Pedia Concepts
The nurse is preparing discharge instructions for the parents of a young child recovering from pneumonia. Which information should the nurse provide to help prevent the reoccurrence of the disease? A. "Report worsening of symptoms to the provider." B. "Complete all prescribed medications." C. "Ensure that all vaccinations are up to date." D. "Provide for periods of rest."
Answer: B
The nurse is instructing a group of college students about the signs and symptoms of "walking pneumonia." Which manifestation should the nurse include? (Select all that apply.) A. Productive cough B. Headache C. Fever D. Muscle aches E. Joint pain
Answer: B, C, D, E
Which of the following should be included when developing a teaching plan to prevent urinary tract infection? Select all that apply. A. Maintaining adequate fluid intake B. Avoiding urination before and after intercourse C. Emptying bladder with urination D. Wearing underwear made of synthetic material such as nylon E. Keeping urine alkaline by avoiding acidic beverages F. Avoiding bubble baths and tight clothing
A, C, F
FYI: 4 risk factors for pediatric gastroenteritis: 1. daycare attendance 2. poor sanitation or hygiene 3. failure to receive rotavirus vaccine 4. late fall - late winter season
...
A nurse is caring for an infant with a suspected urinary tract infection (UTI). Based on the nurse's knowledge of UTIs, which clinical manifestation would be observed? Select all that apply. A. Vomiting B. Jaundice C. Swelling of the face D. Persistent diaper rash E. Failure to gain weight
A, D, E Vomiting is a clinical manifestation observed in an infant with a urinary tract infection (UTI) and can be related to poor feeding. Persistent diaper rash is a clinical manifestation of UTI in an infant. Failure to gain weight is a clinical manifestation of UTI in an infant related to poor feeding and vomiting. Jaundice is not a clinical manifestation of UTI in an infant. Swelling of the face is not a clinical manifestation of UTI in an infant.
The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. The nurse documents this finding as which of the following? a) Bladder exstrophy b) Patent urachus c) Epispadias d) Hypospadias
D
Which system effect of pneumonia should the nurse monitor? A. Cyanosis B. Excess mucus production C. Shortness of breath D. Hemoptysis
Answer: A
Which instruction should the nurse provide to a client who has pneumonia and is being discharged for home care? (Select all that apply.) A. "Maintain adequate fluid intake." B. "Avoid smoking or exposure to secondhand smoke." C. "Limit activities and increase rest." D. "Clean surfaces with household disinfectant." E. "Wear a mask when in contact with other household members."
Answer: A, B, C
The nurse caring for a client with pneumonia reviews the medical administration record and order sheet. Which agent should the nurse expect to administer? (Select all that apply.) A. Oxygen B. Mucolytic agent C. Broad-spectrum antibiotic D. Laxative E.Bronchodilator
Answer: A, B, C, E
The nurse in the emergency department is caring for a client with a temperature of 39°C (102.5°F), productive cough, chills, shortness of breath, and malaise. Which diagnostic test should the nurse expect to prepare the client for? (Select all that apply.) A. Chest x-ray B. Sputum culture and sensitivity C. Polysomnography D. Arterial blood gases E. MRI of the chest
Answer: A, B, D
A client who is significantly immunocompromised is diagnosed with Pneumocystis jiroveci. The client states to the nurse, "Every time I leave my house, I have worn a mask, so that I would not get sick. How did I get this?" Which response by the nurse represents an understanding of the pathogen responsible for the diagnosis? A. "The infection occurred by drinking contaminated water." B. "This organism could have been brought into your home by a visitor." C. "It is not known how this organism is transmitted." D. "This organism is found in undercooked meat."
