Peds test 1 questions

What bacteria usually causes epiglottisis?

hib

What is aerosolized ribavirin used for?

high risk, severely ill child

What are factors influencing morbidity?

homelessness, poverty, low birth weight, chronic health disorders, foreign born adoptions, day care attendance, barriers to healthcare

When should a child start getting the flu shot?

6 months

What is average weight gain per year?

3-5 lbs

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with asthma. Which statement best indicates an understanding of the management and treatment for this diagnosis? "We have taken the carpet out of our house and let my mom take our dog." "He knows how and even when he needs to use his peak flow meter." "Even the babysitter helps us keep up the diary with her symptoms." "The medications she takes are all in one place, ready for her to take at any time."

"We have taken the carpet out of our house and let my mom take our dog." Explanation: Families must make every effort to eliminate any possible allergens from the home. Prevention is the most important aspect in the treatment of asthma. Learning how to use a peak flow meter, using a peak flow and symptom diary, and having the medications available are important aspects of treatment, but prevention is the best.

What age range is an infant?

0-12 months

In what time span does the weight double in a child?

0-6 months

How many liters of O2 does a NC take?

1-4 L

How long is suction applied for?

10-15 seconds

What immunoglobulin factors are given to babies through the placenta?

IgG

What pain scale is used in neonates post op?

CRIES

What virus causes mono?

Epstein-Barr virus

What stage of sleep is an infant in that moves a little while sleeping and startles to noises?

Light sleep

What age group does mono usually infect?

TEENS

The nurse is taking a health history for a 3-year-old girl suspected of having pneumonia who presents with a fever, chest pain, and cough. Which information places the child at risk for pneumonia? The child is a triplet. The child was a postmaturity date infant. The child has diabetes. The child attends day care.

The child attends day care. Explanation: Attending day care is a known risk factor for pneumonia. Being a triplet is a factor for bronchiolitis. Prematurity rather than postmaturity is a risk factor for pneumonia. Diabetes is a risk factor for influenza.

x A nurse is caring for an infant admitted with a diagnosis of bronchiolitis. After completing an assessment, the nurse creates a plan of care for the infant. Which client goal would be priority in the plan of care? The infant will attain oxygen saturation of 90% on room air. The infant's airway will remain clear and free of mucus. The infant's breathing will be less labored. The infant will have decreased nasal stuffiness.

The infant's airway will remain clear and free of mucus. Explanation: Keeping the infant's airway clear is the top priority. An O2 saturation of 90% on room air is minimally acceptable. It is important that the infant's breathing be less labored and that there is decreased nasal stuffiness, but having the airway clear and free of mucus is most important.

A school nurse plans to teach children in the fourth grade some basic first-aid skills before they take a field trip. Which fact would make the nurse believe the children will learn this information most readily? The topic is new to them. The topic will have direct application. The material is review information. The topic concerns actions, not ideas.

The topic will have direct application. Explanation: The nurse is correct to understand the developmental level of the children. Children who are concrete thinkers learn material best when it has direct application. First aid can be applied when on their field trip and in their life. School-age children can understand cause and effect so learning what to do when someone gets hurt is important for them. The topic of first aid may be new to them or it may be review but it is relatable to what they are going to experience.

What is an asymmetric tonic neck?

When the head is turned to the side, the arm/leg on the same side will extend. On the opposite side, the leg/arm will flex

What is palivizumab?

a viral entry inhibitor monoclonal antibody against RSV surface proteins

When does a child usually get croup?

age 2-3

By when is head size more preportional to body?

age 3

What are the s/s of severe dehydration?

alert to comatose sunken fontaneles deeply sunken orbits dry mucus membranes tenting increased HR, progressing to bradycardia Normal, progressing to hypotension Cool, mottled, dusky, delayed cap refill Urine output <1mL/kg/hr

What are the s/s of moderate dehydration?

alert to listless sunken fontaneles mildly sunken orbits pale, slightly dry oral mucosa decreased skin turgur increaesed HR normal BP delayed cap refill urine output <1ml/kg/hr

What is important to watch for post op?

bleeding

What is tx for bronchiolitis?

o2 suctioning hydration bronchodilator

What kind of breathers are babies?

obligate nose/belly breathers

How is mono spread?

oropharyngeal secretions

What often occurs with tonsillitis?

pharyngitis

What are the key principles of atraumatic care?

preventing/minimizing physical stressors preventing/minimizing seperation promoting a sense of control

What should be considered when doing an exam on a teenager?

privacy, attitude of respect, head to toe approach, exposure limited to area examined

What is the nursing care for a tonsilectomy?

promote airway clearance side lying/prone maintaining fluid volume discourage coughing encourage fluids avoid citrus, brown, red food ice collar analgestics

A client asks the nurse why a healthy newborn would be at risk for hypoxemia. How should the nurse reply? "A newborn only has half of the number of alveoli developed, placing the newborn at risk." "A newborn would be at risk, because the newborn has smaller lung volumes." "The shape of the chest and the smaller airway structures place the newborn at higher risk." "The newborn does not take in as much oxygen with each breath, placing the newborn more at risk."

