Chapter 18

A parent asks the nurse about immunizing her 7 month old daughter against the flu. Which response by the nurse would be most appropriate?

"Since your daughter is older than 6 months, she should get the vaccine every year."

The nurse is preparing to provide tracheostomy care to an infant. After gathering the necessary equipment, what would the nurse do next?

Position the infant supine with a towel roll under the neck

The nurse is examining an 8 y.o. boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child's hypoxia?

Pulse oximetry

Bacterial pneumonia is suspected in a 4 y.o. boy with fever, ha, and chest pain. Which assessment finding would most likely indicate the need for hospitalization?

Tachypnea and retractions

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm?

Albuterol

The nurse is examining a 5 y.o. boy. Which s/s is a reliable first indication of respiratory illness in children?

Rapid, shallow breathing

A child requires supplemental oxygen therapy at 8 liters per minute. Which delivery device would the nurse most likely expect to be used?

Simple mask

The nurse is caring for a 3 y.o. girl with a respiratory disorder. The nurse anticipates the need for providing supplemental oxygen to the child when performing which action?

Suctioning a tracheostomy tube

The nurse is providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. The nurse would most likely suspect sinusitis in which child?

7 y.o. with halitosis and thick, yellow nasal discharge

The nurse is assessing a 5 y.o. girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, what would be the least appropriate for the nurse to perform?

Visualizing the throat

When performing the physical examination of a child with cystic fibrosis, what would the nurse expect to assess?

Decrease tactile fremitus

A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which finding?

Children develop hypoxemia more rapidly than adults do

A child with a pneumothorax has a chest tube attached to a water seal system. When assessing the child, the nurse notices that the chest tube has become disconnected from the drainage system. What would the nurse do first?

Clamp the chest tube

A nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason?

Hasten air reabsorption

A nurse is preparing a teaching program for a parenting group about preventing foreign body aspiration. What information would the nurse include?

If an object fits through a standard toilet paper roll, the child can aspirate it

A nurse is preparing a teaching plan for the family of a child with allergic rhinitis. When describing the immune reaction that occurs, the nurse would identify the role of which immunoglobulin?

IgE

The nurse hears wheezing when auscultating a 4 y.o. which condition would the nurse most likely rule out based on the assessment findings?

Influenza

The nurse is discussing discharge instructions with the parents of a 6 y.o. who had tonsillectomy. What is the most important thing to stress?

Inspect the throat for bleeding

The nurse is educating the parents of a 7 y.o. boy with asthma about the medications that have been prescribed. Which drug would the nurse identify as an adjunct to a b2- adrenergic agonist for treatment of bronchospasm?

Ipratropium

A nursing instructor is preparing a class on chronic lung disease. What information would the instructor include when describing this disorder?

It is seen most commonly in premature infants

The nurse is assessing a 7 y.o. boy with pharyngitis. What assessment finding would suggest the child has developed a peritonsillar abscess?

Palatal edema

The nurse is preparing to perform a physical examination of a child with asthma. Which technique would the nurse be least likely to perform?

Palpation

A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally?

Pancreatic enzymes