CH 9: Health Supervision
A dental home (like a medical home) establishes a continuing comprehensive relationship of care with the child and family. The American Academy of Pediatric Dentistry (AAPD) recommends this dental home be established by the time the child is age: A) 1 year. B) 1½ years. C) 2 years. D) 2½ years. E) 3 years.
A) 1 year. The recommendation is by the child's first birthday. This is the time the first dental exam should occur.
Denver Articulation Screening
Age:2 1/2-7 years Definition:Screens for articulation disorders Nursing Implication: 5 minutes to administer. Does not evaluate language ability
While enrolled in a geography course, a student nurse learns that diarrheal illness is deadly for large numbers of infants in Third World countries. What vaccine will this nursing student identify as part of the solution to this problem? A) Diphtheria, tetanus, pertussis (DTap) B) H. influenzae type B (Hib) C) Hepatitis A (HepA) D) Rotavirus (RV)
D) Rotavirus (RV) Rotavirus is a very common cause of gastroenteritis among young children that spreads readily via the fecal-oral route. The disease is most severe in children between 4 and 23 months, causing severe, watery diarrhea that results in dehydration. The other vaccines do not prevent diarrheal illness.
Killed vaccines
Immunizations that are manufactured from dead versions of pathogens
The nurse will record what information about each vaccine after immunizing a child? Select all that apply. Lot number and expiration date of vaccine Whether bacterial or viral Site and route of vaccine administration Manufacturer of vaccine How vaccine was stored
Lot number and expiration date of vaccine Site and route of vaccine administration Manufacturer of vaccine
Toxoid vaccines
chemically or thermally modified toxins used to stimulate active immunity
Conjugate vaccines
created by attaching bacterial capsule polysaccharides to a toxoid
recombinant vaccines
subunit vaccines produced by genetic modification
Ishihara test
tests for color vision
During the health history of a 2-week-old neonate, the nurse discovers the child has not yet had a hearing screening. What test should the nurse schedule? A) Auditory brain stem response test B) Rinne test C) Weber test D) Tympanometry
A) Auditory brain stem response test Auditory brain stem response (ABR) test and the evoked otoacoustic emissions (EOAE) test are indicated for newborns. A child not screened for hearing at birth should be screened before 1 month of age. The Rinne and Weber tests are used with children 6 years and older. Tympanometry is appropriate for children beyond 7 months of age.
The nurse is preparing to administer a diphtheria, tetanus and pertussis vaccine to a 3-year-old child. Which version of the formulation of the vaccine should be administered? A) DTaP B) DPT C) TdaP D) DT
A) DTaP The vaccine currently used for children younger than age 7 is diphtheria, tetanus, acellular pertussis (DTaP). The older version of this vaccine was DPT. Diphtheria and tetanus (DT) vaccine is used for children younger than age 7 who have contraindications to pertussis immunization. The TdaP is used clients over the age of 7.
The nurse is talking with the grandparent of an infant born at 32 weeks' gestation to an adolescent mother who states, "I am concerned my grandbaby will have developmental problems." Which response by the nurse is most appropriate? A) "Children born to adolescent mothers will likely have developmental delays." B) "The risks of developmental concerns are heightened for your grandchild." C) "We cannot know the outcomes for your grandchild at this point in time." D) "Premature children often have problems."
B) "The risks of developmental concerns are heightened for your grandchild." Children born to adolescent mothers and those who are born at a gestation of 33 weeks or less have an increased risk for experiencing developmental delays. The child's grandparent is expressing concerns. It is most appropriate to explain to the grandparent that there are risks involved. The most appropriate response by the nurse is one that personalizes and responds to the client's question.
Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer? A) Naturally acquired active immunity B) Artificially acquired active immunity C) Naturally acquired passive immunity D) Artificially acquired passive immunity
B) Artificially acquired active immunity Artificially acquired active immunity develops through vaccine administration of an antigen that stimulates the child's body to produce antibodies against that antigen (pathogen) and to remember the antigen should it reappear. Natural immunity is produced through natural invasion of an antigen (pathogen). Natural and artificial passive immunity involves providing antibodies to fight a pathogen rather than expecting the child's body to produce them. This type of immunity has a short life.
The mother of a 5-year-old with eczema is getting a check-up for her child before school starts. Which action should the nurse take during the visit? A) Change the bandage on a cut on the child's hand B) Assess how the family is coping with the chronic illness C) Discuss systemic corticosteroid therapy D) Assess the child's fluid volume
B) Assess how the family is coping with the chronic illness Maintaining proper therapy for eczema can be exhausting both physically and mentally. Therefore it is essential that the nurse assess parents' ability to cope with this stress. Changing a bandage is not part of a health supervision visit. Skin hydration is important for a child with eczema; however, fluid volume is not a concern. Systemic corticosteroid therapy is very rarely used and the success of the current therapy needs to be assessed first.
Before administering an immunization to their child, the nurse asks parents to take which priority action? A) Reassure the child B) Sign a consent form C) Provide the child's immunization record D) Assist in restraining the child
B) Sign a consent form Parents must sign a consent form before immunization of the child after receiving full information about the vaccines, their importance, and their administration. Reassuring the child and assisting in restraining are both important but are not the priority. Having the child's immunization record with them allows this record to be updated; otherwise, a full record should be given to the parent
The mother of a 2-year-old child questions when she will need to initially have her child's vision screened. The nurse should inform the mother that vision screening begins at which age? A) 1 year of age B) 2 years of age C) 3 years of age D) 4 years of age
C) 3 years of age In the absence of risk factors vision screening should begin in children once they reach the age of 3.
When working in a very busy pediatric office or clinic, nurses could substitute which screening test for the Denver II Developmental Screening Test to detect delays that otherwise could be missed? A) Goodenough-Harris Drawing Test B) Denver Articulation Screening C) Denver Prescreening Developmental Questionnaire (R-PDQ) D) Bayley Scale
C) Denver Prescreening Developmental Questionnaire (R-PDQ) The Denver Prescreening Developmental Questionnaire serves as a parental report of items on the Denver II. It is designed to identify children for whom follow-up with a complete Denver II Developmental Screening Test is needed. It is useful for practices with little time to conduct the full Denver II for all infants and young children. The Bayley Scale and the Goodenough-Harris Test focus mainly on intelligence testing and require special training to administer and score. The Denver Articulation Screening is designed to assess early speech development.
Which nurse response to the parent indicates the nurse recognizes the importance of the child's increasing responsibility for their personal heath choice? A) "I am so glad you are reading to your baby, especially during feeding time." B) "I suggest you offer your toddler healthy snacks after school and at bedtime rather than after dinner." C) "If your school-aged child isn't current on immunizations, we can work to get them caught up." D) "I recommend you talk with your adolescent child and discuss their preference for which dentist to visit."
D) "I recommend you talk with your adolescent child and discuss their preference for which dentist to visit." The child's participation in their health choices increases as the child grows and develops. By asking the adolescent for input, the nurse is encouraging the parent to include the child in responsible decision making. The other choices are ideal suggestions for younger children, but these children are dependent on their parents providing supervision of their health choices.
The mother of a 4-month-old refuses for her baby to be "stuck" when immunized. What immunization will the nurse administer under these restrictions? A) Polio B) Hepatitis A C) Haemophilus influenzae D) Rotavirus
D) Rotavirus Rotavirus is the only vaccine given orally. All the others are injected. Because of the ease of administration, oral polio vaccine containing a live virus continues to be used in underdeveloped countries. Vulnerable individuals are at risk for infection from live viruses excreted in the stool. This is the reason why only injected polio vaccine is used in the United States.
Live attenuated vaccines
Modified living organisms that are weakened. The organism can produce an immune response but does not produce the complications of the illness.