Chp 11 peds health conditions

What statement is descriptive of kwashiorkor? 1 Kwashiorkor is of multifactorial origin. 2 Kwashiorkor occurs primarily in breastfed infants. 3 Kwashiorkor results from excessive amounts of vitamin K. 4 Kwashiorkor is related to inadequate calories, not adequate protein

1 Cultural, environmental, and infectious components contribute to kwashiorkor, a deficiency of protein with an adequate supply of calories. Kwashiorkor occurs in infants and children who are beyond the age of breastfeeding. There is no correlation between excessive vitamin K and kwashiorkor. Kwashiorkor is a disorder in which there are adequate calories but a deficiency of protein.

What condition is also known as paroxysmal abdominal pain? 1 Colic 2 Cow's milk allergy 3 Positional plagiocephaly 4 Sudden infant death syndrome (SIDS)

1 Paroxysmal abdominal pain is also known as colic. Cow's milk allergy is a multifaceted disorder representing adverse systemic and local gastrointestinal reactions to cow's milk protein. Positional plagiocephaly is an oblique or asymmetric head resulting from cranial molding during infancy. Sudden infant death syndrome, or SIDS, is defined as the sudden death of an infant younger than 1 year of age that remains unexplained after a complete postmortem examination.

The nurse is educating new mothers of infants when they return for a well-baby check. What infant is at high risk of developing sudden infant death syndrome (SIDS) when discussing with the mothers? 1 An infant who sleeps in a crib 2 An infant whose mother smokes 3 An infant who sleeps on firm bedding 4 An infant who sleeps in a supine position

2 SIDS is characterized by the unexplained sudden death of the infant. Maternal smoking is a major risk factor of SIDS. Studies suggest that high nicotine level in the infant's lung tissue may lead to SIDS. Co-sleeping is another risk factor. Infants who share a bed with an elder sibling or any other adult may have high risk of developing SIDS. Infants who sleep in their cribs tend to have decreased risk of SIDS. Infants who sleep in prone position may obstruct their airways. They also tend to inhale carbon dioxide, thereby increasing the risk of SIDS. Soft bedding may accidentally obstruct the airway and increase the risk of SIDS.

2. A 10-year-old child with a peanut allergy would be expected to have which of these as an early manifestation of his allergy? Select all that apply. A. Wheezing B. Nausea C. Headache D. Trouble breathing E. Urticaria

A. Wheezing D. Trouble breathing E. Urticaria

A 1-month-old infant is admitted to the hospital for failure to thrive (FTT) secondary to a cardiac condition. How is this type of FTT categorized? 1 Defective utilization 2 Increased metabolism 3 Inadequate absorption 4 Inadequate caloric intake

2 FTT secondary to a cardiac condition is categorized as increased metabolism. Increased metabolism etiologies of FTT can also include hyperthyroidism and chronic infection. Inadequate caloric intake can result from incorrect formula preparation, neglect, excessive juice consumption, or breastfeeding problems. Inadequate absorption can result from cystic fibrosis, celiac disease, Crohn disease, vitamin or mineral deficiencies, or cow's milk allergy. Defective utilization can result from genetic anomalies such as trisomy 18 or 21, congenital infection, or metabolic storage diseases.

What are the most common allergenic foods? 1 Nuts, eggs, wheat, soy, citrus 2 Milk, legumes, wheat, berries 3 Nuts, eggs, wheat, shellfish, soy 4 Milk, spices, chocolate, shellfish

3 The most common allergens are nuts, eggs, wheat, shellfish, soy, and legumes (peanuts). Other foods that are allergenic include chocolate, spices, milk, corn, and citrus fruits.

5. A 3-month-old is being seen in the well-child clinic for positional plagiocephaly. The nurse knows that the initial interventions for this condition involve which of the following? Select all that apply. A. Place the infant to sleep in the prone position. B. Place the infant in a prone position when awake (approximately 15 min). C. Alternate the infant's head position (side of head) when asleep. D. Have the infant wear a soft helmet for 23 to 24 hours a day. E. Place the infant to sleep in an infant seat twice a day.

B. Place the infant in a prone position when awake (approximately 15 min). C. Alternate the infant's head position (side of head) when asleep.

