PEDS Test 3 Sherpath - Common Infections of the Respiratory Tract

The nurse is providing education to the parents of a child at risk for tuberculosis. The parents wish to forego testing because they report the child is healthy. Which response by the nurse is appropriate? "Children in urban areas are more at risk." "All children should be screened for tuberculosis." "Children with tuberculosis may not have symptoms." "A chest radiograph will show if the child has been exposed."

"Children with tuberculosis may not have symptoms." The response that children with tuberculosis may not have symptoms is the most appropriate response to the parents of an at-risk child who wish to forego testing because the child is healthy.

The nurse is administering the DTaP vaccine to a 4-month-old infant. The parents question the nurse about the importance of this vaccination. Which response by the nurse is appropriate? "DTaP will prevent pertussis after one dose." "DTaP protects against pertussis-associated seizures." "DTaP prevents 1% of infant deaths related to pertussis." "DTaP can prevent pertussis and associated complications."

"DTaP can prevent pertussis and associated complications." Because the most frequent complication of pertussis is pneumonia and DTaP can prevent pertussis, this is the most appropriate response by the nurse when asked about the DTaP vaccine.

A mother is concerned about her infant getting tuberculosis. Which response by the nurse is appropriate? "Are the infant's vaccinations up-to-date?" "Taking rifampin will prevent tuberculosis." "Does a family member have symptoms of tuberculosis?" "The infant should have a Mantoux skin test every year."

"Does a family member have symptoms of tuberculosis?" Because most children are infected by a family member or other person with whom they have frequent contact who has tuberculosis, this response is the most appropriate to address the mother's concern that her infant may contract tuberculosis.

The nurse is caring for child diagnosed with croup, who is now being discharged. The parents are concerned and question the nurse about what to do when they get home. Which response by the nurse is most appropriate? "Observe for signs of respiratory distress." "Give racemic epinephrine if stridor persists." "Provide a sedative to help with sleep at night." "Call back for antibiotics if the child has a fever."

"Observe for signs of respiratory distress." Children with worsening symptoms may require hospitalization, so this is the most appropriate response by the nurse.

A 9-month-old male infant is diagnosed with pneumonia. The parents are confused about the diagnosis because the infant had RSV a few weeks ago. Which response by the nurse is appropriate to help the parents understand the etiology of pneumonia? "Viruses can cause pneumonia in children." "Bacterial pneumonia is common in infants." "He probably had pneumonia a few weeks ago." "Antibiotics are not given for viral pneumonia."

"Viruses can cause pneumonia in children." Viruses, like RSV, cause 80 to 85% of pneumonia, and this response by the nurse helps parents understand the etiology (cause) of pneumonia.

The nurse is screening a child for tuberculosis . Which child is at risk for developing tuberculosis? A 9-year-old child whose father is incarcerated. A 3-year-old male child who lives in a rural area. A 6-year-old Caucasian child with varicella-zoster virus (VZV). A 13-year-old malnourished Latino female who lives in an urban area.

A 13-year-old malnourished Latino female who lives in an urban area. This child is at risk for tuberculosis because malnutrition, Latino race, adolescence, and living in an urban area are all risk factors for tuberculosis.

The mother of a 6-month-old infant who was recently admitted for a "whooping" cough, rhinorrhea, and fever, reports that she has two other children age 3 and 5 at home. Which action should do the nurse take? Advise vaccination with Tdap. Ask if the two children also had a fever and cough. Advise to consult these children with a health care provider. Tell the mother to give the children the same antibiotic taken by infant.

Advise to consult these children with a health care provider. The nurse needs to emphasize that young children are vulnerable to pertussis after a close contact with the sick infant. Consulting with a health care provider is important to prescribe prophylactic treatment.

The nurse is caring for a 7-year-old child due to strident cough and irritability. Upon exam, the nurse finds the child's epiglottis to be edematous and cherry red, with vital signs readings of T = 100.9 oF, HR 100, RR 24, BP 100/70, O2 sat 95% on room air. Which action should the nurse take? Assess lung sounds. Administer amoxicillin. Review arterial blood gas. Apply oxygen via facemask.

