Prepu: Chapter 15: Nursing Care of the Child with an Infection
When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? "Your child must have been exposed to someone with herpes zoster." "Herpes zoster is a reactivation of a previous varicella zoster infection." "Handwashing is an effective way to prevent the spread of infectious disorders." "Children who are immunocompromised are more likely to contract shingles."
"Herpes zoster is a reactivation of a previous varicella zoster infection." Explanation: Herpes zoster (shingles) is reactivation of the latent varicella zoster (chickenpox) infection that occurs during times of immunosuppression and aging. Although it is possible to contract the varicella zoster virus from a person with herpes zoster or varicella zoster, a child diagnosed with herpes zoster has already been exposed to varicella zoster. Handwashing will not directly prevent herpes zoster. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, TABLE 15.4 Common Viral Exanthems of Childhood (Continued), p. 448. Chapter 15: Nursing Care of the Child with an Infection - Page 448
The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first?
Obtain blood cultures
The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first? Initiate antibiotic therapy. Obtain blood cultures. Initiate intravenous therapy. Obtain urine specimen for analysis.
Obtain blood cultures. Explanation: When treating a child suspected of having an infection, the blood cultures must be obtained first. The administration of antibiotics may impact the culture's results. A urine specimen may be obtained but is not the priority action. Intravenous fluids will likely be included in the plan of care but are not the priority action. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, OBTAINING BLOOD SPECIMENS, p. 431. Chapter 15: Nursing Care of the Child with an Infection - Page 431
A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? Severity of the sore throat An enanthematous rash Red, strawberry tongue White exudate on the tonsils
Red, strawberry tongue Explanation: The characteristic assessment finding that distinguishes scarlet fever from other disorders is the appearance of the red, strawberry tongue. Sore throat, an enanthematous and exanthematous rash, and white exudate on the tonsils are also seen with scarlet fever, but it is the strawberry tongue that helps to confirm the diagnosis. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Scarlet Fever, p. 441. Chapter 15: Nursing Care of the Child with an Infection - Page 441
A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client?
The dog was unprovoked when he bit the girl
The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first? a child with herpes simplex who is reporting mouth pain and pruritis a child with erythema infectiosum experiencing fatigue and confusion a child diagnosed with chicken pox reporting nausea and malaise a child diagnosed with measles experiencing photophobia and coryza
a child with erythema infectiosum experiencing fatigue and confusion Explanation: Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, TABLE 15.4 Common Viral Exanthems of Childhood (Continued), p. 450. Chapter 15: Nursing Care of the Child with an Infection - Page 450
Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)? a 1-year-old receiving oral amoxicillin for otitis media an 18-month-old child receiving chemotherapy over 5 days a 2-year-old child with HIV being discharged later that day a 3-year-old child with malnutrition and poor weight gain
an 18-month-old child receiving chemotherapy over 5 days Explanation: Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Community-Acquired MethicillinResistant Staphylococcus Aureus, p. 440. Chapter 15: Nursing Care of the Child with an Infection - Page 440
The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is: penicillin acyclovir ceftriaxone griseofluvin
penicillin Explanation: Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Therapeutic Management, p. 455. Chapter 15: Nursing Care of the Child with an Infection - Page 455
The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother? "The immunities that the infant is born with are not for the same diseases they will be immunized against." "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." "Infants are unable to develop antibodies to protect them from diseases so they must be immunized." "The antibodies the fetus gets from the mother are in the placenta, so after birth they are no longer available to the infant."
"The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." Explanation: During fetal life, the mother's antibodies cross the placenta, giving the fetus a temporary immunity against certain diseases. This immunity is present at birth and decreases during the first year of life. In the meantime, the infant begins developing antibodies to fight against pathogens and disease. In addition, during the first year of life immunizations are started to help the infant develop protection against certain diseases. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Viral Exanthems, p. 447. Chapter 15: Nursing Care of the Child with an Infection - Page 447
An 11-year-old girl arrives at the doctor's office with fever, a sore throat, chills, and malaise. A throat culture indicates scarlet fever. Which other symptom should the nurse notice in this client that clearly indicates scarlet fever? Fever blisters on the lips Vesicles that become purulent, ooze, and form honey-colored crusts There is pain along the jawline just in front of the ear lobe The tongue has a white or red "strawberry" appearance
The tongue has a white or red "strawberry" appearance Explanation: A "strawberry tongue" is a hallmark symptom of scarlet fever and helps to differentiate the disease from other rashes or pharyngeal infections. Pain along the jawline in front of the ear lobe indicates mumps. Vesicles that become purulent, ooze, and form honey-colored crusts are associated with impetigo. Fever blisters on the lips are caused by a herpes simplex infection. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Scarlet Fever, p. 441. Chapter 15: Nursing Care of the Child with an Infection - Page 441
Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)? a 1-year-old receiving oral amoxicillin for otitis media a 3-year-old child with malnutrition and poor weight gain an 18-month-old child receiving chemotherapy over 5 days a 2-year-old child with HIV being discharged later that day
an 18-month-old child receiving chemotherapy over 5 days Explanation: The children at highest risk for contracting a hospital-acquired infection include children younger than 2 years of age, children with a nutritional deficit, those who are immunosuppressed, those who have indwelling vascular lines or catheters, are receiving multiple antibiotic therapy, or who remain in the hospital for longer than 72 hours. To determine the child at greatest risk, count risk factors and determine which child has the most risk factors. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Community-Acquired MethicillinResistant Staphylococcus Aureus, p. 440. Chapter 15: Nursing Care of the Child with an Infection - Page 440
An adolescent comes to the emergency room with high fevers, chills, rigors and sweats. Malaria is suspected. When taking the health history, what question should the nurse ask first? "When did your symptoms begin?" "Is anyone else in your household sick?" "Have you traveled outside North America?" "Are there days your symptoms are worse?"
