Peds Respiratory

When giving tips for how to increase humidity in the home of a child with a respiratory tract infection, the nurse should emphasize that the primary concern is to ensure that the child has: a) A steam vaporizer b) A warm humidification source c) A safe humidification source d) A cool humidification source

A safe humidification source

Of the following children, the one who is most likely to be hospitalized for treatment of croup is: a) A 2 year old child whose croupy cough worsens at night b) A 5 year old child whose croupy cough worsens at night c) A 2 year old child using accessory muscles to breath d) A child with inspiratory stridor during the physical examination

A 2 year old child whose croupy cough worsens at night

RSV is: a) An uncommon virus that usually causes severe bronchiolitis b) An uncommon virus that usually does not require hospitalization c) A common virus that usually causes severe bronchiolitis d) A common virus that usually does not require hospitalization

A common virus that usually does not require hospitalization

What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)? A. Meconium ileus B. History of poor intestinal absorption C. Foul-smelling, frothy, greasy stools D. Recurrent pneumonia and lung infections

A. Meconium ileus

Because the absorption of fat-soluble vitamins is decreased in children with CF, supplementation of which vitamins is necessary?

A, D, E, K

The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. Which of the following statements by the parent would indicate a correct understanding of the teaching? A. "I can use an ice collar on my child for pain control along with analgesics." B. "My child should clear the throat frequently to clear the secretions." C. "I should allow my child be as active as tolerated." D. "My child should gargle and brush teeth at least three times per day."

A. "I can use an ice collar on my child for pain control along with analgesics."

5 year old brought to the ED with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. What to do expect is the cause? most appropriate interventions?

Acute Epiglottitis. vital signs, medical history, assessment of breath sounds, emergency airway equipment readily available

It is generally recommended that a child with acute streptococcal pharyngitis can return to school:

After taking antibiotics for 24 hours

A child with a respiratory disorder who needs bed rest but who is not cooperating. The nurse's best choice is to: a) Be sure child's mother takes the advice seriously b) Allow the child to play quietly on the floor c) Insist that the child play quietly in bed d) Allow the child to cry until he stays in bed

Allow the child to play quietly on the floor

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. This medication should be administered: A. after chest physiotherapy (CPT). B. before CPT. C. after receiving 100% oxygen. D. before receiving 100% oxygen.

B. before CPT.

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). This drug: A. is given subcutaneously. B. may cause voice alterations. C. may cause mucus to thicken. D. is not indicated for children younger than age 12 years.

B. may cause voice alterations.

A 7-month-old with laryngotracheobronchitis is admitted to the pediatric unit. What actions would the nurse expect to take while caring for this infant? (Select all that apply.) A. Administer nonhumidified oxygen. B. Listen to the lung sounds. C. Keep the crying infant in the crib. D. Assess hydration status. E. Monitor the heart rate after racemic epinephrine is given. F. Encourage the mother to hold the infant if helpful.

Answer: B, D, E, F

A child, age 4 years, tells the nurse that she "needs a Band-Aid" where she had an injection. Which of the following is the best nursing action?

Apply a Band-Aid.

Asthma is now classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include all of the following except: a) Lung function b) Associated allergies c) Frequency of symptoms d) Frequency and severity of exacerbations

Associated allergies

Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?

Be persistent through 10 to 15 minutes of food refusal.

Most children with croup syndromes: a) Require hospitalization b) Will need to be intubated c) Can be cared for at home d) Are over 6 years old

Can be cared for at home

One of the goals for children with asthma is to prevent respiratory tract infection. This is because respiratory tract infection does which of the following? a) Increases sensitivity to allergens b) Causes exercise-induced asthma c) Lessens effectiveness of medications d) Can trigger an episode or aggravate asthmatic state

Can trigger an episode or aggravate asthmatic state

Apnea of infancy has been diagnosed in an infant scheduled for discharge with home monitoring. Part of the infant's discharge teaching plan should include?

Cardiopulmonary resuscitation (CPR)

What is a major nursing intervention to do for families with children that have respiratory illnesses?

