Peds Ch. 29, 31, & 32, ob2

family's coping ability

Which is the best determination of the family's ability to manage a chronic condition?

Show the child models of the body that include the organs or parts of the body the child will be having surgery on.

The nurse is caring for a 14-year-old child who is scheduled to have surgery the next day. What would be the most appropriate intervention for the nurse to implement to help prepare this child for surgery?

375 mg per dose

The nurse is caring for a child who weighs 75 lb. The medication ordered for the child has a therapeutic dosage range of 33 mg/kg per day to 48 mg/kg per day. The medication ordered is to be given 4 times per day. Which dosages would be appropriate for the nurse to administer to this child in one dose?

therapeutic play

The nurse is working with a child-life specialist to assist a young preadolescent who is preparing for treatment for cancer. Which technique will the nurse and specialist prioritize to assist this child in better understanding what will be happening in the treatment of the cancer?

The caregiver and child co-write a contract that identifies what reward will be earned when certain self-care treatment goals are mastered.

The nurse is working with a group of chronically ill school-aged children and their caregivers. Which strategy would be most effective in helping the children reach their self-care treatment goals?

Dissolve the tablet in a small amount of water sweetened with corn syrup. delivered by a syringe.

The caregivers of a 1-year-old tell the nurse they are frustrated because the medication their child requires daily comes in pill form, which they have been unable to get him to swallow. After clarifying with the pharmacist, what would be appropriate advice for the nurse to give these caregivers to help them make sure the child gets the full dose of medication each day?

potential social isolation

Which issue would a nurse likely identify as related to caregiving of a child with a chronic illness?

overprotection

The nurse is caring for a mother and 12-year-old who is newly diagnosed with a chronic pediatric condition. When the nurse is instructing on the injection technique needed for care, the mother rises and takes the equipment stating, "I will care for him." Which behavior is recognized?

gown, gloves, and mask

The nurse is reviewing a client's chart and notes that the child is in droplet precautions for pneumonia. What protection would she need to take in caring for the child?

Holding the buttocks tightly together for 1 to 2 minutes after insertion

. The nurse has an order to administer a rectal suppository to a 3-month-old child. In addition to lubricating the suppository, which intervention will help assure appropriate administration of the medication?

Observe him for physical signs which might indicate pain.

A 10-year-old boy who had an appendectomy had expressed worry that following the procedure he would have lots of pain. Two days after the procedure the child is claiming he is having no pain. Which nursing intervention should the nurse prioritize when assessing this child?

Have another staff nurse confirm the calculation.

A nurse has just performed the calculation to check the dosage of amoxicillin/potassium clavulanate prescribed for a child. The calculation indicates that the dosage is within the safe dosage range. Which action is appropriate for the nurse to do next?

A. The LPN monitors the IV site for redness. B. The LPN monitors the IV site for pain. D. The LPN monitors the IV flow rate. F. The LPN monitors the site for swelling

After the RN has initiated intravenous (IV) therapy on the child in the pediatric unit, the newly licensed LPN is caring for the child. Which of the following is the LPN responsible for related to the IV therapy? Select all that apply.

respite

Care of an ill child so that the caregivers can have a period of rest and refreshment is called _____________ care.

False

Caregivers who respond in denial to their child's chronic illness respond by trying to protect the child at all costs.

acceptance

Caregivers who respond with gradual ___________ take a common-sense approach to the child's chronic condition.

long

Chronic illness is a condition of ________duration or one that progresses slowly, shows little change, and often interferes with daily functioning.

safety

Constant observation and supervision of children while they are playing is necessary to ensure the _____________ of the child.

"That must be hard. I know you love your sister; it's normal for you to feel a little embarrassed."

During a well-child checkup, a child shares being embarrassed when she is seen with her 7-year-old sister who wears an arm prosthesis after the limb was amputated. Which statement by the nurse most appropriately addresses the child's concerns?

"I understand that you're worried. It will hurt for only a few days; we'll give you something to help stop the pain when you need it."

