Peds Unit 5 & 6 Test
patient teachings about "croup"
-give Tylenol with fever -stay hydrated; drink plenty of fluids -place in cooler area during an attack
What are classic signs of diabetes type 1?
-glycosuria -polyuria -weight loss despite good appetite
indication a child has hypertrophic pyloric stenosis
a mass along the right of the midline
position that the femur is in with a palvic harness
abduction
cause of Hirschsprung Disease
absence of parasymphathetic ganglionic cells
danger with child who has acute epiglottis
airway obstruction
special considerations for a newborn with spina bifida (myelomeningocele)
always keep incision covered with saline soaked sterile gauze and wrapped to keep in moisture
What do you prevent through TSH replacement for a child with hypothyroidism?
cognitive impairment
What is a serious condition caused due to uncontrolled diabetes?
diabetic ketoacidosis (DKA)
What should be avoided in regards to caring for a plaster cast on a child?
do not apply lotion or powder around the edges to relieve itching
What should be done if a small amount of reddish drainage from a child's ear following the insertion of tympanostomy tubes?
document the findings
a school aged child with type 1 diabetes has soccer practice three afternoons a week. What should the nurse tell the child I regards to how to prevent hypoglycemia?
drink half a cup of orange juice before soccer practice
the nurse, caring for a child with aplastic anemia, is reviewing the lab results and notes a WBC of 6000 cells/mm3 and a platelet of 20K cells/mm3. which nursing intervention should be incorporated into the plan of care?
encourage quiet play activities
a mother of a 6 year old with type 1 diabetes calls the clinic and tells them that the child has been sick and that the urine shows positive ketones. What should the nurse instruct the mother to do?
encourage the child to drink liquids
most common sign of cystic fibrosis
excessive, thick mucus
the nurse reviews the record of a 3 week old infant and notes that the HCP has documentrd a diagnosis of suspected Hirschsprungs disease. the nurse understands that which manifestation led to the mother to seek health care?
foul-smelling, ribbon like stools
What should be avoided with a child diagnosed with croup?
giving cough syrup when a cough develops
the best response to ROM exercises for a child diagnosed with juvenile idiopathic arthritis
have the child perform simple isometric exercises during times of painful exacerbation of the disease
what do you do if a toddler has laryngeotracheobrochitis and O2 is at 25% with normal ABG
increase O2
normal fasting glucose level for a child
less than 100 mg/dL
How long does a child need INH for?
minimum of 9 months
What should be done if a child complains of abdominal discomfort and begins to vomit after a spinal fusion for the treatment of scoliosis?
notify the RN
What should be done if a child with a cast on his leg complains of tingling in the toes distal to the fracture site?
notify the RN
the nurse is monitoring for bleeding in a child after surgery to remove a brain tumor. the nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. which nursing action is appropriate?
notify the RN
What is the best position to place an infant who just had surgiccal repair of the right side cleft lip?
on his or her left side
How do you place an infant with myringotomy?
on the affected side
What is the treatment of choice for thyroidism?
oral thyroid replacement
oral iron supplements are prescribed for a 6 year old child with iron deficiency anemia. the nurse reinforces instructions to the mother and tells the mother to administer the iron with which best food item?
orange juice
What should be avoided when caring for a child in skeletal traction?
placing the bed linens on the traction ropes
10 mm area of induration following a TB skin test should be interpreted how?
positive
infants prone to getting Respiratory Distress Syndrome (RDS)
preterm or Low Birth Weight (LBW) babies
if treatment does not begin immediately for a child with diabetic ketoacidosis, what can happen?
progressive deterioration with dehydration, electrolyte imbalance, ketoacidosis, coma and even death
What is a common symptom of pyloric stenosis?
projectile vomiting
what is expected with a child diagnosed with pyloric stenosis?
projectile vomiting
What should you never do with a child wearing a brace?
put lotion on since it promotes skin breakdown
what method of temperature measurement should be avoided who has diarrhea?
rectal
What does glomerulonephritis cause?
reddish-brown urine due to an infection
which food item is advised for a child with celiac disease?
rice
What should be avoided for a child diagnosed with conjunctivitis?
sharing towels and washcloths
How do you place a child who just had a tonsilectomy?
side lying
the nurse is caring for an 18 month old child who been vomiting. What is the appropriate position to place the child during naps and sleep time?
side lying position
How do you position an infant to prevent SIDs?
supine
What is the most common characteristic of nephrotic syndrome?
swelling or edema
observation that may be indicative of strabismus
the child consistently tilts his or her head to see
indication of airway obstruction in a child diagnosed with epiglottitis
the child thrusts the chin forward and opens the mouth
How do you treat an infant with GER?
thicken milk with rice cereal
How is diabetes mellitus diagnosed?
through a basis of glucose test results including an 8-hour fasting glucose test
why is a child diagnosed with laryngotracheobronchitis kept NPO?
to prevent aspiration
best reason for performing the Ortolani maneuver
to reduce the dislocated femoral head back into th acetabulum
How is a child with an IQ of 45 identified?
trainable level
initial action if a child vomits bright red blood following a tonsillectomy
turn child to the side
What is the difference between type 1 and type 2 diabetes mellitus?