Answer: B
The nurse is caring for a client diagnosed with bronchopneumonia and experiencing apnea. Which condition should the nurse recognize as the cause of apnea? A. Accumulation of fluid in the airways B. Respiratory muscle fatigue C. Bacterial debris in the airways D. Presence of pathogens
Answer: B
Determine whether the nursing action is indicated or contraindicated for a pt. with gastroenteritis and severe dehydration: 1. request closed top crib for hospital room 2. request an order for NPO 3. request an order to administer a fluid bolus 4. request an order to insert a peripheral IV catheter 5. weigh diapers to monitor ouput
1, 3, 4, and 5 are indicated
7-year-old Damon has cystitis; which of the following would Nurse Elena expect when assessing the child? A. Dysuria B. Costovertebral tenderness C. Flank pain D. High fever
A
Most urinary tract infections seen in children are caused by which of the following? A. Hereditary causes B. Intestinal bacteria C. Dietary insufficiencies D. Fungal infections
B
Which of the following should the nurse recommend to prevent urinary tract infections (UTIs) in young girls? A. Avoid public toilets B. Limit long baths as much as possible C. Cleanse perineum with water after voiding D. Ensure clear liquid intake of 2L/day
D
A child has been diagnosed with acute glomerular nephritis. Which of the following changes would the nurse expect to see in the child's laboratory reports? A. Urine white blood cell count: elevated B. Urine creatinine clearance: decreased C. Urine specific gravity: decreased D. Urine red blood cell count: elevated
D
A parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome (MCNS) again. Which is the nurse's best response? A. "It is very rare for a child to have a relapse after having fully recovered." B. "Unfortunately, many children have cycles of relapses, and there is very little that can be done to prevent it." C. "Your child is much less likely to get sick again if sodium is decreased in the diet." D. "Try to keep your child away from sick children because relapses have been associated with infectious illnesses."
D
Alaric was diagnosed with minimal-change nephrotic syndrome; which of the following signs and symptoms are characteristics of the said disorder? A. Hypertension, edema, hematuria B. Hypertension, edema, proteinuria C. Gross hematuria, fever, proteinuria D. Poor appetite, edema, proteinuria
D
In caring for a child with nephrotic syndrome, which of the following interventions will be included in the child's plan of care? a) Ambulating three to four times a day b) Testing the urine for glucose levels regularly c) Increasing fluid intake by 50 cc an hour d) Weighing on the same scale each day
D
The parent of a 3-yr-old calls the nurse advice line. The parent reports the toddler has had diarrhea for the past two days, has had no vomiting, has a dry mouth, and sunken looking eyes. Which is the best recommendation by the nurse? a. administer an antidiarrheal med b. take the toddler to the emergency department c. initiate oral rehydration therapy d. hold all by mouth intake for four hours
c. initiate oral rehydration therapy
The nurse is caring for a 6-yr-old who was admitted to the pediatric unit for dehydration related to gastroenteritis. The nurse is initiating a peripheral IV catheter to administer IV fluids. which s the best statement by the nurse when explaining the procedure to the client?
a. i am going to put this tourniquet on your arm first b. i am going to put a special straw in your hand c. i am going to put a tiny needle in your hand d. i want you to look over at your parent
Then nurse is educating the parent of a child about oral rehydration therapy for mod dehydration. The child weights 12 kg. The nurse advises the child should drink 100ml/kg over 4 hours. What is the minimum number of ounces the child should drink per hour? a. 100 oz b. 10 oz c. 40 oz d. 300 oz
b. 10 oz
as far as nutrition goes in a child with gastroenteritis: 1. continue _____ on demand 2. continue age appropriate diet upon ____ 3. maintain adequate calorie intake 4. avoid foods high in ___ ___ 5. restricted diets like the BRAT diet ______ (are/are not) necessary
breastfeeding, rehydration, simple sugars (jello, juice, pop), are not
name 3 things to look at to determine dehydration status
breathing, skin fold, capillary refill
the nurse is caring for a group of pediatric clients. which client is most at risk for dehydration? a. a 16-yr-old with diarrhea and dry mucous membranes b. 10-yr-old with diarrhea and sunken eyes c. 3- month- old with diarrhea and a sunken fontanel d. 3-yr-old toddler with diarrhea and loss of skin turgor
c. 3-month old
You obtain a history from the mother of a child with glomerulonephritis about how he became ill. Which of the following would you expect her to tell you she noticed? A. Headache, loss of appetite B. Dark brown urine C. Loss of weight, oliguria D. Diuresis and pallor
B
The nurse knows which of the following is a description of peritoneal dialysis when compared to hemodialysis? a) The child must go into a facility to get peritoneal dialysis. b) There are strict diet and fluid restrictions. c) The child can live a more normal lifestyle. d) Therapy is only 3 to 4 days per week.
