★ Peds HESI Practice Questions ★

list the signs and symptoms of esophageal atresia with TEF

chocking, coughing, cyanosis, and excess salivaiton

Treatment for croup includes?

coll mist therapy and Racemic epinephrine with normal saline delivered with humidified oxygen

A nurse instructs a parent regarding the appropriate actions to take when the toddler has a temper tantrum. Which statement by the parent indicates a successful outcome of the teaching? a. I will send my child to a room alone for 10 minutes after every tantrum b. I will reward my child with candy at the end of each day without a tantrum c. I will give frequent reminders that only bad children have tantrums d. I will ignore the tantrums as long as there is no physical danger

d. I will ignore the tantrums as long as there is no physical danger

What are the S/S of congenital dislocated hip in infants?

Unequal skin folds of the buttocks. Ortolani sign, limited abduction of the affected hip, and unequal leg lengths

Tetralogy of Fallot is when

Unoxygenated blood pumped into aorta

What position does a child with epiglottitis assume?

Upright sitting, with chin out and tongue protruding ('tripod position")

Describe feeding techniques for a child with cleft lip or palate

Use lamb's nipple or prosthesis. Feed child upright, with frequent bubbling

list the four defects associated with tetralogy of fallot

VSD overriding aorta pulmonary stenosis right ventricular hypertrophy

Concerning Pediatric Cardiovascular Disorders, if the child is Acyanotic, suspect

VSD, ASD, PDA, Coarc of Aorta, Aortic Stenosis

List the 4 defects assoc'd with tetralogy of Fallot

VSD, overriding aorta, pulm stenosis, and right ventricular hypertrophy

List normal findings in a neurovascular assessment

Warm extremity, brisk capillary refill, free movement, normal sensation of the affected extremity, and equal pulses

What measurements reflect present nutritional status?

Weight, skinfold thickness, and arm circumference

"A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To assess adequacy of support for the child's psychosocial needs, the nurse would ask the parents which question?" a. what signs and symptoms has your child been having? b. Will a family member be able to stay with the child most of the time? c. How long have you known your child's diagnosis? d. what are your child's favorite books, activities and toys?

Will a family member be able to stay with the child most of the time?

How would you elicit the Tonic Neck or "Fencing" reflex, and what is the characteristic response?

With the infant supine, turn their head to one side. The arm and leg on that side should extend; opposite arm and leg should flex.

Muscular Dystrophy is an _____________ diease characterized by

X-linked Recessive, waddling gait, hyper lordosis, and fat pseudohypertrophy of calves.

Is bronchiolitis caused by a virus?

Yes, respiratory syncytial virus (RSV) peaks from mid-winter to early spring Occurs in infants and young children inflammation of the bronchiloes (lower airway structures)

Would a 4 month-old have steady head control?

Yes.

Describe scissoring

a common characteristic of spastic cerebral palsy in infants; legs are extended and crossed over each other, feet are plantar flexed

describe the pathophysiology of vesicoureteral reflux

a malfunction of the valves at the end of the ureters, allowing urine to reflux out of the bladder into the ureters and possibly into the kidneys

Differentiate between right-to-left and a left-to-right shunt in cardiac disease

a right-to-left shunt bypasses the lungs and delivers unoxygenated blood to the systemic circulation causing cyanosis a left-to-right shunt moves oxygenated blood back through the pulmonary circulation

A nurse is reviewing the results of a sweat test performed on a child with cystic fibrosis (CF). The nurse would expect to note which finding? a. a sweat sodium concentration less than 40 mEq/L b. a sweat potassium concentration less than 40 mEq/L c. a sweat potassium concentration greater than 40 mEq/L d. a sweat sodium concentration greater than 60 mEq/L

a sweat sodium concentration greater than 60 mEq/L

what cardiac complications are associated with rheumatic fever?

aortic valve stenosis and mitral valve stenosis

list five risks in cardiac catheterizaiton

arrhythmia bleeding perforation phlebitis obstruction of the arterial entry site

A nurse is preparing to care for a child from a culture different from the nurse's. What is the best way to address the cultural needs of the child and family when the child is admitted to the health care facility? a. ask questions and explain to the family why the questions are being asked b. explain to the family that while the child is being treated, they need to discontinue cultural practices because they may be harmful to the child c. ignore cultural needs because they are not important to health care professionals d. only address those issues that directly affect the nurse's care of the child

ask questions and explain to the family why the questions are being asked

What intervention should the nurse perform first in caring for a child who has ingested a poison?

assessment of the child's respiratory, cardiac, and neurological status

what should be supported by providing guided choices when appropriate ?

autonomy

what is the Erickson's theory for toddlers ?

autonomy vs doubt and shame

What interventions can be taught to prevent UTI in children?

avoid bubble baths; void frequently; drink adequate fluids, especially acidic fluids such as apple or cranberry juice; and clean genital area form front to back

A nurse instructs a mother on measures to take to reduce the incidence of gastroesophageal reflux (GER) in a child. Which statement by the mother indicates a need for further teaching? a. I will give my child small feedings often throughout the day b. I will buy bottle nipples that have smaller holes for my child c. I will add a small amount of cereal to my child's formula d. I will give my child a pacifier and maintain an upright position after meals

b. I will buy bottle nipples that have smaller holes for my child

"A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To assess adequacy of support for the child's psychosocial needs, the nurse would ask the parents which question?" a. what signs and symptoms has your child been having? b. Will a family member be able to stay with the child most of the time? c. how long have you known your child's diagnosis? d. What are your child's favorite books, activities and toys?

b. Will a family member be able to stay with the child most of the time?

A nurse develops a plan of care for a one-month-old infant hospitalized for intussusception. Which nursing measure would be most effective to provide psychosocial support for the parent-child relationship? a. encourage the parents to go home and get some sleep b. encourage the parents to room-in with their infant c. provide educational materials d. initiate home nutritional support as early as possible

b. encourage the parents to room-in with their infant

How should burns in child be assessed?

by using the Lund-Browder chart, which takes into account the changing proportions of the child's body

For cleft lip and palate, the ___ will be corrected first. Post-op both procedures, place on ________ and maintain __________ and __________.

lip, side, Logan Bow, elbow restraints

identify food sources of vitamin A

liver, sweet potatoes, carrots, spinach, peaches and apricots

ID food sources of Vit A

liver, sweet potatoes, carrots, spinach, peaches, apricots

how should a parent be instructed to child-proof a house?

lock all cabinets safely store all toxic household items in a locked cabinets examine the house from the child's point of view

Describe safe monitoring of prednisone administration and withdrawal

long-term prednisone should be given every other day. Signs of edema, mood changes, and GI distress should be noted and reported. The drug should be tapered, no discontinued suddenly

list the laboratory findings that can be expected in a dehydrated child

loss of bicarbonated/decreased pH loss of sodium (hyponatremia) loss of potassium (hypokalemia) elevated Hct and elevated BUN

A mother of a toddler who is hospitalized with mild dehydration must leave her child to go to work. Which behavior would the nurse expect to observe in the toddler immediately after the mother's departure? a. silently curled in bed with a blanket b. loudly crying and kicking both legs c. playing quietly with a favorite toy d. sucking thumb and rocking back and forth

loudly crying and kicking both legs

Describe the postoperative nursing care for an infant with pyloric stenosis

maintain IV hydration and provide small, frequent feedings of glucose or electrolyte solutions or both within 4 to 6 hours. Gradually increase to full-strength formula Position infant on right side in semi-fowler position after feeding

What nursing actions are initiated for the newborn with suspected esophageal atresia with TEF?

maintain NPO immediately and suction secretions

what are the priorities for a child undergoing abdominal surgery?

maintain fluid balance (I/O, NG suction, monitor electrolytes); monitor vital signs; care for drains; if present assess bowel function; prevent infection of incision area and other postoperative complications; and support child and family with appropriate teaching

State the three main gals in providing nursing care for a child experiencing a seizure

maintain patent airway, protect form injury and observe carefully

list dietary sources of iron

meat, green leafy vegetables, fish, liver, whole grains, legumes

List foods high in phenylalanine content

meat, milk, diary products, and eggs

girls may experience what?

menarche

describe the care of a child in a mist tent

monitor child's temperature, keep tent edges tucked in, keep clothing dry, assess respiratory status, look at child inside tent

How can the nurse best evaluate the adequacy of fluid replacement in children?

monitoring urine output

the preschool child's thinking becomes?

more egocentric and concrete

describe developmental factors that would impact the school-age child with diabetes

need to be like peers; assuming responsibility for own care; modification of diet; snacks and exercise in school

How is congenital hypothyroidism diagnosed?

newborn screening revealing a low T4 and a high TSH

What are signs of anorectal malformation?

newborn who does not pass meconium within 24 hours; meconium appearing through a fistula or in the urine; an unusual appearing and dimple

Pertussis fatalities continue to occur in ____________________ in the US

nonimmuniized infants

A nurse notes that a client's eyes are continuously moving back and forth within the eye sockets. The nurse documents in the medical record that the client has: a. ataxia b. nystagmus c. pronator drift d. hyperreflexia

nystagmus

Truncus Arteriosis is when

one main vessel gets mixed blood

Described the function of an osmotic diuretic

osmotic diuretics remove water form the CNS to reduce cerebral edema

The best way to administer oxygen to a child three month old is by?

oxygen hood

What are the signs of air flow restriction and impaired tissue oxygenation?

physiologic compensation: respiratory rate increases, heart rate increases

A home care nurse visits a 3-year-old child with chickenpox. The child's mother tells the nurse that the child keeps scratching the skin at night and asks the nurse what to do. The nurse tells the mother to: a. apply generous amounts of cortisone cream to prevent itching b. place soft cotton gloves on the child's hands at night c. keep the child in a warm room at night so the covers will not cause the child to scratch d. give the child a glass of warm milk at bedtime to help the child sleep

place soft cotton gloves on the child's hands at night

a finger at base of toes causes them to curl downward? how long does it last for?

plantar; 8 months

What are the three classic signs of diabetes?

polydipsia polyphagia polyuria

list the common signs of cardiac problems in an infant

poor feeding poor weight gain respiratory distress infections edema cyanosis

Add ___________ to fluids in peds with diarrhea only when there is adequte urine output

potassium

which age group fear body mutilation?

preschoolers

Explain why hypospadias correction is performed before the child reaches preschool age

preschoolers fear castration, achieving sexual identity, and acquiring independent toileting skills

