Peds unit 3,4
José is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be: Directed at his parents because he is too young to understand Detailed in regard to the actual procedures so he will know what to expect Done several days before the procedure so that he will be prepared Adapted to his level of development so that he can understand
Adapted to his level of development so that he can understand
$ A nurse is providing teaching to the parent of a child who is prescribed both an inhaled bronchodilator and an inhaled corticosteroid. Which of the following information should the nurse include in the teaching? Administer the bronchodilator first Give the corticosteroid alone during an acute asthma attack Wait 20 min or longer between each dose of the medications Rinse the mouth with water before administering the corticosteroid.
Administer the bronchodilator first
A diagnosis of rheumatic fever is being ruled out for a child. Which lab test(s) is/are the most reliable? (Select all that apply.) Throat culture C-reactive protein (CRP) Antistreptolysin-O titer (ASO) titer Elevated white blood cell count (WBC) Erythrocyte sedimentation rate (ESR)
Antistreptolysin-O titer (ASO) titer
Which congenital heart defect results in an increased pulmonary blood flow? Transposition of the great arteries Arterial septal defect Pulmonic stenosis Tricuspid atresia
Arterial septal defect Also PDA; VSD
A 7-year-old boy has reentered the hospital for the second time in a month. Which intervention is particularly important at this time? Assessing his parents' coping abilities Seeking his parents' input about their child's needs Educating his family about the procedure Notifying the care team about his hospitalization
Assessing his parents' coping abilities
$ How to treat sickle cell anemia?
Avoid crowds, don't touch face, no planes, influenza vaccine and pneumonia, pulse ox (93%), NSAIDs and Opioids, hydrate, prevent tissue damage, avoid sports, sleep and rest, don't restrict fluids, cog behavior therapy, biofeedback, acupuncture, massage, aquatic, folic acid (NOT IRON), isotonic fluids, antipyretic, hand wash, antibiotics, warm compress, Deferoxamine (if high level free iron) meperidine is contraindicated
$ The nurse observes an 18mo who has been admitted with respiratory tract infection who is drooling and sitting forward with an open mouth and has a protruding tongue. the nurse should first Position the child supine Call the rapid repsonse team Suction the airway Administer oxygen
Call the rapid response team
A child with hemophilia A has had repeated episodes of hemarthrosis. Which assessment finding is most important to consider? Increased muscle strength Increased cartilage formation Enlargement of the joint space Decreased range of motion
Decreased range of motion
During a sickle-cell crisis, are the following values elevated or decreased; Hgb, WBC count, Bilirubin & reticulocyte levels?
Hgb: decreased WBC: elevated Reticulocytes: elevated
A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? Diarrhea Metabolic acidosis Metabolic alkalosis Hyperacitve bowel sounds.
Metabolic alkalosis
$ pyloric stenosis
Narrowing of the opening of the stomach to the duodenum Hunger, decreased UOP, dehydration, constipaion
$ A nurse is assessing an infant which observation made of the exposed abdomen is most indicative of pyloric stenosis? Substernal retractions Abdominal rigidity Palpable olive like mass Marked distention of lower abdomen
Palpable olive like mass
$ The nurse is caring for a 1-year-old child with a partial airway obstruction with a foreign body. What intervention(s) will the nurse include in the plan of care? Select all that apply Avoid interventions that cause anxiety Place child in a comfortable position Perform back blows and chest thrusts Maintain a quiet environment Keep parents informed of planned procedures and interventions.
Place child in a comfortable position Avoid interventions that cause anxiety Maintain a quiet environment Keep parents informed of planned procedures and interventions.
An 8yr old with asthma is brought to the emergency department with wheezing and shortness of breath which intervention should the nurse implement first: Raise the head of the bed Administer aminophylline Start and intravenous line Perform a peak flow meter test
Raise the head of the bed?