C
A pediatric client with diarrhea lasting 5 days is classifed as having _____ diarrhea, which is most likely due to a _____. Treatment generally includes ____ with the goal of preventing dehydration and resuming a normal diet. 1. acute vs chronic 2. malabsorption or inflammatory dx vs. bacteria or virus 3. hospitalization vs. home care
1. acute 2. bacteria or virus 3. home care
The nurse is caring for a child admitted with acute glomerulonephritis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? A. Smoky colored urine B. Jaundiced skin C. Strawberry red tongue D. Loose, dark stools
A
The nurse is preparing a 7-year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would the nurse include in the discharge teaching plan for the parents? a) "Let's meet with the dietitian and plan some meals." b) "Here is some written information from the dietitian. "c) "She must severely restrict her sodium intake. "d) "She should try to avoid protein."
A
12-year-old Caroline has recurring nephrotic syndrome; which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care? A. Body image B. Sexual maturation C. Muscle coordination D. Intellectual development
A
A child diagnosed acute glomerulonephritis will most likely have a history of which of the following? A. Recent illness such as strep throat B. Hemorrhage or history of bruising easily C. Sibling diagnosed with the same disease D. Hearing loss with impaired speech development
A
A child diagnosed with acute glomerulonephritis will most likely have a history of which of the following? A: recent illness such as strep throat B: hemorrhage or history of brusing easily C: sibling diagnosed w/ same disease D: Hearing loss
A
A nurse is performing an assessment on a child. Which of the following would be indicative of a potential for a urinary tract infection? A. Holding urine while at school. B. Not using cleansing towelettes routinely. C. Washing the genital area with water daily. D. Not using soap when cleaning the urethral area.
A
A nurse is performing an assessment on a child. Which of the following would be indicative of a potential for a urinary tract infection? a) Holding urine while at school .b) Not using cleansing towelettes routinely. c) Washing the genital area with water daily. d) Not using soap when cleaning the urethral area.
A
Chronic hypertension in the child who has chronic renal failure (CRF) is due to which of the following? A. Retention of sodium and water. B. Obstruction of the urinary system. C. Accumulation of waste products in the body. D. Generalized metabolic alkalosis.
A
In planning care for a child diagnosed with minimal change nephrotic syndrome, the nurse should understand the relationship between edema formation and: A. Decreased colloidal osmotic pressure in the capillaries B. Reduced tubular reabsorption of sodium and water C. Increased retention of albumin in the vascular system D. Fluid shift from interstitial spaces into the vascular space
A
Nurse Kai is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement? A. Increased urine output B. Increased appetite C. Increased energy level D. Decreased diarrhea
A
Patient S is a sexually active adolescent; which of the following instructions would be included in the preventive teaching plan about urinary tract infections? A. Drinking acidic juices B. Avoiding urinating before intercourse C. Wearing nylon underwear D. Wiping back to front
A Drinking acidic juices, such as cranberry juice, helps keep the urine at its desired pH and reduces the chance of infection. The client should wipe from front to back, wear cotton underwear, and void before and after intercourse.
Which assessment findings indicate an infant with gastroenteritis and dehydration is improving? SATA a. infant has had no stools for 12 hours b. peripheral IV catheter was removed c. infant is tolerating formula, rice cereal, and baby food d. infant had three wet diapers overnight e. infant has bright red rash to buttocks
A, B, C, D
A 9-year-old female is brought to the provider for a recent history of new daytime wetting accidents since the start of the school year. What history would the nurse want to obtain? Select all that apply. A. How often do the accidents occur? B. Do they occur just at school or at home as well? C. What are your bowel movements like? D. What kinds of things do you drink? E. Do you spread your legs when you void?