In a preadmission visit, a 9-year-old girl says she is afraid her tonsillectomy will hurt too much. Which statement by the nurse would be best to help the child feel more comfortable and less afraid?

Relief of acute symptoms

In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason?

intracellular

In understanding fluid and electrolyte balance, it is important for the nurse to recognize that fluid contained within the body cells is known as:

True

Microorganisms spread by contact can be direct, indirect, or droplet in nature.

Pain

Physiologic changes such as increased pulse rate and blood pressure, sweating palms, dilated pupils, flushed or moist skin, and loss of appetite may indicate ________ in children.

therapy

Play __________ is a technique of psychoanalysis that psychiatric nurse clinicians use to uncover a disturbed child's underlying thoughts, feelings, and motivations.

stigma

Siblings of a child who has a chronic illness may feel ___________, which is the feeling of embarrassment or shame, especially if the ill child has a physical disfigurement or cognitive deficit.

"You are very devoted. Siblings often feel guilty or jealous; be sure that time is planned to spend with those children as well."

The caregivers of 8-year-old Alicia, diagnosed with a chronic illness, are talking with the nurse about how they plan to care for their child at home. In discussing the dietary aspects of her treatment, the caregivers tell the nurse that the entire family is going to follow her diet. In addition, time will be spent each day focusing on the child's growth and development, and tasks will be given to each of her siblings to help in the care of the ill child as well as to help the home run smoothly while the caregivers focus on Alicia. Which statement would be most appropriate for the nurse to respond to the caregivers?

Encourage the grandmother to rock the child in a rocking chair.

The grandmother of a 1-year-old with cancer comes to visit the child in the PICU. She sits close to the bed but doesn't touch the child. Which action by the nurse would be most appropriate?

The older sibling organizes an outdoor game that all can participate in.

The nurse is completing a family assessment. Which behavior best highlights a positive interaction between the younger child with a chronic condition and an older sibling?

Use the client's height and weight

The nurse is determining a pediatric dosage of medication using the West nomogram for estimating body surface area (BSA). Which two known factors are on the left and the right scales?

a chance for rest and refreshment.

The nurse is volunteering at a respite care weekend camp for children with a chronic condition. This provides the caregivers with:

Encourage the client to wear his or her own clothes, talk to friends on the phone, and interact with other clients who have similar illnesses.

The nurse is working with a 12-year-old who is hospitalized with a chronic illness. Which action by the nurse might help the chronically ill preteen thrive while hospitalized?

growth and development changes

The parents and their child with a chronic illness have been seen by the nurse in the pediatrician's office since birth. Which situation is appropriate for instruction by the nurse?

Acknowledge their sadness and their anger and let them know that the staff is available for their support

The parents of a newly admitted client on the pediatric unit are angry and upset about their child's diagnosis. The child has been diagnosed with a serious chronic illness. One parent is weeping, asking, "Are they sure?" The other is pounding his fist into his hand, saying over and over, "It's not fair. I love him too much. It's not fair." Which of the following would be an appropriate response for the nurse in this situation?

Giving medications through the intravenous route is less traumatic than multiple injections.

The pediatric nurse recognizes that what statement is true regarding medications administered via the intravenous route?

Use the scale to locate the child's height and weight. Use a straight edge to align these numbers with the scale indicating the surface area, divide that by the average adult body surface area, and multiply the resulting number by the adult dose.

Using the West nomogram scale, the nurse needs to calculate the safe dosage of a medication for a child. The child is 50 inches tall and weighs 76 lb. The normal dosage of the medication for an adult is 300 mg. Which of the following is the correct way to use the West nomogram scale?

False

When a child is separated from the caregiver, during the stage of response termed despair, the child cries, refuses to be comforted, and looks for the caregiver.

handwashing

______________ is the cornerstone of infection control and must be performed frequently to help in the prevention of infection.

lung and spleen damage sustained in a car accident

A pediatric nurse is caring for a group of 4-year-old clients with various diagnoses. The child being treated for which diagnosis will most need help understanding what is happening to him or her?