What describes avoidance behavior parents may exhibit when learning their child has a chronic condition Refuses to agree to treatment Withdrawlas from the outside world Verbalizes possible loss of child
Refuses to agree to treatment
$ Coarctation of the aorta should be suspected when: The blood pressure in the arms is different from the blood pressure in the legs The blood pressure in the right arm is different from the blood pressure in the left arm Apical pulse is stronger than the radial pulse Point of maximum impulse is shifted to the left
The blood pressure in the arms is different from the blood pressure in the legs
A 4 month old infant has gastroesophageal reflux. Who is thriving without other complications what should the nurse suggest to minimize reflux? Place in Trendelenburg position after eating Thicken formula with rice cereal, burped after every ounce Give continuous nasogastric tube feedings Give larger, less frequent feedings
Thicken formula with rice cereal, burped after every ounce
$ GERD Patho
Understand when they say it a reflux of stomach and are at risk for aspiration pneumonia
$ The nurse is assessing the abdomen of a 4-week-old infant who is suspected of having pyloric stenosis. Which of the following would the nurse most likely assess? Select all that apply Hepatomegaly Visible peristaltic waves Olive-sized mass in the epigastric area Jaundice Upper abdominal distention
Visible peristaltic waves Olive-sized mass in the epigastric area Upper abdominal distention
The nurse is administering packed red blood cells to a child with sickle cell disease (SCD). The nurse is monitoring for a transfusion reaction and knows it is most likely to occur during which time frame? Six hours after the transfusion is given Within the first 20 minutes of administration of the transfusion At the end of the administration of the transfusion Never; children with SCD do not have reactions.
Within the first 20 minutes of administration of the transfusion
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. a. Administer 100% oxygen by blow-by b. Place infant in knee-chest position c. Remain calm d. Give morphine subcutaneously or by an existing intravenous line
b, a, d, c
For hemophiliac joint disease, bleeding episodes must be treated early with ______________ and __________ during the period of pain
factor replacement; infusions joint immobilization
$ The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? Administer the iron at mealtimes Administer the iron through a straw Mix the iron with cereal to administer Add the iron to formula for easy administration
Administer the iron through a straw
$ A nurse is providing care to a 2-year-old child who presented to the emergency department with a severe nosebleed, and bleeding of the gums. The nurse reviews the laboratory results (above). Based on this information, which nursing intervention will the nurse implement? Take temperatures rectally Administer desmopressin (DDAVP) intramuscularly Administer the prescribed anti-hemophillic agent Apply warm compresses
Administer the prescribed anti-hemophillic agent
The nurse is caring for a child who is in a sickle cell crisis and has severe pain. Which nursing intervention is the most appropriate for this child? Giving comfort measures, such as back rubs Suggesting diversional activities, such as coloring Administering pain medication Preparing the child for painful procedures
Administering pain medication
An infant develops staphylococcus pneumonia nursing care of the child with pneumonia includes which interventions? Select all Strict intake and output to avoid congestive heart failure Administration of antibiotics Cluster care to conserve energy Round-the-clock administration of antitussive agents
Administration of antibiotics; Cluster care to conserve energy
A school-age child with hemophilia falls on the playground and goes to the nurses office with superficial bleeding above the knee. Which action by the nurse is the most appropriate? Apply a warm, moist pack to the area Perform some passive range of motion to the affected leg Apply pressure to the area for at least 15 minutes Keep the affected extremity in a dependent position.
Apply pressure to the area for at least 15 minutes
A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. Which action taken by the nurse will most enhance his psychosocial development? Fax the teen's teacher, and have her send in his homework Encourage the teen's friends to visit him in the hospital Encourage the teen's grandparents to visit frequently Tell the teen he is free to use his phone to call or text friends.
Encourage the teen's friends to visit him in the hospital
A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include (Select all that apply): Give medication to suppress lactation Recommend use of a breast pump to maintain lactation until the infant can suck Teach mother to feed breast milk only by gavage Encourage and help being mother to breastfeed
Encouraging and helping mother to breastfeed; Recommending use of a breast pump to maintain lactation until infant can suck.