What care is indicated for a child with juvenile rheumatoid arthritis?

prescribed exercise to maintain mobility; splinting of affected joins; and teaching about medication management and side effects of drugs

What are two nursing priorities for a newborn with myelominingocle?

prevention of infection of the sac and monitoring for hydrocephalus (measure head circumference, check fontanel, assess neurologic functioning)

A nurse is developing a postoperative plan of care for an infant who will undergo a pyloromyotomy for the treatment of hypertrophic pyloric stenosis. The nurse documents in the plan that the infant should be placed in which position in the postoperative period? a. supine with the head of the bed elevated b. prone with the head of the bed elevated c. flat on the nonoperative side d. flat on the operative side

prone with the head of the bed elevated

What are the priorities for a client with a Wilms tumor?

protect the child from injury to the encapsulated tumor. Prepare the family and child for surgery

An infant brought to the emergency room is unresponsive and in respiratory distress. The nurse opens the infant's airway by which method? a. hyperextension b. jaw thrust c. tongue-jaw lift d. head tilt/ chin lift

tongue-jaw lift

this allows for the preschool child to act out his or her experiences and may be helpful?

therapeutic play

describe the purpose of bronchodilators

to reverse bronchospasm

which age group fear intrusive procedures?

toddlers

when neck is turned to side, baby assumes fencing posture, how long does it last for?

tonic neck; 3-4 months

what is the eriksons stage for an infant?

trust vs mistrust

what are the signs and symptoms of congenital dislocated hip in infants?

unequal skin folds of the buttocks, ortolani sign, limited abduction of the affected hip and unequal leg lengths

what position does a child with epiglottitis assume?

upright sitting, with chin out and tongue protruding (tripod positioning)

describe feeding techniques for a child with cleft lip or palate

use lamb's nipple or prosthesis feed child upright, with frequent bubbling

How does epinephrine alleviate symptoms of croup?

vasoconstriction, causes a decrease in blood flow to highly vascular larynx and surronding repiratory tissues

A nurse is preparing a plan of care for a child being admitted to the hospital with a diagnosis of congestive heart failure (CHF). The nurse avoids including which of the following in the plan? a. limiting the time the child is allowed to bottle-feed b. elevating the head of the bed c. waking the child for feeding to ensure adequate nutrition d. providing oxygen during stressful periods

waking the child for feeding to ensure adequate nutrition

list normal findings in a neurovascular assessment

warm extremity, brisk capillary refill, free movement, normal sensation of the affected extremity and equal pulses

The nurse is providing instructions to the parents of a child with a hernia regarding measures that will aid in reducing the hernia. The nurse determines that the parents understand these measures if they state which of the following? a. we will be sure to give our child a fleet enema every day to prevent constipation b. we will make sure that our child participates in physical activity every day c. we will provide comfort measures to reduce any crying periods by our child d. we will encourage our child to cough every few hours on a daily basis

we will provide comfort measures to reduce any crying periods by our child

__________ are a major cause of death in children and adolescents. Teach parents and children ________ _________ ________ and prevention techniques

Accidents, developmentally appropriate safety

Rheumatic Fever is an ________ which affects _______________.

Acquired Heart Disease, aortic and mitral valves

Epiglottitis is caused by __________. The child will sit _________________.

H. influenza B., Child sits upright with chin out and tongue protruding (maybe Tripod position)

Greenstick fx

Incomplete fracture

The school-age child (6-12 years) is in what stage of psychosocial development?

Industry vs. Inferiority

Nursing diagnosis for RSV

Ineffective airway clearance related to increased respiratory secretions. Risk for deficient fluid volume Activity intolerance Interrupted family processes related to hospitalization.

What would you expect to observe when eliciting the rooting reflex in an infant?

Infant turns head toward stimulus and opens mouth. Note: Reflex is difficult to elicit when infant has been fed.

What teaching should parents of a newly shunted child receive?

Information about signs of infn and increased ICP, understanding that shunt should not be pumped and that child will need revisions with growth, guidance concerning growth and development

The preschool child (3-6 years) is in what stage of psychosocial development?

Initiative vs. guilt.

A preschool child conceptualizes the death process as

Involving physical harm

List the S/S of increased ICP in older children

Irritability, change in LOC, motor dysfunction, headache, vomiting, unequal pupil response, and seizures

_______ RSV with contact precautions.

Isolate

What is the genetic transmission pattern of hemophilia?

It is an X-linked recessive chromosomal disorder transmitted by the mother and expressed in male children

What should families and clients do to avoid triggering sickling episodes?

Keep child well hydrated. Avoid known sources of infns. Avoid high altitudes. Avoid strenous exercise.

What position would best relieve the child experiencing a tet spell?

Knee-chest position or squatting.

Wilm's Tumor is a __________. If you know a patient has this _____________.

Large kidney tumor, Don't palpate

What are the symptoms of congenital hypothyroidism in early infancy?

Large, protruding tongue, couarse hair, lethargy, sleepiness, and constipation

What two formulas are prescribed for infants with PKU?

Lofenalac Phenex-1

What 2 formulas are prescribed for infants with PKU?

Lofenalac and Phenex-I

Describe safe monitoring of prednisone administration and withdrawal

Long-term prednisone (a corticosteroid) should be given every other day. Signs of edema, mood changes, and GI distress should be noted and reported. The drug should be tapered, not discontinued suddenly.

List the lab findings that can be expected in a dehydrated child

Loss of bicarb/decreased serum pH, loss of Na (hyponatremia), loss of K (hypokalemia), elevated Hct, and elevated BUN

Bacterial Meningitis is diagnosed with a

Lumbar puncture which shows increased WBC, protein, IICP and decreased glucose

which vaccine should be held if a child has a history of an anaphylactic reaction to eggs or neomycine

MMR

Describe developmental factors that would impact the school-age child with diabetes

Need to be like peers, assuming responsibility for own care, modification of diet, snacks and exercise in school

Describe the signs and symptoms of a child with meningitis

fever, irritability, vomiting, neck stiffness, opisthotonos, positive Kernig sign, positive brudzinski signs; infant may not show all

What contraindicates administration of DTAP?

history of reactions, siezures, neurologic symptoms after previous vaccine, or systemic reactions

explain why hydration is a priority in treating sickle cell disease

hydration promotes hemodilution and circulation of the red cells through the blood vessels

Normal respiratory rates for kids- Newborn, 1-11 months, 1-3 years, 3-5 years, 6-10 years, 11-16 years

Newborn ... 30-60 - 1-11 mo ... 25-35 - 1-3 years ... 20-30 - 3-5 years ... 20-25 - 6-10 years ... 18-22 - 11-16 years ...16-20

How is congenital hypothyroidism diagnosed?

Newborn screening revealing low T4 and high TSH

Pinworm Infection

Obtain rectal specimen by tape test in the morning when the child awakens

In Hydrocephalus the signs of increased ICP are ________________

Opposite of shock

Describe the function of an osmotic diuretic

Osmotic diuretics (i.e. Manitol) remove water from the CNS to reduce cerebral edema

What nutritional support should be provided for a child with CF?

Pancreatic enzyme replacement, fat-soluble vitamins, and a moderate- to low-carb, high-protein, mod- to high-fat diet

In planning and providing nursing care a _________________ is always the priority of care regardless of the age!

Patent airway

What medications are used to tx rheumatic fever?

Penicillin, erythromycin, and aspirin

How would you elicit the palmar reflex?

Place finger in palm of hand.

What are the 3 classic signs of diabetes?

Polydipsia, polyphagia, and polyuria

List the common signs of cardiac problems in an infant

Poor feeding, poor wt gain, resp distress and infections, edema, and cyanosis

List the signs and symptosm of dehydration in an infant

Poor skin turgor, absence of tears, dry mucous membranes, weight loss, depressed fontanel, and decreased urinary output

List the S/S of dehydration in an infant

Poor skin turgor, absence of tears, dry mucous membranes, weight loss, depressed fontanels, and decreased UO

Visual acuity approaches 20/20 when the child reaches what age group? (infant, toddler, preschooler, school-age, adolescent)

Preschooler (3-6 years)

What care is indicated for a child with juvenile rheumatoid arthritis?

Prescribed exercise to maintain mobility, splinting of affected joints, and teaching about medication management and side effects of drugs.

What are 2 nursing priorities for a newborn with myelomeningocele?

Prevention of infn of the sac and monitoring for hydrocephalus (measure head circumference, check fontanels, assess neuro functioning)

List the precautions used for a pt. with RSV in the hospital.

Private room, hand washing, use of clean gloves by carergivers, masks, gown

What are the priorities for a client with a Wilms tumor?

Protect the child from injury to the encapsulated tumor. Prepare the family and child for surgery.

Describe the nsg care of a child with ketoacidosis

Provide care for an unconscious child, administer regular insulin IV, monitor ABGs (Na bicarb for met acidosis), and maintain strict I&O

Tetralogy of Fallot can cause

Pulmonary Stenosis, VSD, Overiding Aorta, Right Ventricular Hypertrophy, TET Spells, and CHF

Appropriate toys and play for the hospitalized toddler (1 to 3 years)?

Push-pull toys, toy telephones, stuffed animals, etc Toddlers benefit from being taken to the hospital playroom when able, because mobility is important to their development.

The isotonic intravenous solution dextrose 5% in .45% NS is used to?

Replenish fluid losses, maintain fluid balance, and provide calories probalby

Primary reason for most medical/ER visits for kids is _______________.

Respiratory disorders

In a Sickle Cell Crisis, the treatment is

Rest, hydration, and avoid high altitude and strenuous activities

List 7 signs of resp distress in a pedi client

Restlessness, tachycardia, tachypnea, diaphoresis, flaring nostrils, retractions, grunting

Children with ____________ pose a serious threat to their unborn siblings.

Ruebella (German measles), the nurse should counsel all expectant mothers, especially those with young children, to be aware of the serious consquenses of exposure to German measles during pregnancy

When should the Babinski reflex disappear?

SHOULD disappear by 1 year of age.

Bacterial Meningitis can lead to ___________ because of ___________. The following signs will be seen:

SIADH, too much ADH; Water retention, fluid overload, and dilutional hyponatremia

Children can be expected to dress themselves completely when they reach what age group?

