Ch. 29, 30, 31, 32 PEDS review

Parents prepare child for hospital visit

3 days

A young child is brought to the clinic to have tests run regarding an endocrine disorder. The nurse knows that the most common endocrine disorder in children is:

Diabetes mellitus type 1

Lung disease in children caused by?

Environmental smoke

Best approach for maintain remission of leukemia

Long term chemo

IM to a 2 yo, preferred injection site?

Mid thigh

The nurse is an integral part of the assessment team for children with learning disabilities. Once the learning disability is established, the nurse's primary intervention for the child is

Seeking appropriate educational referrals

Domestic violence, STD's, school failures & MVA's caused by?

Substance abuse

Discussing growth and development nutrition is the most important influence on

bones and muscles

Toddler receives oxygen disadvantages

changing the bedding (check temp)

8 year old blood pressure taken

it will hug the arm

Nurse use diagram congenital defects

overriding aorta

Max amount suction a child

5 seconds

Average amount of time children spend in media focused activity?

6 ½ hours

Children get how many minutes of physical activity per day?

60 minutes

After feeding nurse should position baby where?

Right side

Pediatric nurse use developmental approach

Strengths of the child

Initiating care plan for special needs child

Stress of the hospitalization makes child regress

Child with hemophilia, nurse anticipates finding?

Abnormal PTT

Nurse recognizes child eat adequate amounts of food

Administer large amounts of nutritious fluids

Scoliosis, a lateral curvature of the spine that causes changes in the spine, chest, and hips, is most commonly seen in:

Adolescents

Reduce number of accidents by providing?

Anticipatory guidance

Before perform gavage feeding nurse should?

Aspirate

Assessing jaundice in African American child with sickle cell nurse should?

Assess their gums

Best time to bath infant is

Before bedtime

Second leading cause in accidental death in 1-4 year olds?

Burns

A mother tells the nurse that her 3-year-old son has been acting out against others and throwing temper tantrums. What is the most important instruction to provide this mother? a.Punish your son every time he says "no" to change his behavior b.Ignore your son when he acts out. c.Set limits on your son's behavior. d.Allow the behavior because it is normal at this age.

C: Set limits on your son's behavior.

Using anticipatory guidance to give injection to child say to child

Ethan I give you medicine that will sting but only for short while

Therapeutic management include administration of what?

Ferasulfate

Nurse teaches that the severity of child with respiratory distress syndrome is most influenced by

Gestational age at birth

Care for a child with sickle cell?

Hydration & pain management

Feeding tube in 8 month old?

Mummy

An off-duty LPN/LVN is buying groceries and observes a child sitting in the cart ahead. The child raises her shirt and picks at some scabs on her abdomen. The LPN/LVN recognizes that the wounds look like the result of cigarette burns. Her response as a health care professional is to:

Notify the appropriate agency that she has reason to believe a child has been abused.

Sickle cell anemia, child experiences pain and is caused by?

Obstructive blood flow

Tetralogy of flow, 4 congenital defects?

Pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, overriding aorta

In which order do you do vitals on child

R, P, T (lease invasive)

A 3-month-old at the clinic is to receive an intramuscular injection. The most appropriate site is the: a.Deltoid muscle b.Vastus lateralis muscle c.Dorsogluteal muscle d.Rectus femoral muscle

b. Vastus lateralis muscle

a nurse is talking with the mother of an 8-year-old child who expresses concern that her child is more focused on friends than anything else. Which is the most appropriate response? a."You need to be concerned." b."At this age, the child is developing his own personality." c."You need to give more praise to your child to stop this behavior." d."You need to monitor your child's behavior closely."

b."At this age, the child is developing his own personality."

Lack of activity and fast food are Causative factors contributing to

Weight gain

The community health nurse is developing a program on obesity in children and adolescents. What does the nurse list as the most common factor contributing to overweight children? a.Decreased physical activity b.Working mothers c.Poverty d.Fast-food consumption

a. Decreased physical activity

The hospital environment can be frightening and traumatic for children. How can the pediatric nurse help alleviate these stressors? a.During preadmission, offer the parents and child a tour of the pediatric unit and inviting the parents to room-in with the child during hospitalization .b.Adhere to strict visiting hours as parents visit, because the child feeds off of parental anxieties leading to more crying. c.Keep the television on at all times while the child is in the hospital to distract the child and muffle unfamiliar noises d.Keep nurse time with the child at a minimum by performing tasks and procedures as quickly as possible.

a.During preadmission, offer the parents and child a tour of the pediatric unit and inviting the parents to room-in with the child during hospitalization

To encourage healthy sleeping patterns in the toddler, the nurse makes which recommendations to the parents (Select all that apply.) a.Establish a nighttime routine. b.Limit daytime naps to promote nighttime sleep. c.Maintain bedtime rituals, such as bedtime stories. d.Engage in vigorous activity to help tire the child out.

a.Establish a nighttime routine. c.Maintain bedtime rituals, such as bedtime stories.