When obtaining a health history from the parents of an infant suspected to have altered cardiac function. What would the nurse expect to hear? Specific concerns related to palpitations the infant is having Feeding difficulty, sweating with activity, and poor weight gain Specific concerns about the infant's shortness of breath Concerns related to the infant's lack of crying
Feeding difficulty, sweating with activity, and poor weight gain
The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. Which precipitating factors to a sickle cell crisis will the nurse include in the explanation? Select all that apply Fever Dehydration Regular exercise Altitude Increased fluid intake
Fever; Dehydration; Altitude
Which is the most appropriate nursing intervention to promote normalization of a school age child with chronic illness? Ask the child peers to make the child feel normal The family rules for the child do not need to be the same as for the healthy siblings Convinced the child that nothing is wrong with him or her Give the child as much control as possible
Give the child as much control as possible
$ 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? Explaining to them about the diagnosis and surgery Reinforcing that the ostomy will be temporary Teaching them about the medications used to slow stool output Having a wound, ostomy, and continence nurse meet with them
Having a wound, ostomy, and continence nurse meet with them
$ A 4yr old is diagnosed with acute Kawasaki disease the child is admitted to the pediatric unit and the nurse performs the initial assessment what clinical finding supports this diagnosis? High fever and swollen lips, hands, and feet Insidious onset of a low-grade fever Pealing and desquamation of the skin on the trunk A white coating on the tongue and intermittent fever
High fever and swollen lips, hands, and feet
What congenital anomaly results in mechanical obstruction because of inadequate motility of part of the intestine? Constipation Acute appendicitis Hirschsprung disease GERD
Hirschsprung disease
A newly admitted 6-month-old infant is exhibiting irritability, bulging fontanels, and sun-setting eyes. The nurse would suspect? Increase intracranial pressure Myelomeningocele Hypertension Skull fracture
Increase intracranial pressure
Parents bring their 10 month old infant to the emergency department they state he's breathing so fast he cant eat and he feels hot. Physical examination reveals nasal flaring, clear nasal drainage intercostal retractions and exploratory wheezing. The nurse suspects the infant has what? Epiglottis Acute spasmodic croup Bronchiolitis Aspirated a foreign body
Bronchiolitis
What is the best response for the nurse to give a parent about contacting the physician regarding an infant with diarrhea? Call your pediatrician if the infant has not had a wet diaper for 6 hours The pediatrician should be contacted if the infant has two loose stools in an 8-hour period Call the doctor immediately if the infant has a temperature greater than 100 degrees F Notify the pediatrician if the infant naps more than 2 hours
Call your pediatrician if the infant has not had a wet diaper for 6 hours
$ A 6-year-old girl had a cardiac catheterization at 9 a.m. At 11 a.m. the nurse notes hypotension as compared to baseline. Based on this assessment finding, which of the following would the nurse do first? Check the toes' capillary refill Check the insertion site Assess the child's temperature Recheck the blood pressure every 15 minutes
Check the insertion site
A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? Obtains a weight Takes the temperature Takes the blood pressure Checks the amount of urine output
Checks the amount of urine output
The nurse is caring for a child with sickle-cell anemia admitted to the pediatric unit. The child reports severe pain and fever. The nurse notes the following laboratory values: white blood cells 18,000/mm3, hemoglobin 6.6 mg/dl (66 g/L), and bilirubin 8 mg/dl (136.83 µmol/L). Which nursing action is priority? Administer pain medications Initiate intravenous access Assess the child's temperature Begin an exchange transfusion
Initiate intravenous access
$ A 10 year old with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? Injection of x factor IV infusion of iron Iv infusion of factor vIII IM injection of iron using the Z-track method
Iv infusion of factor vIII
A 4 year old child is brought to the emergency department experiencing severe respiratory distress. The health care provider has diagnosed epiglottis. What nursing interventions should the nurse include in this child's plan of care? Select all that apply Keep the child quiet Administer prescribed nebulizer treatments Have intubation equipment readily available Administer oxygen Start a peripheral IV
Keep the child quiet; Administer prescribed nebulizer treatments; Have intubation equipment readily available
The nurse is developing a teaching plan for the parents of an 11-month-old infant with gastroesophageal reflux disease (GERD). The infant will be managed medically. What action(s) will the nurse incorporate into the teaching plan? Select all that apply Keep the child upright for 30 minutes after feeding Administer a prokinetic to empty the stomach quickly Thin the formula with water to ease the flow Give the child small frequent feedings Administer omeprazole after meals.
Keep the child upright for 30 minutes after feeding Administer a prokinetic to empty the stomach quickly Give the child small frequent feedings
What is a diagnostic for epiglottitis? Blood test Throat swab Lateral neck x-ray of the soft tissue Signs and symptoms
Lateral neck x-ray of the soft tissue
$ Hemophilia Who carries the trait? What are you monitoring for? Treatment? Activities? Caused by abnormalities in?
