Peds--Exam 2---Evovle Chapter 31 - The Infant and Family

The parent of a 12-month-old infant says to the nurse, "He pushes the teaspoon right out of my hand when I feed him. I can't let him feed himself; he makes too much of a mess." The nurse's BEST response is:

"Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable."

The primary goals in the nutritional management of children with failure to thrive (FTT) are:

-allow for catch-up growth. -correct nutritional deficiencies. -achieve ideal weight for height. -restore optimum body composition. -educate the parents or primary caregivers on child's nutritional requirements.

A 4-month-old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention?

"When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall."

The nurse should provide further teaching about sudden infant death syndrome (SIDS) prevention when hearing the mother of an 8-week-old make which statement?

- "I only smoke in the kitchen." - "I have my baby sleep with me instead of alone in the crib." - "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."

The nurse is providing education to a parent of a 10-month-old infant receiving iron supplements. What will be included in the teaching?

- Place iron toward the back side of the mouth with a dropper. - Apply barrier ointment if needed to buttocks.

When preparing to administer Hepatitis B vaccine to a newborn, the nurse should:

- initiate an immunization record. -confirm the hepatitis B status of the newborn's mother. - obtain a syringe with a 25-gauge, 5/8-inch needle. - confirm that the newborn's mother has signed the informed consent.

Infants most at risk for sudden infant death syndrome (SIDS) are those:

- who sleep prone. -who were premature. -with prenatal drug exposure.

At what age would the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning?

10 months

The nurse expects which characteristic of fine motor skills in a 5-month-old infant?

Able to grasp object voluntarily

A nurse is caring for a 2-month-old exclusively breastfed infant with an admitting diagnosis of colic. Based on the nurse's knowledge of breastfed infants, what type of stool is expected?

Semiformed, seedy, yellow

The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem?

Beginning to put her to bed while still awake

Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake?

Being persistent through 10 to 15 minutes of food refusal

Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. When teaching the parents about the infant's care, what is the most important information the nurse should include in the discharge teaching plan?

Cardiopulmonary resuscitation (CPR)

A 3-month-old bottle-fed infant is allergic to cow's milk. The nurse's BEST option for a substitute is:

casein hydrolysate milk formula (The milk protein is broken down in these formulas.)

The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. The nurse should recognize that:

developmental/neurologic evaluation is needed (The head lag should be almost gone by 4 months of age.)

The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. What is the nurse's best reply?

There is no need to restrain nonnutritive sucking during infancy. (Thumb-sucking and the use of pacifier should be stopped after 4 years of age.)

The nurse in the pediatric clinic identifies which infants at risk for developing vitamin D-deficient rickets?

Those using yogurt as primary source of milk (Yogurt may not be supplemented with vitamin D. Lack of sunlight contributes to vitamin D-deficient rickets.)

The mother of a 3-month-old breastfed infant asks about giving her baby water since it is summer and very warm. The nurse should recommend that:

fluids in addition to breast milk are not needed.

The MOST appropriate recommendation for relief of teething pain is to instruct the parents to:

give child a frozen teething ring to relieve inflammation. (some say a refrigerated and not frozen)

A nurse is providing education to a community group in preparation for a mission trip to a third world country with limited access to protein-based food sources. The nurse is aware that children in this country are at increased risk for:

kwashiorkor (Kwashiorkor is defined as primarily a deficiency of protein with an adequate supply of calories).

A 9-month-old infant is seen in the emergency department after developing a urticaric rash with cough and wheezing. When collecting the history of events before the sudden onset of the rash with cough and wheezing, the mother states they were "feeding the baby new foods." Which food is the possible cause of this type of reaction in the infant?

peanut butter

The nurse is interviewing the parents of a 4-month-old male infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. They say he was "just fine" when they put him in his crib already asleep. The nurse should suspect his death was caused by:

sudden infant death syndrome (SIDS). (the bloody fluid is consistent with SIDS)

The exhausted parents of a 2-month-old infant with colic ask the nurse what is the best method to promote comfort and sleep for the infant. The nurse's initial action is to:

take a thorough, detailed history of usual daily events.

A parent of an 8-month-old infant tells the nurse that the baby cries and screams whenever he or she is left with the grandparents. The nurse's reply should be based on knowledge that:

this is a normal reaction for this age

The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of:

trust

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant?

vitamin D