3. The recommended treatment for cow's milk protein allergy is the substitution of cow's milk-based formula for: A. Goat's milk B. Soy milk or a hydrolyzed formula C. Whole milk D. Evaporated milk

B. Soy milk or a hydrolyzed formula C. Whole milk

Parents tell the nurse that their child wakes up at night because of fear and seeks the physical presence of one of the parents nearby to return to sleep. What would the nurse instruct the parents to do to manage the child's night fear? 1 "Sleep with the child." 2 "Take the child to your room." 3 "Use a reward system to motivate the child." 4 "Put the child to bed after the child falls asleep

3 The nurse should encourage the parents to use a reward system to motivate the child to deal with the fear. The parents should not sleep with the child, but should reassure the child that everything is fine and the child is safe in the child's own bed. The parents should not take the child to their room if the child wakes up at night because of fear. The parents should teach their child to trust that the child's bed is a safe place. This will help keep the child from leaving the bedroom. The parents should put their child to bed when the child is awake.

What clinical manifestations would the nurse expect in an infant diagnosed with failure to thrive? 1 Pica, ascites, emotionally healthy 2 Developmental delays, ascites, apathy 3 Developmental delays, pica, fear of strangers 4 Malnutrition, developmental delays, feeding disorders

4 Clinical manifestations of an infant with failure to thrive include malnutrition, developmental delays, and feeding disorders. Ascites is not associated with failure to thrive. Most infants with failure to thrive are not emotionally healthy, rather, they are withdrawn and apathetic. Infants with failure to thrive tend to exhibit no fear of strangers rather than fear of strangers.

What best describes the origin of a cow's milk allergy? 1 Result of colic in babies 2 Gastrointestinal underresponse to dairy 3 Response caused by gastroesophageal reflux 4 Multifaceted disorder representing adverse systemic and local gastrointestinal reactions to cow's milk protein

4 Cow's milk allergy (CMA) is believed to be a multifaceted disorder representing adverse systemic and local gastrointestinal reactions to cow's milk protein. CMA is not a gastrointestinal underresponse to dairy but rather a hypersensitive response. CMA is not caused by gastroesophageal reflux or best described as the reason for colic in babies.

A nurse is providing education to a community group in preparation for a mission trip to a third world country with limited access to protein-based food sources. What condition would the nurse prepare the team to assess for in the infants of this country? 1 Rickets 2 Pellagra 3 Marasmus 4 Kwashiorkor

4 Kwashiorkor is defined primarily as a deficiency of protein with an adequate supply of calories. Rickets results from a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones. Marasmus results from general malnutrition of both calories and protein. Pellagra is a vitamin-deficiency disease most commonly caused by a chronic lack of niacin (vitamin B3) in the diet.

A 9-month-old infant is seen in the emergency department after exhibiting an urticaric rash with a cough and wheezing. When collecting the history of events preceding the sudden onset of these symptoms, the mother states that the parents have been "feeding the baby new foods." What food is the most likely cause of this reaction in the infant? 1 Spinach 2 Potatoes 3 Green beans 4 Peanut butter

4 Nuts of any type, including peanuts, have a high allergy index in children and infants. The infant has demonstrated cutaneous and respiratory reactions after possible ingestion of peanut butter. Potatoes, green beans, and spinach are not highly allergenic foods.

1. Vitamin A may be administered in significant amounts to children with this childhood communicable illness to decrease morbidity and mortality: A. Pertussis B. Varicella C. Rubella D. Measles

D. Measles

4. Which factors are considered protective factors for sudden infant death syndrome (SIDS)? A. Side sleeping position, breastfeeding, updated childhood immunization status B. Supine sleeping position, breastfeeding, soft bedding C. Prone sleeping position, exposure to maternal tobacco use, updated childhood immunization status D. Supine sleeping position, breastfeeding, updated childhood immunization status

D. Supine sleeping position, breastfeeding, updated childhood immunization status

The nurse is caring for an infant who has protein-energy malnutrition. What nutritional supplement is administered only when the infant is able to tolerate a steady food source? 1 Zinc 2 Iron 3 Copper 4 Vitamin A

2 Iron supplementation in a protein-energy malnourished child should not be recommended until the child is able to tolerate a steady food source. Zinc, copper, and vitamin A are recommended nutritional supplements for a child with protein-energy malnutrition even when the child is unable to tolerate a steady food source.

The parents of a 5-month-old child complain to the nurse that they are exhausted because the infant still wakes up as often as every 1 to 2 hours during the night. When the child awakens, the parents change the diaper and the mother nurses the child back to sleep. What would the nurse suggest to help the parents improve the sleep pattern? 1 Put the child in the parents' bed to cuddle. 2 Start putting the infant to bed while still awake. 3 Give the infant a bottle of formula instead of breastfeeding so often at night. 4 Allow the infant to cry for 30 minutes, then rock the infant back to sleep before putting the infant back in the crib.