Mom carries the trait (X-linked) Monitor clot times (PTT), pain in joints (ROM), internal bleed (tachycardia, decreased BP, tachypena, changes in LOC, pale, cool, pupillary changes, bulging fontanel) Factor replace, RICE, (Packed RBC/platelets?? She said that if deficient) Low risk activities (running or swimming) Protein clotting factors
The nurse is caring for a 5 year old with sickle cell disease. What will the nurse include in the client's plan of care? Assess for maxillary prominence Monitor for signs and symptoms of infection Administer deferasirox as prescribed Maintain oxygen saturation at 93% or higher Maintain fluid intake at 1600 ml/m2
Monitor for signs and symptoms of infection; Maintain oxygen saturation at 93% or higher; Maintain fluid intake at 1600 ml/m2
$ The nurse instructs a 10yr old with asthma to use the peak flow meter because it does what? Identifies asthma triggers Monitors daily changes in airway reactivity Indicates whether allergens exposure has occurred Confirms that asthma diagnosis
Monitors daily changes in airway reactivity
The nurse is providing care for an adolescent client who is experiencing pain related to a sickle cell crisis. Which medication does the nurse prepare to administer to this client? Morphine sulfate Meperidine Acetaminophen Ibuprofen
Morphine sulfate
What should the nurse teach about prevention of sickle cell crisis to parents of a preschool child with sickle cell disease: (select all that apply) Limit fluids at bedtime Notify the health care provider if a fever of 101.3 F or greater occurs Give penicillin as prescribed Use ice packs to decrease the discomfort of vasodilation-occlusion pain and in the legs Notify the health care provider if your child begins to develop symptoms of a cold
Notify the health care provider if a fever of 101.3 F or greater occurs; Give penicillin as prescribed; Notify the health care provider if your child begins to develop symptoms of a cold
A preschooler arrives in the emergency department. She is very anxious and irritable and refuses to lie down to be examined. She is sitting up, leaning forward on her hands, and drooling saliva. She is warm to the touch and her color is pale. The nurse should: Take the child's vital signs Notify the physician immediately Ask the parents to wait outside the examining room Start an intravenous line
Notify the physician immediately
A 3-year-old boy in respiratory distress is treated in the emergency department. A diagnosis of acute spasmodic laryngitis (spasmodiccroup) is made. At the time of discharge, the mother asks how to handle another attack at home. What should the nurse recommend? Placing him near a cool-mist humidifier Bringing him to the emergency department Giving him an over-the-counter cough syrup Offering him warm tea sweetened with honey
Placing him near a cool-mist humidifier
How can frequent hospitalizations associated with chronic illness impact the psychosocial development of a preschooler. Preventing a sense of initiative Interfering with the parental attachment Blocking the development of identity Leading to feelings of inferiority
Preventing a sense of initiative
The charge nurse on a pediatric unit is making a room assignment for a school-age child diagnosed with sickle cell disease, who is in splenic sequestration crisis. Which room assignment is most appropriate for this client? Semiprivate room Reverse-isolation room Contact-isolation room Private room
Private room
The nurse is caring for a child who has been brought to the clinic for the third time in a week for asthma symptoms. If the goal is to have the parents better manage the child's care, which information will the nurse emphasize? Select all that apply Role of good handwashing to reduce transmission of disease Adhering to the recommended immunization schedule Engaging in sedentary age-appropriate activity daily Importance of keeping child away from cigarette smokers Instruction on peak flow meters and nebulizer treatments
Role of good handwashing to reduce transmission of disease Adhering to the recommended immunization schedule Importance of keeping child away from cigarette smokers Instruction on peak flow meters and nebulizer treatments
$ The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first? An infant with rhinorrhea, coughing, and oxygen saturation of 92% A toddler with a temperature of 100.1°F (38°C), and a harsh, barking cough A preschool child with crackles in the right lower lobe and chest paina School-age child with dysphagia, drooling, and a hoarse voice
School-age child with dysphagia, drooling, and a hoarse voice
$ The nurse is assessing a child with sickle cell anemia and suspects acute chest syndrome which assessment finding supports this? High fever mild chest and back pain and slurred speech Severe chest and abdominal pain high fever and retractions Severe vomiting chest pains and low oxygenation saturation Afebrile chest and back pain and a cough
Severe chest and abdominal pain high fever and retractions (Emboli, damages lungs, chest pain, hypoxemia, dyspnea, tachycardia, cough, fever, wheeze, respiratory distress, low oxygen saturation, infiltrate, Medical emergency!)
