolyte imbalance. 4. Urine with an abnormal electrolyte balance and concentration leads to increased blood pressure and subsequent increased glomerular filtration rate.

1.A structural abnormality in the urinary system causes urine to back up and can

A child with minimal change nephrotic syndrome (MCNS) has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony promi- nences. The child has been receiving Lasix twice daily for several days. Which does the nurse expect to be included in the treatment plan to reduce edema? 1. An increase in the amount and frequency of Lasix. 2. Addition of a second diuretic, such as mannitol. 3. Administration of intravenous albumin. 4. Elimination of all fluids and sodium from the child's diet.

3. Administration of intravenous albumin.

Which clinical manifestation would most suggest acute appendicitis?

Abdominal pain that is most intense at McBurney's point

A child is diagnosed with a Wims Tumor. Which nursing action is most appropriate prior to surgery?

Careful bathing and handling

After 12 hours of labor, a G1P1 mother has just given birth to an infant with omphalocele. Which action should the nurse take first?

Cover the abdominal organs with a non-adherent sterile dressing.

Which description of a stool is characteristic of intussusseption?

Current jelly stools

The postoperative care plan for an infant with surgical repair of a cleft lip includes

Elbow restraints to keep the infant's fingers away from the mouth

A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment support this newborn's diagnosis?

Failure to pass meconium; abdominal distension

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely fi

Hard, moveable, olive-shaped mass in the right upper quadrant

The nurse is interviewing the parents of a 6-year-old who has been experiencing constipation. Which could be a causative factor? Select all that apply.

Hypothyroidism. Muscular dystrophy. Myelomeningocele Drinks a lot of milk.

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with which intervention?

IV fluids

The nurse is caring for an 8-year-old hospitalized child with nephrotic syndrome. Which of the following nursing interventions would be appropriate for this child? a) Test the urine for ketones twice a day b) Weigh the child once a week. c) Administer antipyretics as needed. d) Measure the abdominal girth daily.

Measure the abdominal girth daily. Correct Explanation: Measure the child's abdomen daily at the level of the um bilicus, and make certain that all staff personnel measure at the same level. Weigh the child at the same time every day on the same scale in the same clothing. Test the urine regularly for albumin and specific gravity. Elevated temperature is not an issue with nephrotic syndrome.

An infant diagnosed with pyloric stenosis experiences excessive vomiting that can result in which condition?

Metabolic Alkalosis

Which combination of signs is commonly associated with glomerulonephritis?

Mild proteinuria, hematuria, decreased urinary output, and lethargy.

n infant is born and the nurse notices that the child has herniation of abdominal viscera into the base of the umbilical cord. What will the nurse document on her or his assessment of this condition?

Omphalacele

Therapeutic management of the child with acute diarrhea and dehydration usually begins with what intervention?

Oral Rehydration Solution (ORS)

Which medication would most likely be included in the post-operative care of a child with repair of bladder exstrophy?

Oxybutynin (Ditropan)

Which of the following assessment findings would the nurse most expect to find in the child who has been diagnosed with having hypertrophic pyloric stenosis?

Projectile vomiting and hungry soon after eating

The nurse is caring for a 4-year-old who weighs 15 kg. At the end of a 10-hour period, the nurse notes the urine output to be 150 mL. What action does the nurse take? 1. Notifies the physician because this urine output is too low. 2. Encourages the child to increase oral intake to increase urine output. 3. Records the child's urine output in the chart. 4. Administers isotonic fluid intravenously to help with rehydration.

Recording the child's urine output in the chart because the urine output is within the expected range of 0.5-1 mL/kg/hr, or 75-150 mL for the 10-hour period.

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to do which of the following actions?

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

A school-age child has epistaxis. Which intervention by the school nurse is the most appropriate?

Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

Visible peristalsis and weight loss

You are the awesome nursing teacher with a huge class of 80 students. Yikes. Anyway, in pediatric clinical, you ask the students to differentiate omphalocele and gastroschisis. Which statement, if made by a student, indicates that they were smart and knew the right answer?

With omphacele, the organs are covered with a protective sheath while with gastroschisis the organs protruding from the abdomen are exposed completely.

Which assessment finding should the nurse expect in an infant with Hirschsprung disease?

b. Constipation with passage of foul-smelling, ribbon-like stools

Which type of hernia has an impaired blood supply to the herniated organ?

strangulated hernia

Therapeutic management of most children with Hirschsprung's disease is primarily

surgical removal of affected section of bowel

The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing? (Select all that apply.)

— Administration of analgesics for pain — Intravenous (IV) fluids continued until tolerating fluids by mouth — Clear liquids as the first feeding

The nurse is performing a gastrointestinal assessment on a 7-year-old boy. The parents are assisting with the history. Which assessment findings are indicative of constipation? Select all that apply.

— Our child complains of pain because his bowel movements are so hard." — Our child tells us that his belly hurts a lot of the time." — I can tell he holds his bowel movement much of the time because of the way he stands." — I find smears of stool in his underwear almost every day."

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply

— Place the infant in a private room. — Ensure that nurses caring for the infant with RSV do not care for other high-risk children.