PEDS unit 4 ch 27,28,18; ATI ch 21,21,22,5
high fiber foods for an older child with constipation
Whole-grain breads and cereals, Raw vegetables and fruits,Bran,Popcorn
A nurse is reinforcing teaching with the parent of a preschooler about methods to promote sleep. Which of the following statements by the parent indicates an understanding of the instructions?
"I will keep a dim light on in my child's room during the night"
A nurse is reinforcing teaching with the parent of a child who has a new prescription for liquid oral iron supplements. Which of the following statements by the parent indicates an understanding of the teaching?
"My child should take the supplement through a straw"
By what age do children realize that death is final and permanent
10 years old
it is recommended that iron fortified formula be given to infants through age?
12 months
Children with failure to thrive fall below the ___ percentile in weight and height on growth charts
3rd
patient controlled analgesia can be used for the child older than ___ years of age to manage pain caused by sickle cell anemia
7
a newborns total body weight is about _______water
77%
How are pinworms diagnosed?
A "Scotch tape test" in the early morning
The nurse taking a history form parents of an infant with pyloric stenosis would expect them to report the infant experienced which sign
projectile vomiting
the infant with tracheoesophageal fistula will ____________ and ______________ when the 1st feeding is given?
vomit & choke
projectile vomiting
vomiting in which the stomach contents are forcibly ejected
tap water enemas are never given to children because they lead to
water intoxication and death
Gluten is found in
wheat, barley, oats, and rye
Leukocytes
white blood cells
children who carry the sickle cell trait
will not develop any systems of the disease
A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an appropriate action for the nurse to take?
initiate oral rehydration therapy
the greatest concern of a nurse caring for a child with ITP is?
injuries that might initiate bleeding
which of the following presents the greatest risk to the child with hemophilia?
intracranial bleeding
thrombocytes function
involved in blood coagulation
A nurse is assisting with the nutrition education program for a group of parents of preschoolers. Which of the following dietary guidelines should the nurse plan to include?
Average intake should be 1,800 calories per day
_______________________________ is a nasal spray that can stop bleeding and may be the treatment of choice for mild cases of hemophilia
Desmopressin acetate (DDAVP)
A nurse in a provider's office is preparing to administer immunizations to a 5 year old child. Which of the following immunizations should the nurse plan to administer?
Diphtheria, tetanus, pertussis (Dtap), Inactivated poliovirus (IPV), Measles, mumps, rubella (MMR)
What is a characteristic manifestation of Hodgkin's disease?
Enlarged lymph nodes
failure to thrive is infants & children who?
Fail to gain and often lose weight without an obvious cause
common tests used to diagnose GI disorders
GI series, sigmoidoscopy, liver blood tests & biopsy, barium enema, endoscopy, malabsoption, rectal biopsy, flat plate of abdomen, colonoscopy, ESR, CBC differential, ultrasound, stool culture
most common sign of pinworm
Itching of the anal area
Stools in the child with celiac disease are?
Large, bulky, frothy.
possible presenting signs and symptoms of leukemia
Low-grade fever, Pallor, Bruising tendency, Leg and joint pain, Listlessness, Abdominal pain, Enlargement of lymph nodes, Objective signs of petechiae or purpura, Anorexia, Vomiting, Weight loss, Dyspnea, Hematuria, Lemon-yellow skin hue
Pinworm treatment
Mebendazole (Vermox) is a single-dose, chewable tablet and is the drug of choice for children older than age 2. The child must be taught good handwashing, especially after bowel movements. Fingernails are kept short and a soothing ointment can be applied to the rectum
initial onset of intussuception and infant behaviors
Onset is sudden. The infant feels severe pain in the abdomen, cries loudly, strains with effort, kicks, and draws legs up to the abdomen. Initial intervals of comfort shorten. The child vomits. Bowel movements diminish and bowel movements of blood and mucus that contain no feces are common about 12 hours after onset of the obstruction
a 6 year old child has mild diarrhea. how would the nurse advise the child's parents about fluid and food intake?
Oral rehydrating solutions such as Pedialyte or Infalyte with a gradual introduction of a soft, bland diet. Resume regular diet within 2-3 days.
aplastic crisis
RBC production in bone marrow stops, possibly related to infection
goal of poisoning treatment
Remove the poison,Prevent further absorption.,Call Poison Control Center,Provide supportive care and seek medical help.