"Are you feeling sad? Your mom didn't want to leave, but she will be back after two more breakfasts."

A 3-year-old client has been hospitalized for 1 week with her mother rooming in; however, the mother has gone home to tend to other family responsibilities for a few days. After being inconsolable for the first 24 hours after the mother's departure, the nurse notes the child is now lying quietly in bed sucking her thumb. Which response should the nurse prioritize in this situation?

"Respond to her behavior in a firm, loving, consistent way."

A few days after discharge, the parent of an 8-year-old calls the pediatric clinic, expressing concern about the child's behavior now that she is home. The child has been treating her siblings badly and using inappropriate language. Which suggestion should the nurse prioritize to this caregiver as an appropriate way to handle this situation?

Plan an open house and invite the families of the community to come tour the hospital.

A team of nurses has been chosen to devise a program to help educate children and their families about the hospital and being hospitalized. Which activity should the nurses plan to best achieve this goal?

age- and activity-appropriate weekend camps

The health care provider has advised respite care to assist the family of a child with a chronic condition. Which would be most appropriate for the nurse to facilitate?

"His distrust is normal and may have lingering effects, but you should touch and soothe him as much as possible."

The mother of a 4-year-old returns to the hospital after being away for 3 days. She is anxious and excited to be back; however, the toddler turns his back to her and scoots away as she attempts to pick him up. Which response should the nurse prioritize in this situation?

within the first 6 hours following surgery

The nurse is caring for a child who is recovering from a surgical procedure. The nurse will contact the primary care provider if anuria is noted within which time frame?

Taking a child in and out of bed, doing frequent checks and procedures, and caregivers sitting at the side of the bed all bring on an opportunity for the side rails to be left down.

The nurse working in the pediatric unit of the hospital is always monitoring for safety issues on the unit. The nurse determines the greatest concern related to safety of the hospitalized child is related to which situation?

vehicle

The nursing instructor is discussing the various modes of transmission for pathogens. The instructor determines the session is successful when the students correctly point out that microorganisms transmitted by food, water, or blood are spread via which mechanism?

Procedures and treatments are done in a room other than the child's hospital room.

The pediatric unit in the hospital is designed to make the child feel comfortable and secure. Which action will best accomplish this goal?

"It is important for you to take a break from caring for Eddy. I can give you information about the hospital's respite care program."

The primary caregiver of Eddy, a 10-year-old child, is his single grandfather. Over several months of inpatient and outpatient treatment, the nurse notices that the grandfather seems increasingly tired and stressed. Which statement would be most appropriate for the nurse to suggest to this grandfather as a possible course of action for himself and the child?

B. Allow children to wear their own clothing. C. Perform any treatments in the procedure room. E. Involve Child Life in teaching about upcoming surgeries.

What actions can a pediatric hospital staff take to lessen the stress of hospitalization for a child? Select all that apply.

B. to maintain fluid and electrolyte balance C. to have access to the intravenous route for testing E. Medications and nutrients can be infused through the line.

What is a fundamental rationale for the administration of intravenous therapy? Select all that apply.

denial

When a child is separated from the caregiver, the stage of __________ is where the child begins taking interest in the surroundings and appears to accept the situation.

Integrate play into tasks.

When caring for a preschooler with a chronic condition, which nursing action encourages client cooperation with daily tasks?

A. Provide information on state financial assistance. B. Arrange a lunch tray to be sent for the parents. C. Volunteer in a fundraiser for outstanding debts.

Which action by the nurse is the helpful if the parents of a child with a chronic condition are experiencing financial difficulty? Select all that apply.

the client with a pH of 7.55

Which client does the nurse identify as in a state of alkalosis from hyperventilation?

Using a nebulizer

The nurse at a camp for children with asthma is teaching these children about the medications they are taking and how to properly take them. The nurse recognizes that many medications used on a daily basis for the treatment of asthma are given by which method?