type 1 is when the pancreas does not produce insulin and type 2 is when there is an insulin resistance
What is the most common form of diabetes mellitus?
type 2 diabetes mellitus
when should you take a child to the hospital who has Hirschsprung Disease?
when they pass foul smelling, ribbon-like stools
How should someone with a surgically repaired cleft palate drink?
with a cup
the nurse is reviewing the health record of a 14 year old child who is suspected of having Hodgkins disease. which is the primary characteristic of this disease?
painless, firm, and moveable lymph nodes in the cervical area
a 4 year old child is hospitalized with a suspected diagnosis of Wilms tumor. the nurse reciewa the plan of care and should question which intervention that is written in the plan?
palpate the abdomen for a mass
special considerations of a child who has bronchiolitis due to RSV
place in a private room near the nurses station
What should you avoid for a child with an acute spasmodic episode?
placing a steam vaporizer in the child's room
the nurse reinforces instructions to the parents of a child with leukemia regarding measure related to monitoring for infection. which statement by the parents indicates the need for further teaching?
"I need to check my child's rectal temperature daily"
the nurse reinforces home-care instructions to the parent of a 3 year old child who has been hospitalized with hemophilia. which statement by a parent indicates the need for further teaching?
"I will avoid immunizations and dental hygiene treatments for my child"
the nurse reinforces home care to th parents of a child with hepatitis regarding the care of the child and prevention of transmission of the virus. which statement indicates a need for further teaching?
"I will provide a well balanced, high fat diet to my child"
what statement about phenylketonuria (PKU) indicates an understanding?
"all 50 states require routine screening of all newborns for PKU"
the nurse instructor asks a student nurse to describe osteogenic sarcoma. which statement by the student indicates the need to further research the disease?
"the child does not experience pain at the primary tumor site"
What indicates ketoacidosis?
-CBG greater than 300mg/dL -ketones highly present in blood plasma -ABG determinations demonstrate metabolic acidosis (pH less than 7.30) -glycosuria -ketonuria
prediabetic fasting glucose levels
100 - 125 mg/dL
when can a child get out of isolation if diagnosed with meningitis?
24 after the start of antibiotics
glycosylated haemoglobin (A1c) level
4 - 6.5%
What is indicative of diabetes in a child?
A1c value of higher than 6.5% on two separate tests
abnormal lab results for hemophilia
PTT
What is an insulin pump?
a pump that mimics the release of the insulin hormone from the islet cells of the pancreas
best time to administer pancreatic enzymes
before meals or with a snack
Identifiable characteristic of the stool of a child with intussusecption
blood and mucus in the stool
the nurse is caring for a child with a diagnosis of intussusecption. which manifestation should the nurses expect to find?
blood and mucus in the stools
what supplement is required to avoid lactose in the diet of a child who is lactose intolerant?
calcium
priority when performing a neurovascular check for tissue perfusion in a child with an arm cast
checking peripheral pulse in the affected arm
best meal that illustrates the most appropriate diet for a child with cystic fibrosis
chicken tenders and a baked potato with butter
most likely manifestation of a child diagnosed of esophageal atresia with tracheoesophageal fistula (TEF)
choking with feeds
diet restrictions/ type of fluids for a child who had a tonsilectomy
clear liquid diet; give yellow jell-o
What does it mean for a child who has type 1 diabetes?
they are insulin dependent and they should have glucose tested before exercise
lab value considered diabetic
fasting glucose level higher than 125 mg/dL or a random blood glucose level higher than 200 mg/dL
which precipitating factor relating to sickle cell pain crisis indicates a need for further teaching?
fluid overload
a child diagnosed with a hernia has been scheduled for a surgical repair in 2 weeks. the nurse reinforces to the parents about the signs of possible hernia strangulation such as?
vomiting
common symptom of a child with a strangulated hernia
vomiting
How often do you change the cast for a newborn with talipes (club foot)
weekly
How do you measure an infant for dehydration?
weight the diapers
What should you expect for a patient with nephrotic syndrome (nephrosis)?
-high levels of serum lipids -low serum protein and albumin -dark urine with a high specific gravity
What should nursing interventions focus on for a child with diabetes mellitus?
-educating the child and the family about the disease, it's treatment, and possible complications -provide emotional support and reassurance
What determines appropriate daily insulin dosage for a child?
-food intake -activity level -exercise level
the nurse is assigned to care for a child who is scheduled for an appendectomy. which prescriptions does the nurse question?
-initiate an IV line -maintain NPO status -administer IV antibiotics -administer preoperative medications
instructions for caring for a child with a plaster cast
-keep small toys and sharp objects away from cast -elevate extremity on pillows for the first 24 to 48 hours after casting to prevent swelling
What are classic signs of diabetes type 2?
-manifestations of metabolic acidosis with or without stupor -coma
which prescriptions in a childs health record with sickle cell anemia being treated for a vaso-occlusive crisis, should the nurse question?
-restrict fluid intake -administer meperidine (Demerol) 25mg for pain
How do you determine if a child has depression?
ask direct questions about if they have ever thought about suicide
How does the stool of a child with intussusecption look
current jelly stool
What is hard to do for a child who has acute glomular nephritis?
keep on bedrest