School-age children (6-12 years)

You would expect a child with Cerebral Palsy to present with

Scissoring = legs extended, crossed, feet plantar-flexed

What dz occurs with Vit C deficiency?

Scurvy

what disease occurs with vitamin C deficiency?

Scurvy

Indications of shock are ____________________. Indications of IICP are ____________________.

Shock = Increased pulse and decreased BP IICP = Decreased pulse and increased BP

What are the physical features of a child with Down syndrome?

Simian creases in palms, hypotonia, protruding tongue, and upward-outward slant of eyes

You would expect a child with Down Syndrome, or Trisomy 21, will have these characteristics

Simian creases on palms, hypotonia, protruding tongue, upward outward slant of eyes

How is skeletal traction applied?

Skeletal traction is maintained by pins or wires applied to the distal fragment of the fracture

Compound fx

Skin or mucous membrane has been broken

When does the posterior fontanel close?

Sometime between birth and 8-12 weeks (2-3 months) (Yellow NCLEX-RN Review book, pg. 339)

When does the posterior fontanel close?

Sometime between birth and 8ish weeks (2-3 months) (Yellow NCLEX-RN Review book, pg. 339)

Mumps 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Paramyxovirus (viral) 2. Incubation period: 14-21 days 3. Communicable period: Immediately before and after parotid gland swelling begins. 4. Source: Saliva of infected persons. 5. Transmission: Direct contact or droplet spread

Contraindications for HPV vaccine?

1. Individuals with a reaction to a previous injection. 2. PREGNANT WOMEN should not receive HPV vaccine.

State the 3 main goals in providing nsg care for a chile experiencing a seizure

1. Maintain patent airway 2. Protect from injury, and 3. Observe carefully

List 3 class S/S of measles

1. Photophobia 2. Confluent rash that begins on face and spreads downwards 3. Koplik spots on buccal mucosa

Explain why hypospadias correction is performed before the child reaches preschool age.

1. Preschoolers fear castration 2. To achieve sexual identity, and 3. To acquire independent toileting skills

What are the 2 objectives in treating congestive heart failure?

1. Reduce the workload of the heart 2. Increase cardiac output

Chickenpox (Varicella) 3 signs and symptoms

1. Slight fever, malaise, and anorexia are followed by a macular rash that first appears on the trunk and scalp and move to the face and extremities. 2. Lesions become pustules, begin to dry, and develop a crust. 3. Lesions may appear on mucous membranes of mouth, genital area, or rectum.

After how many hours on antibiotics, will epiglottitis due to Hib will no longer be communicable?

24 hr.

Concerning Autosomal Recessive Diseases, there is a _____ chance a child will inherit the disease if the parents have: AS (trait only) X AS (trait only)

25%

X-Linked Recessive Diseases there is an overall ____ chance that each pregnancy will result in a ___________________

25%, child that has the disease

Three to four word sentences should be expected when a child is how many years old?

3 years.

Monosyllabic Babbling will happen at ______ months. Links syllables at _______.

3-6 months links syllables at 6-9 months

what age is the preschool child?

3-6 years

at what age are imaginary playmates and fears common?

3-6 years (preschool child)

at what age does the child learn sexual identity?

3-6 years (preschool child)

the birth weight quadruples by ?

30 months

Children with Rubella can be a ____________________________

= threat to unborn siblings (may require temporary isolation from Mom during PG)

When is the Hib vaccine series started?

Started at two months of age. 3 to 4 subsequent doses are given at two-month intervals after the first does. Children should complete the Hib vaccine series by 15 months of age.

Acute Glomerulonephritis: after ________ antigen-antibody complexes clog up __________ and reduce _____. This results in the presence of _________ and proteinuria.

Strep B, glomeruli, GFR, dark urine

Tonsillitis is usually caused by _______. Pre-Op be sure to get _____________ and ask about a history of bleeding.

Strep, PT and PTT

A home care nurse is providing instructions to a child with cystic fibrosis about how to perform the "huff" maneuver; the child asks the nurse about the purpose of this type of breathing. The nurse makes which response to the child? a. "this type of breathing is used to mobilize secretions so that they can be easily coughed out" b. "this type of breathing prolongs inspiration time" c. "this type of breathing moves air out of the lower lungs" d. "this type of breathing moves air through the lungs"

"this type of breathing is used to mobilize secretions so that they can be easily coughed out"

The most sensitive sign of IICP is

+ Altered LOC

Concepts of bodily injury: School-age (6-12 years) children fear..?

...Loss of control of their bodies.

Concepts of bodily injury: Adolescents (12-18 years) fear...?

...Major concern is change in body image.

The nurse should be sure ______ _____ _______ have been determined prior to tonsillectomy. More importantly, the nurse should ask whether there has been

...PT and PTT, history of bleeding (prolonged or excessive), and whether there is a history of any bleeding disorders in the family

Fine pincer grasp appears...?

...at 10 to 12 months.

Concepts of bodily injury: Preschoolers (3-6 years) fear...?

...body mutilation.

Concepts of bodily injury: Toddlers (1-3 years) fear...?

...intrusive procedures.

Urinary output for infants and children should be _______

1-2 ml/kg/hr

The pneumococcal conjugate vaccin (PCV) prevents infection due to which bacterium.

Streptococcus pneumoniae Epiglottitis can result from Streptococcus pneumoniae infection.

What nsg interventions increase intracranial pressure?

Suctioning and positioning, turning

What are clinical manifestations following foreign body aspiration?

Sudden, violent cough, gagging, vomiting, wheezing, brief episodes of apnea, and cyanosis

Primary meds in ER for respiratory distress

Sus-phrine (Epinephrine HCl) and Theophylline (Theo-dur) ... Both bronchodilators

TVG is

Transposition of Great Vessels

The infant (birth to 1 year) is in what stage of psychosocial development?

Trust vs. Mistrust

What are the S/S of compartment syndrome?

Abnormal neurovascular assessment: cold extremity, severe pain, inability to move the extremity, and poor capillary refill

Ductus Venosus is when the

Umbilical Vein to Inferior Vena Cava

Rubeola (Measles) 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Paramyxovirus (viral) 2. Incubation period: 10-20 days 3. Communicable period: from 4 days before to 5 days after rash appears. 4. Source: Respiratory tract secretions, blood, or urine 5. Transmission: Airborne particles or direct contact with infectious droplets; transplacental

the child appears to be bowlegged and potbellied by which age?

1-3

what is the age range for a todddler?

1-3 years

Scarlet Fever 7 signs and symptoms

1. Abrupt high fever, flushed cheeks, vomiting, headache, enlarged lymph nodes in neck, malaise, ab. pain 2. Red, fine, sandpaper-like rash develops in the axilla, groin, and neck that spreads to cover the entire body except face. 3. Rash blanches with pressure, except in areas of deep creases and folds of joints. 4. Desquamanation of skin on palms and soles appears by weeks 1-3 5. Tongue is initially coated by white, furry covering with red papillae; by fifth day, white coat sloughs off leaving red, swollen tongue (White strawberry tongue -> Red strawberry tongue) 6. Tonsils are reddened and covered with exudate. 7. Pharynx is edematous and beefy red Remember: Key is the strawberry tongue

Pertussis (Whooping Cough) 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Bordetella pertussis (Gram negative bacteria) 2. Incubation period: 5-21 days (usually 10) 3. Communicable period: greatest during the catarrhal stage 4. Source: Discharge from resp. tract of infected person 5. Transmission: Direct contact or droplet spread

Diphtheria 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Corynebacterium diptheriae 2. Incubation period: 2 to 5 days 3. Communicable period: Variable. Until virulent bacteria are no longer present (three consecutively negative cultures of pharyngeal secretions); usually 2 weeks, can be 4 weeks. 4. Source: Discharge from mucous membranes of nose and nasopharynx, skin and other lesions. 5. Transmission: Direct contact with infected person, carrier, or contaminated articles

Infectious Mononucleosis 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Epstein-Barr virus (viral) 2. Incubation period: 4 to 6 weeks 3. Communicable period: Unknown 4. Source: Oral secretions 5. Transmission: Direct intimate contact

Scarlet Fever 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Group A beta-hemolytic streprococci (Gram positive bacteria) 2. Incubation period: 1 to 7 days 3. Communicable period: About 10 days during the incubation period and clinical illness; during the first 2 weeks of the carrier stage, although may persist for months. 4. Source: Nasophayngeal secretions of infected person and carriers. 5. Transmission: Direct contact or droplet spread; indirectly by contact with contaminated articles.

Erythema Infectiosum (Fifth Disease) 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Human Parvovirus B19 (viral) 2. Incubation period: 4 - 14 days, may be 20 days 3. Communicable period: Uncertain, but before onset of symptoms in most children. 4. Source: Infected persons 5. Transmission: Unknown mode of transmission, possibly resp. secretions and blood.

Roseola (Exanthema Subitum) 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Human herpesvirus type 6 (viral) 2. Incubation period: 5-15 days 3. Communicable period: unknown, but thought to be from febrile stage to time rash appears 4. Source: unknown 5. Transmission: unknown

Rocky Mountain Spotted Fever 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Rickettsia rickettsii (Gram negative bacteria) 2. Incubation period: 2 to 14 days 3. Communicable period: NOT CONTAGIOUS 4. Source: Tick bite from mammal, usually wild rodents and dogs. 5. Transmission: Tick bite

Rubella (German Measles) 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Rubella virus (viral) 2. Incubation period: 14 to 21 days 3. Communicable period: From 7 days before to about 5 days after rash appears. 4. Source: Nasopharyngeal secretions; virus is also present in blood, stool, urine. 5. Transmission: Airborne or direct contact w/infectious droplets. Indirectly via articles freshly contaminated. Also transplacental.

Chickenpox (Varicella) 1. Agent? 2. Incubation period? 3. Communicable period? 4. Source? 5. Transmission?

1. Agent: Varicella-zoster virus (viral) 2. Incubation period: 13 to 17 days 3. Communicable period: From 1 to 2 days before the onset of rash to 6 days after the first crop of vesicles, when crusts have formed. 4. Source: Respiratory tract secretions of infected persons; skin lesions. 5. Transmission: Direct contact, droplet, contaminated objects REMEMBER: Child is no longer contagious once lesions have dried and crusts have formed.

Nsg interventions and medical txs for a child with leukemia are based on what 3 physiologic problems?

