Peds

immediately notify the health care provider of the childs status

A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. An abdominal ultrasound is scheduled, and a blood count has been obtained. The child vomits, finds the pain relieved, and calls the nurse. Which should be the nurse's next action?

improving and progressing to a less advanced stage of Reye Syndrome

A child with Reye syndrome is described in the nurse's notes as follows: 1200—comatose with sluggish pupils; when stimulated, demonstrates decerebrate posturing. 1400—unchanged except that now demonstrates decorticate posturing when stimulated. The nurse concludes that the child's condition is:

initiation of dialysis

A child with hemolytic uremic syndrome (HUS) is very pale and lethargic. Stools have progressed from watery to bloody diarrhea. Blood work indicates low hemoglobin and hematocrit levels. The child has not had any urine output in 24 hours. The nurse expects administration of blood products and what else to be added to the plan of care?

confusion, headache, nuchal rigidity, high fever, photophobia, lethargy, seizure, & coma

CM of encephalitis

slowing the rate of solute removal during dialysis

During hemodialysis, the nurse notes that a 10-year-old becomes confused and restless. The child complains of a headache and nausea and has generalized muscle twitching. This can be prevented by which of the following?

we will probably place antibiotics in the dialysis fluid before the next dwell time

The nurse is caring for a 12-year-old receiving peritoneal dialysis. The nurse notes the return to be cloudy, and the child is complaining of abdominal pain. The child's parents ask what the next step will likely be. Which is the nurse's best response?

cheese, banana slices, rice cakes, and whole milk

The nurse is caring for a 14-year-old with celiac disease. The nurse knows that the patient understands the diet instructions by ordering which of the following meals?

immediately obtain all vital signs with a quick head-to-toe

The nurse is caring for a 3-month-old being evaluated for possible Hirschsprung disease. His parents call the nurse and show her his diaper containing a large amount of mucus and bloody diarrhea. The nurse notes that the infant is irritable and his abdomen appears very distended. Which should be the nurse's next action?

record the child urine output in the chart

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?

brudzinski's sig

The nurse is caring for a 6-month-old infant diagnosed with meningitis. When the child is placed in the supine position and flexes his neck, the nurse notes he flexes his knees and hips. This is referred to as:

the baby is always hungry after vomiting, so i feed her again

The nurse is caring for an 8-week-old infant being evaluated for pyloric stenosis. Which statement by the parent would be typical for a child with this diagnosis?

it is a medication that will help control her spasms

The nurse prepares baclofen for a child with cerebral palsy (CP) who just had her hamstrings surgically released. The child's parents ask what the medication is for. Select the nurse's best response.

prepare to get the infant ready for immediate surgical correction

The nurse will soon receive a 4-month-old who has been diagnosed with intussusception. The infant is described as very lethargic with the following vital signs: T 101.8°F (38.7°C), HR 181, BP 68/38. The reporting nurse states the infant's abdomen is very rigid. Which is the most appropriate action for the receiving nurse?

limit fluids in the evening and start a reward system in which your child can choose a reward after a certain number of dry nights

The parent of a 7-year-old voices concern over the child's continued bed-wetting at night. The parent, on going to bed, has tried getting the child up at 11:30 p.m., but the child still wakes up wet. Which is the nurse's best response about what the parent should do next?

the lip is repaired in the first few months of life, but the palate is not usually repaired until the child is 18 months old

The parents of a newborn diagnosed with a cleft lip and palate ask the nurse when their child's lip and palate will most likely be repaired. Which is the nurse's best response?

a 6-month-old who always reached for toys with the right hand

Which child requires continued follow-up because of behaviors suspicious of cerebral palsy (CP)?

place the child in the prone position with a sterile moist dressing over the defect. Begin IV fluids to prevent dehydration.

Which is included in the plan of care for a newborn who has a myelomeningocele?

IV fluids at 1.5 times regular maintenaince

Which order would the nurse question for a child just admitted with the diagnosis of bacterial meningitis?

high pitched cry

Which signs best indicate increased intracranial pressure in an infant?

analysis of serum electrolytes

a 4 month old has had vomiting and diarrhea for 24 hours. the infant is fussy and the anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration?

hypotension, hypervolemia, anemia, infection, muscle cramps, bleeding, fluid shifts

complications of hemodialysis

diet low in protein, salt, & potassium

dietary restrictions for acute glomerulonephritis

corticosteroids (prednisone)

first line medication therapy for nephrotic syndrome

pyloromyotomy

management for pyloric stenosis

PPIs (omeprazole)

medication therapy for the tx of GERD

keep sac intact, position infant prone, do not diaper infant, assess orthopedic function, cover sac with moistened sterile dressing

nursing interventions for spina bifida

hold the infants upright during feeds, offer smaller feedings, burp the infant often, keep infant upright for 30 minutes after feedings

steps to manage GERD

the swollen lining of the small blood vessels damages the red blood cells, which are then removed by the spleen leading to anemia

the manifestations of hemolytic uremic syndrome are due primarily to which event?

long term antibiotics, early tx of UTIs, surgical intervention may be necessary

tx for vesicoureteral reflex

brain & liver

which 2 organs are most affected by Reye's syndrome

mild proteinuria, hematuria, decreased urinary output & lethargy

which combination of signs is associated with glomerulonephritis?