A toddler is admitted to the emergency department with a diagnosis of acute spasmodic laryngitis after the spasms subside the child is ready to be discharged what should the nurse teach the parents to do at home to help prevent another episode Preform postural drainage Use a cool mist vaporizer in the child's room Demonstrate to the child how to expel air after inspiration Discourage a before bedtime snack
Use a cool mist vaporizer in the child's room
$ What measures will the nurse teach parents and children to avoid asthma exacerbations? Select all that apply Limit physical activity Avoid cigarette smoke Use a peak expiratory flow meter (PEFM) Get annual flu vaccine Take prophylactic antibiotics regularly.
Use a peak expiratory flow meter (PEFM) Get annual flu vaccine Avoid cigarette smoke.
$ The child has been diagnosed with asthma and the child's physician is using a stepwise approach. Rank the following in the order the nurse should administer these medications as the child's condition worsens. a. Albuterol as needed. b. Low-dose inhaled corticosteroid c. Medium-dose inhaled corticosteroid d. Medium-dose inhaled corticosteroid and salmeterol
a, b, c, d The first step is to administer a short acting beta 2-agonist as needed. The second step is to administer a low-dose inhaled corticosteroid. The third step is to administer a medium-dose inhaled corticosteroid. The fourth step is to administer a medium-dose inhaled corticosteroid and a long-acting beta 2-agonist.
The nurse is working with the mother of a toddler experiencing constipation. What information regarding childhood constipation should the nurse share with the mother? Select all that apply "Reward your child with a sticker only when he has a bowel movement." "You should not give your son laxatives." "If your child has a fecal impaction, you can give him an enema." "Have your son sit on the toilet twice a day, after breakfast and dinner, for 5 to 15 minutes." "Reward your child for sitting on the toilet as asked, not just when he has a bowel movement."
"Have your son sit on the toilet twice a day, after breakfast and dinner, for 5 to 15 minutes." "If your child has a fecal impaction, you can give him an enema." "Reward your child for sitting on the toilet as asked, not just when he has a bowel movement."
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching? "I should avoid tub baths but may shower." "I have to stay on strict bed rest for 3 days." "I should remove the pressure dressing the day after the procedure." "I may attend school but should avoid exercise for several days."
"I have to stay on strict bed rest for 3 days."
How to use a spacer device?
1. Shake the inhaler before use (3-4) 2. Remove the cap from the inhaler, and from the spacer 3. Put inhaler into spacer 4. Breathe out, away from the spacer 5. Bring spacer to mouth, place mouthpiece between your teeth and close your lips around it 6. Press the top of you inhaler once 7. Breathe in very slowly until you have taken a full breath. If you hear a whistle sound you are breathing in too fast. Slowly breath in. 8. Hold your breath for about ten seconds, then breathe out (rinse mouth each dose)
$ The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child? (Select all that apply.) Finger sticks for blood work instead of venipunctures Avoidance of IM injections Acetaminophen (Tylenol) for mild pain control Soft tooth brush for dental hygiene Administration of packed red blood cells
Avoidance of IM injections; Acetaminophen (Tylenol) for mild pain control; Soft tooth brush for dental hygiene
A child is diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. Which explanation by the nurse is the most appropriate? Both the mother and the father have the sickle cell trait The mother has the trait, but the father doesnt. The father has the trait, but the mother doesnt. The mother has sickle cell disease, but the father doesnt have the disease or the trait.
Both the mother and the father have the sickle cell trait
$ Frequent hospital visits how to support an 8yr old
Homework visitors
What is sequestration crisis?
Pooling of blood in spleen (splenomegaly); sometimes liver (hepatomegaly) reduced circulating blood (anemia) results in hypovolemia and can progress to shock hypovolemic shock: irritability, tachycardia, pallor, decreased urinary output, tachypnea, cool extremities, thready pulse, hypotension,
Parents of a school-age child with hemophilia ask the nurse, "Which sports are recommended for children with hemophilia?" Which sports should the nurse recommend? (Select all that apply.) Soccer Swimming Basketball Golf Bowling
Swimming; Golf; Bowling
The regulation of red blood cell (RBC) production is thought to be controlled by which physiologic factor? Hemoglobin Tissue hypoxia Reticulocyte count Number of RBCs
Tissue hypoxia
A nurse caring for a neonate immediately after birth notices an excessive amount of frothy mucus coming from the child's nose and mouth. What condition does the nurse suspect? Cleft lip Cleft palate Biliary atresia Tracheoesophageal fistula
Tracheoesophageal fistula
What can cause vaso-occlusive crisis?