Caution parents that many cold remedies have acetaminophen

Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include which of the following? A. Give pancreatic enzymes between meals if at all possible. B. Do not administer pancreatic enzymes if child is receiving antibiotics. C. Decrease dose of pancreatic enzymes if child is having frequent, bulky stools. D. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at beginning of meal.

D. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at beginning of meal.

An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires the following isolation:

Contact Precautions.

Fluticasone and salmeterol (advair) budesonide and formoterol (Symbicort) mometasone and formoterol (Dulera) these are combination drugs that are both under category of ____ and _____

Corticosteroid and long acting beta 2 agonist

beclomethasone (Qvar) budesonide (Pulmicort) flunisolide (Aerospan) Fluticasone (Flovent, Veramyst) mometasone (asmanex) They are all under what category and is used for _____ term control

Corticosteroid; Long

The nurse is preparing a staff education program about pediatric asthma. Which of the following concepts should the nurse include when discussing the asthma severity classification system? Select all that apply. A. Children with mild persistent asthma have nighttime symptoms less than two times a month. B. Children with moderate persistent asthma use a short-acting β-agonist more than two times per week. C. Children with severe persistent asthma have a peak expiratory flow (PFE) of 60% to 80% of predicted value. D. Children with mild persistent asthma have symptoms more than two times per week. E. Children with moderate persistent asthma have some limitations with normal activity. F. Children with severe persistent asthma have frequent nighttime symptoms.

D. Children with mild persistent asthma have symptoms more than two times per week. E. Children with moderate persistent asthma have some limitations with normal activity. F. Children with severe persistent asthma have frequent nighttime symptoms.

In providing nourishment for a child with cystic fibrosis (CF), which of the following factors should the nurse keep in mind? a) Fats and proteins must be greatly curtailed b) Diet should be high in calories and protein c) Most fruits and vegetables are not well tolerated d) Diet should be high in easily digested carbohydrates and fats

Diet should be high in calories and protein

The nurse should suspect epiglottitis if the child has: a) Cough, sore throat, and agitation b) Cough, drooling, and retractions c) Drooling, agitation, and absence of cough d) Hoarseness, retractions, and absence of cough

Drooling, agitation, and absence of cough

When planning care for a 4 month old child admitted with respiratory distress caused by respiratory syncytial virus (RSV) and bronchiolitis, it is essential to include which of the following? a) Give antibiotics b) Ensure adequate hydration c) Administer cough syrup d) Feed 4oz of formula every 4 hours

Ensure adequate hydration

Of the following croup syndromes, the one that is potentially life threatening is: a) Spasmodic croup b) Laryngotracheobronchitis c) Acute spasmodic laryngitis d) Epiglottitis

Epiglottitis

Which of the following types of croup is always considered a medical emergency? a) Laryngitis b) Epiglottitis c) Spasmodic croup d) Laryngotracheobronchitis

Epiglottitis

When assessing for hypertension in an infant, the nurse will expect the infant to exhibit which signs?

For adolescents and older children: · Frequent headaches · Dizziness · Changes in vision For infants or young children: · Irritability · Head banging or head rubbing · Waking up screaming in the night

Which of the following is an appropriate action when an infant becomes apneic?

Gently stimulate trunk by patting or rubbing.

What is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?

Give small amounts of favorite fluids frequently to prevent dehydration

What is epiglottitis caused by

H. influenzae

In the child who is suspected of having epiglottitis, the nurse should: a) Have intubation equipment available b) Prepare to immunize the child for H. influenzae c) Obtain a throat culture d) All of the above

Have intubation equipment available

Nurse is teaching an adolescent how to self-administer a corticosteroid per dry powder inhalation (DPI). What is the appropriate teaching

Inhale after medication administration and rinse and expectorate after administrations

Which statement accurately expresses the genetic implications of cystic fibrosis (CF)? a) It is inherited as an autosomal dominant trait b) It is a genetic defect found primarily in non-Caucasian population groups c) If it is present in a child, both parents are carriers of this defective gene d) There is a 50% chance that siblings of an affected child will also be affected

If it is present in a child, both parents are carriers of this defective gene

Clinical manifestations of failure to thrive (FTT) in a 13-month-old may include which of the following?