2 Parents need to develop bedtime rituals that involve putting the child in bed while awake. This will allow the infant to become accustomed to falling asleep somewhere besides the parent's arms or in the parent's presence. The issue of a child sleeping with the parents should be discussed fully. Having the infant in bed with them may still interfere with their sleep and increases the risk of injury to an infant of this age. The elimination of crying episodes should be done progressively, beginning with checking on the infant every 5 minutes during the first night and extending this interval by 5 minutes on subsequent nights. This will allow the infant to learn to self-soothe. Providing formula in a bottle at night will contribute to bottle-mouth caries. Additionally, 5-month-old infants generally wake up during the night not to feed, rather, to be soothed. Using feeding as a mechanism to soothe begins a pattern that may lead to eating problems later in childhood.

What infant is at a high risk for sudden infant death syndrome (SIDS)? 1 Infant weighing 2.7 kg 2 Infant with an Apgar score of 4 3 Infant with campylobacter infection 4 Infant with gestational age of 42 weeks

2 The infant with an Apgar score of 4 is at a high risk of SIDS. The infant who weighs 2.7 kg at birth is considered to be of normal birth weight. Campylobacter infection is caused by bacteria and is not a risk factor for SIDS. A gestational age of 42 weeks is not associated with SIDS.

The nurse is explaining the health problems of infants and children to a student nurse. The student nurse is working with parents who are upset because their child is diagnosed with a dyssomnia. What would the student nurse look for in this child's history to understand about dyssomnias? 1 Parents noticed the child sleepwalks. 2 The child has trouble falling asleep at night. 3 The child has signs of protein-energy malnutrition. 4 The child is allergic to milk and milk-related products

2 The nurse should be aware that in dyssomnias children have trouble with either falling asleep or staying asleep at night. They may have problems with staying awake during the daytime as well. Therefore, to understand dyssomnias, the student nurse has to observe the child's sleeping patterns. Sleepwalking is a parasomnia, not a dyssomnia. There may be other signs and symptoms of deficiency of vitamins, protein-energy malnutrition, or allergy to milk and its products.

A community nurse is conducting an awareness program about the role of vitamins in the prevention of health problems in children. What vitamin would the nurse recommend for all pregnant women to prevent neural tube defects in infants? 1 16.0 mg of niacin 2 0.4 mg of folic acid 3 1.2 mg of thiamine 4 90 mg of ascorbic acid

2 A daily dose of 0.4 mg of folic acid is recommended for all women of reproductive age. If supplemental folic acid is taken daily during early pregnancy, the risk of neural tube defects such as spina bifida is reduced by as much as 70%. Folic acid is also recommended for women on contraceptive pills and antidepressant drugs. A deficiency of niacin causes pellagra, a deficiency of thiamine causes beriberi, and a deficiency of ascorbic acid causes scurvy.

The addition of vitamins to commercially prepared infant foods increases the risk of what condition? 1 Kwashiorkor 2 Malabsorption 3 Hypervitaminosis 4 Vitamin D deficiency

3 Hypervitaminosis—excessive dosage of a vitamin, usually defined as 10 or more times the Recommended Dietary Allowance (RDA)—is more common today with the addition of vitamins to commercially prepared infant foods. Kwashiorkor is a deficiency of protein with an adequate supply of calories that has nothing to do with the addition of vitamins to commercially prepared foods. The potential for malabsorption has not increased as a result of vitamins being added to commercially prepared food

The parent of an 11-month-old infant tells the nurse that the infant vomits a lot and cries for no obvious reason. On examination, the infant's weight is found to fall below the fifth percentile on a standard growth chart. What dietary instruction included in the care plan of the infant is appropriate? 1 "Give the infant skim milk." 2 "Give the infant fruit juice." 3 "Include fortified rice cereals in the infant's diet." 4 "Include low fat yogurt and vegetable oil in the infant's diet.

3 The goal of nutritional management in infants with failure to thrive (FTT) is aimed at correcting nutritional deficiencies, increasing the caloric intake, and achieving ideal weight. Carbohydrate-rich foods should be given to the infant to increase caloric intake. Fortified rice cereals are good sources of carbohydrates, as well as vitamins and minerals. The infant should not be given skim milk, because milk fat is an essential source of energy for infants; skim milk is given to children who are obese. Fruit juices should be restricted until the infant gains adequate weight. Low-fat foods such as low-fat yogurt should not be given to children who are below 2 years of age. Vegetable oil is a good carbohydrate additive that can be included in the diet of infants with FTT.