dehydration localized hypoxemia altitude infection Injury physical or emotional stress temperature extremes (hot or cold)
What does the nurse recognize as a nursing intervention that is contraindicated for children, especially infants with acute diarrhea? Bathing BRAT diet Breastfeeding Rehydration solution
BRAT diet
A two-year-old child is brought to the ER in respiratory distress a child is drooling sitting upright in lean forward which interest out mouth open and tongue protruding which nursing intervention is most appropriate? Check the child gag reflex with the tongue blade Allow the child to cry to keep the lungs expanded Check the airway for a foreign body obstruction Support the child in an upright position on the parents lap
Support the child in an upright position on the parents lap
The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma? "I'm going to have the respiratory therapist get some of the mucus from your lungs." "I'm going to have this hospital worker take a picture of your lungs." "We're going to go take a look at your lungs to see if there are any sores on them." "I'm going to hold your hand while the phlebotomist gets blood from your arm."
"I'm going to have this hospital worker take a picture of your lungs."
The nurse is assessing several children. Which child is most at risk for dysphagia? 7-month old with erythematous rash 8-year old with fever and fatigue 5-year old with epiglottitis 2-month old with toxic appearance
5-year old with epiglottitis
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 milk after each episode of diarrhea" "I should tak the baby's temperature and call my physician" "I could give kaopectate as long as I follow the directions on the bottle" "I should offer pedialyte after 1 hour and frequently thereafter to prevent dehydration"
"I should offer pedialyte after 1 hour and frequently thereafter to prevent dehydration"
$ A school-age child with diarrhea has been rehydrated. The nurse is discussing the child's diet with the family. Which statement by the parent would indicate a correct understanding of the teaching? "I will keep my child on a clear liquid diet for the next 24 hours." "I should encourage my child to drink carbonated drinks but avoid food for the next 24 hours." "I will offer my child bananas, rice, applesauce, and toast for the next 48 hours." "I should have my child eat a normal diet with easily digested foods for the next 48 hours."
"I should have my child eat a normal diet with easily digested foods for the next 48 hours."
A nurse teaching a family about the use of pancreatic enzymes in the treatment of cystic fibrosis should include: "Give the preparation three times a day and before bedtime." "Dissolve the enzymes in warm whole milk." "Increase the dosage if the child has loose, fattystools." "Chewing the enzymes will increase theirefficacy."
"Increase the dosage if the child has loose, fattystools."
$ What meal would be appropriate for school age child with celiac disease? Beef barley soup with rice cakes Baked chicken and corn Cheese burger on rye bread Hot dog and flavored yogurt
Baked chicken and corn
One of the goals for children with asthma is to prevent respiratory tract infection the nurse knows that a respiratory infection does which of the following? Lessen effectiveness of medications Encourage exercise-induced asthma Increase sensitivity to allergens Can trigger an episode or aggravate asthmatic state
Can trigger an episode or aggravate asthmatic state
Which is a common serious complication of rheumatic fever? Seizures Pulmonary hypertension Cardiac arrhythmias Cardiac valve damage
Cardiac valve damage
$ The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality? Greasy Clay- colored Currant Jelly like Bloody
Currant Jelly like
A nurse is teaching the parents of a child with cystic fibrosis about proper nutrition. Which instruction should the nurse include? Selects all Give pancreatic enzymes with meals Give high calorie food and snacks Administer water soluble vitamins Provide foods that are high in proteins
Give high calorie food and snacks Provide foods that are high in proteins (Fat soluble vitamin A, D, E, K; high fat)
In administration of antibiotics. What should the nurse teach about prevention of sickle cell crisis to parents of a preschool child with sickle cell disease? Select all Limit fluids at bedtime Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs Give penicillin as prescribed Use ice packs to decrease the discomfort of vasoocclusive pain in the legs Notify the health care provider if your child begins to develop symptoms of a cold
Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs; Give penicillin as prescribed; Notify the health care provider if your child begins to develop symptoms of a cold
$ The nurse is obtaining the history of an infant with a suspected intestinal obstruction. Which response regarding newborn stool patterns would indicate a need for further evaluation for Hirschsprung disease? Has had diarrhea for 3 days Passed a meconium plug Constipated and passing gas for 2 days Passed a meconium stool in the first 24 to 48 hours of life
Passed a meconium plug No BM within 48hours and have a distended abdomen and temp colostomy
