Pediatrics Ch. 20

What are the benefits of long-term central venous access devices? Select all that apply.

Easy access for bloodwork Ease of parenteral feedings Administration of blood products Central venous pressure monitoring

A 10-year-old child requires daily medications for a chronic illness. The mother tells the nurse that she is always nagging the child to take the medicine before school. What is the most appropriate nursing intervention to promote the child's compliance?

Establish a contract with the child, including rewards.

The nurse needs to give an injection to a 4-year-old preschool child in the deltoid muscle. What is the most appropriate approach by the nurse, drawing on knowledge of preschool development?

Explain with concrete terms such as "putting medicine under the skin."

What play activity by the nurse helps to prevent postoperative respiratory tract infection in the child?

Having a blowing contest with pieces of paper

A nurse is caring for an infant with a tracheostomy. What are some signs of mucus partially occluding the airway? Select all that apply.

Cyanosis Drop in SaO 2 Increase in positive inspiratory pressure on ventilator

Which injection site is contraindicated for an infant?

Dorsogluteal muscle

What instructions must the nurse teach the parents about caring for a child with fever? Select all that apply.

Dress the child in light or minimal clothing. Use a light blan if the child is shivering. Apply cool, moist compresses to the forehead.

The nursing instructor is teaching a group of students about safety measures for children in a hospital setting. Which statement by a student indicates effective learning?

Latex balloons pose a serious threat to children of all ages.

What nursing responsibility should be fulfilled during the care of an infant with a needleless IV system?

Tracing the tubing connections to the point of origin for verification

The nurse is caring for an infant with a tracheostomy when accidental decannulation occurs. The nurse is unable to reinsert the tube. What action should the nurse take next?

Trying to insert a smaller tracheostomy tube

The nurse is giving discharge instructions to the parents of an 8-month-old infant who is receiving a liquid medication. How should the nurse teach the parent to measure liquid medicine to achieve the most accurate measurement?

Use a plastic syringe (without the needle) calibrated in teaspoons/milliliters.

Which is included in standard precautions for infection control?

Use of gloves to change diapers when there are loose or explosive stools

The nurse is caring for a child who suffers from quadriplegia. What nursing intervention promotes tissue integrity for this patient?

Using the drawsheet to move the child onto a stretcher to reduce friction and shearing injuries

What care must the nurse take when obtaining a capillary blood sample by heel stick?

Warm the heel for 3 minutes.

The nurse wears gloves during an intravenous line insertion. What should the nurse do immediately after removing the gloves?

Wash the hands thoroughly.

How many hours before should the nurse teach a mother surgery to stop breastfeeding her child before surgery?

4 hours

An infant with a tracheostomy tube starts to display signs of respiratory distress. What situation requires an immediate tube change?

Inability to pass the suction catheter to the end of the tube

What health condition in a patient prompts the nurse to utilize contact precautions in addition to standard precautions?

Incontinence

What continuous noninvasive method of determining oxygen saturation (Sa02) is used to guide oxygen therapy?

Pulse oximetry

It is time to give a 3-year-old child medication. What approach is most likely to elicit a positive response from the child?

"It's time for your medication now. Would you like water or apple juice afterward?"

A child, age 7 years, is being treated at home and has a fever associated with a viral illness. What is the primary reason for treating the child's fever?

Relief of discomfort

What organ is most vulnerable to the adverse effects of excessive oxygenation in preterm infants?

Retina

The nurse recognizes that certain words can be interpreted as threatening to a child. What words or phrases should nurses avoid when talking to children? Select all that apply.

Shot Edema Put to sleep

How will the nurse ensure that the hospitalized child receives adequate fluid and calories in the diet?

Start with a soup and end with dessert.

How does the nurse calculate urine output for an infant using a diaper?

Subtract the weight of the dry diaper from the weight of the wet diaper.

A 24-hour urine collection is ordered for a 2-year-old child. What does the nurse understand about this procedure?

That the collection period begins and ends with an empty bladder

What should the nurse know about vasodilating anesthetic agents?

That they may cause a postoperative decrease in blood pressure

What is an advantage of using the ventrogluteal site for intramuscular injections in children?

The lack of important nerves or vascular structures

The nurse is asked to administer an intramuscular (IM) injection to a child. Which action by the nurse will prevent tissue shearing and provide less discomfort to the child during the procedure?

The nurse inserts the needle at a 90-degree angle.

Which restraint will the nurse use for a child after a cleft lip repair?

An elbow restraint

What is the best action for the nurse to take to minimize the risk of aspiration when administering a liquid medication to a crying 8-month-old infant?

Administering the medication with an oral syringe placed along the side of the infant's tongue

What is the optimal time to perform bronchial (postural) drainage in a child?

After nebulization medication

What methods can the nurse use to encourage the school-age child to perform range-of-motion exercises? Select all that apply.

Allow the child to play with Mylar balloons Play Twister or Simon Says Encourage the child to comb his or her own hair

What intervention by the nurse is appropriate when preparing an adolescent for a medical procedure?

Ask if the adolescent would prefer to watch the procedure.

Decision-making regarding the care of older children and adolescents should include the patient's assent as well as the parent's consent. What is the meaning of assent in this situation?

Assent means that the adolescent has been informed about the proposed treatment, procedure, or research and is willing to permit a health care provider to perform it.

The nurse is providing care for a child after surgery. The nurse is assessing the patient to identify any potential complications of anesthesia. What action will the nurse take?

Auscultate lungs

In what situations would it be necessary for the nurse to obtain informed consent of the patient, parent, or a legal guardian? Select all that apply.