Which of the following orders written for a child admitted with a diagnosis of sickle cell anemia should the nurse question?
Restrict fluid intake and Administer meperidine (Demerol) 25 mg for pain.
children with hemophilia should avoid?
Salicylates
progression of feeding of an infant after postop correction of pyloric stenosis
Small amounts of glucose water that gradually increase until a regular formula can be taken and retained. Overfeeding is avoided.
S/S of dehydration in infant with diarrhea
Sunken eyes and fontanelle, Dry skin, Dry tongue and mucous membranes, Decreased urination
clinical manifestations of idiopathic thrombocytopenic purpura (ITP)
The child has slow clotting and is easily bruised, resulting in petechiae and purpura. Lab work will show a platelet count of below 20,000/mm3. About 30% have frequent nosebleeds. There may be a recent history of rubella, rubeola, or viral respiratory infection
how is nystatin (Myocostatin) applied to the mouth of a child with thrush?
The mouth is swabbed three or four times a day between feedings with a sterile applicator moistened with the prescribed solution.
Scurvy
Vitamin C deficiency
difference between sickle cell trait and sickle cell disease
a child who has the trait is a carrier and child won't manifest disease; a child who inherited trait from both parents and has disease
A nurse is collecting data from a child who has Meckel's diverticulum. Which of the following manifestations should the nurse expect?
abdominal pain, mucus, bloody stools
Which principle should the nurse teach the parent concerning administering liquid iron preparation to the child with iron-deficiency anemia?
administer between meals
Nursing care of an adolescent with cancer who is refusing to cooperate with treatment should include
allowing the adolescent to make some choices
When a child has pinworms, the nurse should know that
any family member with symptoms should be treated
the nurse is monitoring a 2 year old child for signs of dehydration. which of the following techniques or monitoring body temperature is appropiate?
axillary, tympanic,temporal artery
Children with intussusception may have bowel movements containing blood and mucus and no feces
currant jelly stools
treatment of choice for intussusception is reduction through the use of?
barium enema
principal therapy for hemophilia is to prevent
bleeding by replacing missing factor
splenic sequestration
blood pools in liver and spleen resulting in circulatory collapse and shock
four food sources with high iron content
boiled egg yolk, dried fruits, liver, dry beans, leafy greens, crushed nuts, cream of wheat, whole grain breads
the diagnostic test that confirms a diagnosis of leukemia?
bone marrow aspiration
a child with sickle cell inherits abnormality from _______ parents?
both
four signs of rickets
bow legs, knock knees, beading of ribs, improper formation of teeth
A nurse is caring for a preschooler who says she needs to leave the hospital because her doll is scared to be at home alone. The nurse recognizes that the child is exhibiting which of the following characteristics of preoperational thought?
centration
Signs of transfusion reaction
chills, pain in back, itching, rash, fever, headache
Incarnation
constriction or irreducibility
two priority goals when caring for a child with sickle cell disease
control pain and prevent dehydration, hypoxia and infection
Which menu selections are best for a child diagnosed with celiac disease?
corn tortilla and fresh fruit
A complication of vomiting associated with pyloric stenosis is?
dehydration
four factors that might trigger sickle cell crisis
dehydration, infection, physical/emotional stress, exposure to cold
persistent vomiting can result in?
dehydration; electrolyte imbalance
a child with newly diagnosed leukemia does not have immunizations up to date. Which is an essential step in response to this?
delay active immunizations during chemotherapy
when caring for a child on steroid therapy, it is important to seek immediate medical attention if the child?
develops a fever
what would be the initial nursing action when a child receiving a transfusion of packed RBCS complains of chills and back pain?
discontinue the transfusion
pathologic changes that take place when a child has leukemia
disruption in bone marrow function due to overproduction of immature WBC in bone marrow
Pica
eating non food items
which approach might best support maternal attachment when caring for a child with failure to thrive?
encourage the mother to participate in the child's care
which diagnostic test permits visualization of the upper GI tract?
endoscopy
which action should the nurse take before adding potassium to a child's IV?
establish that the child is voiding
Anxiety can be decreased in both the family and the child who has cancer by
explaining all procedures before they are done
in children under 2 a greater percentage of body water is contained in the?
