Ch. 31

In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason? B. Management of chronic pain A. Relief of acute symptoms D. Prevention of mild symptoms C. To stabilize the cell membranes

A. Relief of acute symptoms

The nurse is determining a pediatric dosage of medication using the West nomogram for estimating body surface area (BSA). Which two known factors are on the left and the right scales? D. Use the milligrams and milliliters of medication. B. Use the weight and milliliters of medication. A. Use the height and milligrams of medication. C. Use the client's height and weight.

C. Use the client's height and weight.

The nurse is preparing an intravenous solution of D5 ¼ NS @ 20 ml/hour for a 6-month-old client. Which safety device will be added to protect against fluid overload? D. pediatric IV tubing C. a syringe pump B. a volume control device A. a secondary line

b

In understanding fluid and electrolyte balance, it is important for the nurse to recognize that fluid contained within the body cells is known as: D. intravascular C. extracellular A. intracellular B. interstitial

a

The nurse is administering an oral medication that comes in an elixir form. When giving the medication, the child begins to choke and sputter. The nurse confers with the pharmacist about alternate ways to give the medication to this child. The pharmacist might recommend that the nurse should: C. mix the medication with food so the medication will be easy to swallow. A. dilute the elixir so that the medication is not as hard to swallow. B. ask the care provider to change the order to give a drug that comes in a suspension. D. give the medication in a glass of orange juice.

a

The nurse is preparing an injection of ceftriaxone sodium 500 mg IM for a 9-month-old client. When assessing the best site for injection, which landmarks are determined in preparation for injection? C. acromion process and armpit D. posterior superior iliac spine, greater trochanter, and gluteus maximus B. anterior superior iliac spine, iliac crest, and greater trochanter A. trochanter and knee joint

a

The caregivers of a 1-year-old tell the nurse they are frustrated because the medication their child requires daily comes in pill form, which they have been unable to get him to swallow. After clarifying with the pharmacist, what would be appropriate advice for the nurse to give these caregivers to help them make sure the child gets the full dose of medication each day? B. Dissolve the tablet in a small amount of water sweetened with corn syrup; delivered by a syringe. D. Break the tablet into smaller pieces and put them beneath his tongue. Remember that babies need to learn how to swallow, so if he thrusts the pill piece out of his mouth, simply push it back in. C. Hold him firmly on the caregiver's lap and insert the tablet beneath his tongue; hold his mouth firmly shut for a minute or so until his urge to expel the tablet passes. A. Grind the tablet to a powder and give it to the child by spoon in the pureed peas he loves to eat.

b

The nurse has brought a 3-year-old's oral medications into the room for administration. Upon approaching the child, the nurse said, "I have your medication. Would you rather have me hand it to you or Mommy?" In critiquing the nurse's actions, which is most accurate? D. The nurse's behavior is incorrect. The mother did not prepare the medication and should not have administered the medication. C. The nurse's behavior is incorrect. The nurse should have been firm in expecting the child to take the medication. B. The nurse's behavior is correct. The nurse provided the child a choice between two acceptable options with the outcome of taking the medication. A. The nurse's behavior is correct. Children are afraid of the nurse.

b

The nurse is administering a PRN pain medication to a child. What is the highest priority for the nurse in this situation? A. The nurse double-checks the medication calculation with another nurse. B. The nurse checks the last time the medication was given. C. The nurse asks the child to explain the pain the child is having. D. The nurse documents the effect of the medication within 1 hour of administration.

b

The nurse is preparing an intravenous infusion for a 3-month-old client with dehydration secondary to gastroenteritis. Which condition or scenario puts this infant at greatest risk for a higher volume of fluid loss? B. greater fluid exchange caused by increased metabolic activity D. experiencing bouts of nausea throughout the day C. only taking sips of fluids when the infant does not feel well A. the decreased body surface area (BSA) to the body fluid volume

b

Using the West nomogram scale, the nurse needs to calculate the safe dosage of a medication for a child. The child is 50 inches tall and weighs 76 lb. The normal dosage of the medication for an adult is 300 mg. Which of the following is the correct way to use the West nomogram scale? C. Locate the child's height and weight on the nomogram. Use a straight edge to align these numbers with the scale indicating percentage of adult dosage and multiply the adult dosage by this number. D. Use the "shortcut" scale because this child is average. This will show the nurse the percentage of the adult dosage appropriate for this child. Use this percentage to calculate the dosage. B. Use the scale to locate the child's height and weight. Use a straight edge to align these numbers with the scale indicating the surface area, divide that by the average adult body surface area, and multiply the resulting number by the adult dose. A. Locate the child's height and weight on the scale, multiply those two numbers, and divide the adult dosage by the resulting number.