1. Anemia (decreased erythrocytes) 2. Infection (neutropenia) 3. Bleeding thrombocytopenia (decreased platelets)

Mumps 5 signs and symptoms

1. Fever 2. Headache and malaise 3. Anorexia 4. Jaw or ear pain aggravated by chewing, followed by parotid gland swelling. 5. Orchitis (inflamed testes) may occur Remember: Key is parotid gland swelling.

Rubeola (Measles) 5 Signs and symptoms

1. Fever 2. Malaise 3. The three "C's" - coryza, cough, conjunctivitis 4. Red, erythematous maculopapular eruption starting on face and spreading down towards feet; blanches with pressure and gradually turns brownish color (1 week) 5. Koplik's spots: small red spots with a bluish white center and red base, located on buccal mucosa Remember: Three "Cs" & Koplik's spots are the key for identifying measles.

Rocky Mountain Spotted Fever 2 signs and symptoms

1. Fever, malaise, anorexia, vomiting, headache, myalgia 2. Maculopapular OR petechial rash primarily on the extremities (ankles and wrists), but may spread to other areas, characteristically on the palms and soles. Key: Rash on ankles, wrists, palms and soles. Remember it is not communicable. Provide parents teaching about preventing tick bites.

Infectious Mononucleosis 3 signs and symptoms and 1 important complication to teach parents to monitor for.

1. Fever, malaise, headache, fatigue, nausea, abdominal pain, sore throat, enlarged red tonsils. 2. Lymphadenopathy and hepatosplenomegaly 3. Discrete macular rash most prominent over the trunk may occur. TEACH PARENTS TO MONITOR FOR SPLENIC RUPTURE: Marked by abdominal pain, left upper quadrant pain, referred left-shoulder pain.

List 2 contraindications to live virus immunization

1. Immunocompromised child. 2. Child in household with immunocompromised indiv

Roseola (Exanthema Subitum) 2 Signs and symptoms?

1. Sudden high (>38.8 C / >102 F) fever of 3 to 5 day's duration in a child that appears well, followed by a rash (rose-pink macules that blanch with pressure. 2. Rash appears several hours to 2 days after fever subsides and lasts 1 to 2 days. Disease is self-limiting and treatment is supportive. Remember: fever first, then rash.

Rubella (German Measles) 4 signs and symptoms and 1 very important intervention to remember

1. low-grade fever 2. Malaise 3. Pinkish red maculopapular rash the begins on face and spreads to the entire body within 1 to 3 days. 4. Petechial, red, pinpoint spots may appear on the soft palate. Key for identification is rash covering entire body and spots on soft palate. REMEMBER: ISOLATE CHILD FROM PREGNANT WOMEN.

Diphtheria 4 signs and symptoms and 2 important interventions

1. low-grade fever, malaise, sore throat 2. Foul-smelling, mucoprurulent nasal discharge 3. Dense pseudomembrane formation of the throat that may interfere with eating, drinking and breathing. 4. Lymphadenitis, neck edema, "bull neck" Interventions: Strict isolation for hospitalized child. Administer diphtheria antitoxin only AFTER a skin or conjunctival test rules out sensitivity to horse serum.

An infant will crawl at

10 months

When should the infant be expected to start crawling?

10 months.

An infant will walk at

10-12 months

at what age does birth weight triple?

12 months

When does the anterior fontanel close?

12-18 months. (1 - 1 1/2 years)

A child needs _______ of the usual calorie intake for normal growth and development

150%

WHEN DOES A CHILD THROW A BALL OVERHAND?

18 MONTHS

When does a child throw a ball overhand?

18 months.

Daytime toilet training should be taught at

18months to 2 years

Cooing will be seen at

2 months

social smile occurs by ?

2 months

when does a child achieve 50% of adult height?

2 years

when does a child speak two-to three word sentences

2 years

Two to three word sentences should be expected when a child is how many years old?

2 years.

When can a child be expected to feed themselves with a spoon and cup?

2 years.

When does a child acheive 50% adult height?

2 years.

When does a child achieve 50% adult height?

2 years.

When does a child speak two- to three-word sentences?

2 years.

A baby has a steady head by ________

4 months

steady head controls is achieved by?

4 months

when does a child use sissors

4 years

When does a child use scissors?

4 years. Note: I had this question on my OB HESI.

what is the normal BG for an infant? when do you report at BG?

40-80; when it gets below 40

whe does a child tie his/her shoe

5 years

When does a child tie his or her shoes?

5 years.

A baby will turn their head over at _______ months

5-6

Birth length increases by _____ at 12 months

50%

Concerning Autosomal Recessive Diseases, there is a _____ chance a child will inherit the disease if the parents have: AS (trait only) X SS (disease)

50%

If one parent has the disease/trait of Autosomal Dominant Diseases there is a _______ chance the child will inherit (and express) the disease.

50%

X-Linked Recessive Diseases there is ____ chance daughters will be carriers, even though they cant _______________

50%, have the disease

X-Linked Recessive Diseases there is ____ chance sons will have the disease, even though they cant ___________

50%, pass it on

at what age is the infant able to remember pain?

6 months

H1N1 Vaccine: When are children old enough to receive it?

6 months. Children younger than six months are not old enough, but family members and caregivers should be vaccinated.

what is the age range for the school-age child?

6-12

Hand-to-hand transfers occur when?

7 months

When does the infant develop stranger anxiety?

7 to 9 months.

when does the child sit unsupported?

8 months

When does the child sit unsupported?

8 months.

the posterior fontanel closes by?

8 weeks

Babies can say "mama" and "dada," plus a few other words at

9-12 months

what is the normal temp of an infant

97.7-99.4f ; 36.5-37.5 c

Differentiate between a right-to-left and a left-to-right shunt in cardiac dz

A R-to-L shunt bypasses the lungs and delivers unoxygenated blood to the systemic circulation, causing cyanosis. A L-to-R shunt moves oxygenated blood back through the pulmonary circulation.

Describe why a barium enema is used to tx intussusception

A barium enema reduces the telescopign of the intestine through hydrostatic pressure without surgical intervention

Describe scissoring.

A common characteristic of spastic cerebral palsy in infants; legs are extended and crossed over each other, feet are plantarflexed

Describe the pathophysiology of vesicoureteral reflux

A malfunction of the valves at the end of the ureters, allowing urine to reflux out of the bladder into the ureters and possibly into the kidneys

What are the signs of anorectal malformation?

A newborn who does not pass meconium within 24 hours, meconium appearing through a fistula or in the urine; an unusual-appearing anal dimple

After immunization, call the physician if the patient experiences

A seizure, high fever, or high-pitched cry

Describe the sequence of events in a vaso-occlusive crisis in sickle cell anemia

A vaso-occlusive crisis is caused by the clumping of red blood cells, which blocks small blood vessels; therefore, the cells cannot get through the capillaries, causing pain and tissue and organ ischemia. Lowered oxygen tension affects HgbS, which causes sickling of the cells

Compare the S/S of acute glomerulonephritis (AGN) with those of nephrosis

AGN: gross hematuria, recent Strep infn, HTN, and mild edema. Nephrosis: severe edema, massive proteinuria, frothy-appearing urine, anorexia

compare the signs and symptoms of acute glomerulonephritis (AGN) with those of nephrosis

AGN: gross hematuria, recent strep infection, hypertension and mild edema Hephrosis: severe edema, massive protinuria, frothy-appearing urine, anorexia

Compare the dietary interventions for AGN and nephrosis

AGN: low sodium diet nephrosis: high protein, low salt diet

Compare the dietary interventions for AGN and nephrosis

AGN: low-sodium diet with no added salt. Nephrosis: high-protein, low-salt diet

Age group concepts of bodily injury: - Infants: after 6 months, their _________ development allows them to __________ ______ - Toddler: they fear _________ procedures - School-age children: they fear loss of control of ______ ________ - Adolescents: their major concern is _______ __ ______ _______

Age group concepts of bodily injury: - Infants: after 6 months, their *cognitive* development allows them to *remember pain* - Toddler: they fear *intrusive* procedures - School-age children: they fear loss of control of *their bodies* - Adolescents: their major concern is *change in body image*

What is a positive Babinski reflex?

All toes hyperextended, with dorsiflexion of big toe.

What ABX are usually prescribed for bacterial meningitis?

Ampicillin, penicillin, or chloramphenicol

What early signs should the nurse assess for if lead posioning is suspected?

Anemia, acute cramping, abdominal pain, vomiting, constipation, anorexia, headache, lethargy, hyperactivity, aggression, impulsiveness, decreased interest in play, irritability, short attn span

List S/S of iron deficiency

Anemia, pale conjunctive, pale skin color, atrophy of papillae on tongue, brittle, ridges, or spoon-shaped nales, and thyroid edema

____________ cause closure of PDA. (aorta - pulmonary artery)

Antiprostaglandins

Ductus Arteriosus is when the

Aorta to Pulmonary Artery

What cardiac complications are assoc'd with rheumatic fever?

Aortic valve stenosis and mitral valve stenosis

Moro reflex disappears when?

Around 4 months of age.

List 5 risks in cardiac catheterization

Arrhythmia, bleeding, perforation, phlebitis, and obstruction of the arterial entry site

How would the nurse conduct a scoliosis screening?

Ask the child to bend forward form the hips, with arms hanging free. Examine the child for a curve in the spine, a rib hump, and hip asymmetry

What interventions should the nurse perform first in caring for a child who has ingested a poison?

Assessment of the child's respiratory, cardiac, and neuro status

"A mother tells the nurse that her child does not want anything to do with toilet training and yells "NO!" consistently when she tries to toilet train. The child is 2 years old. According to Erikson, the nurse interprets that the child is experiencing which psychosocial crisis?" a. autonomy vs shame and doubt b. initiative vs guilt c. industry vs inferiority d. trust vs mistrust

Autonomy vs shame and doubt

The toddler (1-3 years) is in what stage of psychosocial development?

Autonomy vs. Shame and Doubt

What interventions can be taught to prevent urinary tract infns in children?

Avoid bubble baths, void frequently, drink adequate fluids (especially acidic fluids such as apple or cranberry juice), and clean genital area from front to back

Concerning new foods, babies should ____________________________

Be introduced one new food at a time.

Why is genetic counseling important for the family of a child with CF?

Because the dz is autosomal recessive

What antecedent event occurs with AGN?

Beta-hemolytic Streptococcal infn

What antecedent event occurs with AGN?