A, B, C, D, E
The healthcare provider diagnosed the client with gastroenteritis and dehydration. Review the orders by the healthcare provider. Which 3 orders should the nurse implement first? a. acetaminophen for fever greater than 101.1 b. insert a peripher IV catheter c. advance diet intake as tolerated d. administer 0.9% NA chloride bolus over 30 minutes e. administer 20 mEq/l potassium chloride and 0.45 % sodium chloride at 40 ml/hour
A, B, D
The nurse is providing education to the parent of a 3-yr-old child in a pediatric primary care office. The parent brought the toddler in for gastroenteritis and dehydration. The healthcare provider determine the child could likely be rehydrated at home with oral rehydration therapy. Which are benefits of oral rehydration therapy for the nurse to include in education? SATA a. less costly than IV fluid therapy b. faster than IV fluid therapy c. can be used for severe dehydration d. safer than IV fluid therapy e. can be accomplished at home
A, D, E
The nurse is completing the assessment of a 3-yr-old child in a pediatric primary care office. The parent brought the toddler in for gastroenteritis. Which are important assessment questions for the nurse to ask the parent? SATA a. "can you describe your child's activity level since being ill? b. how many times a day has your child had diarrhea episodes? c. how much has your child been eating and drinking? d. has your child had any vomiting? e. does your child attend daycare or preschool?
All
The nurse informs a client with pneumonia that a respiratory therapist is scheduled to perform chest physiotherapy. The client asks, "What does that mean?" Which response by the nurse is best? A. "Chest physiotherapy will help move the liquid out of your lungs." B. "Chest physiotherapy will help you breathe better." C. "Chest physiotherapy will help prevent excessive coughing so you can rest better." D. "Chest physiotherapy will help remove the infecting organism from your lungs."
Answer: A
The nurse is conducting a teaching session for new parents on the causes of viral pneumonia. Which cause should the nurse include in the teaching? (Select all that apply.) A. Adenovirus B. Norovirus C. Cytomegalovirus (CMV) D. Rotavirus E. Influenza virus
Answer: A, C, E
The nurse is caring for a client diagnosed with pneumonia resulting from Staphylococcus aureus. Which classification of medication should the nurse anticipate the healthcare provider will order to eradicate the infection? A. Corticosteroid B. Cephalosporin C. Antitussive D. Bronchodilator
Answer: B
The nurse is caring for a client thought to have lobar pneumonia. Which color does the nurse anticipate the sputum to be when obtaining a sputum sample? A. Brown B. Rust-colored C. Red D. Cloudy
Answer: B
A client admitted from home is diagnosed with community-acquired pneumonia. Which organism does the nurse suspect is the cause of this infection? A. Escherichia coli B. Staphylococcus aureus C. Pneumococcus D. Pneumocystis jiroveci
Answer: C
The nurse is caring for a pregnant woman new to the clinic. Which question will uncover whether the client has the highest risk for developing pneumonia? A. "Are your immunizations up to date?" B. "Do you have a history of asthma?" C. "Does anyone smoke in the house?" D. "Do you have any medical conditions?"
Answer: C
A client with pneumonia is prescribed 100% oxygen. Which type of oxygen delivery device should the nurse use? A. Simple face mask B. Venturi mask C. Nasal cannula D. Nonrebreather mask
Answer: D
The nurse is providing a 68-year-old client with health promotion activities. Which vaccine will the nurse recommend for the prevention of bacterial pneumonia? A. Meningococcal vaccine B. Flu vaccine C. Tetanus, diphtheria, and pertussis vaccine (TDAP) D. Pneumococcal vaccine
Answer: D
An 18 month old, 11 kg male child is brought to the emergency department after 2 days history of diarrhea and vomiting. Mom states "too many episodes to count". On physical exam, patient is lethargic, eyes appear sunken, skin is cool with tenting and mottled in color, buccal mucosa is parched, and diaper is dry. Vitals on arrival in the emergency department are BP: 80/49 mmHg T: 38.4oC (ax) Pulse: 188 bpm RR: 47 bpm Pain: 0 (FLACC) You determine he has severe dehydration. Based on his presentation, what would you recommend for appropriate rehydration therapy? a) No bolus required; initiate IV infusion of D5½NS at twice maintenance fluid rates b) Normal saline 220 mL IV bolus followed by D5½NS at twice maintenance fluid rates c) D5½NS 220 ml IV bolus followed by D5½NS at twice maintenance fluid rates d) Pedialyte 200 ml oral over 3-4 hours
B
The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to do which of the following actions? A. Give the child fluids and report back to the nurse in a few hours. B. Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone. C. Give the child a diuretic and report back to the nurse in a few hours. D. Weigh the child in the same clothes she had been weighed in the day before and report the two weighs to the nurse while the nurse is on the phone.