Administer amoxicillin. Child displays signs and symptoms indicative of epiglottitis, a bacterial infection of the respiratory tract. Administration of antibiotic is a priority intervention for this child, and it will be administered by IV route

A 9-month-old infant has a "whooping" cough after having a runny nose, low-grade fever, and mild cough. Which action should the nurse consider doing next? Administer antibiotics as prescribed. Monitor breathing patterns regularly. Administer vaccination as prescribed. Wear gloves when touching the infant.

Administer antibiotics as prescribed. Administering antibiotics, such as erythromycin and azithromycin, is a priority nursing action that the nurse should take, because this medication will eliminate the organism from the nasophranyx during first one to two weeks of infection, or catarrhal stage, thereby reducing communicability.

A 6-year-old child presents with anxiety, stridor, and becomes agitated when asked questions. The parents report the child had a high fever. Which action by the nurse is a priority? Give acetaminophen. Insert an oral airway. Assess oral temperature. Administer humidified oxygen.

Administer humidified oxygen. Because this child presents with signs of epiglottitis, specifically anxiety, stridor, and agitation which indicate hypoxia, administering humidified oxygen is a priority in this situation.

The nurse is caring for a 2-month-old infant who presents with fever, breathing difficulties, wheezing, persistent cough, and difficulty feeding. Which health instructions by the nurse are appropriate to provide the parents? Select all that apply. Allow rest periods during the day. Administer an antihistamine daily. Offer the child's liquids frequently. Use a humidifier in the child's room. Give a cough suppressant every four hours.

Allow rest periods during the day. An infant with fever, breathing difficulties, wheezing, persistent cough, and difficulty feeding has bronchiolitis. Allowing the infant enough rest periods during the day is appropriate to promote recovery from bronchiolitis. Offer the child's liquids frequently. Providing fluids by offering the child's favorite drink in an infant with bronchiolitis can prevent dehydration. Use a humidifier in the child's room. Using a humidifier in an infant with bronchiolitis is appropriate because it can help loosen secretions.

The nurse is caring for a child recently admitted to the hospital with upper respiratory infection and "whooping" cough. Which prescription would the nurse question? Daily weights Visitor restriction Supplemental oxygen Ambulate in hall daily

Ambulate in hall daily The child with upper respiratory infection and "whooping" cough has pertussis and requires droplet precautions. Thus, allowing the child to ambulate in the hall is prescription the nurse should question.

A 2-year-old female presents with stridor, restlessness, and a hoarse cry. The nurse reviews the health care provider's prescription. Which medication would the nurse question? Racemic epinephrine Ampicillin intravenous Acetaminophen per rectum Dexamethasone oral solution

Ampicillin intravenous Because this child is presenting with signs of croup, which is typically caused by a viral infection, the nurse should question the health care provider's prescription of ampicillin.

A 2-year-old child presents to ER due to chills, fever, chest pain on left side, productive cough, and difficulty breathing. The health care provider prescribes therapies for the child. Which prescription should the nurse question? Daily weight Humidified oxygen Oral antihistamines Position child on right side

Oral antihistamines Because pneumonia is related to inflammation of the lung parenchyma, the nurse should question an order for an antihistamine, which would be used for allergic symptoms.

The nurse is caring for a child with a left lower lobe infiltrate. Labs are obtained and the nurse receives the following results: WBC 16,000, Hgb 12.5, Platelet count 180,000, urine specific gravity 1.035, BUN 22. Which provider's prescription would the nurse anticipate in this patient? Select all that apply. NPO status Antibiotics Acetaminophen Intravenous fluids Pneumococcal conjugate vaccine

Antibiotics The nurse would anticipate receiving a prescription for antibiotics because the child has bacterial pneumonia as evidenced by an increased WBC of 16,000 and left lower lobe infiltrate. Acetaminophen The nurse would anticipate receiving an order for acetaminophen because NSAIDS can be used for symptomatic relief in pneumonia. Intravenous fluids The nurse would anticipate receiving an order for intravenous fluids since the child with pneumonia is at risk for dehydration.