An 18-month-old child is having difficulty maintaining his respiratory status. His physician orders oxygen therapy per nasal cannula. Which of the following statements is true regarding oxygen therapy for children? Select all that apply. a. a nasal cannula is an effective oxygen delivery device even if the child breathes through the mouth. b.Oxygen flow by nasal cannula allows constant oxygen delivery even while eating and talking, because the mouth remains unobstructed. c.To assess adequate oxygenation, the nurse checks cannula placement and oxygen saturation using a pulse oximeter every 2 hours and PRN. d.Maintaining cannula placement may be difficult as the child is able to remove it from the nares. e.Encourage the child to cry because crying ensures the child has adequate oxygen supply.

b.Oxygen flow by nasal cannula allows constant oxygen delivery even while eating and talking, because the mouth remains unobstructed. c.To assess adequate oxygenation, the nurse checks cannula placement and oxygen saturation using a pulse oximeter every 2 hours and PRN. d.Maintaining cannula placement may be difficult as the child is able to remove it from the nares.

A nurse is caring for a 4-year-old child with abdominal pain related to an intestinal obstruction. The nurse knows that the most common cause of intestinal obstruction in a child this age is a.Hernias b.Hirschsprung disease c.Intussusception d.Hypertrophic pyloric stenosis

c. Intussusception

A distraught mother brings her 7-year-old child into the clinic for testing. The child has missed school due to headaches and abdominal pain. She explains that the pain is worse in the morning but is gone by mid-afternoon. The nurse recognizes these symptoms could be associated with: a.hypoglycemia b.child abuse. c.school avoidance. d.malnutrition.

c. School avoidance

According to Piaget, during the adolescent stage of growth and development, an individual's cognitive function reaches maturity. What stage is this considered? a.Concrete operational stage b.Preoperational stage c.Formal operational thought stage d.Formal operational stage

c.Formal operational thought stage

Nurse recognize congenital abnormalities grouped into category called

children with special needs

Assessing jaundice in black child-

compare color on soles of their feet

A young mother comes to the clinic with her 2-month-old daughter. While taking vital signs, the nurse reports the baby's heart rate is 120 beats/min. The mother expresses concern about the fast heart rate. What is the best response by the nurse? a."Her pulse is okay for her age." b."Don't worry; I'll let the health care provider know." c."Has your daughter been having trouble breathing?" d."A normal heart rate for a 2 month old is 120 beats/min."

d."A normal heart rate for a 2 month old is 120 beats/min."

While caring for a patient, the nurse learns that he or she lives in the same house as his or her grandparents. What type of family is this considered? a.Nuclear family b.Homosexual family c.Blended family d.Extended family

d.Extended family

Therapeutic management or iron deficiency anemia includes administration of

ferrous sulfate

Pediatric nurse warns students meds children-

giving through a straw

Mother of child with DM, see child's lab results nurse says

please come to a conference room

Increased suicides City wide program created

suicide hotline

Major dental problem is bottle mouth caries offer at bedtime

water

Some infants and children require gavage feedings. The prudent nurse will check placement of the feeding tube prior to initiating the feeding by:

Aspirating for stomach contents and then injecting air into the feeding tube while listening for gurgling sounds per policy and procedure

Establish a trusting relationship with a child most important thing is?

Be honest

The nurse is assessing a 9-month-old boy for a well-baby check up. Which of the following observations would be of most concern? A The baby cannot say "mama" when he wants his mother. B The mother has not given him finger foods. C The child does not sit unsupported. D The baby cries whenever the mother goes out.

C The child does not sit unsupported.

Safety reminder device responsibility of nurse is to?

Check it every 2 hours

Single most preventable cause of death and disease is?

Cigarette smoking

The nurse uses many communication strategies when talking with children. Which strategies would be appropriate for the pediatric nurse? (Select all that apply.) a.Address all communication to the parent and ask the parent to give the information to the child .b.Avoid phrases that may be misinterpreted or provide more information than the child can understand. c.Always offer children a choice to allow the child control of his or her situation. d.As a general guide, use sentences whose sum of words is equal to the child's age in years plus one. e.Using a calm, unhurried voice in a positive way to give directions or information.

