peds final review

The nurse receives a call from the parent of a 10-month-old who has vomited three times in the past 8 hours. The parent describes the baby as playful and wanting to drink. The parent asks the nurse what to give the child. Select the nurse's best response.

"Give your child 1/2 ounce of Pedialyte eery 10 minutes. If vomiting continues, wait an hour, and then repeat what you previously gave."

A mother brings her newborn into the clinic for follow up exam. The newborn has a cleft lip and palate. The mother is in tears and saying she is never going to be able to breastfeed. What is your best answer?

-"breastfeeding may be an option for you. Would you like more information?"

Which child may need extra fluids to prevent dehydration? Select all that apply

-A 6-mo-old with newly diagnosed pyloric stenosis -A 3-yr-old with full-thickness burns to the chest, back and abdomen

Which interventions decrease cardiac demands in an infant with CHF? Select all that apply

-Allow parents to hold and rock their child -Make frequent position changes -Feed the child when sucking the fists -Change bed linens only when necessary -Organize nursing activities

What is the prognosis for a child with a cleft lip and palate? (Select all that apply)

-Ear infections -Dental problems -Difficulty gaining weight **also includes speech issues

The nurse is caring for an infant newly diagnosed with Hirschsprung disease. What does the nurse understand about this infant's condition? (Select all that apply)

-There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention. -There is an accumulation of bowel contents, leading to non-passage of stools.

A 5-month-old is brought to the ED with severe dehydration. His HR = 170, BP = 68/38. The anterior fontanel is sunken. The blood sugar = 94. The nurse immediately places an IV and notices the infant does not cry. The parents state that the child has been vomiting for the past day. What is the next nursing action:

-administer a bolus of normal saline

A 2-year-old has come into the clinic for a physical assessment. As a nurse, you know that you should approach a pediatric patient by:

-always proceed in a non-invasive to invasive, and have the parent help

What should the nurse assess before administering digoxin (Lanoxin)?

-apical pulse rate

A 5-year-old was seen in the ED for strep throat 3 weeks ago. The parents were given a prescription for ampicillin and instructed to finish a 7 day course of this medication. However, after 3 days, the parents decided the child looked better and discontinued the ampicillin. Today, the child has no specific complaints but "looks ill", is irritable and refusing to eat. What will you assess? (Select all that apply)

-ask for a urine sample -assess for edema -assess the pts BP since you suspect acute poststreptococcal glomerulonephritis

What are the 6 "P's"? (select all that apply)

-pressure -pain -paresthesia -pulselessnes -paralysis -pallor

When caring for a child with either Transposition of the Great Vessels or Tricuspid Atresia, the nurse will prepare to give the following medication to keep the PDA open:

-prostaglandin

What does the therapeutic management of CF patients include? Select all that apply

-providing a high-protein, high-calorie diet -encouraging exercise minimizing pulmonary complications -encouraging medication compliance

A 10-year-old boy is embarrassed because he wet his bed for the past 2 nights. His parents take him to the clinic for evaluation. The nurse will anticipate the following: (select all that apply)

-request a urinalysis to check for ketones in the urine -request a urinalysis to check for leukocytes and nitrates -review the child's chart to check for a family history or a neurologic defect

A 10-month-old is brought into the ED by his parents. The child is listless and having apnea spells. Upon examination, the nurse notices edema of the scalp and retinal hemorrhages. The nurse suspects:

-shaken baby syndrome

A 5-year-old has been brought into surgery for the diagnosis of intussusception. How will the nurse prepare the child and parents for this surgery? (select all that apply)

-start a peripheral IV -give IV fluids for dehydration -educate the parent about the air enema procedure -insert an orogastric tube for decompression of the bowel

The parents of a 2-year-old have just arrived in the ED. Their child is tachypneic, has a barking cough, inspiratory stridor, and moderate retractions. Her pulse ox is 88% on room air. Her curent weight is 14 kg. As the nurse, you will: (select all that apply)

-start humidified oxygen -give neulizer treatments of epinephrine and steroids -start an IV and give D5 with 20 KCl at 58 ml/hr (maintenance rate)

A 3-week-old child has been brought into the clinic for a follow up exam. At birth, he was diagnosed with a VSD. The severity of the affects will determined by: (select all that apply)

-the amount of blood being shunted from left to right -the infant's level of activity intolerance during feedings

A child has been brought into the clinic for education on nutrition for her cystic fibrosis. You would include the following:

-the diet should be high in calories and protein

A 15-yr-old is in the emergency room complaining of abdominal pain in the right lower quadrant, vomiting, and fever. On exam, the WBCs are high, the CRP is high, and the child has rebound tenderness. The nurse will prep the patient for surgery because she knows this is

Appendicitis

An air enema helps to diagnose and correct:

Intussusception

During a well-child checkup for an infant with TOF, the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to :

Hold the child in knee-chest position to decrease venous blood return

The nurse is caring for a child with Kawasaki's Disease. A student nurse who is on the unit asks if there are medications to treat this disease The nurse's response to the student nurse is:

Immunoglobulin G and aspirine

The nurse is caring for a 5-wk old scheduled for a pyloromyotomy in 24 hours. Which would the nurse expect to find in the plan of care?

Keep infant NPO; begin IV fluids at maintenance; place NGT to low wall suction.

While assessing the newborn with respiratory distress, the auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2 and decreased PO2. The nurse suspects that the newborn has:

PDA

Which assessment is of greatest concern in a 15-mo-old?

The child is in the tripod position and has diminished breath sounds and a muffled cough. **diminished breath sounds is the #1 priority

The parent of a child with CF is excited about the possibility of the child receiving a double lung transplant. What should the parent understand?

The transplant will not cure the child of CF but will allow the child to have a longer life

Which child with asthma should the nurse see first?

a 12-mo-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%. **diminished breath sounds is the #1 priority

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?

analysis of serum electrolytes

The nurse is caring for a 4-month-old with GERD. The infant is due to receive omeprazole (Prilosec).Based on the medication's mechanism of action, when should this medication be administered?

at least 60 minutes before a feeding

The parent of a child with croup tells the nurse that her other child just had croup and it cleared up in a couple of days without intervention. She asks the nurse why this child is exhibiting worse symptoms and needs to be hospitalized. Which is the nurse's best response?

children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed

A 10 yr old is recovering from an episode of rotovirus. Electrolytes have normalized and the patient will now be placed on maintenance IV fluids. The patient weighs 87 pounds. Calculate the Holliday-Segar daily fluid requirements for this patient.

1,890 mls/day

A 6-year-old recently was swimming in the ocean near a sewage outlet and has vomiting and diarrhea. The child is anorexic and lethargic. Lab results shows severe anemia and the UA shows proteinuria, hematuria, and an increase in BUN and creatine. As the nurse, you anticipate the following diagnosis and treatment.

Confirmed diagnosis of hemolytic urea syndrome after obtaining abnormal clotting factors and high retic count; dialysis will be the treatment of choice