Pediatric Nursing

A child who weighs 33 pounds has an order for acetaminophen 10mg/kg/dose, every 4 hours prn for pain or fever. How many milligrams will the child receive per dose?

33/ 2.2= 15kg x 10mg= 150 mg

Adjusted age for premature infants → The nurse is assessing a 7-month-old premature infant born at 28 weeks' gestation. What would be the adjusted age upon which the nurse would base assessment of the infant growth and developmental milestones? 2 months 3 months 4 months 5 months

4 months Rationale: The infant was born 12 weeks early (3 months); therefore, the nurse would subtract 3 months from the chronologic age of 7 months to obtain an adjusted age of 4 months. Healthy growth would be demonstrated if the infant were the size of a 4‐month‐old and achieved the developmental milestones of a 4‐month‐old.

You have a child who weighs 7 kg. What is the hourly maintenance rate for IV hydration?

7 x 100ml= 700/ 24 hr= 29.2 ml/hr

A child who weighs 26 lbs with cellulitis has an order for Cector 80mg p.o. Q 8 hours. Cector is mixed in a suspension provided as 125 mg/5mL. How many milliliters will the nurse administer per dose?80/125 x 5= 3.2mL

80/125 x 5= 3.2mL

A child is scheduled for a bone marrow aspiration at 4 pm. The nurse would apply EMLA cream to the intended site at which time? 1:30 pm 3:00 pm 3:30 pm 4:00 pm

1:30 Rationale: EMLA is applied 60 minutes prior to superficial procedures (e.g.: sticks) and 2-3 hours before deeper procedures (e.g.: lumbar puncture and bone marrow aspiration)

The nurse will be administering a medication to a child that is primarily excreted by the kidney. The nurse is aware that this action is especially dangerous until he reaches what age? 4 years 2 years 3 years 5 years

2 years Rationale: kidney's are not fully developed until 2 years old

Maintenance fluid question → The nurse is monitoring the output for a 9-year old child. The medical record indicates the child weighs 60lbs. (27kg). How much urine can be anticipated for this child for a 12-hour period. (*remember that urine output for a school age child is 1-2cc/kg/hour) 320-650 mL 360-900 mL 420-840 mL 600-1200 mL

3 Rationale: Maintenance fluid = 100ml/kg/24 hours for 1st 10 kg, 50ml/kg/24 hours for 2nd 10 kg, 20ml/kg/24 hours for remainder

The parents of a child receiving total parenteral nutrition ask the nurse why their child must have their blood glucose monitored so frequently since they are not diabetic. What is the best response by the nurse? "We like to keep a close check on the blood glucose for all children receiving total parenteral nutrition." "It is important to monitor the blood glucose level because the solution has a high concentration of carbohydrates that convert to glucose." "This is a good time for us to monitor your child in case they start developing signs of diabetes related to receiving total parenteral nutrition." "I would suggest you ask the healthcare provider why blood glucose checks have been ordered so frequently."

"It is important to monitor the blood glucose level because the solution has a high concentration of carbohydrates that convert to glucose." TPN - higher glucose and protein concentrations and solutions containing calcium require CV access. Monitor blood chemistries and BG with initation, rate changes, and discontinuation.

Acetaminophen elixir is provided as 160 mg/5ml. How many milliliters will the nurse administer per dose?

150mg/160mg= 0.94mg x 5 mL= 4.7mL

A nurse has just administered medication via an oral gastric tube. What is the priority nursing action following administration? Check tube placement. Retape the tube. Flush the tube. Remove the tube.

Flush the tube.

The nurse is caring for a 7-year-old who had an appendectomy 2 hours ago. Which pain indicators would the nurse expect to observe? (select all that apply) Strong fear of bodily injury Thrashing of arms and legs Bargaining to delay procedure Denying pain to avoid taking medicine Understanding cause and effect Ability to describe intensity of pain

Strong fear of bodily injury, Denying pain to avoid taking medicine, Ability to describe intensity of pain

The nurse is preparing an in-service on pain assessment tools for newly graduated nurses who are working in a pediatric department. What information should the nurse include in the teaching? The FACES scale should be used with children in critical care settings. The Poker Chip Tool scale should be used with pre verbal or nonverbal children. The APPT scale can be used with children as young as 4 years old. The CRIES scale can be used for neonates and infants younger than 6 months old.

The CRIES scale can be used for neonates and infants younger than 6 months old.

The order reads: "Ampicillin 225 mg p.o., q6 hrs." The bottle from the pharmacy is labeled: 250 mg=5 mL, 225 mg = 4.5 mL. Are you comfortable with the pharmacist's conversion?

The answer is yes 225/250 = 0.9 ... 0.9 x 5 = 4.5

The nurse is preparing to administer eye drops to a 2-year-old child. Which actions indicate the need for additional instruction? Select all that apply. The student nurse explains the medication regimen to the child's parents. The nurse holds the medication bottle 3 inches from the child's eye during the administration. The child is instructed to look down during the installation of the medication in the eyes. The student nurse seeks assistance to hold the child during the medication administration. The child is turned so the medication flows toward the outer corner of the eye.

The nurse holds the medication bottle 3 inches from the child's eye during the administration. The child is instructed to look down during the installation of the medication in the eyes. The child is turned so the medication flows toward the outer corner of the eye.

There is an order for morphine for an infant who weighs 8 kg. The order is 1 mg IV every 3 to 4 hours. The safe dose range for morphine sulfate is 0.1 to 0.2 mg/kg/dose every 3 to 4 hours. The morphine is supplied as 1 m/ mL. Is this a safe dose?

Yes, 1.6mg is the max Respiratory depression is one complication that can happen from morphine. 0.5-0.1 is the most safest range in real practice.

A 5 day old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? gallop and rales blood pressure discrepancies in the extremities right ventricular hypertrophy on ECG heart murmur

heart murmur Rationale: Typically, children with aortic stenosis have a murmur that is best heard along the left sternal border. They do not commonly exhibit a gallop, rales, or right ventricular hypertrophy. Blood pressure and pulse discrepancies between the upper and lower extremities occur with coarctation of the aorta, not aortic stenosis. (pg 632).