ATI review

*Tetanus toxoid vaccine is given after a burn if it has been more than five years since the prior dose.

Anti-microbial ointment should be applied to burn area to prevent infection*

A nurse and an emergency department is assessing the toddler who has Kawasaki disease. Which of the following findings should the nurse expect? Select all that apply.

Increased temperature, cervical lymphadenopathy and exophthalmia are all manifestations of Kawasaki disease.

Newborn vital signs

Resp 30-50 Pulse 120-160 systolic BP 60-80

Tinea capitis

ringworm of the scalp

Complete Blood Count (CBC) lab

WBC: 4,500-11,000 RBC's: 4.5-5.5 PLT: 150,000-450,000 Hgb: FEMALE- 12-16. MALE-13-18. HCT: FEMALE 36%-48% MALE 39%-54%

Erikson's stages of psychosocial development

1. trust vs. mistrust 2. autonomy vs. shame and doubt 3. initiative vs. guilt 4. industry vs. inferiority 5. identity vs. role confusion 6. intimacy vs. isolation 7. generativity vs. stagnation 8. integrity vs. despair

A nurse is reviewing the medical record of a 15-month-old toddler prior to administering immunizations. For which of the following findings should the nurse with all the measles mumps and rubella vaccine?

A history of anaphylactic reaction to neomycin. The MMR vaccine contains a small amount of near my son which could trigger a severe allergic response.

A nurse is developing a plan of care for a child who is experiencing status Asthmaticus. Which of the following intervention should the nurse include?

Administer an intravenous corticosteroid. A child who is experiencing status Asthmaticus. Corticosteroids decrease inflammation quickly due to rapid onset, which improve oxygenation until bronchodilators take effect.

A nurse is caring for a 10-year-old child following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing diabetes insipidus?

sodium 155 mEq/L - A child who has a head injury can develop diabetes insipidus as a result of the pituitary function leading to a deficiency in antidiuretic hormone. Under excretion of antidiuretic hormone leads to polyuria and polydipsia and possibly dehydration. With excessive loss of free water, sodium levels rise above the expected reference range of 136 to 145 mEq/L.

cheiloplasty

surgical repair of the lip

Hypopituitarism

underactive pituitary gland treated with recombinant growth hormone injections.*

A nurse is caring for a school-age child who has diabetes Mellitus and was admitted with a diagnosis of diabetic keto acidosis. When performing the respiratory assessment, which of the following financial the nurse expect?

Deep respirations of 32/min. Kussmaul respirations. Deep and rapid respirations are the bodies attempt to illuminate excess carbon dioxide and achieve a state of homeostasis.

A nurse is developing a plan of care for a child who is receiving chemotherapy via an implanted port. Which of the following intervention should the nurse include access the port?

with a noncoring needle. A noncoring needle has a straight or angle designed to access and implanted port. The nurse can use a local anesthetic cream on the access site or inject a small amount of intradermal lidocaine prior to inserting the needle.

A nurse is reviewing the laboratory results of a school age child who has one week postop her to the following an open fracture repair. Which of the following findings should the nurse identify as an indication of a potential complication?

Erythrocyte sedimentation rate 18 mm/hr the nurse should identify that in erythrocyte sedimentation rate of 18 mm/hr is above the expected reference range of up to 10 mm/hr and is an indication of osteomyelitis.

Teaching a child with ADHD

Faculty should plan to teach challenging subjects in the morning to students who have ADHD are most likely to focus and their medication is most likely to be effective.

A nurse is preparing a toddler for an entertaining as catheter insertion. Which of the following actions should the nurse include in the plan of care?

Give the toddler One Direction at a time during the procedure. use simple terms and phrases during the procedure to gain cooperation from the toddler.

A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following intervention should the nurse include in the plan?

Increase fat content in the child's diet to 40% of total calories. A child who has cystic fibrosis is unable to properly digest fats due to fibrosis of the pancreas and limit secretions of pancreatic enzymes. The nurse should increase the child's fat intake to 35 to 40% of total caloric intake.

A nurse is teaching a group of parents about infectious mononucleosis. Which of the following statements by a parent indicates an understanding of the teaching?