.b.Avoid phrases that may be misinterpreted or provide more information than the child can understand. d.As a general guide, use sentences whose sum of words is equal to the child's age in years plus one. e.Using a calm, unhurried voice in a positive way to give directions or information.

By 2 child should be protected against how many diseases?

10

Drug awareness to what age group has the largest drug use?

12-13 years old

Pediatric nurse recognize significant impact of facial wound

14 year old

Newly admitted 2 year old potty trained before admission, nurse does

2-3 days before admission

College counselor encourage safe sex STD common in people younger than

25

Healthy goal 2010 reduce 11% of obesity to?

5%

Nurse suggests infant receives supplemental fluoride at?

6 months

An LPN/LVN is assisting at a community health fair at the immunization booth. She needs to be prepared to answer parents' questions regarding immunizations. Which of the following statements is accurate? A.Following the recommended immunization schedule will protect children against 10 childhood diseases by age 2 .b.Immunizations have eradicated 10 childhood diseases and may not even be necessary in the future because of advances in medical research. c.If a child falls behind in the immunization schedule, the child must restart the immunizations. d.Immunization is effective and no booster dose is needed to prevent the spread of infectious diseases.

a. Following the recommended immunization schedule will protect children against 10 childhood diseases by age 2.

The parents of a 1-year-old child are concerned because he places "everything" in his mouth. The nurse informs the parents that aspiration of foreign bodies can lead to asphyxiation. Which statements are true? (Select all that apply.) a.Monitor nipples on bottles and pacifiers. Replace if the nipples become worn or detached .b.All toys should be checked for loose objects before use to prevent choking. c.Children older than age 3 are at greatest risk for aspiration of foreign bodies, because hand to mouth activities are common at this age. d.Common foods that can be dangerous are round, such as grapes, hard candy, nuts, popcorn, and hot dogs. e.Objects that can be aspirated are coins, beads, buttons, balloons, small toys, or toy parts.

a. Monitor nipples on bottles and pacifiers. Replace if the nipples become worn or detached. d. Common foods that can be dangerous are round, such as grapes, hard candy, nuts, popcorn, and hot dogs. e. Objects that can be aspirated are coins, beads, buttons, balloons, small toys, or toy parts.

A newborn male infant is being assessed by the pediatrician in the nursery. The infant is showing signs of heart failure and an audible machine-like murmur is heard at the upper left sternal border. Further assessment finds a widened pulse pressure and bounding pulses. This assessment data identifies which type of congenital heart disease? a.Patent ductus arteriosus b.Ventricle septal defect c.Tetralogy of Fallot d.Arterial septal defect

a. Patent ductus arteriosus

A young child with cerebral palsy has been assigned to the care of an LPN/LVN. When reviewing the plan of care, the LPN/LVN knows that the primary goal is to: a.Reinforce the child's abilities and minimize any limitations caused by the disease. b.Eliminate any cause of the disease .c.Prevent the onset of any emotional disturbances. d.Improve muscle coordination and control of extremit

a. Reinforce the child's abilities and minimize any limitations caused by the disease.

An LPN/LVN hears a 1-year-old Vietnamese patient crying shortly after the parents enter the room. The LPN/LVN enters and observes an object in the mother's hand and bright red welts on the toddler's skin. What is the appropriate nursing intervention? a.Ask the parent to explain what is occurring. b.Quickly approach the parents and ask them to leave the room .c.Immediately notify the RN and report the observations. d.Immediately notify social services for the possibility of child abuse.

a.Ask the parent to explain what is occurring.

The nurse is assessing a child with learning disabilities. What signs and symptoms might this nurse expect to find? (Select all that apply.) a.Behavior problems b.Seizures c.Excellent social relationships d.Speech problemse.Slowed academic progress

a.Behavior problems d.Speech problems e.Slowed academic progress

The nurse considers which patient problem the highest priority for an infant born with a cleft lip? a.Imbalanced nutrition: less than body requirements b.Risk for aspiration c.Ineffective coping d.Impaired skin integrity

a.Imbalanced nutrition: less than body requirements

The school-age child diagnosed with attention deficit hyperactivity disorder (ADHD) has multifactorial nursing considerations. What are appropriate nursing interventions? (Select all that apply.) a.Scheduling routine follow-up appointments for medication management and review b.Encouraging the parents to enroll the child in multiple after-school activities c.Educating the parents on discipline, rewarding, accident prevention, and safety needs d.Instruction on the benefits of megavitamins and herbal therapies e.Explaining medications and possible side effects to the parents, the child, and educators

a.Scheduling routine follow-up appointments for medication management and review c.Educating the parents on discipline, rewarding, accident prevention, and safety needs e.Explaining medications and possible side effects to the parents, the child, and educators

