ch. 23 prep U

The nurse has admitted a child to the pediatric unit with diarrhea and vomiting. Accurate intake and output are important care measures for the child. The nurse correctly assesses that output parameters should be:

0.5 to 1 ml/kg/hr.

A grandmother suggests that boiled skim milk should be used to treat her young grandchild's diarrhea. This is an inexpensive, convenient, and often-suggested home remedy. How should the nurse respond?

"Boiled skim milk should not be used. It contains more salt than your grandchild should have."

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has:

severe dehydration.

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?

sunken fontantels (fontanelles)

A child is diagnosed with intussusception. The nurse would prepare the child and family for which of the following?

surgery

The nurse is determining maintenance fluid requirements for a child who weighs 25 kg (55 lb). How much fluid would the child need per day?

1,600 ml

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find?

Hard, moveable, olive-shaped mass in the right upper quadrant

The nurse admits a 7-year-old child who reports pain in the lower right quadrant of the abdomen, nausea, and constipation. An assessment shows that the child has a fever of 101°F (38.3℃). Which nursing intervention should the nurse implement to safely address the child's reported pain?

Help the child find a comfortable position.

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply.

IV fluid administration monitor of intake and output daily weight assessment

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?

Improving hydration

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

A nurse is caring for a 6-year-old girl recently diagnosed with celiac disease and is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching?

"My daughter can eat any kind of fruit."

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac disease. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac disease?

"She loves hot dogs, and we always cut hers up into small pieces."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?

"Tell me about the types of stools your child has been having."

The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a tube. The nurse is reviewing interventions to promote growth and development. Which response from the mother indicates a need for further teaching?

"We need to keep feeding time very quiet."

The nurse enters a client's room to find the new mother crying softly. The client states, "I had my heart set on breastfeeding but my infant was born with a cleft lip. My dreams of breastfeeding are destroyed." Which response by the nurse is appropriate?

"You may still breastfeed your infant. I will show you appropriate techniques to use."

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family?

Ask the parents if they have any questions regarding the care of their child.

A child is diagnosed with an enterovirus infection. Which type of infection control precaution would be most important for the nurse to use?

Contact

The mother of a newborn with a cleft lip reports she is having a hard time looking her baby. What is the best action by the nurse?

Encourage the mother to provide care for her infant.

The parents of a child diagnosed with celiac disease ask the nurse what types of food they can offer their child. What recommendation would the nurse include in the teaching plan?

Fruit juice

Nurses will need to teach the parents of the infant being treated for Hirschsprung disease (aganglionic megacolon) to:

care for a temporary colostomy.

A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client?

Request an intravenous form of the medication.

A child with severe diarrhea cannot drink and requires intravenous rehydration. After beginning the therapy, the nurse determines that potassium can be added to the intravenous fluid because which of the following has occurred?

The child has voided.

Which assessment findings suggest that an infant with diarrhea is severely dehydrated?

elevated hematocrit and depressed eye globes

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 drug?

esomeprazole

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis?

hard, moveable "olive-like mass" in the upper right quadrant

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 lab work, which reports a pH- 7.33, HCO3- 21, PaCO2- 42. Which would be documented?

metabolic acidosis

A child with severe vomiting for 3 days presents with hypopnea and hypokalemia. The nurse reports to the provider that this child is exhibiting signs of which condition?

metabolic alkalosis

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition?

mother age 42 with pregnancy

Which type of nutrition does the nurse anticipate initiating when an infant with gastroenteritis and dehydration begins solid foods?

oral rehydration solutions