Peds Practice: Ch 45 (Integumentary), Peds Practice: CH 37, 38, & 39

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful? a) "I should not cover the area with plastic wrap after applying the cream." b) "I need to shake the preparation before using it." c) "I should use the highest-potency steroid cream I can find." d) "I should apply the medicine at bedtime and rinse it off in the morning."

"I should not cover the area with plastic wrap after applying the cream."

A child is diagnosed with bacterial meningitis. The nurse would suspect which abnormality of cerebrospinal fluid (CSF)? a) Cloudy appearance b) Elevated sugar c) Decreased leukocytes d) Decreased pressure

Cloudy appearance

A child is diagnosed with aseptic meningitis. The child's mother states, "I don't know where she would have picked this up." The nurse prepares to respond to the mother, based on the understanding that this disorder is most likely caused by which of the following? a) Haemophilus influenza type B b) Escherichia coli c) Streptococcus group B d) Enterovirus

Enterovirus

The causative organism for Meningitis at birth to 3 months

Escherichia coli, Streptococcus group B

The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?

Assess the child's ability to convey information.

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis?a) Avoid making noise when in the child's room b) Keep the lights on brightly so that he can see his mother c) Rock the child frequently d) Have the child's 2-year-old brother stay in the room

Avoid making noise when in the child's room

A child is playing in the mud. What helminthic infection can they get?

Hookworm

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?

Irritability, fever, and vomiting

The nurse is providing education to a teen who has tinea pedis. What information should be included in the discussion? Select all that apply.

Keep feet clean and dry. Wear cotton socks.

A child returns to the clinic after an episode of otitis externa, which has resolved. What would the nurse emphasize as the priority for preventing future episodes?

Keeping ear canals dry

The nurse is educating the parents of a 6-year-old child about preventing hearing loss. Which of the following will be included in the discussion? a) Playing the radio loudly b) Tendency to act silly in the classroom c) Prevention and treatment of otitis media d) Suddenly doing poorly in school

Prevention and treatment of otitis media

The nurse is performing a physical assessment for an 8-year-old with an earache. Which of the following signs and symptoms indicates acute otitis externa? a) The child cries out when the ear is grasped. b) Symptoms of upper respiratory infection are present. c) The tympanic membrane reacts to a puff of air. d) The ear canal is devoid of cerumen.

The child cries out when the ear is grasped.

The mother of a child with pediculosis capitis infestation tells the nurse that she does not understand why her child still has the infestation. The mother states, "I used the prescribed treatment just like I was instructed." How should the nurse respond? A. "Have you been combing the hair for nits from the hair on a weekly basis?" B. "After finding the infestation did you wash items that your child's head came into contact with, like bed linen?" C. "Maybe you should use some of the home remedies like petroleum jelly or mayonnaise." D. "Do you wash your child's hair daily? Having clean hair will help get rid of the infestation."

"After finding the infestation did you wash items that your child's head came into contact with, like bed linen?"

The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education? -"I will need to make sure the dog gets a bath if he goes in the woods." -"When he plays in the woods again, I will make sure he wears long pants and long sleeves." -"I can buy a medicine to put on him before he goes out to prevent him from getting this again." -"As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

"As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

A nurse assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. Which should the nurse ask the mother?

"Does she wear sleepers with metal snaps?"

A 5-year-old develops an otitis media with effusion. Myringotomy tube insertion is scheduled. The mother asks, "Why does this have to be done at the hospital?" What would be your best response?

"He will need to lie still afterward, so he will need to remain at the hospital for a short time."

The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement? 1. "I need to wash and rinse clothes thoroughly to be sure all of the detergent is washed out." 2. "I should not overdress the infant." 3. "I should only use ointments and creams as instructed by the health care provider." 4. "I should be certain to use fabric softener in the care of the infant's clothes."

"I should be certain to use fabric softener in the care of the infant's clothes."

The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education? 1. "I will use a warm blow dryer on the rash area for a few minutes every time I change her diaper." 2. "I will use rubber pants over the cloth diapers in the future." 3. "I can still use fragrance fee diaper wipes." 4. "I can leave her diaper off when she naps each afternoon."

"I will use rubber pants over the cloth diapers in the future."

The mother of a child having myringotomy tubes placed asks, "Will my son lose his hearing while the tubes are in place?" What is the nurse's best answer?

"The tubes are inserted into a section of eardrum in which the hearing is not affected."

The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which of the following statements by the parents indicates that further education is needed? a) "We need to make sure we are speaking clearly." b) "We need to face our son when we are speaking." c) "We need to raise the volume of our voices significantly so he can hear us." d) "Using hand gestures as visual cues should help our child understand a little better."