Irregularity in activities of daily living

How do you treat epiglottitis

with O2, anti-inflammatory meds like corticosteriods, antibiotics

The most profound complication of prolonged middle ear disorders is:

Loss of hearing

which of the following should be included in teaching about a peak flow meter?

zero the meter before each use, perform three attempts, stand upright while doing this, hard fast breathe for accurate measurements, the highest number achieved should be recorded.

The most likely reason that the respiratory tract infection rate increases drastically in the age range from 3 to 6 months is that the: a) Infant's exposure to pathogens is greatly increased during this time b) Viral agents that are mild in older children are severe infants c) Maternal antibodies have disappeared and the infant's own antibody production is immature d) Diameter of the airways is smaller in the infant than in the older child

Maternal antibodies have disappeared and the infant's own antibody production is immature

Cystic fibrosis may affect one system or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations?

Mechanical obstruction caused by increased viscosity of exocrine gland secretions

An appropriate nursing intervention when caring for a child with pneumonia is which of the following? a) Avoid placing child on affected child b) Monitor respiratory status frequently c) Place in Trendelenburg position d) Administer antitussive agents around the clock

Monitor respiratory status frequently

What clinical manifestation would the nurse expect when a pneumothorax occurs in a neonate who is undergoing mechanical ventilation?

Nasal flaring and retractions

Skin testing for tuberculosis (TB) is recommended: a) Every year for all children older than 2 years b) Every year for all children older than 10 years c) Every 2 years for all children starting at age 1 year d) Periodically for children who are high-risk populations

Periodically for children who are high-risk populations

______ or whooping cough, is an acute respiratory tract infection caused by Bordetella pertussis that occurs primarily in children less than 4 years old who have not been immunized. It is highly contagious and is particularly threatening in young infants,

Pertussis

One of the goals for children with asthma is to prevent respiratory infection. Why?

Respiratory infections can trigger an episode or aggravate an asthmatic state

Treating a child with strep with antibiotics will prevent?

Rheumatic Fever

Infectious mononucleosis is usually a: a) Disease complicated by pneumonitis and anemia b) Self-limiting disease c) Disabling disease d) Difficult and prolonged disease

Self-limiting disease

The severity of asthma in a child with daily asthmatic symptoms would be classified as: a) Mild intermittent b) Mild persistent c) Moderate persistent d) Severe persistent

Severe persistent

Albuterol and levabuterol are under what category

Shortacting beta 2 agonist

In about half of all cases of infectious mononucleosis, there will be: a) Skin rash b) Otitis media c) Splenomegaly d) Difficult and prolonged disease

Splenomegaly

The nurse is interviewing the parents of a 4-month-old infant brought to the ER. The infant is dead on arrival, and no CPR. The baby was found in the crib with a blanket over the head, lying face down in bloody fluid from the nose and mouth. What happened

Sudden infant death syndrome (SIDS)

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily which of the following?

The mother's presence will reduce anxiety and ease child's respiratory efforts.

A 5-year-old child is brought the Emergency Department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. Acute epiglottitis is suspected. All of these are most appropriate nursing interventions EXCEPT A. Vital signs B. Assessment of breath sounds C. Emergency airway equipment readily available D. Throat culture

Throat culture

The primary therapeutic regimen for croup usually includes: a) Vigilant assessment, racemic epinephrine, and corticosteroids b) Vigilant assessment, racemic epinephrine, and antibiotics c) Intubation, racemic epinephrine, and corticosteroids d) Intubation, racemic epinephrine, and antibiotics

Vigilant assessment, racemic epinephrine, and corticosteroids

The largest percentage of respiratory tract infections in children are caused by: a) Pneumococci b) Viruses c) Streptococci d) Haemophilus influenzae

Viruses

Ominous sign indicating ventilatory failure and imminent respiratory arrest in a child with asthma

shortness of breath with air movement in the chest restricted to the point of absent breath sounds sudden rise in respiratory rate

humidified atmosphere is recommended for a young child with an upper respiratory tract infection because this environment facilitates?

soothing inflamed mucous membranes / Liquifes Secretions

4 year old needs a meter dose inhaler but cant coordinate breathing to use it effectively. Nurse should suggest?

spacer

A young child with tetralogy of Fallot may assume a posturing position as a compensatory mechanism. The position automatically assumed by the child is:

squatting.

a child is suspected to have cystic fibrosis. which of the following tests should the nurse prepare to administer to confirm the diagnosis?

sweat chloride. they excrete an abnormal amount of sodium and chloride in their sweat.