"A newborn only has half of the number of alveoli developed, placing the newborn at risk." Explanation: Alveoli begin developing in the fetus at 24 weeks' gestation. In a healthy newborn born at term, there are approximately 150 million alveoli present. The number of alveoli duplicate until the adult number of 300 million are present somewhere between 3 and 8 years of age. The smaller numbers of alveoli place the newborn at a higher risk for hypoxemia and carbon dioxide retention, because this is where gas exchange occurs. This is also more pronounced if the newborn is premature. Newborns consume twice as much oxygen (6 to 8 L) as adults (3 to 4 L). This is due to higher metabolic and resting respiratory rates. The shape of the chest and smaller airways contribute to adequate oxygenation for the size of the newborn. They do not place the newborn at high risk for hypoxemia. Newborns do have smaller lung volumes, but these volumes are adequate for size and grow as the newborn grows.

What should a baby be doing at 9 months?

Hold themselves to stand Cruising Can hold bottle/cup Can say mom/dada Able to wave bye Separation anxiety

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2saturation 95% on room air. Which action will the nurse take first? Administer the bronchodilator via a nebulizer. Give the antibiotic as prescribed. Apply oxygen at 2 liters via a nasal cannula. Apply a cardiac monitor to the child.

Administer the bronchodilator via a nebulizer. Explanation: The nurse would first administer the bronchodilator to open the child's airway and facilitate breathing. Once the airway was open, the nurse could administer oxygen, if indicated. At this time, the child's saturation level is normal but it should be monitored. The nurse would then administer the antibiotic medication. The heart rate is within normal range for a child of this age (65 to 110 beats/minute); therefore, a cardiac monitor is not needed at this time.

will preschoolers report their pain?

No- they think pain is something to expect. They think adults are aware of their pain.

What children are at greater risk for a severe influenza infection?

chronic heart/lung diabetes chronic renal disease immune deficiency cancer recieving chemo

What are assessment findings for a pneumonothorax?

diminished air on affected side collapse of lung

What is the nursing management for epiglottis?

do not visulaize throat do not lead unattended do not place supine provide 100% O2 in least invasive manner Trach may be necessary

what are some warning signs indication problems of sensory development?

does not respond to loud noises does not focus on a near object does not make sounds or babble by 4 months does not turn head to locate sound at 4 months Infant crosses eyes most of time at 6 months

Is epiglottitis rare or common?

rare

What necessitates a tonsilectomy?

recurrent strptococcal tonsilitis, kissing tonsils

What does an infant in the active alert state do?

infants face/body move activly

What is epiglotitis?

inflammation/swelling of the epiglottis

Are mottling and acrocyanosis common in babies?

tyes

What are the s/s of mild dehydration?

mental status alert, fontanels, soft/flat, eyes normal, pink/moist oral mucosa, elastic skin turgur, HR/BP normal, warm, pink, brisk cap refill, urine output slightly decreased

What are warning signs indicating issues with language development /

no sounds at 4 months does does laugh/squeel by 6 months does not babble at 8 months Does not use single words with meaning at 12 months

What are signs a toddler is ready for toilet training?

reg BM expresses need to pee/poo diaper isn't always wet toddler is willing to follow instructions walks well alone, can pull down pants follows caregiver to bathroom climbs onto potty chair or toilet

What are some typical behaviors of the toddler?

rely on security item aware of gender differences displays agressive behaviors Shows fear of loss of parents and strangers no clear boundries, more self aware

What are the complications of pharyngitis?

rheumatic fever acute glomerulonephritis

What causes ARDS?

sepsis near drowning smoke inhalation

What is telegraphic speech?

speech in which words not critical to the message are left out

What should a baby be doing at 2 months?

Cooing Social smile Head held up Baby recognizing parents

How do you calculate the amount of maintance fluid to give?

