Pediatric Nursing Ch 15

A neonate is brought to the emergency department by the parent because the child "just doesn't look right." The neonate is suspected of having sepsis. Which statement by the parent would help to confirm this suspicion?

"My water broke quite a while before I actually birthed the child." Rationale: Prolonged or premature rupture of membranes increases a neonate's risk for sepsis. A weak cry or lack of smile or facial expression may be present with sepsis. A significant increase in breathing rate (tachypnea) or increased work of breathing evidenced by nasal flaring, grunting, and a retraction is noted with sepsis. Neonates with sepsis do not have a fever. In fact, they may have below-normal temperature

The parents of a 4 month old diagnosed with sepsis tell the nurse that the healthcare provider explained sepsis to them but they don't really understand it. The parent's state, "Could you please explain it to us?" What is the best response by the nurse?

"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."

A nurse is preparing a presentation for a local parents' group about common viral infections associated with a rash during childhood. When describing rubella, what information would the nurse include? SATA

-incubation period usually ranges from 16-18 days -any itching with the rash is usually mild -the infection is communicable for a week before to a week after the rash appears Rationale: Rubella has an incubation period ranging from 12-23 days, but usually 14 days. It is communicable for 7 days before the rash to 7 days after the onset of the rash. Itching is usually mild. It occurs most commonly during late winter and early spring and the rash typically begins on the face and spreads down the neck, trunk, and extremities

The nurse is caring for a 7 year old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene?

-parents state, "We have been limiting our child's fluids to help decrease the amount of coughing." -parents state "we should postpone immunizing our 5 year old since there has been contact with the infection"

The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation?

Head lice are becoming very resistant to treatment

A child has been brought to the pediatric clinic. The assessment reveals the child has temperature of 100.9 F (38.3 C), as well as a rash that is pink and has raised areas. When the area is palpated the skin blanches. Which disease is most associated with these findings?

Exanthem subitum Rationale: Exanthem subitum or 6th disease is a member of the herpes viruses. It presents with a pinkish rash that may be flat or raised. The area blanches when palpated.

A child who developed parotid gland swelling on March 5 was diagnosed with mumps. The nurse determines that the child will no longer be contagious at which time?

March 14 Rationale: Children with mumps are no longer considered contagious 9 days following the onset of parotid swelling

A 6year old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102 F (38.9 C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?

Scarlet fever

A child is brought to the emergency department by his parents. The parents report that the child stepped on a rusty nail about a week and a half ago. The child is reporting cramping in the jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next?

neck Rationale: Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach

A 9 month old child has been admitted to rule out sepsis. Which finding offers the best support to the presence of this disorder?

the child has had 8 ounces of formula in the past 24 hours. Rationale: Sepsis is a systemic overresponse to infection resulting from bacteria and viruses, the most common of which are fungi, viruses, rickettsia, or parasites. It can lead to septic shock, which results in hypotension, low blood flow, and multisystem organ failure. Signs of sepsis include lack of appetite, lethargy, hypotonia, and temperature elevations

The nurse is caring for a 10 year old child with diphtheria. What would the nurse institute as a tier 2 precaution?

use of protective mask -Use of protective mask if within 3 feet of the child is a tier 2 precaution with diphtheria, which is transmitted through contact droplets. Use of a protective gown is a tier 2 precaution for contact transmission. Negative air pressure ventilation is a tier 2 precaution for airborne transmission. Face shields are part of tier 1 precautions against contaminated splashes