PEDS PREP U nero

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."

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."

A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select all that apply.

-Complaints of stiff neck -Photophobia -Vomiting

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

The eyes of a 9-year-old who suffered a head injury are crossed. Besides checking ICP, which intervention would be most important for the nurse to perform?

Assess the child's level of consciousness.

The nurse caring for a child with a cranial injury knows that broad-spectrum antibiotics are used to reduce cerebral edema.

False

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 Signs of increased intracranial pressure (ICP)

Absence seizures are marked by what clinical manifestation?

Loss of motor activity accompanied by a blank stare

A symptom often seen in the child diagnosed with Haemophilus influenzae meningitis occurs when the child has a stiff neck. This symptom is referred to as which of the following?

Nuchal rigidity

The premise behind using plasmapheresis in patient diagnosed with Guillain-Barré syndrome includes which of the following?

Prevention of demyelination

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?

Sunlight is "too bright" Support for maintaining self-esteem because of his altered lifestyle

The nurse is caring for a child admitted with simple partial motor seizures. Which clinical manifestation would likely have been noted in the child with this diagnosis?

The child had shaking movements on one side of the body.

The treatment for children with seizures disorders is most often:

Use of anticonvulsant medications

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.

The nurse is caring for an infant with increased intracranial pressure. The mother is preparing to feed the child. What action by the mother indicates an understanding of the proper care of this infant?

placing the infant in an infant car seat after feeding the infant

In understanding the nervous system, the nurse recognizes that the central nervous system is made up of:

the brain and spinal cord.

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.

The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure?

"He was just staring into space and was totally unaware."

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 providing teaching to the parents of a child recently prescribed carbamazepine for a seizure disorder. Which statement by a parent indicates successful teaching?

"I need to watch for any new bruises or bleeding and let my health care provider know about it."

A child is home with the caregivers following a treatment for a head injury. The caregiver should contact the care provider if the child makes which statement?

"You look funny. Well, both of you do. I see two of you."

Put the following events of a generalized epileptic seizure in correct order:

-Prodromal period -Tonic stage -Clonic stage -Postictal period

What information is most correct regarding the nervous system of the child?

As the child grows, the gross and fine motor skills increase.

A nurse is performing a complete neurological examination of a 7-year-old boy. She will now test his cerebellar function. Which of the following tests would be appropriate for this purpose? The best way to evaluate a child's level of consciousness is through conversation.

Ask the boy to touch each finger on one hand with the thumb that hand in rapid succession

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis?

Avoid making noise when in the child's room

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 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 father reports that his 7-year-old has been observed seemingly staring into space and rubbing his hands several times over the last month. The behavior lasts for a minute or so. When asked, the child denies any memory of such events. These behaviors support the existance of what form of seizure activity?

Complex partial seizures

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.

During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed?

Dramatic increase in head circumference

Haemophilus influenzae meningitis is usually spread by which of the following methods of transmission?

Droplet

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 preparing a toddler for a lumbar puncture. For this procedure, the nurse should place the child in which position?

Lying on one side, with the back curved

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

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"

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

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.

The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be:

The child is in status epilepticus.

The nurse is caring for a child diagnosed with Sturge-Weber syndrome. Which assessment finding supports this diagnosis?

port-wine birthmark on the upper part of the face

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 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

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

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

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.

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)

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 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

The nurse is caring for a 6-year-old child who has a history of febrile seizures and is admitted with a temperature of 102.2°F(39°C). What is the nurse's highest priority?

Institute safety precautions