A 3-year-old female presents with a persistent cough, rhonchi and poor oral intake. The nurse reviews the health care provider's prescription. Which prescription would the nurse question? Antibiotics Regular diet Cool humidified oxygen Oral cough suppressant

Antibiotics Because this child presents with signs of bronchitis, which is typically related to a viral infection, the nurse should question the order for antibiotics.

A 3-year-old male presents with drooling, retractions, and oxygen saturation of 88% on room air. The parents report the child became sick over the past few hours and cries quietly when disturbed. Which action by the nurse is priority? Administer dexamethasone. Obtain a throat culture stat. Send child for a chest x-ray. Anticipate emergency support.

Anticipate emergency support. Because this child is presenting with signs of epiglottitis—which can quickly progress to airway obstruction—the priority is to anticipate for emergency support, which includes notification of the provider and ensuring availability of emergency equipment and supplies, to make sure that intubation can be done appropriately.

A 14-year-old child who was admitted due to fever, night sweats, mild cough, and weight loss, with a positive Mantoux test, is being prepared for discharge. Which actions should the nurse consider doing next? Select all that apply. Assess the family's financial status. Coordinate care with health department. Take medication until symptoms resolve. Isolate the child from other family members. Return to the hospital if night sweats develop.

Assess the family's financial status. Because the medications for tuberculosis are expensive, an appropriate intervention by the nurse should include assessing the family's financial status before discharging the child to ensure the medication regimen can be followed. Coordinate care with health department. Because tuberculosis is a reportable disease, an appropriate intervention by the nurse should include notifying the health department to manage care.

A 3-year-old male presents with persistent coughing and a temperature of 101.8 oF. The parents report the child became sick over the past few days. The child is now resting. Which action by the nurse is a priority? Count respirations. Obtain blood culture. Apply humidified oxygen. Administer acetaminophen.

Count respirations. Because the nurse must assess before intervening, counting the respirations in this situation where the child shows symptoms of bronchitis is a priority.

The nurse is providing education to the parents of a 6-month-old infant diagnosed with bacterial pneumonia, who is now being discharged home from the emergency department. Which education by the nurse is appropriate? Select all that apply. Education on offering the infant a bottle frequently Education on administering acetaminophen for a fever Giving guidance and education on how to use a car seat to promote drainage Advising the parents on allowing the child to cry to increase circulation and oxygenation Providing instruction and emphasizing the importance of finishing the antibiotics prescribed

Education on offering the infant a bottle frequently Educating the parents to offer the infant a bottle frequently can help prevent dehydration and is appropriate education for the infant diagnosed with bacterial pneumonia. Education on administering acetaminophen for a fever Educating the parents to give acetaminophen for a fever is appropriate education for the infant diagnosed with bacterial pneumonia. Providing instruction and emphasizing the importance of finishing the antibiotics prescribed Educating the parents to finish the antibiotics as prescribed is appropriate education for the infant diagnosed with bacterial pneumonia.

A 5-year-old child who was admitted for chills, fever, breathing difficulties, and chest pain, begins coughing and is restless. Which action by the nurse is a priority? Auscultate the lungs Elevate the head of bed Count the respiratory rate Apply oxygen via face mask

Elevate the head of bed Repositioning the child with pneumonia who begins coughing and is restless is the priority, because restlessness indicates hypoxia, and elevating the head of bed can improve lung expansion.