Beta-hemolytic streptococcal infection

Appropriate toys and play for the hospitalized school-aged child (6-12 years)?

Board and card games, hobbies, video games.

Signs of IICP in infants include

Bulging fontanels, high pitched cry, increased hd circum, sunset eyes, wide suture lines, lethargy

When does birth length double?

By 4 years.

How should a parent be instucted to childproof a house?

By being taught to lock all cabinets, to safely store all toxic household itemsin locked cabinets, and to examine the house fromt he child's POV

How can the nurse best evaluate the adequacy of fluid replacement in children?

By monitoring UO

How should burns in children be assessed?

By using the Lund-Browder chart, which takes into account the changing proportions of the child's body

Autosomal Recessive Diseases

CF, PKU, Sickle Cell Anemia, Tay-Sachs, Albinism

What are the metabolic effects of PKU?

CNS damage, mental retardation and decreased melanin

What are the metabolic effects of PKU?

CNS damage, mental retardation, and decreased melanin

For all cases of poisoning, ________________. DO NOT give _________.

Call Poison Control Center, No Ipecac!

A child from birth to two years conceptualizes the death process as

Cannot grasp the concept of illness and death

Describe the preop nsg care for a child with Hirschsprung dz

Check VS and take axillary temperatures. Provide bowel cleansing program, and teach about colostomy. Observe for bowel perforation; measure abd girth

What D/C instructions should be included concerning a child with a spica cast?

Check child's circulation. Keep cast dry. Do not place anything under cast. Prevent cast soilage during toileting or diapering. Do not turn child using an abductor bar.

List the S/S of esophageal atresia with TEF

Choking, coughing, cyanosis, and excess salivation

Appropriate toys and play for the hospitalized preschooler (3-6years)?

Coloring books, puzzles, cutting and pasting, clay... etc.

Communated fx

Complete fx across the shaft of the bone with splintering of the bone fragments

If a child has no meconium within 24 hrs or ribbon-like foul smelling stools suspect _________ or ___________. This is caused by a ___________ due to absence of ganglionic cells in colon.

Congenital Megacolon = Hirschsprung's Disease; lack of peristalsis

What is compartment syndrome?

Damage to nerves and vasculature of an extremity due to compression

What are common signs of digoxin toxicity?

Diarrhea, fatigue, weakness, N/V; the nurse should check for bradycardia prior to Dig administration

_________ is the treatment for CHF. A TR is _________ for kids.

Digoxin, TR = 0.8-2.0 for kids

Birth weight __________ at 6 months and _________ at 12 months

Doubles at 6 months, and triples at 12 months

Describe the mechanism of inheritance of Duchenne muscular dystrophy

Duchenne muscular dystrophy is inherited as an X-linked recessive trait

What is the relationship between hypoglycemia and exercise?

During exercise, insulin uptake is increased and the risk for hypoglycemia occurs (give less insulin before exercise, insulin causes hypoglycemia)

Rheumatic Fever labs show _________________________. Treat with ____________ which is a ____________ for recurrence of RF

Elevated ASO titer and ESR, Penicillin G, Prophylaxis

What are the physical assessment findings for a child with asthma?

Expiratory wheezing, rales, tight cough, and signs of altered ABGs

what are the physical assessment findings for a child with asthma?

Expiratory wheezing, rales, tight cough, and signs of altered blood gases

What care is needed for a child with a temporary colostomy?

Family needs education about skin care and appliances. Referral to an enterostomal therapist is appropriate

Describe the S/S of a child with meningitis

Fever, irritability, vomiting, neck stiffness, opisthotonos, positive Kernig sign, positive Babinski sign (toes should not fan on stimulation, a positive sign, after 18mos), infant may not show all classic signs even though very ill

Erythema Infectiosum (Fifth Disease) Signs and symptoms

Fifth Disease is marked by a rash that appears in three stages. Just prior to the rash appearance the child may experience mild fever, malaise, headache or runny nose. Stage 1: Erythema on face, chiefly on cheeks. "Slapped cheek" appearance. Disappears by 1 - 4 days. Stage 2: About 1 day after rash appears on face, maculopapular red spots appear, symmetrically distributed on the extremities; the rash progresses from proximal to distal surfaces and may last a week or more. Stage 3: The rash subsides, but may reappear if skin becomes irritated by sun, heat, cold, exercise, or friction. REMEMBER: Pregnant women need to avoid infected persons. Key to identification is "slapped cheek" appearance. Child is not usually hospitalized as disease is self-limiting.

How is a child usually positioned after brain tumor surgery?

Flat or on either side

How many doses of PCV are given?

Four doses. started at two months of age. two subsequent doses are given at two-month intervals. should be completed by 15 months of age

Why are fractures of the epiphyseal plate a special concern?

Fractures of the epiphyseal plate (growth plate) may affect the growth of the limb

Why are fractures of the epiphyseal plate a special concern?

Fractures of the epiphyseal plate may affect the growth of the limb

Simple fx

Fx of the bone across its entire shaft with some possibly displacement without breaking the skin

What are the side effects of Dilantin (Phenytoin)?

Gingival hyperplasia, dermatitis, ataxia, GI distress

Girls finish growing around ______. Boys finish growing around ______.

Girls ~ 15 Boys ~ 17

With Iron Deficiency Anemia, nursing care should include _________________. Be sure to use a ______ to avoid _________

Give Iron on empty stomach with citrus juice (vitamin C enhances absorption), straw, staining teeth.

Describe the info families should be given when a child is receiving oral Fe preparations

Give oral Fe on an empty stomach and with Vitamin C. Use straws to avoid discoloring teeth. Tarry stools are normal. Increase dietary sources of Fe

Describe nursing interventions to reduce the workload of the heart

Give small, frequent feedings or gavage feedings. Plan frequent rest periods. Maintain a neutral thermal environment. Organize activities to disturb child only as indicated.

Children with Muscular Dystrophy will display ______ sign.

Gower's Sign (walking up own body)

What is the Gowers sign?

Gowers sign is an indicator of muscular dystrophy; to stand, the child has to "walk" hands up legs

The ________ will test the dried blood heel stick and screen for PKU

Guthrie Test

Human Papillomavirus Vaccine How many injections comprise the full course of vaccination and at what age should girls receive it? What age should boys receive it?

HPV vaccine is administered in three injections over six months. First dose, then the second dose 2 months later, followed by the final dose 6 months after the first. Girls can receive it around age 11 to 12. Boys can receive it from age 9 to 18. Guards against cervical cancer and genital warts in females and genital warts in males.

Which vaccine has decreased the incidence of epiglottitis?

Haemophilus influenzae type b (Hib) conjugated vaccine

Handedness is established during what age bracket? (Infant, toddler, preschool, school-age, adolescent)

Handedness is established in the preschool-age child (3-6 years)

In X-Linked Recessive Diseases, males _________ the disease but cannot __________.

Have, pass it on

Children with chronic OM are at risk for developing what problem?

Hearing loss

What is the most common postoperative complication following a tonsillectomy? Describe the signs and symptoms of this complication

Hemorrhage frequent swallowing, vomiting fresh blood, and clearing throat

What is the most common postop complication following a tonsillectomy? Describe the s/s of this complication

Hemorrhage. S/S: frequent swallowing, vomiting fresh blood, and clearing throat

Some Autosomal Dominant Diseases are

Huntington's, Marfans, Polydactyl, Achondroplasia, Polycystic Kidney Disease

Explain why hydration is a priority in treating sickle cell dz

Hydration promotes hemodilution and circulation of the red cells through the blood vessels

In Sickle Cell Disease, __________ is most important inorder to avoid a ______________.

Hydration, SC Crisis

Differentiate the signs of hypoglycemia and hyperglycemia

Hypoglycemia: tremors, sweating, HA, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around moth, nightmares. Hyperglycemia: polydipsia, polyuria, blurred vision, weakness, wt loss, and syncope

What is the physiologic reason for the lab finding of hypoproteinemia in nephrosis?

Hypoproteinemia occurs because the glomeruli are permeable to serum proteins

TET Spells are

Hypoxic episodes that are relieved by squatting or knee chest position

Methylphenidate (Ritalin) is prescribed for a child with attention deficit hyperactivity disorder (ADHD). The nurse provides instructions to the mother regarding the administration of the medication. Which statement by the mother would indicate a need for further instructions? a. I will administer the medication with the noontime meal b. I will keep the medication tightly capped and away from direct heat c. I should inform the school nurse that my child is taking this medication d. I should avoid giving the medications on Saturdays and Sundays to provide a medication holiday

I should avoid giving the medications on Saturdays and Sundays to provide a medication holiday

"Methylphenidate hydrochloride (Ritalin) is prescribed for a 10-year-old child diagnosed with attention deficit hyperactivity disorder, and the nurse provides instructions to the mother about administration of the medication. The nurse determines that the mother understands the instructions when the mother states:" a. I will give my child the medication at bedtime so that he will be rested and alert for school the next day b. I will give my child the medication after meals to obtain the full effects of the medication c. I will give my child the medication at breakfast and lunch to prevent insomnia d. I will give my child the medication with water to prevent kidney damage

I will give my child the medication at breakfast and lunch to prevent insomnia

A nurse caring for a child with congestive heart failure provides instructions to the parents regarding the administration of digoxin (Lanoxin). Which statement by the mother indicates a need for further instructions? a. if my child vomits after I give the medication, I will not repeat the dose b. I will check my child's pulse before giving the medication c. I will check the dose of the medication with my husband before I give the medication d. I will mix the medication with food

I will mix the medication with food

"A nurse is providing instructions to the mother of a child with a diagnosis of strabismus of the left eye, and the nurse reviews the procedure for patching the child. The nurse determines that the mother understands the procedure if the mother makes which statement?" a. I will place the patch on the right eye b. I will place the patch on both eyes c. I will place the patch on the left eye d. I will alternate the patch from the right to the left eye every hour

I will place the patch on the right eye

The adolescent (12-18 years) is in what stage of psychosocial development?

Identity vs. role confusion

Describe the postop nsg care for an infant with pyloric stenosis

Maintain IV hydration, and provide small, frequent oral feedings of glucose or electrolyte solutions or both w4ithin 4-6 hours. Gradually increase to full-strength formula. Position infant on right side in semi-Fowler position after feedings

What nsg actions are initiated for the newborn with suspeted esophageal atresia with TEF?