A child with bronchopulmonary dysplasia is being discharged. The nurse includes teaching about ways to manage the child's airway secretions. Which of the following would the nurse likely include? Select all that apply Suctioning Chest physiotherapy Coughing Pulse oximetry Oxygen therapy
Suctioning; Chest physiotherapy
When evaluating the extent of an infant's dehydration, the nurse should recognize that the symptoms of severe dehydration are: Tachycardia, decreased tears, 5% weight loss Normal pulse and blood pressure, intense thirst Irritability, moderate thirst, normal eyes and fontanels Tachycardia, parched mucous membranes, sunken eyes and fontanels
Tachycardia, parched mucous membranes, sunken eyes and fontanels
$ A nurse is teaching the parents of a child with cystic fibrosis how to perform chest physiotherapy. Which of the following techniques would the nurse include in the teaching plan? Select all that apply Deep breathing Postural drainage Suctioning Percussion Coughing
Deep breathing Postural drainage Percussion Coughing
A toddler with a history of enlarged lymph nodes prolonged fevered that is unresponsive to antibiotics arrhythmia of the extremities in a rash is admitted with a diagnosis of Kawasaki disease. What would the nurse suspect was essential in confirming this diagnosis? An increased sedimentation rate An increase anti-titer A low grade fever A combination of signs
A combination of signs
A nurse is caring for a 14month old boy with cystic fibrosis which sign of ineffective family coping requires urgent and immediate intervention? The child feels fearful and isolated Siblings are jealous and worried The family becomes over vigilant Compliance with therapy is diminished
Compliance with therapy is diminished
The nurse is caring for a 14-month-old boy with cystic fibrosis. Which sign of ineffective family coping requires urgent intervention? The child feels fearful and isolated Siblings are jealous and worried Compliance with therapy is diminished The family becomes over vigilant
Compliance with therapy is diminished. Cystic Fibrosis
$ The nurse is admitting a child who has been diagnosed with Kawasaki disease. What is the most serious complication for which the nurse should assess in Kawasaki disease? Cardiac valvular disease Cardiomyopathy Coronary aneurysm Rheumatic fever
Coronary aneurysm
Which therapy is least likely to be used for a child with cystic fibrosis who is hospitalized with a respiratory infection? Chest physiotherapy every 3 hours Intravenous antibiotics Cough-suppressant medications Postural drainage
Cough-suppressant medications
$ A 4yr old is suspected of having an intussusception and is scheduled for an enema. What symptoms of this disorder would you see in your assessment? Watery diarrhea Palpable mass in the left lower quadrant Constant severe abdomen pain Stools that are bloody and contain mucus
Stools that are bloody and contain mucus
What is the most common causative agent of bacterial endocarditis? Staphylococcus albus Streptococcus hemolyticus Staphylococcus albicans Streptococcus viridans
Streptococcus viridans
$ Fistula teaching What to do s/s
Suctioning Breastfeeding Frothy mucus drool NG tube to decompress the stomach notice if they start to eat
$ The nurse encourages the mother of a 20 month old with acute laryngotrachobronchitis (LBT). To stay at the bedside as much as possible. What is the rationale for this action? Separation from the mother is a major developmental threat at this age The mother can provide constant observation of the child's respiratory effort The mothers presence will reduce anxiety and ease the childs respiratory efforts
The mothers presence will reduce anxiety and ease the childs respiratory efforts
The newborn was diagnosed with esophageal atresia and a nasogastric tube was inserted. Which findings are most consistent with this condition? Select all. The newborns mouth was very dry The newborn coughed excessively during attempts to feed The newborns skin was very jaundiced Coarse crackles were auscultated throughout all lung fields X-ray revealed that the nasogastric tube was coiled in the upper esophagus
The newborn coughed excessively during attempts to feed Coarse crackles were auscultated throughout all lung fields X-ray revealed that the nasogastric tube was coiled in the upper esophagus
A child diagnosed with hemophilia plans on participating in a bicycling club. Which recommendation by the nurse is the most appropriate Consider a swim club instead of the bicycling club Wear kneepads, elbow pads, and a helmet while bicycling Participate only in the social activities of the club Not join the club
Wear kneepads, elbow pads, and a helmet while bicycling
An infant, with a medical diagnosis of severe dehydration, is on parenteral therapy. Which of the following would be the most valuable information for the nurse to obtain to evaluate the infant's response to the therapy? Count the number of wet diapers every shift Weigh the infant at the same time every day Assess the mucous membranes every shift Palpate the anterior fontanel every morning
Weigh the infant at the same time every day
