Units H & I

Nasopharyngitis

Common cold. Caused by numerous viruses. Antipyretic for mild fever and discomfort. Rest during fever +1 day post fever. Antihistamines are usually ineffective, may cause drowsiness but have a paradoxial stimulatory effect on children. Antibiotics are not indicated.

The nurse is assessing a group of infants and notes one of the infants has chronic constipation and an enlarged abdomen. The nurse would determine this infant is showing indications of which condition? Congenital hypothyroidism Phenylketonuria Turner syndrome Galactosemia

Congenital hypothyroidism

It is summer time, and the mother of a 6-year-old boy tells the nurse that the mosquitoes in their neighborhood are terrible this year. She says she has heard of cases of West Nile virus in the area and asks the nurse what she can do to protect her son from it. Which of the following should the nurse recommend to the mother? Instruct the son to stay inside from 11 am to 3 pm Avoid using mosquito repellants that contain DEET Have the son dress in light-colored clothing Drain any standing water in the yard

Drain any standing water in the yard

When should the nurse count the respiratory rate of a child? During sleep During running During playing During crying

During sleep

Nursing care for impaired cognitive function

Earliest intervention is to identify and educate. Teach child self-care skills, promote optimal development, play and exercise, socialization.

Nurse management-respiratory

Ease respiratory effort, promote rest and comfort, prevent spread of infection, reduce temperature, promote hydration and nutrition, family support and home care.

Tonsillitis

Edema causing tonsils to "kiss" leading to difficulty swallowing and breathing. Adenoids can be involved which make it difficult or impossible for air to pass from the nose to the throat. TX: important to know the cause of infection. Viral; treated with cool mist, warm saltwater gargles, throat lozenges, and analgesic-antipyretic drugs. For bacterial; ATB prescribed. Tonsillectomy and adenoidectomy for recurrent infection.

What are the 3 criteria needed to identify an intellectual disability?

Intellectual functioning (determined by IQ). Functional strengths and weaknesses (unable to 2 out of the 10 adaptive functions). Diagnosed before the age of 18.

chronic illness

Interferes with ADL's for more than 3 months in a year.

The nurse is preparing to assess an infant who is diagnosed with a ventricular septal defect. Which assessment finding should the nurse be prepared to document? Fatigue and dyspnea Bounding pulse Loud, harsh murmur Delayed growth and development

Loud, harsh murmur

Developmental delay

Maturational lag.

Which situation requires parental permission to perform an autopsy on a child who has died?

Medical research and progress

Education- Mono

Patients should avoid contact sports and rough housing to prevent injury to the spleen. Patients should make sure they are completely healed before returning to activities to avoid relapse which may be worse. Acetaminophen should be avoided to because the patient would be at greater risk for hepatotoxicity when the liver is enlarged. Avoid alcohol.

Flu

Range from mild-severe. Dry throat, nasal mucosa, a dry cough, hoarseness, a sudden onset of fever and chills. Last up to 4-5 days. TX: only symptoms are treated, Antivirals (tamiflu) may be used to shorten symptoms.

Pyloric stenosis has been diagnosed in a 3-week-old male infant who has frequent vomiting after feedings. An important preoperative nursing intervention is: Reducing vomiting by feeding small amounts of clear liquids or breast milk frequently. Providing adequate pain control. Assessing the abdomen hourly for distention and bowel sounds. Maintaining NPO status while restoring hydration and electrolyte balance

Maintaining NPO status while restoring hydration and electrolyte balance.

The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care? Offering Kool-Aid or popsicles as tolerated Encouraging consumption of fruit juice Maintaining the intravenous (IV) fluid rate as ordered Encouraging milk products to boost caloric intake

Maintaining the intravenous (IV) fluid rate as ordered

A nurse is caring for a 17-year-old female client with bulimia. Which complication of this disease may the nurse see in this child? Severe acne Menstrual problems Hernia Partial paralysis

Menstrual problems

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The mother informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The physician diagnoses the child with erythema infectiosum. The nurse tells the mother that this is also known as: enterovirus. fifth disease. pityriasis rosea. rosacea.

fifth disease.

ADHD- problem areas

Receptive language, expressive language, information processing, memory, motor coordination, orientation, behavior.

