Price Chapter 3- Pediatric Procedures

A 2-Year-Old is seen in the clinic with a respiratory rate of 28. The nurse understands that:

This is a normal finding.

Prior to obtaining a clean-catch specimen from a 4-Year-Old, the nurse could best get the child to comply by:

Using the term the child uses for urination in explanations

The nurse has drawn up 5 unites of insulin to give to an 8-Year-Old. As a safety precaution prior to giving the drug, the nurse should:

Verify the dose with another nurse

Extravasation

Escape of fluid or blood from a blood vessel into a body tissue

When parenteral fluids have escaped into the surrounding tissue, the nurse would document and report that ____________________________ had occurred.

Extravasation or infiltration

The nurse sees an order to give 500mg of an oral suspension of ampicillin to a child who weighs 22 pounds. After the nurse has calculated the dose based on the child's weight and sees that the dose should be 50 mg/kg/day, the nurse should:

Give the ordered dose

Ostomy

Surgical procedure that creates an opening into a body structure.

Infant bath water

Temperature should not exceed 38*C

When the nurse chooses a blood pressure cuff:

It should be long enough to encircle the extremity

Which of the following statements is true regarding obtaining a 24-hour urine specimen on a pediatric patient?

Lost specimens necessitate restarting the test

1 mL

Maximum volume (IM) administered to deltoid muscle

pulse oximeter

Measured by a pulse oximeter, a means of determining the amount of oxygen in the blood. Infrared light measures the amount of saturated arterial hemoglobin (oxyhemoglovin)during a pulse. Accuracy is influenced by adequate blood flow.

The nurse monitoring the TPN infusion for a small child assessed that the infusion is behind. The nurse should:

Notify the charge nurse

Following a gavage feeding, a 4-Year-Old child should be positioned:

On the right side to aid in stomach emptying.

A catheter threaded into the superior vena cava for the purpose of parenteral nutrition (TPN) is referred to as a _________________________.

PICC (Peripherally Inserted Central Catheter)

Interventions that may be used with fever in a 5-Year-Old pediatric patient include:

Reduction of room temperature Removal of blankets and clothing Acetaminophen administration Monitoring the fever

Nomogram

Representation by graphs, diagrams, or charts of the relationship between numerical variables.

During a lumbar puncture procedure, the nurse should be constantly assessing the child's:

Respiratory status

The nurse while assisting the physician with a lumbar puncture of a small child will take special precaution to closely monitor the:

Respiratory status

Nasopharyngeal culture

Rules out pertussis

The age group that benefits most from explanations through drawings, pictures, and contact with equipment is the:

School-age group

Enema

Should be administered over 10 to 15 minutes.

Gastrostomy feeding

Should take 20 to 25 minutes to complete

In order to prepare a child for a lumbar puncture, the nurse would place the child in which position?

Side-lying with neck and knees held in flexed position

Considerations about possible risk factors of giving medications to children include: (SATA)

Smaller body mass of a child Immaturity of body systems Need for individuality of dose High toxicity of many modern drugs

Which of the following is a contraindication to obtaining a throat culture on a child with a "sore throat"?

Suspected epiglottis

Palpation

The act of feeling with the hand; the application of the fingers with tight pressure to the surface of the body for the purpose of determining the consistency of the parts beneath in physical diagnosis.

Hyperalimentation

The administration or ingestion of unusually large amounts of nutrients.

Surface area

The exterior of the human body (also called body surface area [BSA]).

Thrombosis

The formation, Development, or existence of a blood clot or thrombus within the vascular system.

Azotemia

The presence of nitrogenous bodies in the blood

Alimentation

The process of nourishing of body fluids and accumulation of alkalis or reduction of acids.

Thrombosis, hyperglycemia, and contamination are all potential complications of which therapy?

Total parenteral nutrition

When selecting a cuff for a child, the nurse should confirm that the width of the cuff covers approximately __________________ of the upper arm.

Two-thirds

midstream specimen

Urine specimen collected after the first few milliliters of urine have been voided.

Tepid baths

Used for hyperthermia

Half-strength hydrogen peroxide

Used to clean tracheal stoma

An intramuscular (IM) injection is ordered for a 6-month-Old child. The nurse should select the injection site of:

Vastus lateralis

The injection site that is well developed at birth, has relatively few major nerves and blood vessels, and is the largest muscle mass in infants is the:

Vastus lateralis

The nurse brings the medication into a child's room for administration. The intervention that will ensure safe administration of this medication is:

Verify the patients identity with the hospital identification band for child's birth date.

An infant with diarrhea is dehydrated. IV fluids have been ordered to restore fluid balance. The most effective device used to prevent fluid overload is:

A precision-controlled syringe pump

tracheostomy

A surgical procedure in which an opening is made in the trachea to enable the child to breathe.

