Chapter 37 Peds Diagnostic Therapeutic PrepU
A nurse is discussing post-procedure interventions with new pediatric nurses. Which statement addresses the most immediate safety action required? "Remove all equipment related to the procedure from the child's environment." "Handle all contaminated linens in accordance with the facility policies." "Assess to ensure that the side rails are up and the bed is lowered to the floor." "Document the procedure and the response of the child as soon as the procedure is completed."
"Assess to ensure that the side rails are up and the bed is lowered to the floor."
The nurse is teaching a group of first-time parents who are being discharged with their newborns. One parent asks the nurse what to do if the child has a temperature. After conducting teaching regarding how to care for a child with an elevated temperature, the caregivers make the following statements. Which statement would indicate a need for further teaching? "A rectal temperature above 102.5℉ (39.1℃) should be lowered." "Giving extra fluids is the way I have always heard to lower a temperature." "I don't plan to give my child medications, but the pediatrician might tell us to give our child acetaminophen every 4 to 6 hours if she has a fever." "If my child starts to shiver I will know that what I am doing is working and that her fever will soon come down."
"If my child starts to shiver I will know that what I am doing is working and that her fever will soon come down."
A parent asks the nurse to explain positron emission tomography (PET) after learning that the child will be having a PET scan of the abdomen. What is the nurse's best response? "It is a very short procedure done in the diagnostic imaging department." "It would be best to ask your health care provider about this procedure." "It is similar to computed tomography but uses an injection of dye to help visualize the abdominal organs." "Positron emission tomography is different from computed tomography (CT)."
"It is similar to computed tomography but uses an injection of dye to help visualize the abdominal organs."
What explanation will the nurse give the mother who wonders why her neonate's gavage tube was placed through the mouth? "It is more direct from mouth to stomach." "Neonates sneeze a good deal with a tube in the nose." "The infant can suck on the tube for comfort." "Neonates are nose breathers. A tube can interfere."
"Neonates are nose breathers. A tube can interfere."
A parent calls the nurse in the emergency department and reports giving a tepid bath to decrease temperature in a feverish child. The parent states the child is shivering and wants to know if this means the bath was effective. What is the best response by the nurse? "Shivering means the child is chilling, which will cause the body temperature to increase." "The child may be getting ready to have seizure activity." "The child's fever is going to go down after the bath because of the shivering." "You should pour more hot water in the tub so the child will not shiver."
"Shivering means the child is chilling, which will cause the body temperature to increase."
A nurse is requesting that the unlicensed assistive personnel (UAP) take vital signs on a group of children in the pediatric clinic. Which child does not need blood pressure assessed? 6-year-old with asthma 2-year-old for well-child check 10-year-old with gastroenteritis 14-year-old for athletic physical
2-year-old for well-child check
A nurse has just received an order to apply an ice bag to a client's groin. Which of the following intervals for placement of the ice bag does the nurse plan to use? 20 minutes 30 to 45 minutes 10 minutes 60 minutes
20 minutes
A child is prescribed several diagnostic procedures. How can the nurse advocate for this client? Ask that the procedures be scheduled back to back to prevent fatigue. Advocate for procedures to be separated to allow time for food and rest. Attend all procedures with the child when going to another area of the hospital. Ensure that all procedures are performed with the child under general anesthesia.
Advocate for procedures to be separated to allow time for food and rest.
A pediatric nurse is mentoring a new graduate nurse. Which action by the new nurse would require intervention by the pediatric nurse? explaining a procedure to an adolescent taking a rectal temperature on a newborn taking a family history from the mother starting an IV in the procedure room
taking a rectal temperature on a newborn
The nurse is caring for a child with an ileostomy. What nursing intervention will be included in this child's plan of care? Clean the outside of the collection device. Check for leakage around the stoma. Leave the ileostomy open to the air. Apply a sterile dressing around the stoma.
Check for leakage around the stoma.
A child has undergone a procedure requiring moderate sedation. The child asks the nurse, "I am thirsty; can I have something to drink?" Before giving the child something to drink, what will the nurse do first? Check the child's gag reflex. Ask the child their name and birth date. Assess the child's level of consciousness. Check the child's vital signs.
Check the child's gag reflex.