Signs a child with asthma is in severe respiratory distress

sweats profusely remains sitting upright refuses to lie down

Which of the following tests aids in the diagnosis of cystic fibrosis (CF)? a. Sweat test, stool for fat, chest x-ray films b. Sweat test, bronchoscopy, duodenal fluid analysis c. Sweat test, stool for trypsin, biopsy of intestinal mucosa d. Stool for fat, gastric contents for hydrochloride, chest x-ray films

a. Sweat test, stool for fat, chest x-ray films

Three clinical observations that are predictive of epiglottitis are?

absence of spontaneous cough presence of drooling agitation

What are the first line treatments during an asthma attack?

albuterol and levalbutrol

A child with asthma is having a pulmonary function test. The purpose of the peak expiratory flow rate is to?

assess the severity of asthma

The most appropriate time to perform bronchial postural drainage is

before meals and at bedtime

Advise the family to seek medical evaluation of a child with mono if these manifestations occur?

breathing becomes difficult severe abdominal pain develops sore throat pain is so severe that the child is unable to drink liquids respiratory stridor is heard

These 3 signs indicate that the child is truly choking and requires immediate action?

cannot speak becomes cyanotic collapses

A critical nursing responsibility in the postoperative care of the neonate includes:

carefully monitoring infant's weight.

Most important thing to monitor for after a child has a tonsillectomy?

continuous swallowing

The most obvious early sign of bleeding after a tonsillectomy?

continuous swallowing

Mother of a 20 month old tells the nurse that he has a barking cough and a temp. The nurse suspects croup and should recommend?

cool-mist vaporizer at night and watching for signs of difficulty breathing

The school nurse is called to the cafeteria because a child 'has eaten something he is allergic to.' The child is in severe respiratory distress. The first action by the nurse is to

have someone call for an ambulance and paramedic rescue squad or 9-1-1.

Throat inspections in child with epiglottitis should be avoided unless?

immediate endotracheal intubation can be performed if needed

The doctor suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent:

increased pulmonary vascular congestion.

Early signs of impending airway obstruction include?

increased pulse and respiratory rate substernal, suprasternal, and intercostal retractions flaring nares increased restlessness

Common ________ are bacterial tracheitis, bronchitis, and respiratory syncytial virus (RSV) bronchiolitis

infections of the lower airways

The combination with corticosteroids and long acting beta 2 agonist are used to reduce _____ and keep the ariways ____ for long-term asthma control

inflammation; relaxed

This is an anticholinergic medacation that inhbits lare ariway constriction

ipratropium (Atrovent)

CF may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is?

mechanical obstruction caused by increased viscosity of mucous gland secretions

The nurse is preparing to give digoxin to a 9-month-old infant. He or she checks the dose and draws up 4 ml of the drug. The MOST appropriate nursing action is to:

not give the dose; suspect dosage error.

Child has a froglike croak, agitated, and drooling. She insists on sitting up. The nurse should?

notify physician immediately and be prepared to assist with intubation

parent reports that a child with CF has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse tells the parent to bring the child to the clinic because these symptoms suggest?

pneumothorax

An immediate intervention when an infant chokes on a piece of food would be to?

position the infant in a head-down, face-down position and administer 5 quick blows between the shoulder blades

An infant with a congenital heart defect is receiving Palivizumab. The purpose of this med is to?

prevent RSV infection

Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. The nurse should recognize that in clinical practice this system is:

problematic because children with acyanotic heart defects may develop cyanosis.

Blood pressure falling with inspiration and rising with expiration.

pulsus paradoxus