Maintain NPO immediately, and suction secretions

What are the priorities for a child undergoing abd surgery?

Maintain fluid balance (I&O, nasogastric suction, monitor electrolytes); monitor VS; care for drains, if present; assess bowel function; prevent infn of incisional area and other postop complications; and support child and family with appropriate teaching

List dietary sources of Fe.

Meat, green leafy vegetables, fish, liver, whole grains, legumes

List foods high in phenylalanine content

Meat, milk, dairy products, and eggs

Hypothyroidism can lead to

Mental Retardation

PKU can lead to

Mental Retardation

What are the outcomes of untreated congenital hypothyroidism?

Mental retardation and growth failure

What are the outomes of untx'd congenital hypothyroidism?

Mental retardation and growth failure

With Scoliosis, the child should be in a _____________ for _____ hours a day, and ________ after Surgery

Milwaukee Brace, 23 hrs/day, Log rolling

For a patient with RSV, use a _________ to provide O2 and ________.

Mist tent, Ribavirin

Appropriate toys and play for the hospitalized infant (birth to 1 year)?

Mobiles, rattles, squeaking toys, picture books, balls, colored blocks, activity boxes.

Describe the care of a child in a mist tent

Monitor child's temp; keep tent edges tucked in; keep clothing dry; assess resp status; look at child inside tent

when startled, baby symmetrically extends and abducts all extremities forefingers form a c shape? how long does this last for?

Moro; 3-4 months

X-linked recessive diseases are

Muscular Dystrophy, Hemophilia A

In a child with _____________ the nurse should cover it with moist sterile water dressing, and ____________ of it.

Myelomeningocele, keep pressure off

Haemophilus influenzae type b (Hib) is transmissible through which contact?

Nasopharyngeal/resiratory secretions. Droplet precautions and standard precautions are needed.

Post-Op tonsillectomy if frequent swallowing, vomiting blood, or clearing throat ________________. The highest risk of ______________ is in the first 24 hours and 5-10 days post-op with the cloughing of scabs.

Suspect bleeding, hemorrhage

Immunization Side Effects include _______________. For this, ____________________

T < 102, redness and soreness at injection site for 3 days; give Tylenol and bike pedal legs (passively) for child

Common cold does not contraindicate for _________

TB testing

With Iron Deficiency Anemia, expect stools to be ______ and limit ______

Tarry, milk intake to <32 oz/day

Concerning Pediatric Cardiovascular Disorders, if the child is cyanotic, suspect __________________________. _________ is common in cyanotic disorders.

Tetralogy of Fallot, Truncus Arteriosis, TVG; Polycythemia

The 3 T's of Cyanotic Heart Disease

Tetralogy, Truncus, Transposition

Which fontanel closes first?

The POSTERIOR fontanel. It closes in birth to 2-3 months. The anterior fontanel closes in 12-18 months.

A community health nurse is providing instructions to a group of mothers regarding the safe use of car seats for toddlers. The nurse determines that the mother of a toddler understands the instructions if the mother states which of the following? a. The care seat can be placed in a face-forward position when the height of the toddler is 27 inches b. The car seat should never be placed in a face-forward position c. the car seat can be placed in a face-forward position at any time d. The car seat is suitable for the toddler until the toddler reaches the weight of 40 pounds

The car seat is suitable for the toddler until the toddler reaches the weight of 40 pounds

Why are IV fluids important for a child with an increased resp rate?

The child is at riisk for dehydration and acid-base imbalance

Why are IV fluids important for a child with an increased respiratory rate?

The child is at risk for dehydration and acid-base imbalances

What instructions should a child with scoliosis receive about the Milwaukee brace?

The child should be instructed to wear the brace 23 hours per day; wear a T-shirt under brace; check skin for irritation; perform back and abd exercises, and modify clothing. The child should be encouraged to maintain normal activities as able

Describe the purpose of bronchodilators

To reverse bronchospasm

How would you elicit the rooting reflex?

Touch infants lip, cheek, or corner of mouth with finger.

TEF = The 3 C's of TEF

Tracheoesophageal Atresia, coughing, choking, cyanosis

Describe the sequence of events in a vaso-occulsive crisis in sickle cell anemia

a vaso-occulsive crisis is caused by the clumping of red blood cells, which blocks small blood vessels; therefore, the cells cannot get through the capillaries, causing pain and tissue and organ ischemia. Lowered oxygen tension affects HgbS, which causes sickling of the cells

Older kids with IICP will have

a widened pulse pressure

A nurse prepares to administer digoxin (Lanoxin) to a newborn infant with a diagnosis of congestive heart failure. The nurse notes that the apical rate is 140 beats per minute. Which of the following nursing actions is appropriate? a. administer the digoxin because the apical rate is within normal limits b. recheck the apical rate in 1 hour and administer the medication at that time c. notify the physician because the apical rate is lower than the normal range d. hold the medication, because the apical rate is normal, indicating that the medication is not needed

a. administer the digoxin because the apical rate is within normal limits

"A hospitalized toddler cries when anyone enters the room, and kicks, yells, and clings to the parents if they try to leave. Based on these data, the nurse determines that the priority nursing diagnosis is:" a. fear related to unfamiliar surroundings b. deficient divisional activity related to developmental stage c. compromised family coping related to the sick child d. delayed growth and development related to overprotective parenting

a. fear related to unfamiliar surroundings

A 4-year-old child is reluctant to take deep breaths after abdominal surgery. The most effective measure to encourage deep breathing is to: a. have the child pretend he is the big, bad wolf blowing the little pig's house down b. give the child colorful latex balloons to blow up c. tell the child to exhale forcefully through the peak flow meter d. administer chest percussion in several postural drainage positions

a. have the child pretend he is the big, bad wolf blowing the little pig's house down

A 9-month-old infant is admitted to a pediatric unit with a diagnosis of dehydration and malnutrition and suspected failure to thrive. Child neglect is suspected. Which of the following would be most important for the nurse to observe when the parents visit the infant? a. the parents' level of concern about the child b. the parents' patterns of visitation c. the parents' interactions with one another d. clues regarding the nutritional patterns of the other children in the family

a. the parents' level of concern about the child

"A client with gastroesophageal reflux disease (GERD) complains of chest discomfort that feels like heartburn, especially following each meal. After teaching the client to take antacids as prescribed, the nurse suggests that the client lie in which position during sleep?" a. with the head of the bed elevated 6 to 8 inches b. flat c. supine with the head of the bed flat d. on the stomach with the head of the bed flat

a. with the head of the bed elevated 6 to 8 inches

What are the signs and symptoms of compartment syndrome?

abnormal neurovascular assessment; cold extremity, severe pain, inability to move the extremity and poor capillary refill

A nurse is caring for a child after an inguinal hernia repair. Which finding would indicate that the surgical repair was effective? a. abdominal distention b. absence of inguinal swelling with crying c. a clean, dry incision d. an adequate flow of urine

absence of inguinal swelling with crying

what is a major cause of death in children and adolescents?

accidents

with the pediatric client physiologic responses to pain are most on seen in response to______rather than in response to chronic pain

acute pain

A nurse prepares to administer digoxin (Lanoxin) to a newborn infant with a diagnosis of congestive heart failure. The nurse notes that the apical rate is 140 beats per minute. Which of the following nursing actions is appropriate? a. administer the digoxin because the apical rate is within normal limits b. recheck the apical rate in 1 hour and administer the medication at that time c. notify the physician because the apical rate is lower than the normal range d. hold the medication, because the apical rate is normal, indication that the medication is not needed

administer the digoxin because the apical rate is within normal limits

which age group has their major concern being a change in body image

adolescents

Common childhood problems are encountered by nurses caring for children in community of hospital settings. The child's ______ directly influences the severity and management of these problems

age

"When administering a liquid medication to an uncooperative toddler, the nurse would implement which strategy?" a. allow the parents to remain the room b. remove the child to another room away from the parents c. restrain the child in a high chair d. restrain the child in a papoose restraining device

allow the parents to remain the room

What antibiotics are usually prescribed for bacterial meningitis?

ampicilin, ceftriazzone, chloramphenicol

Nursing interventions and medical treatment for a child with leukemia are based on what three physiologic problems?

anemia (decreased erythrocytes) infection (neutropenia) bleeding thrmbocytopenia (decreased platelets)

What early signs should the nurse assess for if lead poisoning is suspected?

anemia, acute cramping, abdominal pain, vomiting, constipation, anorexia, headache, lethargy, hyperactivity, aggression, impulsiveness, decreased interest in play, irritability, short attention span

list the signs and symptoms of iron deficiency

anemia; pale conjunctive; pale skin; atrophy of papillae on tongue; brittle, ridged, or spoon-shaped nails; and thyroid edema

A client with gastroesophageal reflux disease (GERD) has just received a breakfast tray. The nurse setting up the tray for the client notices that which of the following foods is the only one that will increase the lower esophageal sphincter (LES) pressure and thus lessen the client's symptoms? a. fresh scrambled eggs b. nonfat milk c. whole wheat toast with butter d. coffee

b. nonfat milk

A 4-year-old child who was recently hospitalized is brought to the clinic by his mother for a follow-up visit. The mother tells the nurse that the child has begun to wet the bed ever since the child was brought home from the hospital. The mother is concerned and asks the nurse what to do. The appropriate nursing response is which of the following? a. you need to discipline the child b. this is a normal occurrence following hospitalization c. we will need to discuss this behavior with the physician d. the child probably has developed a urinary tract infection

b. this is a normal occurrence following hospitalization

when sole of foot is stoked from heel to ball, toes hyper-extend and fan apart from big toe. how long does it last for? how long does it last for

babinski; 1 year to 18 months

Why is genetic counseling important for the family of a child with cystic fibrosis?

because the disease is autosomal recessive in its genetic pattern

Methylphenidate (Ritalin) is prescribed for a child with a diagnosis of attention deficit hyperactivity disorder (ADHD). The nurse provides instructions to the mother regarding the administration of the medication and tells the mother to administer the medication: a. before dinner and at bedtime b. before breakfast and before the noontime meal c. in the morning after breakfast and at bedtime d. at the noontime and evening meals

before breakfast and before the noontime meal

Involving death, a schoolage child can

begin to understand something is wrong

Rheumatic Fever is preceded by _________________. A large Rheumatic Fever characteristic is ______________________. Other characteristics are ___________________________.