An 8-month old infant has a colostomy placed following abdominal surgery for removal of a section of bowel. The stoma is 2/3 full, draining liquid stool and the bag appears inflated. What actions would the nurse take in caring for this client? Select all that apply. Remove the stoma bag and discard it every day. Empty the bag and record the output. Examine the skin around the stoma site for redness or irritation. Look at the infant's intake to determine if any foods could be causing gas. Remove the stoma bag and allow the stoma to remain open to air for 1 to 2 hours.
Empty the bag and record the output. Examine the skin around the stoma site for redness or irritation. Look at the infant's intake to determine if any foods could be causing gas.
When performing a procedure on a child in the health care setting, what should the priority intervention by the nurse be? Ensuring the child's safety Making sure that the child is restrained Making sure that the parents are present during the procedure Ensuring the child trusts what the nurse is saying
Ensuring the child's safety
A 9-year-old child requires gastrostomy tube feedings to meet nutritional requirements. How will the nurse suggest these feedings should be arranged to be least disruptive to the child's daily activities? Feed the child continuously throughout the night using a feeding pump. Instruct the school health aide in administering a feeding to the child at school. Administer a more nutritionally dense formula before and after the school day. Teach the child to self-administer his feedings while at school.
Feed the child continuously throughout the night using a feeding pump.
A 6-year-old with hemoptysis is about to undergo a procedure the nurse is not fully familiar with. The nurse is present when the primary health care provider explains the procedure to the family, including its purpose, benefits, and risks, and is now preparing for the procedure. The nurse notices that the parents have not yet signed the informed consent form and asks them about this. The mother is unsure about signing because she is not sure she understands what exactly the risks are with the procedure. Which is the next nursing action? Have the health care provider return and explain the risks in greater detail and ask for questions. Reassure the mother that this is a common procedure and urge her to sign so that procedure can begin. Reiterate the risks which were previously discussed by the health care provider and ask her to sign. Reinforce the right of the family to refuse the procedure for their child if they have any concerns.
Have the health care provider return and explain the risks in greater detail and ask for questions.
When an infant is scheduled for a painful procedure, what is the most important action by the nurse? Explain the procedure to the client. Explain the procedure to the caregiver. Help to soothe and comfort the baby before and after the procedure. Nothing—the infant is too young to know what is going on.
Help to soothe and comfort the baby before and after the procedure.
The nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). What accurately describes the use of TPN? It is used short term to supply additional calories and nutrients as needed. It is delivered via the peripheral vein to allow rapid dilution of hypertonic solution. It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals. It is usually used when the child's nutritional status is within acceptable parameters.
It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals.
A child is reporting pain where an IV infiltrated his hand earlier in the shift. The doctor orders warm compresses to the right hand every 4 hours. What precautions would the nurse implement for this client? Heat the moistened towels in the microwave. Use hot water on gauze for the warm compress. Limit treatments to 20 minutes at a time. Have the parents apply the warm compresses if the nurse is tied up elsewhere.
Limit treatments to 20 minutes at a time.
A nurse is preparing to insert a nasogastric (NG) tube in an infant. How will the nurse determine the appropriate length of tubing to use for the infant? Measure from the tip of the child's nose to the earlobe down to the tip of the sternum. Measure from the lip line down to the middle of the sternum. Measure from the earlobe to the tip of the sternum. Measure from the tip of the child's nose down to the tip of the sternum.
Measure from the tip of the child's nose to the earlobe down to the tip of the sternum.
A urine specimen has been ordered for a 1-year-old girl. Which method would be the best way for the nurse to obtain this urine specimen? Clean the child's genital area thoroughly and when she has urinated, squeeze the urine from her diaper into a specimen cup. Give the child some water or juice, leave off her diaper, ask the caregiver to call you when the child needs to void, and obtain the specimen in a sterile container. Place a sterile cotton ball into the child's diaper; after the child has urinated, squeeze the urine from the cotton ball into a sterile container to be sent to the lab. Get down on the child's level and speak to her explaining that you need her to tell you when she needs to use the bathroom and when she does, obtain the specimen.
Place a sterile cotton ball into the child's diaper; after the child has urinated, squeeze the urine from the cotton ball into a sterile container to be sent to the lab.
The nurse is caring for a 2-year-old child in the pediatric unit. The child was being fed by unlicensed assistive personnel and had a temper tantrum and spit out the food. The child now needs to be taken for a diagnostic procedure. Which nursing action would be the best method of transporting this child? Place the child in a crib with high side rails or in a crib with a bubble top. Walk alongside the child with age-appropriate toys at hand. Request the UAP carry the child in his or her arms to the other department. Allow the child to sit in a stroller after reminding him temper tantrums are not acceptable.