How are respiratory infections described?

According to the anatomical area involved. Causes and course are affected by the age of the child, the season, living conditions and pre-existing medical problems.

A 3-year-old who has been attending preschool has been diagnosed with leukemia. The caregivers of this child ask the nurse what they can do to help their child feel secure. Which recommendation could the nurse make to these caregivers that would be helpful in making the child feel secure?

"Let your child continue to attend preschool as much as possible."

Which piece of equipment is most helpful in determining airway obstruction in the client with asthma? A peak flow meter An incentive spirometer A nebulizer An inhaler

A peak flow meter

A nursing student is learning about developmental disorders. The nursing instructor realizes that further instruction is necessary when the student makes which statement? "Families should not be blamed for causing a developmental delay." "A definitive cause can be found for every developmental disorder." "Families should work to facilitate the child's progress." "Families should be helped to accept the child's developmental delay."

"A definitive cause can be found for every developmental disorder."

A woman has just confided in the nurse that her partner slapped and kicked her that morning. What is the best response by the nurse?

"It's very brave of you to tell me all this. Help is available if you choose it."

A nurse is preparing a 6-year-old boy for an emergency appendectomy. The boy is in a lot of pain and also scared. Which statement would be best to explain this surgery to him? "We are going to fix the part that hurts down there so that it doesn't hurt anymore." "The surgeon is going to perform an emergency appendectomy, which involves the surgical removal of your vermiform appendix." "The surgeon is going to remove your appendix, so that it doesn't hurt anymore." "The surgeon is going to cut off part of your large intestine that hurts and sew you back up."

"We are going to fix the part that hurts down there so that it doesn't hurt anymore."

The mother of a 10-year-old boy phones the school nurse. The child has attention deficit/hyperactivity disorder (ADHD) and must go to the office to take medication at lunchtime. The child informed the mother that kids have been making fun that he no longer wants to take the medication. Which is the nurse's best response? "He must take his medication, just tell your son to ignore the kids." "I will tell his teacher to talk with the kids causing trouble." "Tell your son if he doesn't take his medication, his grades may suffer." "You can speak with your doctor about extended-release medications for treatment of ADHD."

"You can speak with your doctor about extended-release medications for treatment of ADHD."

The nurse recognizes which person as needing further education? A nursing assistant who is obtaining vital signs in the playroom. A nurse who is giving detailed instructions to a 15-year-old on obtaining a clean catch urine specimen. A nurse who is suctioning an infant for 5 seconds to obtain a sputum specimen. A parent who is using distraction during a blood draw.

A nursing assistant who is obtaining vital signs in the playroom

Denial

Acts a defense mechanism to cushion, prevents disintegration/breakdown and is a normal response to grieving for loss no matter the loss. Denial helps children positively cope with their diagnosis by allowing them to maintain hope in the face of overwhelming odds and function adaptively and productively.

Technology-dependent

Birth to 21 years old with chronic disability that requires routine use of a medical device to compensate for loss of life-sustaining body function. Requires daily care.

Developmental disability

Any mental or physical disability present before age 22.

Which approach would be most appropriate when counseling a woman who is a suspected victim of violence?

Ask, "Have you ever been physically hurt by your partner?"

The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease? Bull's-eye rash around the bite Multiple erythema migrans on the skin Cranial nerve palsies Recurrent arthritis in the large joints

Bull's-eye rash around the bite

Infectious Mononucleosis

Caused by Epstein-Barr virus, transmitted through saliva, commonly seen among adolescent. Symptoms: fever, exudative pharyngitis, chills, fever, headache, anorexia and malaise. Also during the initial disease phase, the spleen ( may become enlarged). Avoid palpating the spleen or placing any pressure over the area.

The nurse identifies increased stress in the pediatric client and family prior to an upcoming surgery. Which suggestion is most helpful to decrease the level of stress in parents? Cancelling surgery until stress level decreases. Requesting an overnight stay following the surgery. Letting parents stay in the operating room with the child. Choosing an ambulatory surgery site.

Choosing an ambulatory surgery site.

Handicap

Condition or barrier imposed by society, environment, or own self.

Congenital disability

Existed since birth.

