Peds Exam 2
Hgb values
1-6 yr: 9.5-14 g/dL 6-18 yr: 10-15.5 g/dL
School-age children with cancer often have a body-image disturbance related to hair loss, moon face, ordebilitation. Which of the following interventions is(are) most appropriate? Select all that apply. 1. Encourage them to wear a wig similar to their own hairstyle 2. Emphasize the benefits of the therapy they are receiving. 3. Have them play only with other children with cancer. 4. Use diversional techniques to avoid discussing changes in the body because of chemotherapy. 5. Help them find a "special friend" who understands what they are experiencing
1. Encourage them to wear a wig similar to their own hairstyle. 5. Help them find a "special friend" who understands what they are experiencing
The Nurse is caring for a child with leukemia. The nurse should be aware that children being treated for leukemia may experience which of the following complications? Select all that apply. 1. Fever 2. Rash 3. Oliguria 4. Hypotension 5. Chills
1. Fever 3. Oliguria 5. Chills
A 5-year-old is admitted to the hospital with complaints of leg pain and fever. On physical examination, the child is pale and has bruising over various areas of the body. The health-care provider suspects that the child has ALL. The nurse informed the parent that the diagnosis will be confirmed by which of the following? • 1. Lumbar puncture • 2. White blood cell count • 3. Bone marrow aspirate • 4. Bone scan
3. Bone marrow aspirate
The parent of a child diagnosed with Wilms Tumor asks the nurse what the treatment plan will be. The nurse Explains the usual protocol for this condition. Which information should the nurse give to the parent? • 1. The child will have chemotherapy and after that has been completed, radiation • 2. The child will need to have surgery to remove the tumor. • 3. The child will go to surgery for removal of the tumor and the kidney and will then start chemotherapy. • 4. The child will need radiation and later surgery to remove the tumor.
3. The child will go to surgery for removal of the tumor and the kidney and will then start chemotherapy.
An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days. The nurse's approach should include which action? a. Answering questions with straightforward honesty b. Avoiding discussing the seriousness of the condition c. Explaining that, although the amputation is difficult, it will cure the cancer d. Assisting the adolescent in accepting the amputation as better than a long course of chemotherapy
A. Answering questions with straightforward honesty
The nurse is taking care of a child with sickle cell disease. The nurse is aware that which of the following problems is (are) associated with sickle cell disease?• Select all that apply 1 .Polycythemiia 2 Hemarthrosis 3 Aplastic crisis 4 Thrombocytopenia 5 Vaso-occulusive disorder
Aplastic crisis Vaso-occulusive disorder
A 9-year-old boy diagnosed with leukemia has completed his first treatment with chemotherapy. When providing discharge instructions to the parents, which of the following does the nurse include? • A. Provide a low-protein, high- carb. Diet • B. Avoid fresh vegetables that are not peeled or cooked. • C. Notify the healthcare provider if his temperature is greater than 101 (39C) • D. Increase use of humidifiers in the house.
B. Avoid fresh vegetables that are not peeled or cooked. (bacteria)
The nurse is teaching the parents of a 6-year-oldgirl with sickle cell disease. When addressing Sickle cell crisis, which of the following should the nurse include? A. Sickle cell crisis results from altered metabolism and dehydration B. Primary problems are to tissue hypoxia and vascular occlusion C. Increased bilirubin levels lead to hypertension D. Clotting factors decrease with increased white blood cells.
B. Primary problems are to tissue hypoxia and vascular occlusion
Hemophilia
Bleeding disorder resulting from deficiency or dysfunction of factors (proteins) needed for clotting
A husband and wife both have the sickle cell trait and ask the nurse about the possibility of their children inheriting sickle cell disease. What is the most appropriate response by the nurse? A. One child will have sickle cell disease B. Only male children will be affected C. Each pregnancy carries a 25 percent chance of the child being affected D. If four children are born, one will have sickle cell disease.
C. Each pregnancy carries a 25 percent chance of the child being affected.
A 6-year-old girl diagnosed with Hemophilia is in the ER after falling off her bicycle. The nurse assess the child and finds the knee is extensively swollen. What is the first action the nurse should perform? • A. Initiate a peripheral IV to administer cryoprecipitate • B. Monitor the child's vital signs for the first five minutes • C. Type and Crossmatch for transfusion • D. Apply an ice pack and compression dressing to the knee.
D. Apply an ice pack and compression dressing to the knee.
Anemia Manifestations
Fatigue Pallor Murmurs Growth retardation Tachycardia
Iron deficiency anemia
Give iron on empty stomach Black/green stools normal Give iron to breast fed babies by 4 months
Anemia Labs
Labs: CBC, Hgb, Hct
Parents of a school-age child with hemophilia ask the nurse "Which sports are recommended for kids with hemophilia?" Which sports should the nurse recommend? Select all that apply a. Soccer b. Swimming c. Basketball d. Golf e. Bowling
Swimming Golf Bowling
Anemia Management
Treat cause Transfusions Nutritional interventions IVF, rest, decrease O2 demands
Which immunization should be considered carefully before being given to a child receiving chemotherapy for cancer? a. Tetanus vaccine b. Inactivated polio vaccine c. Diptheria, tetanus, and pertussis (DTaP) d. Measles, mumps, rubella (MMR)
d. Measles, mumps, rubella (MMR) (because it's a live vaccine)
Hemophilia manefestations
• Prolonged bleeding • Hemorrhage • Bruising • Hemarthrosis • Spontaneous hematuria
Sickle cell crisis
• Vaso-occlusive- "painful episode"• Splenic sequestration - pooling of blood in the spleen• Aplastic - decreased production of RBCs