Place the child in a crib with high side rails or in a crib with a bubble top.
Included in the nursing care plan for the child receiving total parenteral nutrition (TPN) will be which intervention? Regularly monitoring the child's blood glucose A daily stool softener Keeping the child nothing by mouth (NPO) Flushing the peripheral catheter delivering the TPN solution regularly with saline
Regularly monitoring the child's blood glucose
A young client has a temperature of 102℉ (38.9℃). In addition to the scheduled antipyretic the child received, the nurse is treating the fever with nonpharmacologic methods by removing the blanket that covers the child. What is the rationale for this action? The blanket adds heat to the child. Removing excess coverings allows for evaporation, which aids in cooling the child. The blanket soaks up the sweat, making the child warmer. Covering the child with a blanket leads to shivering, which will only generate more heat.
Removing excess coverings allows for evaporation, which aids in cooling the child.
A nurse working with a client who has an elevated temperature notices that the child is beginning to shiver. Which of the following should the nurse do immediately? Remove more clothing. Apply cool compresses. Lower the room temperature. Stop whatever intervention is being done to lower the temperature.
Stop whatever intervention is being done to lower the temperature.
A 1-year-old child with an abdominal wound is undergoing a dressing change. The child's parent is at the bedside. Which action would the nurse instruct the parent to do? Talk to the child in a quiet, soothing voice. Sit across from but directly in the view of the child. Wait outside until the procedure is finished. Participate by holding the legs still during the treatment.
Talk to the child in a quiet, soothing voice.
Under which conditions would the nurse be justified in restraining a child in the hospital? Select all that apply. The child is a toddler and continues to attempt to crawl out of the crib. The mother has to go home for a short time and there is no one to sit in the room with the child. The parents request that their child be restrained. The child had a new gastrostomy tube placed today. The preschool-aged client needs to have an IV started.
The child is a toddler and continues to attempt to crawl out of the crib. The child had a new gastrostomy tube placed today.
How does the nurse know that the expected outcome(s) for the child undergoing a magnetic resonance imaging (MRI) procedure has been met? Select all that apply. The child was able to describe the procedure before going. The child removed all metal objects prior to the procedure. The child was able to remain still throughout the procedure. The child was able to tolerate the procedure using earplugs. The child's parents were able to go with the child to the procedure holding area.
The child was able to describe the procedure before going. The child removed all metal objects prior to the procedure. The child was able to remain still throughout the procedure. The child was able to tolerate the procedure using earplugs. The child's parents were able to go with the child to the procedure holding area.
A child has returned to the unit after having a lumbar puncture. Which instructions are important for the nurse to provide the parents and child? The child will need to remain flat to prevent a headache. The child may be fearful of staff after having this procedure. The child should be up and ambulating as soon as possible. This procedure needs to be repeated again in 24 hours to determine the results.
The child will need to remain flat to prevent a headache.
The nurse is administering a gavage feeding through a nasogastric feeding tube. Which nursing intervention is the highest priority? The nurse positions the child in a sitting position. The nurse verifies the position of the feeding tube. The nurse replaces stomach content that has been aspirated. The nurse documents how the child tolerated the feeding.
The nurse verifies the position of the feeding tube.
A child has been admitted to the pediatric unit with diarrhea. The nurse must collect a stool specimen for ova and parasites. The nurse knows that the proper procedure must be followed for detection of the ova and parasites. The proper procedure includes: Place the stool specimen in a sterile container. Refrigerate the specimen until it can be taken to the laboratory. Only use stool from a bed pan. Transport the stool specimen to the laboratory promptly. Use tongue blades to separate the stool from urine.
Transport the stool specimen to the laboratory promptly.
A 14-year-old adolescent is stating flank pain that keeps them up at night. The nurse instructs the adolescent in obtaining a clean catch urine specimen. Place the steps in order from first to last for preparing an adolescent female for a clean catch urine specimen. Use all options. Verify the prescription from the health care provider. Explain the procedure to the adolescent. Have the adolescent spread their labia and clean front to back with the wipe. Have the adolescent urinate a small amount into the toilet. Have the adolescent void into the urine specimen cup. Have the adolescent empty their bladder into the toilet.
Verify the prescription from the health care provider. Explain the procedure to the adolescent. Have the adolescent spread their labia and clean front to back with the wipe. Have the adolescent urinate a small amount into the toilet. Have the adolescent void into the urine specimen cup. Have the adolescent empty their bladder into the toilet.