An 11-year-old boy with cerebral palsy is having trouble adapting to middle school, as he says the classrooms seem so far apart. He is still making friends, and says other students have been friendly. Which factor should the nurse most suspect as a hindrance to this boy's adjustment? Fatigue. Social exclusion. Self-concept. Discrimination.

Fatigue

Disability

Functional limitation that interferes with a person's ability (walk, lift, hear, or learn).

Clinical manifestations-respiratory

Generalized signs and symptoms and local manifestations differ in young children. Fever, anorexia, vomiting, diarrhea, adbominal pain, cough, sore throat, nasal blockage/discharge, respiratory sounds.

Adjustment

Gradually follows shock and is usually characterized by an open admission that the condition exists. Responses can be guilt, self-accusation, bitterness and anger.

Which collaborative interventions will the nurse provide when caring for an infant diagnosed with pertussis? Select all that apply. Utilize droplet and standard precautions. Have suction available in the room. Administer erythromycin for 10 days. Encourage small, frequent feedings. Restrict visitors for 48 hours of hospitalization.

Have suction available in the room. Encourage small, frequent feedings. Administer erythromycin for 10 days. Utilize droplet and standard precautions.

Despair

Inactive, withdraws from others, depressed, sad; uninterested in environment, uncommunicative. Regressive behavior- time varies, child may deteriorate from refusal to eat or drink.

ADHD-symptoms (3 core)

Inattention, impulsivity, hyperactivity

A nurse is caring for a family whose child has been admitted to the hospital for orthopedic surgery. Which of the following should the nurse do to promote a positive hospital stay for the child and the family? Perform injections to the child while he is in the hospital's playroom, to distract him from the pain. Avoid setting limits on the child's behavior because doing so will make the child feel insecure and unsafe. Limit diagnostic procedures to only those necessary to minimize the length of the hospital stay. Divide the care of the child among as many nurses as possible.

Limit diagnostic procedures to only those necessary to minimize the length of the hospital stay

The nurse cares for preterm infants and assesses them for potential complications to provide adequate countermeasures to prevent futher complications. Which complication should the nurse prioritize and initiate proper measures to protect the newborn? Loss of body heat Excess antibodies acquired from the mother Increased caloric intake Decreased muscle tone

Loss of body heat

Impairment

Loss or abnormality of structure or function.

Lower respiratory tract

Lower trachea, bronchi

Developmental focus

Normalizing experiences, adapting the environment and promoting coping skills. Based on child's developmental level not age.

Protest phase-infancy

Observed during later infancy; cries, screams, searches for parent with eyes, clings, avoids and rejects contact with strangers.

Separation anxiety

Occurs in infants 6 months and older. More pronounced in toddlers.

Which of the following is TRUE regarding intimate partner violence?

One in four women will be a victim of violence.

Upper respiratory tract

Oronasopharynx, pharynx, larynx, upper trachea

During adjustment what are the 4 types of parental reactions?

Overprotection, rejection, denial, gradual acceptance.

Family centered-care, communication, therapeutic relationships, shared decision making and cultural role

Parent's collaborate with health care providers in decision making and care for the child with special needs. Parents become experts in delivering care. "Shared decision making among the child, family, and health care team can result from open, honest, culturally sensitive communication and the establishment of a therapeutic relationship between the family and health care providers."

A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child? Acyclovir Doxycycline Ibuprofen Penicillin V

Penicillin V

Three stages of separation anxiety

Protest, despair, denial or detachment.

An emergency nurse is caring for a teenager who has just been sexually assaulted. Which actions should be taken at this time? Select all that apply. Provide privacy and explanations throughout examination. Obtain blood samples and anal cultures, vaginal cultures if female. Ensure that legal action is initiated against the perpetrator. Determine if the client has showered or bathed since the assault. Provide prophylaxis for sexually transmitted infections. Assign a supportive, calming same gender nurse to provide care.