"We need to raise the volume of our voices significantly so he can hear us."

A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? -"We should use soap to clean only dirty areas." -"We should use a mild soap for sensitive skin." -"We should bathe our child in hot water, twice a day." -"We need to avoid any skin product containing perfumes, dyes, or fragrances."

"We should bathe our child in hot water, twice a day."

Signs of scabies include

*intense itching* and *fine, dark, wavy lines* at the flexor surface of the wrist or elbow, the webbed area of the fingers, the axilla, and the genitals.

The meningococcal vaccine should be offered to high-risk populations. If never vaccinated, who has an increased risk of becoming infected with meningococcal meningitis? Select all that apply.

- 18-year-old student who is preparing for college in the fall and has signed up to live in a dormitory with two other suite mates - 12-year-old child with asthma - 5-year-old child who routinely travels in the summer with her parents on mission trips to Haiti - 9-year-old child who was diagnosed with diabetes mellitus when he was 7 years old

A child is hospitalized and diagnosed with bacterial meningitis. What can the nurse anticipate will be included in the plan of care and treatment? Select all that apply.

- Acetaminophen - Antibiotic therapy - Administering tepid baths as needed

treatment for scabies

-permethrin cream or Elimite -Clothing & bedding washed in hot soapy water - Kwell lotion -vacuum all hard surfaces

A 6-year-old child is diagnosed with tinea capitis and treatment is initiated. The nurse instructs the parents to have the child return to school within which time frame? a) 24 hours b) 5 days c) 1 week d) 72 hours

1 week

6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room? a) A room with an 8-month-old infant with failure to thrive b) A private room near the nurses' station c) A room with a 12-month-old infant with a urinary tract infection d) A two-bed room in the middle of the hall

A private room near the nurses' station

Signs and Symptoms of roundworm (Ascaris lumbricoides) includes

Abdominal pain, vomiting with bile staining, and abdominal obstruction

The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39°C (102.2°F). Which intervention would the nurse expect to implement?

Administering antibiotics as soon as they're available

The nurse is teaching parents of a 6-year-old child about otitis media (OM). What predisposes the child to OM infections? A. Swimming and other water activities B. Eustachian tubes that are long and narrow in children C. The use of cotton swabs, which can damage the eardrum D. Bacteria entering through the eustachian tube

Bacteria entering through the eustachian tube

In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure?

During this procedure, small tubes are inserted into the typmpanic membrane.

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? a) Cerebral edema b) Renal failure c) Left-sided heart failure d) Cardiogenic shock

Cerebral edema

If the child is following a normal development process, visual acuity gradually increases from birth. What is most accurate regarding the age children develop 20/20 vision?

Children usually develop 20/20 vision by 5 years of age.

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? a) Take vital signs every 4 hours b) Encourage the parents to hold the child c) Monitor temperature every 4 hours d) Decrease environmental stimulation

Decrease environmental stimulation

An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client?

Disturbed body image

A 6-year-old child is being treated for a parasitic infection. When reviewing results from the child's white blood cell count, which finding would be anticipated?

Increased eosinophils levels

The causative organism for Meningitis at 3 months to 16 years old

Neisseria meningitides

A child puts a contaminated toy in their mouth. What helminthic infection can they get?

Roundworm

How to diagnose a enterobius vermicularis "pinworm" infection?

Scotch tape test

A 14-year-old child is diagnosed with tinea versicolor. Which of the following would the nurse expect the nurse practitioner to order? a) Topical nystatin b) Diphenhydramine c) Oral griseofulvin d) Selenium sulfide

Selenium sulfide

Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis? a) Occurrence of urine and fecal contamination b) Degree and extent of nuchal rigidity c) Onset and character of fever d) Signs of increased intracranial pressure (ICP)

Signs of increased intracranial pressure (ICP)

A nurse is preparing a presentation for a local health fair about meningitis and has developed a display that lists the following causes: Streptococcus group B Haemophilus influenzae type B Streptococcus pneumoniae Neisseria meningitidis What would the nurse highlight as the most common cause of meningitis in newborns?

Streptococcus group B

A mother asks the nurse if there is any way to prevent acute otitis media. What would the nurse state to the mother?

The frequency of otitis media is reduced in breast-fed infants.

After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful? A) Infants with congenital deformities have an increased risk for ear infections. B) Ear infections typically increase as the child gets older. C) The shorter and wider eustachian tubes of an infant increase the risk. D) Adenoids shrink as the child grows, allowing more bacteria to enter.

