Peds Chapter 38: PrepU

A newborn was diagnosed as having hypothyroidism at birth. The parent asks the nurse how the disease could be discovered this early. Which is the nurse's best answer?

A simple blood test to diagnose hypothyroidism is required in most states.

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?

Administration of levothyroxine indefinitely

The nurse completes a 1-month-old's feeding and sits the infant up to burp. The infant vomits back the feeding. Which is the nurse's primary concern?

Aspiration

A child has presented to the clinic with diarrhea. The nurse should teach the parent to give which item to properly care for the child?

Bananas

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?

Barium enema

The nurse is educating a family on celiac syndrome. Which is conclusive and confirms the diagnosis?

Biopsy of the jejunum through endoscopy showing changes in villi

A young child has presented to the pediatric unit with a swollen abdomen, edema, thin patchy hair, and irritability with growth retardation and muscle wasting. The nurse suspects a malnutrition disorder. The nurse identifies this child to most likely have which condition?

Kwashiorkor

Pyloric stenosis has been diagnosed in a 3-week-old male infant who has frequent vomiting after feedings. An important preoperative nursing intervention is:

Maintaining NPO status while restoring hydration and electrolyte balance.

The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care?

Maintaining the intravenous (IV) fluid rate as ordered

The nurse is caring for a 3-year-old with repeated diarrhea. The client is listless and clings to the parent. The nurse reviews the lab work which reports a pH- 7.33, HCO3- 21, PaCO2- 42. Which would be documented?

Metabolic acidosis

A group of students are reviewing information about oral diabetic agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver?

Metformin

A preschooler has celiac disease. The parent is preparing a gluten-free diet. The nurse knows that the parent understands the diet when the parent prepares which breakfast foods?

Eggs and orange juice

A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client?

Fluid replacement

The nurse is caring for a child with a gastrointestinal disorder and measuring intake and output. The nurse observes that the child is demonstrating symptoms of adequate hydration when she/he has which of the following? Select all that apply.

Fontanelles with normal tension Adequate skin turgor Pink and moist mucous membranes

What occurs in the gastrointestinal system of the child with Hirschsprung disease?

There is a partial or complete mechanical obstruction in the intestine.

A parent is stating that his school-aged child is having anal itching in the middle of the night, and the nurse suspects pinworms. Which instruction provided by the nurse helps prevent the spread of infestation to other siblings? Select all that apply.

Trim all nails short. Wash the hands after toileting and before meals. Change the bedding and wash in hot water. Encourage all family members to get treated with an anthelmintic.

The client calls the health care provider's office stating that her preschooler drank laundry detergent from under the sink. Which statement by the parent needs further instruction?

"I will use syrup of ipecac to get it out of my child's system."

The nurse is collecting data on a child who has been brought to the clinic. The child has urticaria, pruritus, stomach pains, and respiratory symptoms. The nurse recognizes that the clinical manifestations noted in this child are commonly seen in which disorder?

Food allergies

Noah is an 18-month-old boy who is brought to the emergency department with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that this condition is most likely the result of which of the following?

Gastroesophageal reflux disease

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dl. What would the nurse do next?

Give 10 to 15 grams of a simple carbohydrate.

The nurse recommends rotavirus vaccine for which group of clients?

Infants

The nurse is advising a group of new parents on how to care for their infant at home if the baby develops mild diarrhea. Which statement indicates that teaching has been effective?

"I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration."

A child and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes. Which statement by the nurse is true?

"Kids can usually be managed with an oral agent, meal planning, and exercise."

A nurse is making a home visit to a 12-year-old child with type 1 diabetes and is reviewing insulin administration. The nurse determines that the teaching was successful when the child performs which actions? Select all that apply.

Draws up the short-acting insulin before the intermediate-acting insulin. Stores the insulin vial at room temperature. Gives the injection at a 45-degree angle.

A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus?

A fasting blood glucose greater than 126 mg/dl

The nurse is providing care for a child who has been diagnosed with rickets. What is the nurse's priority intervention?

Administration of adequate vitamin D

Nurses will need to teach the parents of the infant being treated for Hirschsprung disease (aganglionic megacolon) to:

Care for a temporary colostomy.

Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply.

Polyuria Polydipsia Polyphagia

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention?

Prepare the infant for surgery.

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?

Pyloric stenosis

Which congenital condition leads to the infant being hungry, irritable, losing weight and rapidly becoming dehydrated with the potential of metabolic alkalosis?

Pyloric stenosis

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?

Regular insulin

The nurse is caring for an infant recovering from surgery for pyloric stenosis. Which nursing diagnosis should the nurse use to guide care during the immediate postoperative period?

Risk for infection of incision line, related to disruption of skin barrier during surgery

The nurse is caring for a school-aged child newly diagnosed with type 1 diabetes mellitus. Which nursing action supports the 2020 National Health Goals to reduce the long-term complications from this disease process?

Schedule the child and parents to attend diabetes education classes.

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which classic symptoms? Select all that apply.

Steatorrhea Constipation Diarrhea Failure to thrive

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is:

Steatorrhea.

When providing diaper care to an infant after pyloric stenosis surgery, which approach is indicated?

Diapers should be folded so that the incision line does not become contaminated.

A child is admitted with a temperature, 101.2°F (38.4°C); pulse rate 100 beats/min; respirations 24 breaths/min. On admission the pain is localized in right lower quadrant. Legs are drawn up against the abdomen. Bowel sounds are sluggish. Rebound tenderness is present. White blood cell count of 17,000/mm3. Ultrasound confirms appendicitis. Which instruction would the nurse give to the child and the parent?

Do not rub or put pressure on the abdomen.

The nurse instructs a preadolescent child with type 1 diabetes mellitus how to self-administer an injection of short-acting and long-acting insulin. Which observation indicates to the nurse that teaching has been successful?

Draws up the short-acting insulin into the syringe first

The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents?

Having a wound, ostomy, and continence nurse meet with them.

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?

Hirschsprung disease

A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

Hormonal secretion

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case?

Intussusception

What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy?

It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse.

A child with severe vomiting for 3 days presents with hypopnea and hypokalemia. The nurse reports to the provider that this child is exhibiting signs of which condition?

Metabolic alkalosis

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?

Sunken fontanels (fontanelles)

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?

Type 1 diabetes mellitus

During the assessment of a preschooler, the nurse notes that the child has abnormal dryness and thickening of the conjunctiva and dry and scaly skin. Which vitamin deficiency does the nurse suspect this child is experiencing?

Vitamin A