extracellular compartment
hemophilia A is caused by a deficiency of ______________________
factor 8
hemophilia B is caused by a deficiency of ________________________
factor 9
The nurse doing a newborn assessment knows the earliest sign of Hirschsprung's disease is
failure to pass meconium
Fever is a reliable sign of appendicitis in children. (True or False)
false
presenting sign of Hodgkin's disease is usually pain in the neck and shoulders?
false
with appendicitis, vomiting begins before abdominal pain
false
A nurse is collecting data from a preschooler who has a rotavirus infection. Which of the following are expected manifestations?
fever, vomiting, watery stools
Leukocytes function
fight infection and provide immunity
classic symptom of hemophilia is severe joint pain, which is caused by?
hemarthrosis
what test done if the screening test is positive and why?
hemoglobin electophoresis identifies those with and without trait
A nurse is caring for an infant whose screening test reveals that he might have sickle cell disease. Which of the following tests should be performed to distinguish if the infant has the trait or the disease?
hemoglobin electrophoresis
hemathrosis
hemorrhage into a joint
hemarthrosis
hemorrhage into joint cavity
the pathological disturbance if pyloric stenosis results from?
hypertrophy of the pyloric muscle
the greatest threat to a life in isotonic dehydration is
hypovolemic shock
leukemia results in the uncontrolled growth of?
immature WBCS
Immediate nursing care of a child with hemophilia who has hemarthrois includes
immobilization of the area of pain
following splenectomy, the child faces the long term risk of serious?
infection
A nurse is reinforcing teaching to the parents of a toddler who has salmonella. Which of the following information should the nurse include in the teaching?
it is a bacterial infection, bloody diarrhea is common, transmission can be from house pets
what signs and symptoms are characteristics of pinworm?
itching, irritability, restlessness
a child appears apathetic and weak. his growth is below normal for his age. there is a white streak in the child's hair. the nurse recognizes these signs as a characteristic of
khawshiorkor
purpura
large hemorrhagic spots in the skin
Plumbism
lead poisoning
most common form of childhood cancer is?
leukemia
the nurse should explain to parents that infants are more susceptible to accidental ingestion of foreign bodies because they are
likely to put everything in their mouths
The organ damaged by acetaminophen poising is the
liver
overdose of acetaminophen can result in
liver damage
alopecia
loss of hair
gastroesophageal reflux
lower esophageal sphincter is relaxed or not competent, which allows stomach contents to be easily regurgitated into the esophagus.
interventions for an infant hospitalized for gastroenteritis
maintain record of intake and output, skin care & frequent diaper changes, record daily weight
celiac disease is the leading ___________________ problem in children
malabsorption
A child who is in a vasocclusive crisis caused by sickle cell anemia is experiencing acute pain. The nurse understands that Demerol (meperidine) is not an appropriate pain medication to administer to this child because it?
may induce seizures
an appropriate nursing intervention for the child admitted to the hospital in sickle cell crisis would be to?
monitor the child's response to analgesics
Thalassemia major (Cooley's anemia) is treated primarily with:
multiple blood transfusion
lead poisoning can have a lasting effect on
nervous system
pyloric stenosis
obstruction at lower end of end of stomach caused by overgrowth of circular muscles of pylorus or by spasms of splinter
A nurse is reinforcing teaching with the parents of an infant about gastrointestinal reflux disease. Which of the following interventions should the nurse include in the instructions?
offer frequent feedings, thicken formula with rice cereal, position the infant upright after feedings
pyloromyotomy
operation to correct pyloric stenosis
iron supplement absorption is increased by taking it with?
orange juice
Vasocclusive
painful; related to obstruction of blood flow by abnormally shaped RBCs, infarctions, and vasospasm
children with Hodgkin's disease usually present with a?
painless cervical neck lump
primary source of lead poisoning
paint
major signs and symptoms of iron deficiency anemia
pallor, irritability, anorexia, decrease in activity
A nurse is caring for a child who is suspected to have Enterobius vermicularis. Which of the following actions should the nurse take?
perform a tape worm
signs and symptoms that might indicate that a child has ITP include?
petechiae and purpura
petechiae
pinpoint hemorrhagic spots beneath the skin
A nurse is caring for an infant who is postoperative following cleft lip and palate repair. Which of the following actions should the nurse take?
