Chapter 29: Nursing Care During a Pediatric Emergency
The nurse is assessing the neurologic status of an 11-month-old girl. Which finding would be cause for concern?
Inspection shows a sluggish pupillary reaction.
"I need to administer small amounts of fluid as quickly as possible."
Minimal air movement through the lungs
The nurse notes absent breath sounds in the right upper, middle, and lower lung fields of a 24-month-child. What question by the nurse to the parents of the child would be most appropriate?
"Was your child playing with a toy with small parts?"
The nurse is caring for a child brought to the emergency room by the babysitter. The babysitter reports the child was playing and acting "fine" but started to be "sick and get worse" all of a sudden after lunch. The babysitter denies any obvious reason or situation leading to the child's decline. What would the nurse further assess for?
ingestion of a toxin
A nurse is providing care to a child hospitalized after an accident that resulted in a substantial loss of blood. The nurse is preparing to administer IV fluids using a 60-milliliter syringe attached to the child's IV site. The child's parent asks the nurse why there is no IV bag hanging. What is the best response for the nurse to make?
"I need to administer small amounts of fluid as quickly as possible."
The nurse is assessing the neurologic status of an infant. What would the nurse identify as an abnormal finding?
Lack of interest in surroundings
An infant is in the neonatal intensive care unit and has a temperature of 93 °F (33.8 °C). Hypothermia can lead to which clinical manifestation?
Metabolic acidosis
An emergency department nurse is caring for a 5-year-old child who was just brought in by ambulance with partial-thickness (second-degree) and full-thickness (third-degree) burns to their face, neck, and chest. The client is awake and alert. Vital signs: temperature, 97.2°F (36.2°C); heart rate, 148 beats/min; blood pressure, 68/39 mm Hg; respiratory rate, 32 breaths/min; oxygen saturation, 90% on 2 liters by nasal cannula. The nurse receives prescriptions for the client. Click to highlight the prescription(s) that requires immediate implementation.
Apply oxygen to maintain oxygen saturations 95% or greater. Administer 100 mcg/kg morphine via intravenous push (IVP) for pain prn q4 hour. Initiate fluid resuscitation per Lund and Browder chart using Parkland formula with 0.9% saline.
A 3-year-old child has sustained injuries from a fall. Once the airway is secured, what interventions would be next?
Stabilize the cervical spine.
A nurse on a pediatric unit finds a 3-year-old child unconscious. The child does not respond to stimuli. The nurse calls a code and starts to perform cardiopulmonary resuscitation (CPR). The nurse should first address the child's: BLANK followed by the child's: BLANK, then: BLANK
airway breathing perfusion
A child is brought to the emergency department in severe respiratory distress. As the nurse begins an assessment, the child becomes unresponsive and stops breathing. The nurse calls for help and the health care team begins resuscitative measures. The nurse attempts to escort the child's parent from the room but the parent refuses to leave. Which is the best action for the nurse to take?
Allow the parent to stay in the room but remain at the parent's side for support.
Administration of which medication reverses the histamine release and hypotension that are seen in anaphylaxis?
epinephrine
A 6-year-old girl who is being treated for shock is pulseless with an irregular heart rate of 32 bpm. Which intervention is priority?
Initiate cardiac compressions.
A 10-year-old child comes to the emergency department as a victim of abuse. The child's parent reports that the child was hit repeatedly with a baseball bat a few hours prior. The initial assessment indicates the child's blood pressure is 84/40 mm Hg. The nurse would further assess the child for what finding?
injuries resulting in ongoing blood loss