Mononucleosis is caused by an infection with Epstein bar virus. The nurse should identify that mononucleosis is a mildly contagious illness that occurs sporadically or in groups and is primarily caused by Epstein bar virus. ** abnormal lab finding with mononucleosis; platelets 96,000/mm** (range is 150,000 to 400,000/mm)

Bilirubin levels

Newborn is 2 to 6 MG/DL

A nurse is caring for an infant who is receiving IV fluids for the treatment of tetralogy of fallot and begins to have hypercyanotic spell. Which of the following actions should the nurse take?

Place the infant and I need chest position. During a hypercyanotic spell to decrease the return of the saturated venous blood from the legs into the direct more blood into the pulmonary artery by decreasing systemic vascular resistance.

A nurse is assessing a six-month-old infant during a well child visit. Which of the following findings should the nurse report to the provider?

Presence of strabismus. Strabismus, or crossing of the eyes, typically disappears at 3 to 4 months of age. If not corrected early, this can lead to blindness.

Basal Metabolic Panel (BMP) Lab

SODIUM: 135-145 mEq/L POTASSIUM: 3.5-5.0 mEq/L CHOLRIDE: 95-105 mEq/L CALCIUM:9-11 mg/dL BUN: 7-20 mg/dL CREATININE: 0.6-1.2 mg/dL ALBUMIN: 3.4-5.4 g/dL TOTAL PROTEIN: 6.2-8.2 g/dL

A nurse is caring for a child who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?

Sweating. The nurse should identify diaphoresis or sweating, as a manifestation of hypoglycemia. Other manifestations include hunger, tremors, headache and dizziness.

Rotavirus

The most important global cause of infantile gastroenteritis. Major cause of acute diarrhea in the USA during winter, especially in daycare centers, kindergartens. Villous destruction w/ atrophy leads to decreased absorption of Na+ and water. ROTA = Right Out The Anus

care after cheiloplasty

The nurse should instruct the parents to apply a thin layer of antibiotic ointment on the infant suture line daily for three days and then continue to apply petroleum jelly to the area for several weeks to promote healing.

A nurse is planning a developmental activity for a newly admitted 10-year-old child who has neutropenia. Which of the following actions should the nurse plan to take?

The nurse should provide a school-age child with a book about adventure as a developmental activity because children are expanding their knowledge and imagination during this age. Through reading, school-age children can feel powerful and skillful as they imagine themselves and the stories they read.

A nurse is admitting an infant who has intussusception. Which of the following findings the nurse expect?

Vomiting, diarrhea, lethargy, draws up legs toward the abdomen in severe pain while crying, currant-jelly stools (bloody), sausage shaped mass in upper mid-abdomen.

A nurse is teaching a school-age child and their parent about postoperative care of following cardiac catheterization. Which of the following actions should the nurse include?

Wait three days before taking a tub bath. This keeps the site clean and dry for at least three days to reduce the risk of infection. D/C instructions* remove the pressure dressing tomorrow* The pressure dressing should be removed the day following the catheterization then covered with an adhesive bandage for several days.

A nurse is teaching a guardian of a six month infant about teething. Which of the following statements should the nurse make?

Your baby might pull their ears when they are teething. This is a sign from the baby that they are in discomfort, difficulty sleeping increased drooling and or increased fussiness.

Neutropenia

abnormally low count of neutrophils (type of white blood cells)

diabetes insipidus

body can't regulate how it handles fluids. Condition is caused by a hormonal abnormality that isn't related to diabetes.

Wilms tumor (nephroblastoma)

cancerous kidney tumor of childhood Most common kidney cancer in children, 9 0f 10 are wilms'.

nonheme iron

dietary iron not associated with hemoglobin; the iron of plants and other sources **Raisins are good source for nonheme Iron*

Maslow's Hierarchy of Needs

physiological, safety, love/belonging, esteem, self-actualization

>12yr vital signs

resp 12-20 pulse 60-90 systolic BP 100-120

8-12yr vital sings

resp 12-20 pulse 80-100 systolic BP 100-110

5-8yr vital sings

resp 14-20 pulse 90-100 systolic bp 90-100

2-4 yr vital signs

resp 20-30 pulse 100-110 systolic BP 80-95

6 Mo - 1yr. Vital sings

resp 30-40 Pulse 120-160 Systolic BP 70-80