Peds Ch 49
The mother of a 6-month-old states that she does not understand how her child has contracted botulism. What is the best response by the nurse?
"Botulism is caused by contaminated food. Honey is a common source."
A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which question?
"Did you use any medications like aspirin for the fever?"
The nurse is assisting to position a child for a lumbar puncture. Which statement describes the correct positioning for this procedure?
"For a lumbar puncture, the child will be placed in a side-lying position with knees bent and neck flexed to assist with arching the back."
The nurse is collecting data on an 18-month-old child admitted with a diagnosis of possible seizures. When interviewing the caregivers, which questions would be most important for the nurse to ask?
"Have you checked your child's temperature?"
An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done?
"I always keep phenobarbital with me in case of a fever."
The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?
"I hate to think that I will need to be worried about his having seizures for the rest of his life."
While caring for a child who will be undergoing a lumbar puncture, the nurse explains the procedure to the infant's mother. Which statement by the mother would indicate a need for further education?
"I will cradle her in my arms after the procedure for at least 30 minutes."
Isabelle, age 7, has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when Isabelle first said she had a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which statement would be best for the nurse to say to this mother?
"This might or might not be a problem. Watch Isabelle for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome."
The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope?
"Use this information to teach family and friends."
The health care provider orders phenytoin 4 mg/kg/day in three divided doses for a child who has a seizure disorder. The child weighs 35 lb and the medication is available at 30mg/5mL. What is the amount in mL for one dose of this child's medication? Round to the nearest tenth.
3.5 mL
What information is most correct regarding the nervous system of the child?
As the child grows, the gross and fine motor skills increase.
The nurse is caring for a child who was injured in a bike accident. The nurse determines that a child is experiencing late signs of increased intracranial pressure based on which assessment findings? Select all that apply.
Bradycardia Fixed dilated pupils Irregular respirations
What finding is consistent with increased ICP in the child?
Bulging fontanelle
To detect complications as early as possible in a child with meningitis who's receiving I.V. fluids, monitoring for which condition should be the nurse's priority?
Cerebral edema
A nurse is performing triage on victims of a school bus accident and conducts brief screening examinations to determine if any have neurologic deficits. Which nursing actions will be performed during this screening? Select all that apply
Cerebral function Cranial nerves Cardinal fields of gaze Reflexes Sensory system
A child is diagnosed with bacterial meningitis. The nurse would suspect which abnormality of cerebrospinal fluid (CSF)?
Cloudy appearance
Antibiotic therapy to treat meningitis should be instituted immediately after which event?
Collection of cerebrospinal fluid (CSF) and blood for culture
The nurse is discussing with a parent the difference between a breath-holding spell and a seizure. The nurse would be correct in telling the parent what information in regard to seizures?
Convulsive activity occurs.
A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?
Decrease environmental stimulation
Haemophilus influenzae meningitis is usually spread by which of the following methods of transmission?
Droplet
A doctor orders the placement of an ICP monitor in a patient with cerebral edema. The nurse is aware that this surgery will take place in the infratentorial region of the brain.
False
A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of what information into the discussion?
Febrile seizures are benign in nature.
The nurse is preparing a room for a child being admitted with meningitis. What is the appropriate action by the nurse?
Gather appropriate equipment and signage for respiratory isolation precautions.
The nurse is caring for a 12-month-old infant diagnosed with Haemophilus influenzae meningitis. Which clinical manifestation would likely have been noted in this child?
High-pitched cry and nuchal rigidity
The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding?
Indications of increased intracranial pressure
A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. Which intervention should the nurse take initially?
Institute droplet precautions in addition to standard precautions.
The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?
Irritability, fever, and vomiting
A 9-year-old girl who is suspected of having an infection of the central nervous system is undergoing a lumbar puncture to withdraw cerebrospinal fluid for analysis. The nurse knows that the needle will be introduced into the subarachnoid space at the level of which of the following vertebrae?
L4 or L5
Absence seizures are marked by what clinical manifestation?
Loss of motor activity accompanied by a blank stare
The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure?
Minimal or no alteration in muscle tone, with a brief loss of consciousness
The physician has ordered rectal diazepam for a 2-year-old boy with status epilepticus. Which instruction is essential for the nurse to teach the parents?
Monitor their child's level of sedation.
A nurse is preparing a school-aged child for a lumbar puncture. The nurse would expect to position the child in which manner?
On her side with the head flexed forward and knees flexed to the abdomen
A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges?
Positive Kernig sign
The prevention of cerebral palsy is the most important aspect of care. Which of the following are focus areas for the prevention of cerebral palsy? Select all that apply.
Prenatal care to improve nutrition Postnatal prevention of infection Perinatal monitoring to decrease birth trauma
The caregiver of a child who has a history of seizures reports that her child was complaining of being dizzy, and the caregiver noted the child seemed drowsy and was clumsy. The nurse recognizes that the description of the child's behavior was most likely which stage of a tonic-clonic seizure?
Prodromal
The mother of a child newly diagnosed with an intellectual disability tells the nurse that her partner disagrees with the diagnosis and believes that the child is perfectly normal. The mother shares with the nurse that she finds this reaction frustrating and confusing. Which action by the nurse would be appropriate in supporting this mother?
Reassure the mother that her partner's reaction is a normal stage in the grieving process.
In caring for the child with meningitis, the nurse recognizes that which nursing diagnosis would be most important to include in this child's plan of care?
Risk for injury related to seizure activity
Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis?
Signs of increased intracranial pressure (ICP)
The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as:
Sunsetting
The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would be most important to address when teaching the child and parents about living with this condition?
Support for maintaining self-esteem because of his altered lifestyle
A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate?
Teach the child and his parents to keep a headache diary.
During a well-child visit, the nurse assesses an infant's ability to suck on a pacifier. The nurse is assessing which cranial nerve?
Trigeminal
The best way to evaluate a child's level of consciousness is through conversation.
True
The nurse caring for a teenager who sustained a spinal cord injury in an MVA knows that the immediate response to SCI is spinal shock, in which the reflexes controlled by nerves below the level of the injury are temporarily suppressed.
True
The nurse is educating the parents of a 7-year-old girl with epilepsy about managing treatment of the disorder at home. Which intervention is most effective for eliminating breakthrough seizures?
Understanding the side effects of medications
The nurse is assessing a child who has suffered a head injury. Which assessment finding would indicate loss of midbrain functioning?
arms adducted and extended with pronation of wrists with fingers flexed
When caring for an infant who is hospitalized with Haemophilus influenzae meningitis, an important nursing intervention for the child would be for the nurse to:
check the child's neurological status every 2 hours.
A nurse is caring for an infant who has just undergone a ventricular tap. In what position should the nurse place the infant immediately after the procedure?
semi-Fowler's position with a parent at the bedside
16s In caring for a child with a seizure disorder, the primary goal of treatment is:
the child will be free from injury during a seizure.
Put the following events of a generalized epileptic seizure in correct order:
Prodromal period Tonic stage Clonic stage Postictal period
A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority?
Protecting the child from harm during the seizure
A 16-year-old boy reports to the school nurse of headaches and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis?
Sunlight is "too bright"