A mother brings her 2-year-old to the medical clinic with burns to his arms. Based on the risk factors, which statements are correct? Select all that apply. a.The burns occurred at his home .b.The burns are a result of chemicals. c.The burns are from scalding. d.Toddlers are more vulnerable to accidental burns .e.The burns are a result of a flame.

a.The burns occurred at his home .b.The burns are a result of chemicals. c.The burns are from scalding. d.Toddlers are more vulnerable to accidental burns

Obtain Respirations requires modified approach

abdominal

Measuring head circumference place the tape measure where?

above eyebrows and the peanea (top of ear)

Attempting to provide info on child, parents don't seem to remember being told why

anxiety

Leading cause to fatal injury younger than 1 is?

asphyxiation

The nurse is educating a parent group regarding accidental poisoning. What will the nurse be sure to include as a measure of prevention? a.Place medications in a medicine cabinet. b.Remind grandparents to keep their medications out of reach when children visit. c.Tighten caps on cleaning supplies under the sink. d.Keep syrup of ipecac on hand for all types of suspected poisonings.

b. Remind grandparents to keep their medications out of reach when children visit. Rational: Grandparents are not used to having children around. They often leave medication that can lead to accidental overdose within reach of children. Medications should be placed in a locked cabinet. Poisonous substances should be kept locked and high out of reach of children, not under the sink. Not all types of poisons should be treated by inducing vomiting with ipecac.

Which statement is true in regards to nutrition in children? a.Fat restriction is an appropriate intervention for overweight toddlers. b.The most important role a nurse can play related to overweight and obese children is education. c.Environmental tobacco smoke does not result in increased risk of heart and lung disease among children. d.Cigarette smoking is prevalent among 55% of senior high school students.

b. The most important role a nurse can play related to overweight and obese children is education Rational: Educating children and their parents regarding obesity and being overweight is the most important role a nurse can play. Placing a toddler on a diet can lead to eating disorders.The prevalence of cigarette smoking in senior high school students is 28.5%. Environmental smoking does increase the risk of heart and lung disease in children.

A 4-year-old child has a respiratory infection. The health care provider has ordered Rocephin IM for treatment. Which statement by the LPN/LVN will best prepare the child for the injection? a."I am going to give you a shot. It will feel like a mosquito bite and will burn for a short time afterward." b."Other kids tell me different things about how this feels. Some say it feels like a cat scratch. Will you tell me how it felt to you after we are done?" c."This shot will hurt but you are a big girl, so don't cry." d."The health care provider says you need a shot of medicine to get better since you keep spitting out the other medicine."

b."Other kids tell me different things about how this feels. Some say it feels like a cat scratch. Will you tell me how it felt to you after we are done?"

A 12 year old tearfully informs the school nurse that she does not fit in. What is the most appropriate intervention? a.Use effective listening techniques to gain further information so the nurse can report to the parents. b.Be aware that these feelings are common in adolescents and place the girl at risk for substance abuse, depression, and eating disorders. c.Offer suggestions on how to fit in with her peers. d.Immediately make a referral to a mental health professional as the girl is depressed and suicidal.

b.Be aware that these feelings are common in adolescents and place the girl at risk for substance abuse, depression, and eating disorders.

The nurse addresses the local PTA about accident prevention for adolescents. What is most important for the nurse to highlight during the session? a.Wearing seat belts; teaching fire safety; and the need to inform parents of whereabouts b.Education and review of basic first aid; setting consequences for substance abuse; and discussing the dangers of swimming alone c.Teaching proper use of protective gear in sports; review acceptable behavior in a moving car; and practicing fire drills d.Teaching of traffic dangers; keeping sharp objects out of reach; and avoiding use of pillows

b.Education and review of basic first aid; setting consequences for substance abuse; and discussing the dangers of swimming alone

A nurse is employed in an impoverished area. Nursing responsibilities include teaching proper oral care for infants. What information would the nurse provide regarding prevention of caries? a.No oral care is necessary, because the infant may have only a few teeth and these teeth are not permanent. b.Giving the last bottle before bedtime and wiping off the teeth and gums with a damp washcloth before bed. c.Breast-fed infants do not need oral care as breast milk does not promote dental caries because of low lactose content. d.Use water in the bedtime bottle and brush the infant's teeth with a soft bristle toothbrush with fluorinated toothpaste.

b.Giving the last bottle before bedtime and wiping off the teeth and gums with a damp washcloth before bed.

