PrepUs for pediatric chapter 38
Insulin deficiency, increased levels of counter regulatory hormones, and dehydration are the primary causes of:
diabetic ketoacidosis.
The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality?
Currant jelly-like
When providing diaper care to an infant after pyloric stenosis surgery, which approach is indicated?
Diapers should be folded so that the incision line does not become contaminated.
In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention?
prepare the infant for surgery
The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is:
steatorrhea
The nurse is advising a group of new parents on how to care for their infant at home if the baby develops mild diarrhea. Which statement indicates that teaching has been effective?
"I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration."
The nurse is instructing new parents on caring for their infant if gastroenteritis symptoms should occur. Which parental statement indicates understanding of appropriate care?
"I should take the baby's temperature and call my health care provider.
The client calls the health care provider's office stating that her preschooler drank laundry detergent from under the sink. Which statement by the parent needs further instruction?
"I will use syrup of ipecac to get it out of my child's system.
The client calls the health care provider's office stating that her preschooler drank laundry detergent from under the sink. Which statement by the parent needs further instruction?
"I will use syrup of ipecac to get it out of my child's system."
Kate and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes. Which statement by the nurse is true?
"Kids can usually be managed with an oral agent, meal planning, and exercise."
A 10-year-old boy has been diagnosed with type 1 diabetes mellitus. He is curious about what the cause of his disease is and asks the nurse to explain it to him. What explanation is best?
"Special cells in a part of your body called the pancreas can't make a chemical called insulin, which helps control the sugar level in your blood."
How will the nurse respond to parents who express regret that they did not seek care for their young child early enough to prevent perforation of the child's appendix?
"Symptoms are not always clear to any of us. Also the thin wall of the appendix in a child perforates readily."
The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which finding would the nurse identify as the hallmark of this condition
A sausage-shaped mass in the upper midabdomen
A newborn was diagnosed as having hypothyroidism at birth. The parent asks the nurse how the disease could be discovered this early. Which is the nurse's best answer?
A simple blood test to diagnose hypothyroidism is required in most states
The nurse is providing care for a child who has been diagnosed with rickets. What is the nurse's priority intervention?
Administration of adequate vitamin D
Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?
Administration of levothyroxine indefinitely
The nurse completes a 1-month-old's feeding and sits the infant up to burp. The infant vomits back the feeding. Which is the nurse's primary concern?
Aspiration
A child has presented to the clinic with diarrhea. The nurse should teach the mother to give which of the following to properly care for her child?
Bananas
A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?
Barium enema
The nurse is reviewing the laboratory work for a new client who is 6 weeks' pregnant. Based on the above results, what is the nurse's conclusion?
Client is anemic and at risk for gestational diabetes
Which is most important for caregivers to consider when caring for a newborn with colic?
Colic is temporary; disappears around 3 months of age.
Which assessment findings suggest that an infant with diarrhea is severely dehydrated?
Elevated hematocrit and depressed eye globes
A 2-month-old infant experiencing severe diarrhea is prescribed intravenous fluid replacement. Before adding potassium to this solution, which assessment should the nurse make?
Ensure that the child is voiding
The nurse is collecting data on a child who has been brought to the clinic. The child has urticaria, pruritus, stomach pains, and respiratory symptoms. The nurse recognizes that the clinical manifestations noted in this child are commonly seen in which disorder?
Food allergies
A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect?
Gastroenteritis
Noah is an 18-month-old boy who is brought to the emergency department with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that this condition is most likely the result of which of the following?
Gastroesophageal reflux disease
A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next
Give 10 to 15 grams of a simple carbohydrate.
The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents?
Having a wound, ostomy, and continence nurse meet with them
A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?
Hirschsprung disease
A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?
Hormonal secretion
A young child has presented to the pediatric unit with a swollen abdomen, edema, thin patchy hair, and irritability with growth retardation and muscle wasting. The nurse suspects a malnutrition disorder. The nurse identifies this child to most likely have which condition?
Kwashiorkor
A child is diagnosed with gastroesophageal reflux disease and is prescribed drug therapy. The primary health care provider prescribes medication that suppresses acid secretion. The nurse would anticipate administering which of the following?
Omeprazole
Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply.
Polyphagia Polydipsia Polyuria
A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?
Pyloric stenosis
Which congenital condition leads to the infant being hungry, irritable, losing weight and rapidly becoming dehydrated with the potential of metabolic alkalosis?
Pyloric stenosis
A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?
Regular insulin
The nurse is caring for an infant recovering from surgery for pyloric stenosis. Which nursing diagnosis should the nurse use to guide care during the immediate postoperative period?
Risk for infection of incision line, related to disruption of skin barrier during surgery
The nurse is caring for a school-aged child newly diagnosed with type 1 diabetes mellitus. Which nursing action supports the 2020 National Health Goals to reduce the long-term complications from this disease process?
Schedule the child and parents to attend diabetes education classes.
The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with disorder
The parents report that their son "can't drink enough water."
What occurs in the gastrointestinal system of the child with Hirschsprung disease?
There is a partial or complete mechanical obstruction in the intestine.
Which nursing interventions are most helpful for the 6-week-old who continues to vomit stomach contents after feeding? Select all that apply.
Thicken formula with rice cereal Place infant in a side-lying position Complete daily weights Offer small, frequent feedings
A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?
Type 1 diabetes mellitus
Which assessment finding would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed?
Vomiting
A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus?
a fasting blood glucose greater than 126 mg/dL
Nurses will need to teach the parents of the infant being treated for Hirschsprung disease (aganglionic megacolon) to
care for a temporary colostomy.
A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client?
fluid replacement
Pyloric stenosis has been diagnosed in a 3-week-old male infant who has frequent vomiting after feedings. An important preoperative nursing intervention is:
maintaining NPO status while restoring hydration and electrolyte balance.
Which body system is most sensitive to lead ingestion?
nervous system
The nurse is presenting information related to intestinal parasite infections to a group of community health nurses. One member of the group asks the nurse how she might know if a child had a pinworm infestation. The nurse correctly answers this question by stating which of the following?
The primary symptom of pinworms is intense perianal itching.
A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant?
Lower right
A mother brings her 3-month-old infant to the community clinic with complaints of diarrhea for the past week. The infant's vital signs are normal and there are no signs of dehydration. When questioned about her baby's diet, the mother who is bottle-feeding states that she has been giving her baby some baby cereal at night to help her sleep through the night. What teaching intervention would be appropriate for this mother?
Teach the mother that infants are relatively intolerant of starches and may have diarrhea if cereal is offered too soon.
A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case?
Intussusception Intussusception, the invagination of one portion of the intestine into another, usually occurs in the second half of the first year of life. Children with this disorder suddenly draw up their legs and cry as if they are in severe pain; they may vomit. After the peristaltic wave that caused the discomfort passes, they are symptom-free and play happily. In approximately 15 minutes, however, the same phenomenon of intense abdominal pain strikes again. After approximately 12 hours, blood appears in the stool and possibly in vomitus, described as a "currant jelly" appearance. Volvulus with malrotation and necrotizing entercolitis typically occur in the first 6 months of life and do not match the symptoms described above. Short-bowel/short-gut syndrome typically occurs when a large portion of the intestine has been removed due to a previous disease or trauma.
The nurse is caring for a 3-year-old with repeated diarrhea. The client is listless and clings to the parent. The nurse reviews the labwork which reports a pH- 7.33, HCO3- 21, PaCO2- 42. Which would be documented?
Metabolic acidosis