The nurse monitors urine output for a child utilizing which of the following?

0.5 to 2 mL/kg/hr

When preparing an enema solution for a child younger than 2 years of age, the total amount of fluid should not exceed_________________________.

240mL

The nurse is preparing to administer a subcutaneous injection. Which syringe will be used?

25-gauge, 1/2-inch needle

The nurse caring for a 2-month-Old baby uses an ______________________ to administer a very small dose of oral medication that is in a suspension.

Oral syringe

When the nurse is suctioning a tracheostomy, suction should be held no longer than:

5 seconds

For a child who weighs 32 pounds, what is the maximum pediatric dose for a medication that is recommended to be given at 35mg/kg/day?

507.5 mg

EMLA cream has been applied to the antecubital fossa of a child to lessen the pain of Venipuncture. The nurse is aware that in order for this cream to produce the desired effect it needs to be in place for approximately:

60 minutes

The nurse is aware that an IV antibiotic medication should infuse in no longer than:

60 minutes

In order to lessen the discomfort of a venipuncture for a blood draw for a 3-Year-Old child, the nurse may apply EMLA (local anesthetic cream) to the antecubital fossa:

60 minutes prior to venipuncture

Enteral

A method of nutrient delivery in which fluid is give directly into the gastrointestinal tract.

Nomogram

Calculates body surface area

The nurse modified the technique of administering eyedrops for a 1-month-old infant by:

Placing the drops in the nasal corner of the eyelid

When the nurse is instilling drops into the ear of a 2-Year-Old, the nurse should:

Draw the earlobe down and back to straighten the ear canal

The nurse monitors a child for which of the following after a lumbar puncture?

Fever, CSF leakage, and headache

As part of the preparation for obtaining a throat swab from a toddler, the nurse will:

Give a brief simple explanation to the child

Lumbar Puncture

Insertion of a hollow needle into the subarachnoid space between the third and fourth vertebrae; also called spinal puncture and spinal tap.

After a blood draw from the antecubital fossa of a 5-Year-Old child, the child continues to cry and to press his hand against the puncture site. The nurses best intervention would be to say:

"This big band aid will fix that hole, and you won't have to hold it anymore. You were very brave!"

rectal temperature

Contraindicated in newborns

The signs that indicate the need for tracheal suctioning in a 3-month-Old Child are:

Coughing A bubbling sound during respiration Noisy breathing

Apical heart rate

Counted for 1 full minute

In demonstrating technique for bathing an infant, the home health nurse stresses to the parents considerations such as:

Apply lotions, not powder, after the bath

The best procedure for the nurse to follow if an infant clenches the eyes shut when administering eye drops is to:

Apply the drops in the nasal corner where the lids meet.

Following a successful lumbar puncture, in order to avoid post-procedure discomfort for the patient, the nurse should:

Ask the parents to keep the child flat for several hours

Carrying out procedures in the least stressful manner to the child is called______________________

Atraumatic care

Fever

Body temperature above 38*C

Hyperthermia

Body temperature exceeding the set point, such as from heat stroke of seizures.

A child with spina bifida requires home catheterization. The child is now old enough to learn how to perform this procedure himself. The child is taught:

Clean the top of the penis with soap and water or betadine

The nurse would assess a 5-Year-Old patient who had a lumbar puncture completed 30 minutes ago for:

Drainage at the puncture site Evidence of headache Elevation of temperature

The nurse recognizes that signs of inadequate oxygenation include:

Increased restlessness, decreased pulse oximetry, and increased respiratory rate

Metabolic Rate

Increases 10% for every 1* C

The nurse giving an intramuscular (IM) dose of 2mL to a 6-month-Old child should:

Inject 1 mL into each vastus lateralis

The nurse giving an allergy desensitization injection to a well-fed 8-month-Old child in a subcutaneous injection would: (SATA)

Inject at a 90-degree angle Give the injection in the abdomen

The nurse is aware that the most effective form of comfort for an 11-Year-Old school-age child after a painful procedure is:

Praise for cooperation

Head circumference should be measured on all children: (SATA)

Younger than 36 months of age With neurological defects

Place the steps of the infant bath in the correct sequence: a. Apply water and shampoo to the head, and shampoo the hair/scalp b. Fill the tub, and test the water for appropriate warmth c. Remove secretions from the baby's eyes. d. Bathe the trunk and limbs e. Wash the perineal area

b. Fill the tub, and test the water for appropriate warmth c. Remove secretions from the baby's eyes. a. Apply water and shampoo to the head, and shampoo the hair/scalp d. Bathe the trunk and limbs e. Wash the perineal area