PEDS EXAM #2 PREPU ch 42

The infant is listless with sunken fontanels (fontanelles) and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 lb (6 kg). At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift? Record your answer using a whole number.

48 (6 kg x 1 mL/kg = 6 mL/hour ... 6 mL x 8 hours = 48 mL/8-hour shift)

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition?

mother age 42 with pregnancy

The nurse is talking with a woman in her second trimester of pregnancy who has been diagnosed with polyhydramnios. The physician has ordered an ultrasound be performed to check for the presence of esophageal atresia. Which statement by the woman indicates an understanding of the relationship between these conditions?

"Babies with esophageal atresia have an inability to swallow amniotic fluid causing the excess buildup."

The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which response from the mother indicates a need for further teaching?

"I should position him on his abdomen with knees bent."

The student nurse is caring for a child with the nursing diagnosis "Risk for fluid volume deficit related to inadequate oral intake." Which statement by the student would indicate a need for further education by the nursing instructor?

"I will make sure there is plenty of orange juice available. It's her favorite juice."

A nurse is caring for a 6-year-old girl recently diagnosed with celiac disease and is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching?

"My daughter can eat any kind of fruit."

The nurse is providing discharge teaching regarding oral fluid rehydration to a mother who brought her child to the clinic because of vomiting over the past 2 days. The child is mildly dehydrated. Which comments by the mother indicated learning occurred?

"Oral rehydration solutions (ORS) are good sources of fluids for rehydration." "I should be sure my child receives 50 to 100 ml/kg of oral rehydration solution (ORS) over 4 hours." "I should not give my child any fluids for 1 to 2 hours after an episode of vomiting."

The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply.

"The only treatment for celiac disease is a strict gluten-free diet." "Gluten is found in most wheat products, rye, barley and possibly oats." "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders."

The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for how long?

7 to 14 days

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?

Barium enema

A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect?

Gastroenteritis

The nurse is caring for a teenager diagnosed with acute pancreatitis. Which order would the nurse question?

PO pain management

The nurse is caring for a 6-month-old infant with diarrhea and dehydration. The parent is concerned because the infant has some patches on the tongue. Which feature indicates a geographic tongue?

Some patches are light in color and other patches are dark in color.

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate?

esophageal atresia (EA)

The parent reports that the health care provider said that the infant had a hernia but cannot remember which type. When recalling what the health care provider said, the parent said that a surgeon will repair it soon and there is no problem with the testes. Which hernia type is anticipated?

inguinal hernia

A parent brings a 10-year-old child to the emergency room with reports of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse suspect?

pancreatitis

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has:

severe dehydration.

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which classic symptoms? Select all that apply.

steatorrhea constipation diarrhea failure to thrive

The child has been diagnosed with severe dehydration. The health care provider has prescribed a bolus of 20 ml/kg of normal saline over a 2-hour period. The child weighs 63.5 lb (28.8 kg). At which ml/hour should the nurse set the child's intravenous administration pump? Record your answer using a whole number.

288 (20 ml/kg x 28.8 kg / 2 hrs)

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?

Improving hydration

A parent brings their 4-year-old male child to the pediatrician's office for a scheduled wellness appointment. The assessment reveals weight loss since the last visit. The client looks malnourished and pale, with dry lips and mucous membranes. The client appears lethargic. The parent reports numerous liquid stools and abdominal cramping daily. Complete the following sentence(s) by choosing the best answers from the lists of options. The nurse suspects that the client may have

Chron disease malnutrition frequent liquid stools

The nurse is caring for a 6-month-old infant who was admitted to the emergency department 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104°F (40°C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the prioritynursing intervention?

Take a stool culture