Peds Chapter 37: PrepU

A nurse is leading a discussion with a group of new mothers about newborn nutrition and its importance for growth and development. One of the mothers asks, "Doesn't the baby get iron from me before birth?" Which response by the nurse would be most appropriate?

"Because the baby grows rapidly during the first months, he uses up what you gave him."

The parents of a child with heart failure ask the nurse, "How will the digoxin he is getting help?" Which response by the nurse would be most appropriate?

"Digoxin helps to improve the heart's ability to contract ."

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning?

"I mix ferrous sulfate with milk in a bottle."

The parents of a 6-year-old child with idiopathic thrombocytopenic purpura (ITP) ask the nurse, "What causes this disease?" Which response by the nurse would be most appropriate?

"ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason."

A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate?

"Preterm infants are at risk for iron-deficiency anemia."

The nurse is preparing a presentation for a local parent group about nutritional measures to prevent anemia. The group of parents have children between the ages of 4 and 8. The nurse would recommend a daily iron intake of which amount?

10 mg

The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant's apical pulse rate was:

80 beats per minute.

A nurse is caring for an infant who is experiencing heart failure. What would be the most appropriate care for this infant?

Administer oxygen.

To prevent infective endocarditis in the child with an artificial heart valve, the nurse teaches parents to:

Administer prophylactic antibiotics before dental work.

A nurse is preparing a teaching plan for a child with hemophilia and his parents. Which information would the nurse be least likely to include to manage a bleeding episode?

Apply heat to the site of bleeding.

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend?

Baseball

What information would be included in the care plan of an infant in heart failure?

Begin formulas with increased calories.

The nurse will select which meal as the best choice for a child with iron-deficiency anemia?

Cheeseburger, broccoli, and fresh strawberries

A nurse is providing care to a child with hemophilia who is experiencing muscle and joint involvement related to the bleeding. Which would the nurse include as an adjunctive measure to control bleeding?

Compression

The nurse is concerned that a school-aged child has iron-deficiency anemia. What did the nurse assess in this client?

Craving for ice cubes

The nurse is caring for a child who had a stem cell transplant and is being monitored for engraftment. Which nursing action is priority?

Ensure neutropenic precautions are in place.

An 11-year-old male is diagnosed with mild hemophilia. Upon review of the child's factor assay, the nurse identifies which factor level for this category of hemophilia?

Factor level of 5% to 50%

A school nurse is caring for a child with a severe sore throat and fever. What is the nurse's best recommendation to the parent?

Have the child be seen by the primary care provider.

A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare?

Iliac crest

A nurse is teaching the parents of a child with sickle cell disease about factors that predispose the child to a sickle cell crisis. The nurse determines that the teaching was successful when the parents identify what as a factor?

Infection

The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management?

Initiate pain assessment with a standardized pain scale.

After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding?

Jerky movements of the face and upper extremities

When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority?

Monitor the site dressing and vital signs.

When assessing a child for a possible hematologic disorder, which would the nurse need to keep in mind as most important?

Multiple body sites can be affected.

The nurse is planning care for a child with idiopathic thrombocytopenic purpura. Which client education should be included?

Not to pick or irritate the nose

To prevent further sickle cell crisis, the nurse would advise the parents of a child with sickle cell anemia to:

Notify a health care provider if the child develops an upper respiratory infection.

The nurse is assessing a child and notices pinpoint hemorrhages appearing on several different areas of the body. The hemorrhages do not blanch on pressure. The nurse documents this finding as:

Petechiae

What would be the most important measure to implement for an infant who develops heart failure?

Placing the infant in a semi-Fowler position

An infant with congenital heart disease is not growing and developing adequately. The nurse will institute what feeding strategy?

Raise the caloric density of the feeding beyond 20 calories per ounce.

Which nursing diagnosis should the nurse identify as being the most appropriate for a child with idiopathic thrombocytopenic purpura?

Risk for bleeding related to insufficient platelet formation

The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child's diagnosis?

Slightly yellow sclera

A nursing instructor is preparing for a class about the structural and functional differences in the cardiovascular system of infants and children as compared to adults. What would the instructor include in the class discussion?

The heart's apex is higher in the chest in children younger than the age of 7 years.

The nurse is caring for a client who has leukemia. Which of the following nursing interventions should be implemented to decrease the likelihood of bleeding or injury? Select all that apply.

Use a soft, sponge-type brush or gauze strips to give oral care. Use mouthwash composed of hydrogen peroxide and saline solution. Apply pressure to sites of injections or venipunctures. Maintain isolation precautions as ordered

Which nursing diagnosis would best apply to a child with rheumatic fever?

Activity intolerance related to inability of heart to sustain extra workload

A nurse is assessing an 8-year-old child brought to the emergency department by his mother. The child has a history of sickle cell anemia and reports acute back pain and joint pain. His mucous membranes are dry; skin turgor is poor. Capillary refill is slowed and nail beds are pale. The child is diagnosed with sickle cell crisis. Which nursing diagnosis would the nurse identify as the priority?

Acute pain related to effects of sickling

An infant is prescribed digoxin. What should the nurse explain to the parents regarding the action of this medication?

Slows and strengthens the heartbeat

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?

Strawberry tongue

A nurse is caring for a child who is experiencing heart failure. Which assessment data was most likely seen when initially examined?

Tachycardia