mother/baby chapter 39

A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 mL/8 hr is being infused rather than the ordered amount of 300 mL/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours?

300 mL

What is the most appropriate statement for the nurse to make to a 5-year-old child who is undergoing a venipuncture?

"This will hurt like a pinch. I'll get someone to help hold your arm still so it will be over fast and hurt less."

A child with congestive heart failure is placed on a maintenance dosage of digoxin (Lanoxin). The dosage is 0.07 mg/kg/day, and the child's weight is 7.2 kg. The physician prescribes the digoxin to be given once a day by mouth. Each dose will be _____ milligrams. Record your answer using one decimal place.

0.5 Calculate the dosage by weight: 0.07 mg/day 7.2 kg = 0.5 mg/day.

An appropriate method for administering oral medications that are bitter to an infant or small child would be to mix them with:

A small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream.

When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration?

Administering the medication with a syringe (without needle) placed along the side of the infant's tongue

The nurse approaches a group of school-age patients to administer medication to Sam Hart. To identify the correct child, the nurse should:

Check the patient's identification name band.

Which information should the nurse include in teaching parents how to care for a child's gastrostomy tube at home?

Clean around the insertion site daily with soap and water.

Using knowledge of child development, the best approach when preparing a toddler for a procedure is to:

Demonstrate the procedure on a doll.

The nurse gives an injection in a patient's room. What should the nurse do with the needle for disposal?

Dispose of syringe and needle in a rigid, puncture-resistant container in patient's room.

Nursing considerations related to the administration of oxygen in an infant include to:

Ensure uninterrupted delivery of the appropriate oxygen concentration.

The nurse must suction a child with a tracheostomy. Interventions should include:

Ensuring that each pass of the suction catheter take no longer than 5 seconds.

Kimberly, age 3 years, has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102° F even though Kimberly had acetaminophen 2 hours ago. The nurse's action should be based on knowing that:

Fevers such as this are common with viral illnesses.

An appropriate intervention to encourage food and fluid intake in a hospitalized child is to:

Give high-quality foods and snacks whenever child expresses hunger.

The nurse is preparing a 12-year-old girl for a bone marrow aspiration. She tells the nurse that she wants her mother with her "like before." The most appropriate nursing action is to:

Grant her request.

When teaching a mother how to administer eyedrops, where should the nurse tell her to place them?

In the conjunctival sac that is formed when the lower lid is pulled down

An important nursing consideration when performing a bladder catheterization on a young boy is to:

Insert 2% lidocaine lubricant into the urethra.

Guidelines for intramuscular administration of medication in school-age children include to:

Insert the needle quickly, using a dartlike motion.

The nurse has just collected blood by venipuncture in the antecubital fossa. Which should the nurse do next?

Keep arm extended, and apply pressure to the site for a few minutes.

The advantages of the ventrogluteal muscle as an injection site in young children include which of the following (Select all that apply)?

Less painful than vastus lateralis Free of important nerves and vascular structures Easily identified by major landmarks

The nurse is preparing for the admission of an infant who will have several procedures performed. In which situation is informed consent required (Select all that apply)?

Lumbar puncture Computed tomography (CT) scan with contrast

Which nursing action is the most appropriate when applying a face mask to a child for oxygen therapy?

Make sure the mask fits properly.

A venipuncture will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. The nurse should recognize that this:

May help the child relax.

In some genetically susceptible children, anesthetic agents can trigger malignant hyperthermia. The nurse should be alert in observing that, in addition to an increased temperature, an early sign of this disorder is:

Muscle rigidity.

In preparing to give "enemas until clear" to a young child, the nurse should select:

Normal saline.

When administering a gavage feeding to a school-age child, the nurse should:

Position the child on the right side after administering the feeding.

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, the nurse's best action is to:

Prepare child for conscious sedation during the test.

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. What best explains why an intraosseous infusion is started?

Rapid venous access is not possible.

An 8-month-old infant is restrained to prevent interference with the intravenous infusion. The nurse should:

Remove the restraints whenever possible.

A 6-year-old child is hospitalized for intravenous (IV) antibiotic therapy. He eats little on his "regular diet" trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which is the best nursing action?

Request these favorite foods for him.

A nurse must do a venipuncture on a 6-year-old child. An important consideration in providing atraumatic care is to:

Restrain the child only as needed to perform venipuncture safely.

Tepid water or sponge baths are indicated for hyperthermia in children. The nurse should:

Stop the bath if the child begins to chill.

The emergency department nurse is cleaning multiple facial abrasions on 9-year-old Mike. His mother is present. He is crying and screaming loudly. The nurse should:

Tell him it is okay to cry and scream.

The nurse is planning how to best prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include:

Telling the child that procedures are never a form of punishment.

What should the nurse consider when having consent forms signed for surgery and procedures on children?

The risks and benefits of a procedure are part of the consent process.

What nursing action is appropriate for specimen collection?

Use Standard Precautions when handling body fluids.

What is critical information for the nurse to incorporate into her care when using restraints on a child?

Use the least restrictive type of restraint.

The nurse is caring for an unconscious child. Skin care should include:

Using draw sheet to move child in bed to reduce friction and shearing injuries.

Which is the preferred site for intramuscular injections in infants?

Vastus lateralis

The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should:

Wash hands thoroughly.

A nurse is caring for a child in Droplet Precautions. Which instructions should the nurse give to the unlicensed assistive personnel caring for this child (Select all that apply)?

Wear gloves when entering the room. Wear an isolation gown when entering the room. Wash your hands upon exiting the room.

Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. The most appropriate nursing action is to:

Allow her to wear her underpants.

The nurse is doing a prehospitalization orientation for a 7-year-old child who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that she will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is:

An appropriate part of the child's preparation.

A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen (Tylenol). The nurse should explain that antipyretics:

Are of no value in treating hyperthermia.

Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. The most appropriate way to collect small amounts of urine for these tests is to:

Aspirate urine from cotton balls inside the diaper with a syringe.

The nurse must do a heel stick on an ill neonate to obtain a blood sample. Which procedure is recommended to facilitate this?

Wrap foot in a warm washcloth.

It is important to make certain that sensory connectors and oximeters are compatible since wiring that is incompatible can cause:

Burns under sensors.

The nurse is teaching a mother how to perform chest physiotherapy and postural drainage on her 3-year-old child, who has cystic fibrosis. To enable the mother to perform percussion, the nurse should instruct her to:

Cover the skin with a shirt or gown before percussing.

When caring for a child with an intravenous infusion, the nurse should:

Observe the insertion site frequently for signs of infiltration.