The shorter and wider eustachian tubes of an infant increase the risk.

The nurse is caring for a 10-year-old male patient in a pediatric clinic with presenting symptoms of small circular patches of hair loss on the scalp. Which of the following skin conditions does the patient most likely have? a) Tinea corporis b) Tinea capitis c) Tinea cruris d) Tinea versicolor

Tinea capitis

A nurse is preparing a presentation for a parent group about ear infections. The nurse would identify the highest incidence of acute otitis media as occurring during which time? a) Spring b) Fall c) Summer d) Winter

Winter

The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? 1. administer griseofulvin with a fatty meal 2. institute contact isolation precautions 3. apply topical antibiotic cream 4. apply topical antifungal cream

apply topical antifungal cream

How to use Permethrin cream

at night, massage into all skin surfaces (neck to the sole of feet) and leave on for 8 to 14 hrs; reapply one week later

Signs and Symptoms of Hookworm (Necator americanus)

dermatitis, blood loss, malnutrition

The most effective approach to prepare a school-aged boy for a myringotomy procedure is to

explain the procedure to the child using puppets.

What causes bacterial otitis media? select all that apply

hemophilus influenza streptococcus pneumoniae

treatment for tapeworm

niclosamide

treatment for Hookworm

pamoate and pyrantel

The nurse is caring for a preschool-aged child diagnosed with acute otitis media. Which intervention should be a priority for the nurse? a) Relief of pain b) Administration of a mydriatic c) Cautioning the child not to blow the nose d) Cautioning the child not to pull on the ear

Relieving pain

In caring for the child with meningitis, the nurse recognizes that which of the following nursing diagnoses would be the most important to include in this child's plan of care? a) Risk for injury related to seizure activity b) Risk for acute pain related to surgical procedure c) Delayed growth and development related to physical restrictions d) Ineffective airway clearance related to history of seizures

Risk for injury related to seizure activity

The nurse is caring for a 6-month-old infant diagnosed with otitis media. Which of the following clinical manifestations would likely have been noted in this child? a) Shaking the head and pulling the ear b) Severe vomiting and confusion c) High-pitched cry and nuchal rigidity d) Body stiffening and loss of consciousness

Shaking the head and pulling the ear

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"

A teen experiencing contact dermatitis reports that he is experiencing pruritis. What recommendation may reduce this occurrence?

Take oatmeal baths.

You eat infected beef or pork. What helminthic infection can they get?

Tapeworm

Treatment of roundworms

Mebendazole, Pyrantel, pamoate

A nurse is giving instructions to the parents of a girl with otitis media with effusion who has just undergone placement of myringotomy tubes in her ears. Which of the following should she mention to the parents? a) Use cotton-tipped applicators to clean around the tubes b) Have the child shower rather than bathe c) Notify the school nurse of the child's condition d) Encourage the child to swim for exercise

Notify the school nurse of the child's condition

After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable: a) Gonorrhea b) Pinworm c) Pertussis d) Lyme disease

Pinworm

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 nurse is caring for a child with a suspected fungal infection. Which of the following tests would the nurse anticipate as being ordered? a) Potassium hydroxide (KOH) prep b) Patch or skin testing c) Culture of wound/drainage d) Erythrocyte sedimentation rate (ESR)

Potassium hydroxide (KOH)

A child diagnosed with acute otitis media has been given a prescription for benzocaine. The nurse is correct when she makes which statement?

"Benzocaine drops should be placed in your ear to numb it and reduce pain."

A child with persistent otitis media with effusion is to undergo insertion of pressure-equalizing tubes via a myringotomy. The child is to be discharged later that day. After teaching the parents about caring for their child after discharge, which statement indicates that the teaching was successful? A) "The tubes will stay in place for about a month and then fall out on their own." B) "His chances for ear infections now have dramatically decreased." C) "He should wear earplugs when swimming in a pool or a lake." D) "We should keep the ears protected with cotton balls for the first 24 hours."

"He should wear earplugs when swimming in a pool or a lake."

The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? a. "That is an infection that you get under your fingernails." b. "I always tell my daughter to use her own hairbrush." c. "My son got that infection when he was at the swimming pool." d. "My husband had that once and his groin itched so much."

"I always tell my daughter to use her own hairbrush."

The nurse has finished teaching the parents of a 10-month-old male ways to prevent another acute otitis media infection. Which statement by the mother indicates she has the correct understanding of the information provided?

"I should continue to breastfeed my son because it lowers the incidence of acute otitis media."

The caregiver of a 2-year-old calls the clinic concerned that her child may have pushed paper into her ears, and she asks the nurse what to do. The mother found the child pushing on her ears with torn paper on the floor in front of her. What would be the appropriate response by the nurse?