A nurse is caring for a hospitalized infant being treated for dehydration. What does the nurse need to do to measure the output when the child is wearing a diaper? Record the weight of the diapers that the baby uses in a 24-hour period. Weigh the baby on the scale with the wet diaper and then subtract the weight of the dry diaper. There is no accurate way to measure the output of the infant wearing a diaper. Weigh the wet diaper and subtract the weight of a dry diaper; the difference is the amount to record.
Weigh the wet diaper and subtract the weight of a dry diaper; the difference is the amount to record.
A nurse is measuring the respiratory rate of an infant. Which location should the nurse observe when making this assessment? abdominal region apical region radial region above and outside the left nipple
abdominal region
While teaching parents how to effectively reduce the child's fever, the nurse should emphasize avoiding which intervention? acetaminophen acetylsalicylic acid placing a cool cloth on the forehead dressing the child in lightweight clothing
acetylsalicylic acid
A nurse is preparing a 14-year-old client for a dye contrast study. The client will receive the contrast medium intravenously in the procedural area of the hospital. When preparing this client for the procedure, which is the nurse's priority concern? confirming that there is no iodine allergy to the contrast dye administering a topical analgesic for insertion of the intravenous catheter cautioning parents to keep their distance for 24 hours after the procedure providing emotional support throughout the procedure
confirming that there is no iodine allergy to the contrast dye
The nurse will apply which type of restraint for the infant recovering from cleft lip repair? clove hitch jacket elbow mummy
elbow
A nurse is preparing to apply heat therapy to a client who has a back abscess. Heat has which of the following benefits? Select all that apply. increases circulation causes vasodilation causes vasoconstriction promotes muscle relaxation prevents drainage of abscess
increases circulation causes vasodilation promotes muscle relaxation
A child has been admitted to the pediatric unit with vomiting and diarrhea. The physician orders strict monitoring of intake and output. The mother asks the nurse what fluids she will need to measure. The nurse responds that fluid intake can include which of the following? Select all that apply. popsicles Gatorade Jell-O applesauce IV fluids
popsicles Gatorade Jell-O IV fluids
A child is in recovery after having a bronchoscopy. Which nursing assessment takes priority immediately following this procedure? respiratory status level of consciousness return of the gag reflex tolerance of the procedure
respiratory status
A nurse is performing a capillary puncture on a 15-year-old client with chronic anemia. The client requests the capillary puncture to be on the left side because it is the nondominant side. Because that side of the body is selected, which is the optimal site for the nurse to obtain blood? side of the finger center of the finger dorsal surface of the hand antecubital fossa
side of the finger
What supply is best to use to catheterize a young toddler for a urine specimen? straight urinary catheter with small lumen Foley catheter with 3 ml balloon sterile feeding tube with small lumen small suction catheter, well-lubricated
sterile feeding tube with small lumen
The nurse is assigned to care for a child diagnosed with a chronic illness. The child has just been admitted but has been on the unit many times before. From the report the admitting nurse gives, the child is sicker than the last time she was admitted. In planning the child's care, the nurse notes that the provider has ordered a nasogastric gavage feeding, but the nurse remembers that even the last time the child was on the unit, she was unable to tolerate the nasogastric feedings. The most appropriate nursing action would be for the nurse to: begin the nasogastric gavage feeding to see if the child can tolerate it. begin an orogastric gavage in hopes the child can handle the feeding. ask the nursing supervisor to decide which type of feeding to give. talk with the health care provider and request further instruction and orders.
talk with the health care provider and request further instruction and orders.
Which of the following are situations that might warrant a restraint of a pediatric client? Select all that apply. to protect the child from injury during a procedure or examination to ensure the child's safety to keep an active child confined to bed to teach a child how to be cooperative
to protect the child from injury during a procedure or examination to ensure the child's safety
The nurse is conducting teaching with the caregivers of a child who is being discharged from the pediatric unit. The care provider has recommended the child have moist heat applications at home. In conducting teaching with this caregiver, the nurse will teach the caregiver to use which of the following to provide the moist heat? an electric heating pad towels dampened and heated in the microwave a hot water bottle towels dampened with hot water
towels dampened with hot water
A preschool child has been admitted to the hospital. Which prescription should the nurse question? NPO tap water enema 500 ml nasogastric tube to suction IV normal saline 25 ml/hour
tap water enema 500 ml