b

The nurse is caring for a child who weighs 75 lb. The medication ordered for the child has a therapeutic dosage range of 33 mg/kg per day to 48 mg/kg per day. The medication ordered is to be given 4 times per day. Which dosages would be appropriate for the nurse to administer to this child in one dose? D. 375 mg per dose C. 250 mg per dose A. 28.0 mg per dose B. 40.8 mg per dose

d

Which client does the nurse identify as in a state of alkalosis from hyperventilation? Answers: B. the client with a pH of 7.3 D. the client with a pH of 7.55 C. the client with a pH of 7.45 A. the client with a pH of 6.

d

The nurse has an order to administer a rectal suppository to a 3-month-old child. In addition to lubricating the suppository, which intervention will help assure appropriate administration of the medication? A. Placing the child on the abdomen for insertion of the suppository B. Pre-warming the suppository in the hand for 10 to 20 seconds C. Using the index finger to insert the suppository into the rectum D. Holding the buttocks tightly together for 1 to 2 minutes after insertion

d

The nurse is caring for a child who weighs 31 kg. A medication is ordered for this child with a dosage range of 20 to 40 mg per kg of body weight per dose. Which dosage would be appropriate for the nurse to administer to this child in one dose? D. 1,000 mg per dose B. 62.0 mg per dose A. 12.4 mg per dose C. 124.0 mg per dose

d

An order for an intramuscular medication has been ordered for a 4-year-old. The nurse finds the child in the playroom with his caregiver. Which action by the nurse would be the best procedure to follow when administering this medication? B. Take him back to his bed to give him his injection. Let him go back to the playroom if he doesn't cry. Complete all required documentation. C. Take him to a separate treatment room to give him his injection. Praise his cooperation even if he cries. Take him back to the playroom. Complete all required documentation. D. Ask the caregiver to let you know when he is finished playing and give him his injection in a treatment room at that time. Document the time you actually give the injection. A. Move him to a spot in the room where no other children are playing and give the injection. Reward him with a lollipop or sticker if he cooperates. Complete all required documentation.

c

The nurse at a camp for children with asthma is teaching these children about the medications they are taking and how to properly take them. The nurse recognizes that many medications used on a daily basis for the treatment of asthma are given by which method? C. Using a nebulizer D. Sprinkled onto the food B. Through a gastrostomy tube A. Directly into the vein

c

The nurse has administered a medication to a child. When documenting the dosage given, the nurse realizes that an incorrect dose has been administered. The nurse has taken the child's vital signs, and they are within normal range. The child does not appear to be in any distress and is acting normally. Which of the following would be the next action for the nurse to take? B. Monitor the child for any change in vital signs or behavior. D. Notify the next nurse who cares for this child that a dosage error has been made. A. Give the correct dosage the next time the medication is given. C. Follow the facility policy regarding medication errors.

c

The nurse has been caring for a 12-year-old boy during his 5-day hospitalization. The child's IV has infiltrated, and the care provider is getting ready to change the intravenous line site. Which statement made by the nurse would be appropriate in supporting the child? D. "The nurses on the unit know the client well, so maybe a nurse could start the IV." C. "The client is left-handed and likes to draw; an IV site in his right arm would be best." A. "I will be back after your IV is in place." B. "Would you like me to stay with you or are you OK alone?"

c

The nurse is caring for a pediatric client who requires vitamins, minerals, lipids and amino acids through the circulatory system instead of the gastrointestinal tract. Which type of intravenous therapy is anticipated for long-term therapy? C. central venous catheter infusions D. use of a short line catheter and volume control chamber B. intermittent fluids via a syringe pump A. peripheral venous catheter infusions

c