"Have you traveled outside North America?" Explanation: Malaria comes from a bite of Anopheles species of mosquito. The infection produces high fevers, chills, rigors, sweats, headaches and arthralgia. If the disease is suspected, it would be most important for the nurse to know if the adolescent had traveled to any areas in Africa, Asia or South America, where the type of mosquitoes are found that produce malaria. All of the other questions are appropriate, but they are not as important as the travel, which could help lead to a definitive diagnosis. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, TABLE 15.5 Other Zoonotic and Vector-Borne Illnesses, p. 453. Chapter 15: Nursing Care of the Child with an Infection - Page 453
When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? "Herpes zoster is a reactivation of a previous varicella zoster infection." "Your child must have been exposed to someone with herpes zoster." "Children who are immunocompromised are more likely to contract shingles." "Handwashing is an effective way to prevent the spread of infectious disorders."
"Herpes zoster is a reactivation of a previous varicella zoster infection." Explanation: Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, TABLE 15.4 Common Viral Exanthems of Childhood (Continued), p. 448. Chapter 15: Nursing Care of the Child with an Infection - Page 448
A child has been diagnosed with hookworm. The nurse is teaching the parent about the treatment for the condition. Which statement made by the parent confirms that further education is needed? "I should have my child eat more foods with iron." "The medications should be taken for 2 weeks." "My child can play outside bare footed when treatment is done." "I should have my other children tested."
"My child can play outside bare footed when treatment is done." Explanation: Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, p. 460. Chapter 15: Nursing Care of the Child with an Infection - Page 460
The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse? "The pathogens cause an overproduction of proinflammatory cytokines. These cytokines are responsible for the clinically observable effects of the sepsis." "Sepsis results in systemic inflammatory response syndrome (SIRS) due to infection." "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys." "The pathophysiology of sepsis is complex."
"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."
The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? Encourage rest and relaxation. Range of motion to prevent contractures. Antiviral medications can be prescribed. Antibiotic therapy may be initiated.
Encourage rest and relaxation. Explanation: Rubella infection is usually mild and self-limited. The care given is normally supportive. Rest is encouraged. Medications administered are normally limited to antipyretics and analgesics. Antibiotic and antiviral therapies are not normally included in the plan of treatment. Range of motion is not needed as mobility of the client is not limited. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, TABLE 15.4 Common Viral Exanthems of Childhood, p. 446. Chapter 15: Nursing Care of the Child with an Infection - Page 446
A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply. Ascariasis Lyme disease Scabies Psittacosis Rocky Mountain spotted fever
Lyme disease Rocky Mountain spotted fever Explanation: Infectious diseases caused by tick bites include Lyme disease and Rocky Mountain spotted fever. Psittacosis is transmitted to children by birds. Ascariasis is a roundworm infection. Scabies is a parasitic infection caused by a female mite. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, INTRODUCTION, p. 424. Chapter 15: Nursing Care of the Child with an Infection - Page 424
An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate? Take the child to a private room and interview her regarding her sexual history and partners. Take the caregiver to a private room and tell her that the child's diagnosis can only come from sexual activity. Contact the necessary authorities to report a suspected case of sexual abuse. Talk to the child and caregiver together and explain that the condition is often a result of a sexually transmitted infection and discuss the importance of safe sex practices.
Take the child to a private room and interview her regarding her sexual history and partners. Explanation: Adolescents must be made aware of the seriousness of PID, a common result of a chlamydial infection. Pelvic inflammatory disease can cause sterility in the female, primarily by causing scarring in the fallopian tubes that prohibits the passage of the fertilized ovum into the uterus. A tubal pregnancy may be the consequence of a chlamydial infection. In the male, sterility may result from epididymitis caused by a chlamydial infection. All sexual partners must be treated. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Female Symptoms, p. 465. Chapter 15: Nursing Care of the Child with an Infection - Page 465
A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder? The child has had 7 wet diapers in the past 24 hours. The child cries when his mother is not in sight. The child's birth history indicates he was born at 42 weeks' gestation. The child has had 8 ounces of formula in the past 24 hours.
The child has had 8 ounces of formula in the past 24 hours.
Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)? a 3-year-old child with malnutrition and poor weight gain an 18-month-old child receiving chemotherapy over 5 days a 1-year-old receiving oral amoxicillin for otitis media a 2-year-old child with HIV being discharged later that day
an 18-month-old child receiving chemotherapy over 5 days Explanation: The children at highest risk for contracting a hospital-acquired infection include children younger than 2 years of age, children with a nutritional deficit, those who are immunosuppressed, those who have indwelling vascular lines or catheters, are receiving multiple antibiotic therapy, or who remain in the hospital for longer than 72 hours. To determine the child at greatest risk, count risk factors and determine which child has the most risk factors. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 15: Nursing Care of the Child with an Infection, Community-Acquired MethicillinResistant Staphylococcus Aureus, p. 440. Chapter 15: Nursing Care of the Child with an Infection - Page 440