Chapter 35

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with otitis media. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of otitis media?

"After the eardrum ruptures, the child's pain is relieved."

Seven-year old Isabelle has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when Isabelle first complained of a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which of the following statements would be best for the nurse to say to this mother?

"This might or might not be a problem. Watch Isabelle for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome."

A child is home with the caregivers following a treatment for a head injury. If the child makes which of the following statements, the caregiver should contact the care provider.

"You look funny. Well, both of you do. I see two of you."

The nurse is administering acetaminophen to a child with a history of febrile seizures who has an elevated temperature. The dosage for this child is 15mg/kg/dose. The child weighs 20 lb. How many milligrams (mg) of medication with the nurse administer? (Round to the nearest tenth) ______________________

135 mg

The health-care provider orders Amoxicillin 35 mg/kg/day in three divided doses for a child with otitis media. The child weighs 44 lb and the medication is available in a suspension of 50 mg/mL. What is the total daily dosage in mL for this child?

14.0 mL

The nurse recognizes that if the infant is following normal development, the infant will be able to focus and follow an object with the eyes by which of the following ages?

2 months of age

The health-care provider orders Phenytoin (Dilantin) 4 mg/kg/day in three divided doses for a child who has a seizure disorder. The child weighs 35 lb and the medication is available at 30mg/5mL. What is the amount in mL for one dose of this child's medication? (Round to the nearest tenth)

3.5 mL

The nurse is doing an in-service with a group of peers. The topic of the four stages seen in tonic-clonic seizures is being discussed. Place the following stages seen in the tonic-clonic seizure in the order they would occur.

A) Clonic phase B) Aura C) Postictal period D) Tonic phase E) Prodromal period A, B, C, D, E

The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is which of the following?

Astigmatism

The father of a 7-year-old boy reports to the nurse that two or three times over the past weeks he has observed his son seemingly staring into space and rubbing his hands. The behavior lasts for a minute or so, followed by an inability of the child to understand what's being said to him. When the nurse asks the child about his experience, he says he doesn't know what his father is talking about. The symptoms this child is exhibiting might indicate the child is having

Complex partial seizures

The nurse caring for a deaf child is preparing to give the child an intramuscular injection in the child's upper arm. The child's attention is focused on the caregiver on the opposite side of the bed. Before administering the injection, it would be most important for the nurse to do which of the following?

Move around the bed and make eye contact, then show the child the syringe and indicate that the shot is going to be given.

In caring for the child with meningitis, the nurse recognizes that which of the following nursing diagnoses would be the most important to include in this child's plan of care?

Risk for injury related to seizure activity

The nurse is caring for an 8-year-old hospitalized child who is visually impaired. Which of the following nursing interventions would be the highest priority in helping this child reduce anxiety related to hospitalization?

The nurse talks to the child when entering and leaving the room.

Which of the following age groups of children have the highest actual rate of death from drowning?

Toddlers

The nurse is talking with the mother of a 4-year-old son who will soon be going to a prekindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which of the following statements made by the nurse would be most appropriate to tell this mother regarding the child's vision?

"Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness."

The nurse is reinforcing teaching with the caregivers of a child who has had a head injury and is being discharged. Which of the following statements made by the caregiver indicate an accurate understanding of the follow-up care for their child?

"Even if the flashlight bothers him, we will check his eyes."

The nurse is collecting data on an 18-month-old child admitted with a diagnosis of possible seizures. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask?

"Have you checked your child's temperature?"

The nurse is collecting data from the caregivers of a child admitted with seizures. Which of the following statements indicates the child most likely had an absence seizure?

"He was just staring into space and was totally unaware."

The caregiver of a 2 1/2-year-old child tells the nurse, "They told me my daughter has an eye disorder called hyperopia." Which of the following statements made by the mother most indicates she has an understanding of this child's current condition?

"Now I know why when she is working on puzzles she says her eye is sleepy."

The nurse is discussing discipline issues with a group of caregivers of preschool-age children who have a cognitive impairment. One father tells the group that after he tells his child to stop doing something, the child just continues. Parents in the group make the following statements. Which statement indicates an understanding of disciplining the cognitively impaired child?

"We wait until a behavior happens a second time and immediately put our child in time out."

The treatment for children with seizures disorders is most often which of the following?

Use of anticonvulsant medications

When caring for a child who has a history of seizures, which of the following nursing interventions would be appropriate? (Select all that apply)

A) The nurse pads the crib or side rails before a seizure. B) The nurse positions the child on the side during a seizure. C) The nurse places a washcloth in the mouth to prevent injury during seizure. D) The nurse goes for help as soon as a seizure begins. E) The nurse has oxygen available to use during a seizure. F) The nurse teaches the caregivers regarding seizure precautions. A, B, D, F

The nurse is caring for a 3-year-old child with a history of seizures and observes the child having a seizure. Following the seizure activity, the nurse documents which of the following? (Select all that apply)

A) Time the seizure started B) Factors present before seizure started C) Persons in attendance during seizure D) Number of seizure child has had E) Eye position and movement F) Incontinence of urine or stool A, B, E, F

Haemophilus Influenzae Meningitis is usually spread by which of the following methods of transmission?