Provide privacy and explanations throughout examination Obtain blood samples and anal cultures, vaginal cultures if female Determine if the client has showered or bathed since the assault Provide prophylaxis for sexually transmitted infections Assign a supportive, calming same gender nurse to provide care

The nurse is caring for a child who has been admitted with a diagnosis of asthma. What laboratory/diagnostic tool would likely have been used for this child? Pulmonary functions test Blood culture and sensitivity Purified protein derivative test Sweat sodium choloride test

Pulmonary functions test

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child? Appendicitis Peptic ulcer disease Pyloric stenosis Gastroesophageal reflux

Pyloric stenosis

A nurse is completing a dressing change on a 5-month-old in a crib in the procedure room. The wrap needed to complete the care is just outside of arm's reach. What action should the nurse take? Use the emergency call button to obtain assistance in getting the needed supply. Gather the needed supply, immediately returning to the side of the crib. While keeping a close eye on the infant, quickly grab the needed supply. Raise the side rail, then gather the needed supply.

Raise the side rail, then gather the needed supply

Normalization

Refers to behaviors and intentions of the disabled to integrate into society by living life as persons without a disability would. For example, the family adapting the routine of the chronically or disabled child or the child attending school at a befitting level.

A pediatric nurse observes signs of separation anxiety and suggests rooming- in. The goal of rooming-in is to prevent which? Denial for both pediatric client and caregiver. Separation anxiety for both pediatric client and caregiver. Separation anxiety for caregiver. Separation anxiety for pediatric client.

Separation anxiety for both pediatric client and caregiver

Which nursing action is required when caring for the post-term infant? IV initiation Echocardiogram at the end of pregnancy Serial blood glucose levels temperature checks every 2 hours

Serial blood glucose levels

Detachment

Shows interest in environment, interacts with strangers or familiar caregivers, forms new but superficial relationships. Appears happy-detachment usually occurs after prolonged separation from parent, rarely seen in hospitalized children. Behaviors represent superficial adjustment to separation.

The incidence of vitamin D deficiency in the United States is less than in many countries. What is the most likely reason for this? Some foods in the U.S. have been fortified with vitamin D. Many children in the U.S. take daily vitamin supplements. The water in many towns and cities in the U.S. has vitamin D added. The amount of ultraviolet sunlight each day in the U.S. is adequate to provide needed vitamin D.

Some foods in the U.S. have been fortified with vitamin D.

What type of environment should be provided for children with ADHD?

Stable learning environment, free of distractions, set fair but firm limits.

Acute streptococcal pharyngitis

Strep throat. Abrupt onset with fever, sore throat, headache and abdominal pain. Tonsils and pharynx are inflamed and covered with exudate. TX: ABT for 10 days, antipyretics, warm saline gargles, cold/warm compress to the neck, cold liquids.

What is an example of impaired adaptive functioning in an 8-year-old girl with a developmental disorder?

The child cannot properly dress herself.

Preventing/minimizing separation

This is a primary nursing goal; preventing separation, especially in children younger than 5.

The nurse is assessing a 6-year-old with attention deficit/hyperactivity disorder (ADHD). The nurse observes the boy making repeated clicking noises and notes he has a slight grimace. The nurse recommends the boy receive further evaluation for:

Tourette syndrome.

A meconium plug is an extremely hard portion of meconium that has completely blocked the intestinal lumen, causing bowel obstruction. False True

True

Homicide from intimate partner violence is the number-one cause of death in pregnant women. False True

True

Nurses who care for children who are terminally ill experience the same stages of grief as do the children's parents. False True

True

Protest phase- toddler

Verbal attack, physical attack, attempts to find parent, tries to force parent to stay. Behaviors may last from hours to days. Protest such as crying may be continuous and only cease with physical exhaustion.

If there is a foreign body in the larynx, how will the client present? With stridor Edematous Quietly Speaks clearly

With stridor

The student nurse is collecting data on a child diagnosed with cystic fibrosis and notes the child has a barrel chest and clubbing of the fingers. In explaining this manifestation of the disease, the staff nurse explains the cause of this symptom to be: chronic lack of oxygen. high sodium chloride concentration in the sweat. impaired digestive activity. decreased respiratory capacity.

chronic lack of oxygen.

A nursing student has read that cleft lip is diagnosed at birth based on inspection of physical appearance and that cleft palate is diagnosed in which way? blood work ultrasound feeling the palate with a gloved finger or using a tongue blade X-ray

feeling the palate with a gloved finger or using a tongue blade

Croup syndromes

infections of epiglottis, larynx