What is an appropriate patient problem for the adolescent who is experimenting with tobacco? a.Imbalanced nutrition: less than body requirements related to decreased appetite from cigarette smoking b.Potential for injury related to accidental poisoning c.Ineffective health maintenance related to smoking tobacco d.Potential for infection related to tobacco use

c.Ineffective health maintenance related to smoking tobacco

The nurse must know how to compute medication doses correctly for children. Which is correct regarding the dosage calculation for children? a.Unit doses are used in pediatrics and are based on a child's weight. b.A child dose is half the adult dose. c.The proportional amount of BSA to body weight is calculated. d.The BSA of an adult divided by the BSA of a child multiplied by the adult dose equals the child's dose.

c.The proportional amount of BSA to body weight is calculated.

Because pain is often underestimated in children, how will the nurse best assess a child's pain? a.Observe the child's activity. b.Monitor vital signs for elevated pulse or blood pressure. c.Use accepted pain assessment tools. d.Observe the child's facial expressions.

c.Use accepted pain assessment tools.

Nurse delays assess temp due to elevation of temp due to

crying vigorously

A young mother is at the clinic with her 5-year-old daughter. She has just been diagnosed with iron deficiency anemia. The physician has ordered iron supplements. As the nurse, what instructions would you give the mother? a."Give the iron supplement when your daughter is showing increased signs of fatigue." b."Give the iron supplement with meals." c."Give the iron supplement at night before bed." d."Give the iron supplement with citrus fruit juice on an empty stomach."

d. "Give the iron supplement with citrus fruit juice on an empty stomach."

An autistic 8-year-old child is a new admission to the pediatric floor. What special needs for autism does the nurse implement? a.Arranging for extra time to spend with the child to explain thoroughly procedures and treatments b.Use of communication techniques that maintain eye contact and physical contact c.Monitoring for loose liquid stools, typical with autistic children, and encourages fluids at each interaction d.Provision of a private room to decrease stimulation from noises and movement

d.Provision of a private room to decrease stimulation from noises and movement

Nurse stress regular physical activity, positive effect on children

increase bone and muscle strength

Nurse compresses nail bed child with arm cast for

peripheral circulation

Communicating with 5 year old

speak in no more than 6 word sentences

After feeding the nurse should be

the right side

Assess neonate, pediatric should alert doctor for

the tuft of hair on the sacrum

An LPN/LVN works with adolescents diagnosed with depression. When an adolescent is started on an antidepressant, it is critical that the LPN/LVN inform the parents to:

Continue to monitor for suicidal tendencies during the first few weeks of antidepressant therapy.

A child newly diagnosed with juvenile rheumatoid arthritis (JRA) has come to the clinic for a check-up. While there, the parents ask about activities at school. What is the nurse's most appropriate response?

"Talk with the school nurse to arrange for medications and rest periods."

6 month old with Iron deficient anemia, why not diagnosed earlier?

Happens when maternal source of iron are depleted after 6 months

Lillian Wald return 20th century founded

Henry Street Settlement

Child with resp. difficulty is placed in mist tent, purpose is?

Liquefy secretions

Dr. Abraham Jacoby promoted-milk stations

Milk stations-factory worker institution, mothers come learn hygiene

Stability in IV insertion site less than 9 months of age, site is where?

Scalp vein

The nurse is doing discharge teaching with a new mother regarding the recommended position to lay her infant down for sleep. This position is:

Supine

Weight limit on rear facing safety seat

Up to 20lbs

Caring child cortication nurse assesses

Upper extremity hypertension

A patient and her newborn son are getting ready to go home. The nurse is doing discharge teaching regarding the use of an infant car seat. Which statement by the patient would be correct? a."There are no laws governing the use of infant car seats. It is just standard practice. "b."The car seat should be secured in the back seat, rear facing until the infant reaches 20 lb." c."The car seat should be secured in the front seat between the parents." d."Short trips from home do not require the infant to be placed in the car seat as long as the parents hold him."

b."The car seat should be secured in the back seat, rear facing until the infant reaches 20 lb." Rational: An infant car seat needs to be secured in the back seat and rear facing until the infant is at least 20 lb. The infant should be placed in the car seat no matter how short the trip. Car seat use is mandated by laws.

A nurse is collecting information from a patient's mother while in the clinic. It is suspected that the patient has scarlet fever and the nurse will assess the child for what signs or symptoms of scarlet fever? (Select all that apply.) a.Koplik spots b.Peeling skin on palms c.Pharyngitis d.White strawberry tongue e.Sandpaper-like red rash

c.Pharyngitis d.White strawberry tongue e.Sandpaper-like red rash