B
The clinical manifestations of minimal change nephrotic syndrome (MCNS) are due to which of the following? A. Chemical changes in the composition of albumin. B. Increased permeability of the glomeruli. C. Obstruction of the capillaries of the glomeruli. D. Loss of the kidney's ability to excrete waste and concentrate urine.
B
The most common cause of gastroenteritis in children throughout the winter months is? a) RSV b) Rotavirus c) Adenovirus d) Shigella
B
To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? A. Teach her to take frequent tub baths to clean her perineal area. B. Teach her to wipe her perineum front to back after voiding. C. Suggest she drink less fluid daily to concentrate urine. D. Encourage her to be more ambulatory to increase urine output
B
To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? a) Teach her to take frequent tub baths to clean her perineal area. b) Teach her to wipe her perineum front to back after voiding. c) Suggest she drink less fluid daily to concentrate urine. d) Encourage her to be more ambulatory to increase urine output
B
What is most likely the underlying physiology of primary enuresis? A. Psychogenic stress B. Delayed bladder maturation C. Urinary tract infection D. Vesicoureteral reflux
B
The mother of a child diagnosed with pyelonephritis asks if the kidneys were damaged because of this. What is the best response by the nurse?
B. The child's risk for renal scarring is increased with pyelonephritis.
A 5-year-old female child has been sent to the school nurse for urinary incontinence 3 times in the past 2 days. The nurse should recommend to her parent that the FIRST action is to have the child evaluated for: A. School phobia B. Emotional causes C. possible urinary tract infection D. possible structural defects of the urinary tract
C
A child with minimal change nephrotic syndrome (MCNS) has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony promi- nences. The child has been receiving Lasix twice daily for several days. Which does the nurse expect to be included in the treatment plan to reduce edema? A. An increase in the amount and frequency of Lasix. B. Addition of a second diuretic, such as mannitol. C. Administration of intravenous albumin. D. Elimination of all fluids and sodium from the child's diet.
C
A mom calls to inform you that her toddler has finished the Pedialyte regimen you recommended for a "stomach virus". When should she restart the child's normal diet? a) Introduce clear liquids for first 24 hours after oral rehydration therapy prior to resuming normal diet b) Feed child rice-based cereal for first 24 hours after oral rehydration prior to resuming normal diet c) Re-introduce age appropriate diet as soon as possible after completing oral rehydration d) Wait 24 hours to re-introduce normal diet after completing oral rehydration therapy
C
A nurse is developing a teaching plan for the parents of an 8 year old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify which of the following as an appropriate measure? A. Engaging the child in stress reduction measures B. Giving desmopressin intranasally C. Encouraging fluid intake after dinner D. Practicing bladder-stretching exercises
C
A nurse is developing a teaching plan for the parents of an 8 year old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify which of the following as an appropriate measure? a) Engaging the child in stress reduction measures b) Giving desmopressin intranasally c) Encouraging fluid intake after dinner d) Practicing bladder-stretching exercises
C
An 18 month old, 11 kg male child is brought to the emergency department after 2 days history of diarrhea and vomiting. Mom states "too many episodes to count". On physical exam, patient is lethargic, eyes appear sunken, skin is cool with tenting and mottled in color, buccal mucosa is parched, and diaper is dry. Vitals on arrival in the emergency department are BP: 80/49 mmHg T: 38.4oC (ax) Pulse: 188 bpm RR: 47 bpm Pain: 0 (FLACC) Based on history, vital signs, and physical exam of the child what is his state of dehydration? a) Dehydration not present b) Moderate dehydration c) Severe dehydration d) Mild or minimal dehydrated
C
During your General Pediatrics rotation at Children's Hospital a medical student complains of vomiting all night with episodes of diarrhea. He has had contact with a rotavirus positive patient. Other students ask how they can avoid rotavirus gastroenteritis. What would you recommend? a) Rotavirus vaccine b) Zinc 50 mg oral daily c) Meticulous hand washing d) Ciprofloxacin 400 mg oral every 12 hours
C
The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also complains of a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100 degrees Fahrenheit. The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may hav a) Rheumatic fever b) A urinary tract infection c) Acute glomerulonephritis d) Lipoid nephrosis (idiopathic nephrotic syndrome)
C
The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also complains of a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100 degrees Fahrenheit. The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: A. Rheumatic fever B. A urinary tract infection C. Acute glomerulonephritis D. Lipoid nephrosis (idiopathic nephrotic syndrome)
C
The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? A. Sacrum B. Abdomen C. Eyes D. Fingers
C
The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?a) Sacrum b) Abdomen c) Eyes d) Fingers
C
The nurse is collecting data on a 6-year-old child admitted with a possible urinary tract infection. Which of the following vital signs might indicate the possibility of an infection? A. Respirations 22 per minute B. Blood Pressure 100/70 C. Pulse rate 135 bpm D. Pulse oximetry 93% on room air
C
The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTI's). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which of the following statements would be accurate for the nurse to tell this mother? A. "It is unlikely that your daughter is practicing good cleaning habits after she voids." B. "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." C. "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." D. "The position of the urethra in girls makes girls more susceptible than boys to UTI's."