"Some people go here to have babies, or when they're sick or hurt, so they can try to get better."

The nurse at a pediatric clinic is preparing a 5-year-old child for admission to the hospital for surgery. Which response should the nurse prioritize when asked by the child what happens at the hospital?

Follow the facility policy regarding medication errors.

The nurse has administered a medication to a child. When documenting the dosage given, the nurse realizes that an incorrect dose has been administered. The nurse has taken the child's vital signs, and they are within normal range. The child does not appear to be in any distress and is acting normally. Which of the following would be the next action for the nurse to take?

the child with muscular dystrophy

The nurse is assigned four clients in the pediatric unit. Which child with a chronic condition does the nurse anticipate having the nursing diagnosis, Impaired physical mobility?

central venous catheter infusions

The nurse is caring for a pediatric client who requires vitamins, minerals, lipids and amino acids through the circulatory system instead of the gastrointestinal tract. Which type of intravenous therapy is anticipated for long-term therapy?

the number of loose teeth the child has and which teeth are missing

The nurse is doing the preoperative preparation for a 6-year-old who is having surgery. What is most important for the nurse to document in the child's preop chart?

a 7-year-old who has told the nurse about using the control button

The nurse is preparing a child for surgery and is demonstrating and evaluating the child for using a patient-controlled analgesia device after surgery. The nurse would determine which client would be most appropriate to use this device?

vector

The nurse is preparing a presentation depicting the various ways pathogens are spread around. The nurse will illustrate that pathogens passed around via insects is referred to as which mechanism?

are aware of the implications of the disease and the resources available in the community for the child and family

The nurse who regularly cares for chronically ill children will be most effective in helping the family adjust to the child's condition when they:

The nurse checks the last time the medication was given.

The nurse is administering a PRN pain medication to a child. What is the highest priority for the nurse in this situation?

"Sometimes I wonder if the reason she is sick is because I have so many responsibilities at work and at home."

The nurse is meeting with a group of families to assist them in dealing with the hospitalization of their child. Which comment by a family member should alert the nurse to assist the family in coping with the situation?

While attending to the child, reassure the sister and suggest interventions she can help with.

A 5-year-old boy is brought to the emergency room with a possible broken arm. His 18-year-old sister, who is also his primary caregiver, has come with him. The boy is relatively calm, but his sister is so upset she is nearly hysterical. The nurse notes that as her behaviors show more anxiety, the boy is getting more upset and his anxiety is also increasing. What initial action would be best for the nurse to take in this situation?

Taking the child to the local library at least monthly to check out children's craft books to support the interest in arts and crafts.

An 8-year-old diagnosed with a chronic illness is returning home after an extended hospital stay. While the child tires easily, she is mobile and active when rested. Keeping in mind that the child is particularly interested in engaging in arts and crafts, which intervention should the nurse suggest to meet the child's development and socialization needs?

Take him to a separate treatment room to give him his injection. Praise his cooperation even if he cries. Take him back to the playroom. Complete all required documentation.

An order for an intramuscular medication has been ordered for a 4-year-old. The nurse finds the child in the playroom with his caregiver. Which action by the nurse would be the best procedure to follow when administering this medication?

Both parents are demonstrating normal responses, but they will be most helpful to Jared if they can find a middle ground.

The nurse caring for chronically ill Jared notices that the relationship between his parents is quite strained. His father has been doing everything for him, while his mother has been expecting him to have the same capabilities as his healthy twin. Which statement would accurately describe this situation?

Let the child see the nurse's face before the mask is put on.

The nurse has been assigned to care for a child who is on transmission-based precautions. This nurse has not cared for this child before. Which action would be the best way to help the child feel comfortable with the nurse?

"The client is left-handed and likes to draw; an IV site in his right arm would be best."

The nurse has been caring for a 12-year-old boy during his 5-day hospitalization. The child's IV has infiltrated, and the care provider is getting ready to change the intravenous line site. Which statement made by the nurse would be appropriate in supporting the child?