"The child should be seen by a care provider. Don't put anything in her ear and bring her in right away."

A child having myringotomy tubes placed asks, "How and when will the tubes be removed?" What is your best response?

"The tubes remain in place for 6 to 12 months until they come out by themselves."

Antibiotic therapy to treat meningitis should be instituted immediately after which event? a) Identification of the causative organism b) Collection of cerebrospinal fluid (CSF) and blood for culture c) Initiation of I.V. therapy d) Admission to the nursing unit

Collection of cerebrospinal fluid (CSF) and blood for culture

Hearing aids can improve hearing for children who have inner ear or nerve deafness.

False

diagnostic for Roundworm, Tapeworm, and Hookworm

Feacal smear

The nurse is caring for a child with a tinea corporis infection involving several sites. Which information would be the most important for the nurse to include in the teaching plan for the parents? a) Allowing the child to return to school after 3 days of treatment b) Keeping socks on before, during, and after athletic events c) Finishing all prescribed oral medication, even after lesions fade d) Applying oils and petroleum jelly to the affected areas

Finishing all prescribed oral medication, even after lesions fade

The term tinea is also called ringworm and it is applied to which of the following? a) Bacterial infections b) Sexually transmitted infections c) Fungal infections d) Contagious infections

Fungal infections

The nurse is caring for an 8-year-old boy with otitis media with effusion. Which situation may have caused this disorder? A. He is experiencing recurrent nasal congestion. B. He has good attendance at school. C. He frequently goes swimming. D. He had recent bacterial conjunctivitis.

He is experiencing recurrent nasal congestion.

A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. Which of the following interventions should the nurse take initially? a) Institute droplet precautions in addition to standard precautions. b) Palpate the child's fontanels. c) Encourage the mother to hold and comfort the infant. d) Educate the family about preventing bacterial meningitis.

Institute droplet precautions in addition to standard precautions.

The nurse is examining a 3-year-old boy with acute otitis media who has a mild earache and a temperature of 38.5º C. Which of the following actions will be taken? A) Obtain a culture of the middle ear fluid. B) Instruct the parents to watch for worsening symptoms. C) Administer antibiotics. D) Administer antivirals.

Instruct the parents to watch for worsening symptoms.

A nurse is caring for a child with tinea pedis. Which assessment finding should the nurse expect?

Red scaling rash on soles and between the toes

A community health nurse investigates an outbreak of pinworm at a local day care center. In order to minimize the spread of infection, which of the following suggestions would the nurse provide to the day care workers? a. Close the day care until all surfaces are cleaned. b. No action is necessary because it is easily treated with oral vermicides. c. Using good hand washing is important to prevent the transmission. d. Every child in the day care should be treated because they all are probably infected.

Using good hand washing is important to prevent the transmission.

Which of the following would the nurse include when teaching parents how to prevent otitis externa? A) Daily ear cleaning with cotton swabs B) Wearing ear plugs when swimming C) Using a hair dryer on high to dry the ear canals D) Using hydrogen peroxide to dry the canal skin

Wearing ear plugs when swimming

A nurse is caring for a client who has been diagnosed with a parasitic infection. Which of the following information should the nurse know when caring for this client? a. The medication to prescribe to treat these infections b. The nature and symptoms of all parasitic illnesses c. What specimens to collect and how and when to collect them d. Public policy about parasitic infections

What specimens to collect and how and when to collect them

signs and symptoms of tapeworm (Taenia Saginata)

anorexia, weight loss

A nurse is assessing a toddler who is brought to the clinic by his mother. The mother states, "He's been so irritable lately and I've noticed him frequently pulling on his right ear." The nurse suspects acute otitis media based on an assessment of which of the following? Select all that apply. a) Low-grade fever b) Upper respiratory infection 3 months ago c) Red bulging tympanic membrane d) Loss of appetite

• Low-grade fever • Red bulging tympanic membrane • Loss of appetite

The nurse is caring for a child who has a severe case of contact dermatitis following exposure to Toxicodendron radicans (poison ivy). The nurse adds the nursing diagnosis, "Knowledge deficit regarding disease process and care of the client," to the care plan. What nursing interventions should the nurse add to the care plan for this nursing diagnosis?

• Teach the client and parents that even contact with dormant plants or plants perceived to be dead may cause an allergic response. • Inform the client that itching is very common for contact dermatitis. • Notify the client and parents that the rash may last for 2 to 4 weeks. • Encourage the client to not scratch the skin since this can cause a secondary infection.