beta hemolytic strep infection, erythema Marginatum = Rash; Chest pain, shortness of breath (Carditis), migratory large joint pain, tachycardia (even during sleep)

What is the best way to administer oxygen to a toddler?

blow-by oxygen

toddlers are learning to name body parts and are concerned about their? _____(what)?

body parts

at what age does the birth weight double?

by 6 months

when does the birth length double ?

by four years

"A nurse gathers assessment data from a client admitted to the hospital with gastrointestinal reflux disease (GERD) who is scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse determines that the client may be at risk for which complication?" a. diarrhea b. belching c. aspiration d. abdominal pain

c. aspiration

When giving an intramuscular injection to a 4-year-old child the nurse should: a. use the vastus lateralis muscle only b. allow the child to choose between a lying or a standing position c. obtain assistance to administer the injection d. distract the child with conversation or a toy

c. obtain assistance to administer the injection

A nurse is preparing a plan of care for a child being admitted to the hospital with a diagnosis of congestive heart failure (CHF). The nurse avoids including which of the following in the plan? a. limiting the time the child is allowed to bottle-feed b. elevating the head of the bed c. walking the child for feeding to ensure adequate nutrition d. providing oxygen during stressful periods

c. walking the child for feeding to ensure adequate nutrition

A mother of a 3-year-old child calls a neighbor who is a nurse and tells the nurse that her child just ate the mouse poison that was stored in a cabinet. The nurse would instruct the mother to take what action immediately? a. call the poison control center b. give the child a glass of carbonated beverage to drink c. take the child to the ER d. try to determine how much mouse poison the child consumed

call the poison control center

In X-Linked Recessive Diseases, females are ________ but ___________ have the disease.

carriers, dont ever

when caring for a preschool child explain that he or she did not ? and that painful procedures are not a ? for misdeeds

cause the illness; punishment

A nurse is providing home care instructions to the parents of an infant who had surgical repair of an inguinal hernia. The nurse instructs the parents to do which of the following to prevent infection at the surgical site? a. change the diapers as soon as they become damp b. report a fever immediately c. soak the infant in a tub bath twice a day for the next 5 days d. restrict the infant's physical activity

change the diapers as soon as they become damp

What discharge instructions should be included concerning a child with spica cast?

check child's circulation keep cast dry do no place anything under cast prevent cast soilage during toileting or diapering do not turn child using an abductor bar

Describe the preoperative nursing care for a child with Hirschsprung disease

check vital signs and take axillary temperatures provide bowel cleansing program and teach about colostomy observe for bowel perforation measure abdominal girth

A nurse caring for a child with congestive heart failure provides instructions to the parents regarding the administration of digoxin (Lanoxin). Which statement by the mother indicates a need for further instructions? a. if my child vomits after I give the medication, I will not repeat the dose b. I will check my child's pulse before giving the medication c. I will check the dose of the medication with my husband before I give the medication d. I will mix the medication with food

d. I will mix the medication with food

A nurse is caring for a child with a diagnosis of congestive heart failure (CHF). The nurse avoids which action in caring for the child? a. allowing uninterrupted rest periods b. limiting the time the child is allowed to bottle-feed c. providing oxygen during stressful periods d. keeping the head of the bed flat

d. keeping the head of the bed flat

what is compartment syndrome?

damage to nerves and vasculature of an extremity due to compression

what are common signs of digoxin toxicity?

diarrhea fatigue weakness nausea vomiting check for bradycardia before administering

describe the mechanism of inheritance of Duchenne muscular dystrophy

duchenne muscular dystrophy is inherited as an X-linked recessive trait

what is the relationship between hypoglycemia and exercise?

during exercise, insulin uptake is increased and the risk for hypoglycemia occurs

No MMR immunization for kids with Hx of allergic rxn to ________ or __________

eggs or neomycin

At what age is a child's airway fully developed?

eight years of age

A nurse develops a plan of care for a one-month-old infant hospitalized for intussusception. Which nursing measure would be most effective to provide psychosocial support for the parent-child relationship? a. encourage the parents to go home and get some sleep b. encourage the parents to room-in with their infant c. provide educational materials d. initiate home nutritional support as early as possible

encourage the parents to room-in with their infant

during hospitalization, ______(what) from parents is the greatest threat to the toddlers psychological and emotional integrity

enforced separation

Do not examine the throat of a child with

epiglotitis (i.e. do not put a tongue blade or any object into the throat) because of the risk of obstructing the airway completely. Prepare for intubation or trach

Involving death, an adolescent may

express fear, withdrawal, and denial

What care is needed for a client with a temporary colostomy?

family needs education about skin care and appliances referral to an enterostomal therapist is appropriate

_____by procedures is common. a______may be quite helpful in restoring body integrity

fear of mutilation; band-aide

Sickle Cell Crisis is characterized by

fever, abd pain, painful edematous hands and feet (hand-foot syndrome), arthralgia

A toddler is admitted to the hospital for fever of unknown origin. The mother's time at the hospital is limited to the hours that her other children are in school. The nurse shows an understanding of a toddler's psychosocial development by making which statement to the mother? a. it is better to leave without saying good-bye, so your child will not be upset b. your child is too old to be having separation anxiety. Crying is just a way for children to control parents c. your child is egocentric, which allows a child to self comfort d. games like peek-a-boo and hide and seek will help your child understand that you will return

games like peek-a-boo and hide and seek will help your child understand that you will return

what are the side effects of Dilantin?

gingival hyperplasia dermatitis ataxia GI distress

Girls' growth spurt as early as ____ years. Boys catch up around age ___

girls: 10 years, boys: ~ 14

describe the information families should be given when a child is receiving oral iron prepartions

give oral iron on an empty stomach and with vitamin C use straws to avoid discoloring teeth tarry stools are normal increase dietary sources of iron

Describe nursing interventions to reduce the workload of the heart

give small, frequent feedings or gavage feedings plan frequent rest periods maintain a neutral thermal environment organize activities to disturb child only as indicated

Use facts and principles related to ___________ ____ ____________ in planning teaching interventions.

growth and development

A nurse is assessing a child admitted to the hospital with a diagnosis of rheumatic fever. The nurse asks the child's mother which significant question during the assessment? a. has your child had difficulty urinating? b. has any family member had a sore throat within the past few weeks? c. has any family member had a gastrointestinal disorder in the past few weeks? d. has your child been exposed to anyone with chickenpox?

has any family member had a sore throat within the past few weeks?

A nurse is collecting data on a child suspected of having rheumatic fever. The nurse plans to obtain specific data regarding recent illnesses in the child and asks the parent which question? a. has the child had a recent streptococcal infection of the throat? b. has the child had a recent ear infection? c. has the child had a recent case of otitis media? d. has the child had a recent case of pneumonia

has the child had a recent streptococcal infection of the throat?

Children with chronic otitis media are at risk for developing what problem?

hearing loss

A home care nurse is instructing the mother of a child with cystic fibrosis (CF) about the appropriate dietary measures. The nurse tells the mother that the child needs to consume a: a. low calorie, low fat diet b. high calorie, high protein diet c. low calorie, low protein diet d. high calorie, restricted fat

high calorie, high protein diet

What contraindicates administration of MMR?

history of anaphylactic reaction to eggs or meomycin contraindicate administration

Differentiate the signs of hypoglycemia and hyperglycemia

hypoglycemia: tremors, sweating, headache, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around mouth, nightmares hyperglycemia: polydipsia,polyuria, ployphagia, blurred vision, weakness, weight loss, and syncope

what is the physiologic reason for the lab finding of hypoproteinemia in nephrosis?

hypoproteinemia occurs because the glomeruli are permeable to serum protieins

what is the Erickson's theory for the adolescent?

identity vs role confusion

Pertinent information should be obtianed prior to giving certain _________ because __________ to previous ________________ or current health condition may contraindicate current ______________

immunizations, reactions, immunizations, immunizations

list two contraindications to live virus immunization

immunocompromised child a child in a household with an immunocompromised individual

A child is admitted to the hospital with a diagnosis of acute rheumatic fever. The nurse analyzes the laboratory results and determines that which of the following findings would confirm the likelihood of acute rheumatic fever? a. increased leukocyte count b. decreased hemoglobin count c. increased antibody level d. decreased erythrocyte sedimentation rate

increased antibody level

A child is admitted to the hospital with a diagnosis of acute rheumatic fever. The nurse reviews the blood laboratory findings knowing that which of the following will confirm the likelihood of this disorder? a. increased leukocyte count b. decreased hemoglobin count c. increased antistreptolysin-O (ASO) d. decreased erthrocyte sedimentation rate

increased antistreptolysin-O (ASO)

A 2-year-old child is admitted to the hospital with juvenile rheumatoid arthritis (JRA). During the focused assessment, the nurse makes it a priority to note the presence of which of the following?" a. increased irritability and the child's insistence to be carried out b. complaints of joint stiffness c. history of daily temperature elevations d. description of how difficult it is to move around after periods of inactivity

increased irritability and the child's insistence to be carried out

what is the Erickson's theory?

industry vs inferiority

School age children are in Erickson's stage of ________, meaning they like to do and accomplish things. _____ are also becoming important for children of this age

industry, peers

What teaching should parents of a newly shunted child receive?

information about signs of infection and increased ICP; understanding that shunt should not be pumped and that child will need revisions with growth; guidance concerning growth and development

what is the erikson's theory for a preschool child?

initiative vs guilt

The use of ___________ is no longer recommended

ipecac syrup

List the signs and symptoms of increased ICP in older children

irritability change in LOC motor dysfunction headache vomiting unequal pupil response seizures

"A newborn infant is diagnosed with hypospadias, and the mother asks the nurse about the disorder. The nurse bases the response on which of the following?" a. it is a congenital anomaly in which the actual opening of the urethra meatus is below the normal placement on the glans penis b. it occurs when one or both testes fail to descend through the inguinal canal into the scrotal sac c. it is a congenital anomaly in which the actual opening of the urethral meatus is dorsal to the urethral opening d. it is a congential anomaly characterized by the extrusion of the urinary bladder to the outside of the body

it is a congenital anomaly in which the actual opening of the urethra meatus is below the normal placement on the glans penis

what is the genetic transmission pattern of hemophilia?

it is an X-linked recessive chromosomal disorder transmitted by the mother and expressed in male children