The patient requires a dental extraction. A lumbar puncture is to be performed for diagnosis. The patient's photograph is required for educational use.

When is informed consent valid? Select all that apply.

When it is given by a competent person over the age of majority When enough information is provided to facilitate an intelligent decision When the choice being exercised is free of force, fraud, duress, or coercion

A heel stick for a complete blood count is ordered for a premature infant. How can the nurse help reduce the infant's pain during the procedure?

encouraging skin-to-skin contact with the mother before and during the procedure

The nurse is providing care for a postoperative child. The nurse is monitoring the vital signs of the child. What physiologic issues are likely to decrease the child's heart rate? Select all that apply.

Нуроxia Vagal stimulation Increased intracranial pressure

The nurse is preparing a school-age child for a blood sampling procedure. Which is an appropriate method used by the nurse?

Let the child handle syringes and empty ampules

The nurse is asked to administer 1 teaspoon of medication to a child. Which measuring device is best for the nurse to use to administer the medication?

Molded plastic cup

What is the appropriate nursing consideration in the care of a child with a chest tube?

Notify the physician if obstruction is suspected.

The nurse obtains consent from the parents of a 15-year-old patient prior to a wrist surgery. What other action will the nurse take before the procedure begins?

Obtain the adolescent's assent

The nurse is asked to collect a urine specimen from a preschooler. The nurse observes that the child is unable to void at the time of collection. What the most appropriate nursing intervention in this case?

Offer the child a favorite juice and wait for 30 min

Which blood oxygenation test is the photometric measurement of oxygen?

Oximetry

When should a nurse apply a mummy restraint to a child?

Performing a throat examination

The nurse needs to take the blood pressure of a preschooler for the first time. What action would be best for gaining the child's cooperation?

Permit the child to handle equipment and see the dial move before putting the cuff in place.

What should the nurse do when administering a nasal medication to a child?

Place a pillow under the child's shoulders.

A child is prescribed eye drops and ointment for both eyes. How will the nurse administer these drugs to the child?

Place the ointment in the lower conjunctival sac

Which device will the nurse use to measure small amounts of oral liquid medication accurately?

Plastic syringe

The nurse is preparing a plan to teach a mother how to administer 1½ teaspoons of medicine to her 6-month-old infant. What does the nurse teach the parents to use, based on knowledge of administering pediatric medications?

Plastic syringe (without needle) calibrated in milliliters

The parents of a child with cystic fibrosis ask the nurse how chest physical therapy (CPT) helps their child. What is the priority of care for CPT?

CPT helps to clear the airway.

The nurse notes erythema, pain, and edema at a child's intravenous (IV) infusion site and streaking along the vein. What is the nurse's priority action?

Immediately stopping the infusion

The nurse is caring for a preterm infant born at 36 weeks with a nasogastic tube. What is the procedure for administering more than one medication at the same time?

Flushing the tube between medications with clear water

A nurse is caring for a 2-year-old child for whom nothing-by- mouth status has been imposed. What intervention can the nurse use to keep the child's mouth moist?

Giving ice chips

What is the minimum fastinf period for clear liquids before scheduled surgery?

2 hours before surgery

Several types of long-term central venous access devices are used in practice. What is the benefit of a long-term central venous access device such as a Port-a-Cath?

Implanted devices do not require limitations on regular physical activity, including swimming.

A child is prescribed nothing per mouth (NPO) for 4 days and receives only intravenous (IV) fluids. The child is at risk for which condition?

Breakdown in skin integrity

How can the nurse encourage a hospitalized child to eat and drink?

By giving high-quality foods and snacks whenever the child expresses hunger

What are the most appropriate interventions for a nurse caring for a child receiving an intravenous (IV) infusion to carry out? Select all that apply.

Checking the insertion site frequently for signs of infiltration Checking IV fluids and infusion rate with another licensed professional Using an infusion pump with microdropper to ensure the prescribed infusion rate

A light meal is recommended for an adolescent who is prescribed 6 hours of fasting before surgery. Which dietary item should the nurse offer the adolescent?

Clear tea

The nurse is caring for a child with anemia. The nurse explains the treatment plan to the child's parents. What are the best actions for the nurse take to ensure that the family follows the prescribed treatment regimen? Select all that apply.

Informs about generic brands to reduce costs Assess the child's medication schedule Assess the child's ability to take medicines Encourage the use of cues as memory aids

What is the best explanation for the use of oximetry in young children?

It is noninvasive

What intervention by the nurse is appropriate when a medical procedure is being performed for an infant?

Keep the parent in the infant's line of vision.

What guidelines should the nurse follow when preparing a toddler for a procedure? Select all that apply.

Keeping frightening objects out of view Telling the child that it is okay to cry, yell, or use other means to express discomfort Explaining the procedure in relation to what the child will see, hear, taste, smell, and feel

The nurse is caring for a 4-year-old child with a tracheostomy. What clinical manifestations require immediate attention from the practitioner?

Large amounts of bloody secretions

A neonate underwent corrective surgery 3 days ago for esophageal atresia. The nurse notices that after gastrostomy feedings there is often a backup of feeding fluid into the tube. What is the most appropriate intervention by the nurse?

Leave the gastrostomy tube open and suspended after feedings.

The nurse is conducting preoperative teaching with a child and the parents. The parents say that the child "is dreading the shot before surgery." On which fact should the nurse's response be based?

Preanesthetic medication should be "atraumatic," administered through the oral, existing intravenous, or rectal route.

What is a way to increase a 6-year-old child's intake when the child has no appetite?

Providing carbonated drinks and ice pops