The nurse's behavior is correct. The nurse provided the child a choice between two acceptable options with the outcome of taking the medication.

The nurse has brought a 3-year-old's oral medications into the room for administration. Upon approaching the child, the nurse said, "I have your medication. Would you rather have me hand it to you or Mommy?" In critiquing the nurse's actions, which is most accurate?

Monitor for any change in vital signs.

The nurse is caring for an adolescent just transferred from PACU to the inpatient unit. As the nurse helps the child settle into the unit, which nursing intervention should the nurse prioritize?

trochanter and knee joint

The nurse is preparing an injection of ceftriaxone sodium 500 mg IM for a 9- month-old client. When assessing the best site for injection, which landmarks are determined in preparation for injection?

vastus lateralis muscle

The nurse is administering an intramuscular injection of an antibiotic to a 3- month-old infant. Which would be the best site for the nurse to give this medication?

The nurse encourages the child to develop a chart of times when medications are due.

The nurse is administering oral medications to an 11-year-old child. Which intervention should the nurse implement to encourage the child to be medication adherent?

A sedative to be given one-and-a-half to two hours before surgery and an analgesic-atropine mixture given just before the child leaves for the operating room.

The nurse administering the preoperative medications to the child going to surgery would anticipate which of the following related to giving preoperative medications?

dilute the elixir so that the medication is not as hard to swallow.

The nurse is administering an oral medication that comes in an elixir form. When giving the medication, the child begins to choke and sputter. The nurse confers with the pharmacist about alternate ways to give the medication to this child. The pharmacist might recommend that the nurse should:

Pull the pinna down and back

The nurse is administering otic medication to a 22-month-old with a diagnosis of otitis media. Which nursing action ensures that the medication is distributed appropriately?

1,000 mg per dose

The nurse is caring for a child who weighs 31 kg. A medication is ordered for this child with a dosage range of 20 to 40 mg per kg of body weight per dose. Which dosage would be appropriate for the nurse to administer to this child in one dose?

how the family reacts to the news

Which does the nurse identify as the best indicator of how a child will react to the diagnosis of a chronic condition?

The client will adjust to adjust to their condition.

The nurse is caring for a child with a chronic condition who has advanced skills and can perform activities of daily living independently. Which nursing goal is progressing?

The nurse conducts the assessment while gently reassuring both the child and the parents.

The nurse is providing care for a 4-year-old being treated in the emergency department. Which intervention demonstrates a nurse's understanding of the basic principle of emergency care when addressing the child's need for a sense of security?

Precautions are followed if a client has a disease that can be easily spread.

The nurse must follow certain precautions in order to protect everyone from the spread of disease. Which action will the nurse prioritize when utilizing transmission-based precautions?

Offer stickers and coloring books for the sibling to play with.

The nurse is interacting with a family of 3 (parent, school-aged child with a chronic illness, and preschool sibling) in a specialty clinic office. The parent is struggling with the sibling being disruptive when preparing the child with a chronic illness for the exam. Which nursing action is most helpful?

greater fluid exchange caused by increased metabolic activity

The nurse is preparing an intravenous infusion for a 3-month-old client with dehydration secondary to gastroenteritis. Which condition or scenario puts this infant at greatest risk for a higher volume of fluid loss?

a volume control device

The nurse is preparing an intravenous solution of D5 ¼ NS @ 20 ml/hour for a 6-month-old client. Which safety device will be added to protect against fluid overload?

Plan to review information and procedures with the family caregivers before discharge

The nurse is preparing discharge teaching for a child and the caregivers after a week of hospitalization. Which activity should the nurse prioritize in this plan?

low back pain

Which medical diagnosis does the nurse understand most often begins with an acute injury and then turns into a chronic condition?

facilitator of coping skills

Which role of the nurse is the highest priority when a child is newly diagnosed with a chronic condition?

decline in involvement with peer activities

Which scenario does the nurse anticipate for the life of an adolescent with a chronic condition who has deteriorating function?