A 13-month-old female is brought to the hospital because the parents suspect spasmodic croup. What information would help the nurse determine appropriate interventions for this child? Select all that apply. Family history Onset of symptoms Presence of mucus Exposure to bacteria When coughing occurs

Family history Because spasmodic croup may have a genetic predisposition, asking about family history can help the nurse determine interventions for a 13-month-old child with suspected croup. Onset of symptoms Because spasmodic croup usually has a sudden onset, asking about onset of symptoms can help the nurse determine interventions for a 13-month-old child with suspected croup. Presence of mucus Because spasmodic croup is associated with mucosal inflammation, asking about presence of mucus can help the nurse determine interventions for a 13-month-old child with suspected croup. When coughing occurs Because coughing with spasmodic croup usually occurs at night, asking when coughing occurs can help the nurse determine interventions for a 13-month-old child with suspected croup.

A 9-month-old infant is brought to the hospital by the parents because the infant is "breathing fast." Assessment reveals retractions, wheezing, rhinorrhea, and oxygen saturation is 89%. Which question would help the nurse determine the next intervention? Has the infant had a fever? Was the infant born preterm? Did the infant receive palivizumab this year? How many wet diapers has the infant had today?

How many wet diapers has the infant had today? The infant presents with signs of bronchiolitis and asking about urine output will help determine dehydration and the next intervention for this infant.

A 2-year-old child is brought to the hospital for persistent coughing, weight loss, and appearing malnourished. While gathering history, the mother reports the child has a positive Mantoux test "a few months ago." Which action should the nurse take? Call for a chest radiograph. Obtain a medication history. Perform a Mantoux skin test. Place on contact precautions.

Obtain a medication history. Because the child presents with signs of tuberculosis and a history of positive skin test, asking for a medication history to determine if the child completed the six month treatment is the most appropriate intervention.

A 1-year-old female presents with restlessness, rhinorrhea, retractions, and poor feeding. The nurse reviews the health care provider's prescription. Which treatment would the nurse question? Palivizumab IM Albuterol nebulizer Normal saline bolus Cool humidified oxygen

Palivizumab IM Because this child presents with signs of bronchiolitis, indicating RSV, the nurse should question the health care provider's order for palivizumab because this is given to prevent RSV.

Why might a patient who tests positive for Bordetella Pertussis also present with an unusually low blood pressure? Pertussis releases endotoxins. Pertussis causes a high fever. Pertussis can bind to the mitral value affect cardiac output. Pertussis has a thick cell wall which can affect the cardiovascular system.

Pertussis releases endotoxins. Pertussis is a gram negative bacteria that can release endotoxins and cause symptoms of shock, including low blood pressure.

Bordatella pertussusis have pili that surround their thin cell wall. Why is this significant for understanding the pathophysiology of the disease? Pili make phagocytosis of the bacteria by the host cells more difficult. Pili propel the bacteria through the host's body by excreting exotoxins. Pili help the bacteria survive and adhere to the mucosa of the respiratory tract. Pili hide the bacteria's presence in the host so the immune system cannot respond.

Pili help the bacteria survive and adhere to the mucosa of the respiratory tract. Pili are rigid projections help the bacteria survive and adhere to the mucosa of the respiratory tract, which is significant for understanding the pathophysiology of pertussis.

The nurse is caring for a child who presents with tachypnea, cyanosis, and periods of apnea. ABG results show pH 7.32, CO2 35, HCO3 18, paO2 78. The nurse also notes diminished breath sounds bilaterally. Labs are obtained. Which action should the nurse take? Start oxygen inhalation. Document the ABG finding. Administer a bronchodilator. Notify the health care provider.

Start oxygen inhalation. The manifestations of the child indicate bronchiolitis while the ABG results represent metabolic acidosis. Administering cool, humidified oxygen will relieve dyspnea, hypoxemia, and insensible water loss from tachypnea in this patient.

A 6-month-old infant presents with retractions and a sunken anterior fontanel. The nurse obtains the following vital signs: temperature 102.3o F, HR 148, RR 62, and oxygen saturation 89% on room air. Order the nursing interventions based on priority, with the highest priority being placed first. a-Administer oxygen b-Reposition infant c-Apply cardio/resp monitor d-Start IV access

b a d c