PEDS EXAM #2 PREPU ch 38
An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done?
"I always keep phenobarbital with me in case of a fever."
The nurse is caring for a 3-year-old child who experienced a febrile seizure for the first time. What statements by the parents of the child should the nurse address further? Select all that apply.
"I am afraid that our 10-year-old will start having febrile seizures." "It is so scary to think that our child will likely develop epilepsy now."
The nurse is providing teaching to the parents of a child recently prescribed carbamazepine for a seizure disorder. Which statement by a parent indicates SUCCESSFUL teaching?
"I need to watch for any new bruises or bleeding and let my health care provider know about it."
While caring for a child who will be undergoing a lumbar puncture, the nurse explains the procedure to the infant's mother. Which statement by the mother would indicate a need for further education?
"I will cradle her in my arms after the procedure for at least 30 minutes."
The parents of a child with a history of seizures who has been taking phenytoin ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate?
"Small increments in dosage lead to sharp increases in plasma drug levels."
The nurse is providing education to the parents of a 2-year-old boy with hydrocephalus who has just had a ventriculoperitoneal shunt placed. Which information is most important for the parents to be taught?
"Watch for changes in his behavior or eating patterns."
The emergency room nurse is taking a history of a 1-year-old child whose parent said that she had a "fit" at home. Which inquiry would be best to start with?
"What happened just before the seizures?"
A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?
Decrease environmental stimulation
The mother of an infant reports that her child is frequently choking when breastfeeding or taking a bottle. The nurse plans on assessing which cranial nerve when addressing the mother's concerns?
IX
A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. Which intervention should the nurse take initially?
Institute droplet precautions in addition to standard precautions.
A nurse demonstrates understanding of the various levels of consciousness as they progress from most alert to least alert. Place the levels of consciousness in the order that reflects this progression.
Oriented to person, place, and time Disorientation Obtundation Stupor Coma
In caring for the child with meningitis, the nurse recognizes that which nursing diagnosis would be most important to include in this child's plan of care?
Risk for injury related to seizure activity
When caring for a child who has a history of seizures, which nursing interventions would be appropriate?
The nurse pads the crib or side rails before a seizure. The nurse positions the child on the side during a seizure. The nurse stays with the child and calls for help when a seizure begins. The nurse has oxygen available to use during a seizure. The nurse teaches the caregivers regarding seizure precautions.
The nurse is educating the parents of a 7-year-old girl with epilepsy about managing treatment of the disorder at home. Which intervention is most effective for eliminating breakthrough seizures?
Understanding the side effects of medications
The nurse is preparing a child experiencing new-onset seizures for an electroencephalogram (EEG) test. How can the nurse best explain this procedure to the child?
Use a doll with electrodes attached to the head.
The nurse is assessing a toddler for motor function. Which activity will be the most valuable?
Watch the child reach for a toy.
The nurse is assessing a child who has suffered a head injury. Which assessment finding would indicate loss of midbrain functioning?
arms adducted and extended with pronation of wrists with fingers flexed
A group of nursing students are reviewing cerebral vascular disorders and risk factors in children. The students demonstrate understanding of the material when they identify which as a risk factor for hemorrhagic stroke?
arteriovenous malformations (AVMs)
A child is diagnosed with aseptic meningitis. The child's mother states, "I don't know where she would have picked this up." The nurse prepares to respond to the mother based on the understanding that this disorder is most likely caused by:
enterovirus.
The nurse is caring for a child with suspected increased intracranial pressure (ICP). Which assessment finding would indicate increased ICP?
hypertension
The nurse is caring for an infant with increased intracranial pressure. The mother is preparing to feed the child. What action by the mother indicates an understanding of the proper care of this infant?
placing the infant in an infant car seat after feeding the infant
A child is brought to the emergency department after experiencing a series of continuous seizures. The nurse is reviewing the orders for care and treatment. Which order would be of the highest priority?
serum glucose level
The nurse is caring for a 3-year-old boy who is experiencing seizure activity. Which diagnostic test will determine the seizure area in the brain?
video electroencephalogram
A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which question?
"Did you use any medications, like aspirin, for the fever?"
A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate?
Teach the child and his parents to keep a headache diary.
