Nursing Care of Children Health Promotion and Maintenance

The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?

The importance of crossing streets safely Motor-vehicle accidents are a leading cause of death in this age group. p 10

A nurse is educating the parents of an infant about symptoms that should be reported to the provider. What finding should be immediately reported? Select one: a. Mild diarrhea b. Difficulty evacuating bowels c. Decreased urine output d. Abdominal distension

c. Decreased urine output

The nurse is caring for a 16-year-old female who has been brought to the clinic by her mother seeking information about contraceptives. What action by the nurse will best promote the client's autonomy?

After a review of suitable contraceptive options, ask the client which is of the greatest interest.

The nurse is caring for a child who underwent an appendectomy 12 hours ago. The child has reported incisional pain. When the nurse attempts to administer the prescribed analgesic the child's mother declines the medication. What initial action by the nurse is most appropriate?

Ask the child's mother to elaborate on her concerns about the medication. Some people may not approve of the administration of narcotics or medications containing alcohol. The nurse must first determine the cause of the concern. Then action can be taken to best provide care to the child. Continuing observation of the child does not address the needs related to pain management. Although the client's physician or the nursing supervisor may be contacted, it is not the initial action in this scenario.

What is a current trend in child health care?

Health promotion rather than health restoration is stressed. It is recognized that keeping individuals well is more cost effective for a system than helping ill individuals return to wellness.

The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation?

Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved. When a nurse believes the physician has unduly coerced parents in their treatment decision, the nurse would be obliged to intervene and disclose any concerns. Such intentional or unintentional action would violate ethical principles of conduct. pg 18

The nurse is focusing on health promotion for a 6-year-old girl. Which intervention best supports Healthy People goals?

Recommending a helmet for biking Recommending that the child wear a protective helmet best supports the goals of Healthy People because unintentional injury remains a leading cause of mortality and morbidity for children. Proper diet, adequate sleep, and after-school child care are important but do not affect child health status as much as injury prevention does.

A nurse is planning community education focusing on the principles of first aid. Which of the following strategies is likely to be most effective with adolescent learners? Select one: a. Actively involve the participants in practice of techniques. b. Simple lecture format. c. Teach the most crucial content early in the session. d. Divide the planned program into several sessions over several weeks.

a. Actively involve the participants in practice of techniques. Adolescent learners will learn best when actively involved in participation and use of psychomotor skills.

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role?

Facilitating return to school by working with the school nurse

Following the discharge of a child who has a chronic health condition from the hospital, the nurse case manager follows up with a visit to the home and meets with the family and child. This visit best represents which philosophy of pediatric nursing?

Family-centered care The home visit by the case manager to some degree meets principles of each type of care, but is most representative of family-centered care because family-centered care is described as a mutually beneficial partnership between the child, the family, and health care professionals.

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject best supports the emphasis on preventive care?

Showing the mother how to teach hand washing to her child. Teaching hand washing helps to prevent infection, emphasizes preventive care, and is basic to avoiding many common illnesses. Reminding the mother that the child will imitate her may promote safe parental role-modeling but does not reach the level of prevention that hand washing does. Knowing about developmental milestones and typical physical changes in toddlers does not directly promote preventive care.

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?

Teach injury prevention and proper safety practices. The leading cause of death throughout childhood is unintentional injury. pg 15

The parent of a two-year-old child reports feeling frustrated with the fact that her son is saying no to everything. The nurse should teach the parent that this behavior is a normal expression of the child's desire to accomplish which of the following? Select one: a. Increase their independence. b. Gratify their oral fixation. c. Develop their sense of trust. d. Finish a project they set out to do.

a. Increase their independence. The drive for independence is expressed by the toddler opposing the desires of those in authority (tantrums) and attempting to do everything for themselves. The Erickson developmental stage for this age is "Autonomy vs. Shame and Doubt."

A nurse is helping parent's select appropriate independent activities for their 8-year-old child. Which of the following would be an appropriate activity? Select one: a. Providing frequent trips to the library b. Encouraging the child to assume care of the family pet c. Allowing the child to play video games d. Playing touch football

a. Providing frequent trips to the library

A nurse is changing a dressing on a preschool-aged child who has a healing wound on a lower extremity. Which of the following nonpharmacologic comfort measures would be most appropriate for this child? Select one: a. Promising the child a special treat in exchange for cooperation. b. Encouraging the child to watch a favorite cartoon on television. c. Assisting the child to take deep breaths and focus on relaxing. d. Teaching the child how to go 'to a different place' using their imagination.

b. Encouraging the child to watch a favorite cartoon on television.

A nurse is taking the health history of a school-age girl. Which statement by the client's mother indicates a need for further teaching regarding the client's nutritional status? Select one: a. "We increase her protein intake when she's playing sports." b. "She enjoys helping to prepare her snacks in the kitchen." c. "We allow her to pick out a treat at the grocery store for good behavior." d. "She eats a large breakfast every morning."

c. "We allow her to pick out a treat at the grocery store for good behavior." This statement indicates a need for further teaching. This client's mother should be educated about the importance of praising the client's abilities and skills rather than using food as a reward, which may lead to an increased risk for obesity.