100mg/kg (up to 10kg) 50mg/kg (up to 20kg) 20mg/kg beyond 20kg

Is pharyngitis caused by a virus or a bacteria?

can be caused by either or

When do toddlers generally reach half of adult height?

Age 2

What vaccines are given at 2 months?

DTaP, IPV, Hep B, HIB, PCV, Rota

What are interventions for peds pain?

sucking/sucrose heat/cold applications massage, pressure

What is tonsilitis?

inflammation of the tonsils

What are other causes of pediatric deaths?

suicide, homicide, heart diseases, influenza, pneumonia

What are techniques for providing atraumatic care?

therapeutic communication, therapeutic play, child education

what are common developmental concerns of the toddler?

toilet training negativism temper tantrums thumb sucking pacifiers sibliing rivalry agression

What is the leading cause of death for children ages 5-14?

unintentional injuries then cancer

What is the leading cause of death for 1-4 year olds?

unintentional injuries, congenital malformations

What should be considered when doing an exam on a school age child?

very concrete thinking objective realistic privacy, respect for feelings

What is croup?

viral infection- causing edema of the larynx, trachea, bronchi Symptoms- at night- hourseness, barky cough tx- steroids, racemic epi

When do fontanels close?

18 months

What is the amount of fluid given in a bolus?

20ml/kg

What is average height increase per year?

3 inches

What are indications of pain in infantS?

Behavioral- facial expressions, body movements, crying Physiologic- changes in HR, RR, BP, SPO2, vagal tone, palmar sweating, plasma cortisol, catecholamine levels

What would ABG's show in those with RSV?

Co2 retention hypoxemia

What vaccines are given at birth?

Hep B

The registered nurse (RN) and licensed practical nurse (LPN) are caring for a adolescent clients. The RN will intervene if the LPN is seen in which situation while caring for a client? Actively listening to the client while maintaining a relaxed, open body posture Speaking to the client while the caregivers listen and observe Asking open-ended questions when talking to the client Using medical terminology to answer the client's questions

Using medical terminology to answer the client's questions Explanation: The RN will intervene when the LPN uses medical terminology to answer the client's questions. Terminology should be used that the client can easily understand. It is appropriate for the LPN to actively listen, speak to the client, and ask open ended questions.

How should the health assessment be done on newborns and infants?

caregiver holds baby auscultate heart, lungs, abdomen while quiet count RR, HR b/f waking baby head to toe

What can be done to promote safety for the toddler?

childproof safe car seat in back avoid tobacco exposure prevent injury prevent poisoning

What stage of sleep is an infant in that lies quietly without movement?

deep sleep

What is the most important aspect when looking at childhood morbidity?

degree of disability, amount of days missed from school or confined to bed

What are the roles/actvities of an infant?

eat, sleep, suck, poo/pee

When is wheezing heard? inspiration or expiration?

expiration, high pitched

What does a drowsy infant look like?

eyes may close, infant dozes

What does an infant in the quiet alert state do?

eyes open wide, body is calm

What is rales a result of?

fluid in the lungs, can occur with pneumonia

What are some distraction methods for children while doing procedures?

have child point toes inward and wiggle them ask child to squeeze hand encourage child to count out loud Sing a song, have child sing along point out pictures Have child blow bubbles Play music appealing to child

What happens to the cardiovascular system in the first year of an infants life?

heart doubles in size pulse decreases 140-140 ---> 100 BP increases 60/40 ---> 100/50 peripheral capillaries are closer to the surface of the skin thermoregulation is more effective teeth

What are peds pain assessment tools?

FACES Oucher Poker chip tool Word-graphic rating scale Visual analog/numatic scale adolescent peds pain tool

What pain scale is used in young children post op?

FLACC

What can be done to make the health assessment easier for a toddler?

incooperate play allow toddler to sit on mom's lap

What does an infant look like who is crying?

infant cries, body moves in disorganized fashion

What is the moro reflex?

infant extends the arms, then slowly retracts them and cries in response to a sensation of falling

What is bronchiolitis?

inflammation of the bronchioles, caused usually by RSV, leads to hyperinflation, atelectasis, impaired gas exchange

How might a toddler interpret a health exam or procedure?

invasive fears body invasion, multilation

What is the focus of discipline for the toddler?

limit setting negotiation techniques to assist toddler to learn problem solving

What are the differences in the respiratory system in a child vs adult?

nasal passages narrower trachea/chest wall more compliant bronci/bronchioles shorter/narrower larynx is more funnel shaped tongue is larger fewer alveioli