Droplet

The caregivers of a child who has had difficulty learning to walk notice that when the child attempts to pull himself up to stand, he can't seem to get his legs uncrossed and beside each other. When he is in a standing position, he stays up on his toes. This is different from what they saw with their older children and they are concerned. Further diagnostic tests indicate the child has cerebral palsy. Which type of cerebral palsy do these symptoms indicate? The child has

Spastic cerebral palsy

In understanding the nervous system, the nurse recognizes that the central nervous system is made up of which of the following?

The brain and spinal cord

A symptom often seen in the child diagnosed with Haemophilus Influenzae Meningitis occurs when the child has a stiff neck. This symptom is referred to as which of the following?

Nuchal Rigidity

The nurse is observing a group of children diagnosed with various types of cerebral palsy. One of the children has an awkward and wide-based gait. The nurse recognizes this characteristic as common in which type of cerebral palsy?

Ataxic cerebral palsy Rationale:Ataxic cerebral palsy is essentially a lack of coordination caused by disturbances in the kinesthetic and balance senses; it is characterized by an awkward and wide-based gait. Athetoid cerebral palsy is marked by involuntary, uncoordinated motion with varying degrees of muscle tension. Children with this disorder are constantly in motion; the whole body is in a state of slow, writhing muscle contractions whenever voluntary movement is attempted. Rigidity cerebral palsy is uncommon and is characterized by rigid postures and lack of active movement. Spastic cerebral palsy is characterized by scissoring caused by severe hip adduction.

The caregivers of a child are giving information about their child to the nurse. The caregivers report that the child has involuntary, uncoordinated motion and that he is constantly in motion. The child is found to have cerebral palsy. Which type of cerebral palsy do these symptoms indicate?

Athetoid cerebral palsy

The nurse is caring for a child who had a seizure, fell to the ground, and hit and injured his face, head, and shoulders. This information indicates the child likely had which of the following types of seizures?

Atonic

In children with otitis media, a procedure known as a myringotomy may be performed. Which of the following statements are most accurate regarding this procedure?

During this procedure small tubes are inserted into the typmpanic membrane.

The nurse is discussing the ears and hearing in a child with a group of peers. Which of the following statements is most accurate related to this topic?

The eustachian tube in the infant is straighter and wider than in the adult.

The caregiver of a 2-year-old calls the clinic concerned that her child may have pushed paper into her ears, and she asks the nurse what she should do. The mother found the child pushing on her ears with torn paper on the floor in front of her. Which of the following would be the appropriate response by the nurse?

"The child should be seen by a care provider. Don't put anything in her ear and bring her in right away."

When caring for an infant who is hospitalized with Haemophilus influenzae meningitis, an important nursing intervention for the child would be for the nurse to?

Check the child's neurological status every two hours

If the child is following a normal development process, visual acuity gradually increases from birth. Which of the following is most accurate regarding the age children develop 20/20 vision?

Children usually develop 20/20 vision by 7 years of age.

A diet used in the treatment of some seizure disorders is high in fat and low in carbohydrates and protein and causes the child to have high levels of ketones which help to reduce seizure activity. This diet is referred to as a ________________ diet.

Ketogenic

The nurse is observing a child following an eye injury. Which of the following symptoms might alert the nurse to the possibility that the uninjured eye may be exhibiting signs of an inflammatory reaction?

Photophobia or an intolerance to light

The caregiver of a child who has a history of seizures reports that her child was complaining of being dizzy, and the caregiver noted the child seemed drowsy and was clumsy. The nurse recognizes that the description of the child's behavior was most likely which stage of a tonic-clonic seizure?

Prodromal

The mother of a child newly diagnosed with mental retardation tells the nurse that her partner disagrees with the diagnosis and believes that the child is perfectly normal. The mother shares with the nurse that she finds this reaction frustrating and confusing. Which of the following would be appropriate in supporting this mother? The nurse should

Reassure the mother that her partner's reaction is a normal stage in the grieving process

The nurse is observing a child admitted with a seizure disorder. Which of the following observations would the nurse most likely note in the tonic stage of the seizure?

The child becomes cyanotic.

The nurse is caring for a child admitted with simple partial motor seizures. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

The child had shaking movements on one side of the body.

Which of the following is most correct regarding the nervous system of the child?

The child has underdeveloped fine motor skills and well-developed gross motor skills.

The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be which of the following?

The child is in status epilepticus

The nurse is caring for a child admitted with complex partial seizures. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

The child was rubbing the hands and smacking the lips.

In caring for a child with a seizure disorder, the highest priority goal is which of the following?

The child will be free from injury during a seizure.