A student nurse examines an Asian American infant's eyes and notes that the infant's eyes are crossed. The registered nurse asks the student to interpret the finding. Which statement by the student indicates an understanding of this assessment finding? a. it probably isn't strabismus but appears that way because of the child;s ethnic background b. you will want to call the pediatrician immediately because this could lead to detached retina c. it probably is strabismus because the baby's mother has abused tranquilizers d. strabismus isn't life threatening but it requires surgery in the first 2 months to prevent the crossed eyes from being a life long condition

it probably isn't strabismus but appears that way because of the child;s ethnic background

what should families and clients do to avoid triggering sickling episodes?

keep child well hydrated avoid known sources of infection avoid high altitudes avoid strenuous exercises

A nurse is caring for a child with a diagnosis of congestive heart failure (CHF). The nurse avoids which action in caring for the child? a. allowing uninterrupted rest periods b. limiting the time the child is allowed to bottle-feed c. providing oxygen during stressful periods d. keeping the head of the bed flat

keeping the head of the bed flat

"A client is unable to expectorate sputum for a sputum sample, and the nurse is preparing to obtain the sample via saline inhalation. The nurse instructs the client to inhale the warm saline vapor via nebulizer by:" a. hold the nebulizer under the nose b. keeping the lips closed lightly over the mouthpiece c. keeping the lips closed tightly over the mouthpiece d. alternating one vapor breath with one breath from room air

keeping the lips closed lightly over the mouthpiece

what position would best relieve the child experiencing a tet spell?

knee-chest position or squatting

What are the symptoms of congenital hypothyroidism in early infancy?

large, protruding tongue; coarse hair; lethargy; sleepiness and constipation

More _____ is absorbed on an empty stomach.

lead, Hot water can contain higher levels of lead because it dissolves lead more quickly than cold water, so use only cold water for consumption (drinking and especially for making infant formula)

what task could a 5 year old boy with diabetes expect to accomplish by himself?

let him choose the injection sites

A clinic nurse is performing an assessment on a child. Which finding indicates the presence of an inguinal hernia? a. painless inguinal swelling that appears when the child cries or strains b. complaints of difficulty defecating c. complaints of a dribbling urinary stream d. absence of the tests with scrotum

painless inguinal swelling that appears when the child cries or strains

when examiners finger is placed in the infants palm, the newborn will curl his or her fingers around the examiners finger? how long will this last for?

palmar grasp; 3-4 months

What nutritional support should be provided for a child with cystic fibrosis?

pancreatic enzyme replacement, fat-soluble vitamins, and moderate to low carbohydrates, high protein, moderate to high fat diet

A nurse is assessing a child after hydrostatic reduction for intussusception. The nurse would expect to observe which finding after this procedure? a. severe colicy-type pain with vomiting b. currant jelly like stools c. passage of barium or water soluble contrast with stools d. severe abdominal distention

passage of barium or water soluble contrast with stools

"When obtaining a history from parents of a 5 month old child suspected of having intussusception, which assessment area would be most important for the nurse to address?" a. pattern of abdominal pain b. known allergies c. dietary intake during the past 24 hours d. usual pattern of bowel movements

pattern of abdominal pain

A clinic nurse is providing home care instructions to the mother of a 3-year-old child with a diagnosis of vomiting and diarrhea due to gastroenteritis. The nurse instructs the mother to give the child which of the following to maintain hydration status? a. popsicles b. soda pop c. apple juice d. pedialyte

pedialyte (oral electrolyte solution)

What medications are used to treat rheumatic fever?

penicllin, erythromycin, and aspirin

Breathing exercises and postural drainage is prescribed for a child with cystic fibrosis. A nurse implements these procedures by telling the child to: a. perform the postural drainage, then the breathing exercises b. perform the breathing exercises, then the postural drainage c. schedule the procedures so they are 4 hours apart d. perform postural drainage in the morning and breathing exercises in the evening

perform the postural drainage, then the breathing exercises

A 5-year-old child is admitted to the hospital for heart surgery to repair the tetralogy of Fallot. The nurse reviews the child's record and notes that the child has clubbed fingers. The nurse understands that the clubbing is most likely caused by: a. peripheral hypoxia b. delayed physical growth c. chronic hypertension d. destruction of bone marrow

peripheral hypoxia

For infants with IICP, treat with ____________ shunt. Do not _________ the shunt.

peritoneal shunt, do not pump

Aspartame (NutraSweet) has ____________ in it and should not be given to a PKU patient

phenylalanine

list three classic signs and symptoms of measles

photophobia confluent rash that begins on the face and spreads downward Koplik spots on the buccal mucosa

"A 10-month-old infant is hospitalized for respiratory syncytial virus (RSV). Using knowledge of growth and development according to Erik Erikson and Jean Piaget, the nurse should do which of the following to meet the infant's developmental needs?" a. wash hands, wear a mask and keep the infant as quiet as possible b. follow the home feeding schedule and allow the infant to be held only when the parents visit c. restrain the infant continuously to prevent tubes from being dislodged d. provide a consistent routine, as well as touching, rocking, and cuddling throughout the hospitalization

provide a consistent routine, as well as touching, rocking, and cuddling throughout the hospitalization

describe the nursing care of a child with ketoacidosis

provide care for an unconscious child, administer regular insulin IV in normal saline, monitor blood gas values and maintain strict I/O

with toddlers what is the main type of toy as far as toys are concered?

push-pull

what are the two objectives in treating CHF?

reduce the workload of the heart increased cardiac output

A nurse is teaching the client taking medications by inhalation about the advantages of a newly prescribed spacer device. The nurse determines the need for further teaching if the client states that the spacer device: a. reduces the frequency of medication to only once per day b. reduces the chance of yeast infection because large drops arn't deposited on the oral tissues c. disperses medication more deeply and uniformly d. reduces the need to coordinate timing between pressing the inhaler and inspiration

reduces the frequency of medication to only once per day

describe why a barium enema is used to treat intussusception

reduces the telescoping of the intestine through hydrostatic pressure without surgical interventions

"A nurse is caring for a child with intussusception. During care, the child passes a normal brown stool. The most appropriate nursing action is to:" a. report the passage of a normal brown stool to the physician b. prepare the child and parents for the possibility of surgery c. note the child's physical symptoms d. prepare the child for hydrostatic reduction

report the passage of a normal brown stool to the physician

List seven signs of respiratory distress in a pediatric client

restlessness tachycardia tachypnea diaphoresis flaring nostrils retractions grunting

which reflex? baby turns toward stimulus when cheek or corner of lip is touched. how long does it last?

rooting; 3-4 months

what should be verified prior to administration a pain medication to a pediatric client ?

safe does based on weight

CF Kids taste _________ and need __________________ on their food.

salty, enzymes sprinkled

at what age is egocentric thinking replaced by social awareness of others?

school age

which age group fear loss of control of their bodies?

school-age

at what age does the loss of primary teeth and eruption of most permanent teeth occurs

school-age child

The community health nurse is providing a yearly summer educational session to parents in a local community. The topic of the session is prevention and treatment measures for poison ivy. The nurse instructs the parents that if the child comes in contact with poison ivy they should: a. immediately bring the child to the ER b. not be concerned if a rash is not noted on the skin c. shower the child immediately, lathering and rinsing the child several times d. apply calamine lotion immediately to the exposed skin areas

shower the child immediately, lathering and rinsing the child several times

What are the physical features of a child with down syndrome?

simian creases in palms, hypotonia, protruding tongue, and upward-outward slant of eyes

Foreign body aspirations is common in which age group?

six months to five years

How is skeletal traction applied?

skeletal traction is maintained by pins or wires applied to the distal fragment of the fracture

when infant is held in upright position with feet touching a hard surface, walking motions are made? how long does it last for?

stepping; 3-4 months

What nursing interventions increase intracranial pressure?

suctioning and positioning, turning

IICP can be caused by

suctioning, coughing, straining, and turning

Clinical manifestations of bronchiolitis include?

tachypnea, tachycardia, adventitious breath sounds, retractions, apneic episodes

A client is taking albuterol (Ventolin) by inhalation but cannot cough up secretions. The nurse teaches the client to do which of the following to best help clear the bronchial secretions? a. administer an extra dose before bedtime b. take in increased amounts of fluids every day c. get more exercise each day d. Use a dehumidifier in the home

take in increased amounts of fluids every day

what is common with the toddler age group?

temper tantrums

"A 12-year-old child is seen in the health care clinic. During the assessment, which finding would suggest to the nurse that the child is experiencing a disruption in the development of self-concept?" a. the child has a part-time babysitting job b. the child enjoys playing chess and mastering new skills with this game c. the child has many friends d. the child has an intimate relationship with a significant other

the child has an intimate relationship with a significant other

What instructions should a child with scoliosis receive about a skeletal brace?

the child should be instructed to wear brace 23 hours per day; wear T-shirt under brace; check skin for irritation; perform back and abdominal exercises; and modify clothing. The child should be encouraged to maintain normal activities as able

"A child with a tracheal obstruction is brought to the emergency room by emergency medical services. The child has aspirated a marble, and the foreign body is removed in the emergency room by direct laryngoscopy. After the procedure, the nurse informs the mother of the child that:" a. the child will need to be hospitalized for observation b. the child may go home with a prescription for antibiotics c. the child will need to return to the hospital for a chest x-ray in 1 week d. the child will require a bronchoscopy for follow up evaluation in 1 month

the child will need to be hospitalized for observation

A client with diplopia has been given an eye patch to promote better vision and prevent injury. The nurse teaches the client to do which of the following as part of correct use of this item? a. wear the patch continuously, alternating eyes each day b. wear the patch continuously, alternating eyes each week c. use the patch only when vision is exceptionally blurry d. put the patch on for an hour, and then take it off for an hour

wear the patch continuously, alternating eyes each day

What measurements reflect present nutritional status?

weight, skin-fold thickness, and arm circumference

Signs and symptoms in croup include:

wheezing, harsh cough, hoarseness, dyspnea

"A client taking albuterol (Ventolin) experiences a severe episode of wheezing, which the nurse interprets as bronchospasm. A telephone call is made to the physician's office to report the occurrence. The nurse does which of the following while waiting for the physician to return the call?" a. administer the next dose of albuterol as scheduled b. withholds the next dose of albuterol c. administer a double dose of albuterol d. administers half the dose of albuterol

withholds the next dose of albuterol

Are RSV infections contagious?

yes