place elbow restraints on the infant
which information would the nurse give to the parents of an infant with GERD?
place in upright prone position after feeding
Thrombocytes
platelets
A nurse is caring for a child who has Hirschsprung's disease. Which of the following actions should the nurse take?
prepare the family for surgery
A nurse is reinforcing teaching about epistaxis with the parent of a school age child. Which of the following should the nurse include as actions to take when managing an episode of epistaxis?
press the nares together for at least 10 mins, pack cotton or tissue into the naris that is bleeding, apply a small ice pack across the bridge of the nose
A nurse is collecting data from an infant who has hypertrophic pyloric stenosis. Which of the following manifestations should the nurse expect?
projectile vomiting, dry mucous membranes, constant hunger
Kwashiorkor Disease
protein deficiency
inguinal hernia
protrusion of part of the intestine through the umbilical cord
Hyperhemolytic
rapid rate of hemolysis is superimposed on an already severe process; rare condition
Erythrocytes
red blood cells
A nurse is assisting the provider with a developmental screening on a 3 year old child. Which of the following gross motor skills should the nurse expect the child to perform?
ride a tricycle
to prevent aspiration of vomiting after feeding an infant should be placed in what position
right side lying
why is meperidine not recommended for children with sick cell disease
risk of normeperidine induced seizures
primary fear of dying in children younger than 5 years of age concerns
separation from their parents or abandonment
A nurse is reinforcing teaching with a group of parents about E coli. Which of the following information should the nurse include in the teaching?
severe abdominal cramping occurs, it can lead to hemolytic uremic syndrome, it is a foodborne pathogen
causes of iron deficiency anemia
severe hemorrhage, inability to absorb iron, excessive growth requirements, or an inadequate diet
hemophilia is inherited by the male as an ______________________ trait?
sex linked recessive
_____________ is the greatest threat to life in isotonic dehydration?
shock or hypovolemia
common test used to screen for sickle cell disease?
sickledex
A nurse is reinforcing teaching about the management of epistaxis with a school age child. Which of the following positions should the nurse instruct the child to take when experiencing a nosebleed?
sit up and lean forward
Priority teaching for a parent of a child who ingested a foreign body includes
slicing each stool passed to observe for the foreign body
Homeostasis
state of equilibrium of the body
if child showed signs of transfusion reaction the nurse's action would be to?
stop the blood transfusion by clamping off the tubing immediately; then keep the intravenous line open with normal saline solution and notify the nurse in charge
When the patient experiences apprehension and urticaria while receiving a blood transfusion, the nurse?
stop the transfusion allows normal saline solution to run slowly and notifies the charge nurse
assessment findings in a newborn who has pyloric stenosis
sunken fontanelle,inelastic or "tenting" skin, reduced urine output, signs of malnutrition
earliest sign of Hirschsprung's disease is treated? It may be necessary for an infant to have an __________ temporarily?
surgically; colostomy
describe the preschooler's response to the death of a sibling
they think its temporary and blame death on themselves
included in nurses documentation for a child who is vomiting?
time,amount,color, consistency, force, frequency, whether proceeded by nausea or feeding
a nurse is giving a newborn her 1st feeding when the baby starts coughing and chocking. this is indicative of which condition?
tracheoesophageal atresia
Erythrocytes function
transport oxygen and carbon dioxide to and from the lungs and tissues
abdominal pain associated with appendicitis in a child is located in the right lower quadrant
true
hodgkins disease is a malignancy of the lymphatic system
true
the child with appendicitis may exhibit guarding and rebound tenderness when the nurse performs an abdominal assessment
true
the treatment of Hodgkin's disease involves chemotherapy and radiation therapy?
true
After a feeding, an infant with gastroesophageal reflux should be placed in which position?
upright prone or propped on left side
A nurse is preparing to administer iron dextran IM to a school cage child who has iron deficiency anemia. Which of the following actions by the nurse is appropiate?
use the Z track method when administering the dose
name four types of sickle cell crisis
vasocclusive, splenic sequestration, aplastic crisis, hyperhemolytic
to prevent scurvy add what into their diet?
vitamin C, citrus, raw leafy veggies
decreased incidence of rickets in the world is attributed to?
vitamin supplements and vitamin D fortified foods