C
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. The nurse's BEST reply is: A. "Blood pressure changes are a common side effect of antibiotic therapy." B. "Blood pressure changes are a sign that the condition has become chronic." C. "Acute hypertension, or high blood pressure, must be anticipated and identified." D. "Hypotension, or low blood pressure, leading to sudden shock can develop at any time."
C
Which of the following is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)? A. Reduce blood pressure B. Lower serum protein levels C. Minimize excretion of urinary protein D. Increase ability of tissue to retain fluid
C
Which of the following organisms is the most common cause of urinary tract infection (UTI) in children? A. Klebsiella B. Staphylococcus C. Escherichia coli D. Pseudomonas
C
Which of the following is an important nursing consideration when caring for a child with end-stage renal disease (ESRD)? A. Children with ESRD usually adapt well to minor inconveniences of treatment. B. Children with ESRD require extensive support until they outgrow the condition. C. Multiple stresses are placed on children with ESRD and their families until the illness is cured. D. Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.
D
The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position? a) Supine b) Sims' position c) Prone d) Fowler's
D
The nurse is caring for an 8-year-old hospitalized child with nephrotic syndrome. Which of the following nursing interventions would be appropriate for this child a) Test the urine for ketones twice a day b) Weigh the child once a week .c) Administer antipyretics as needed. d) Measure the abdominal girth daily.
D
criteria for referring patient with gastroenteritis for medical evaluation
young age (<6 months or <8 kg), fever, visible blood in stool, premature birth, chronic medical condition, concurrent illness, frequent and substantial volumes of diarrhea, signs of dehydration, mental status changes, inadequate response to ORT or failure/inability to administer ORT
supplemental _____ may be effective in treatment and prevention of diarrheal disease as there is a link between diarrhea and abnormal ____
zinc, zinc (0.5-1 mg elemental zinc/kg/day oral divided in 3 doses/day)
Are antimicrobial agents routinely recommended in gastroenteritis? What if the cause is bacterial?
No, even if the cause is bacterial (except in immunocompromised, premature infants, and underlying disorders)
for gastroenteritis, ______ should be initiated rapidly, start diet back when ___ is corrected, continue breastfeeding, diluted or special formula is usually not indicated, and avoid unnecessary lab tests and medications
ORS (oral rehydration solutions), dehydration
______ is the standard of care for acute gastroenteritis
ORT (oral rehydration therapy)
The nurse is caring for a child admitted with acute glomerulonephritis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? Smoky colored urine b) Jaundiced skin c) Strawberry red tongue d) Loose, dark stools
Smoky colored urine
_____ is a diarrheal disease that has rapid onset, it can also be accompanied by nausea/vomiting, fever, and abomdinal pain
gastroenteritis
what kind of products are NOT appropriate for ORT?
high osmolarity (like juice and pop)
when breathing is normal/fast, skin fold has recoil <2 seconds, and capillary refill is prolonged, what state of dehydration is present?
mild/moderate
when breathing is normal, skin fold has instant recoil, and capillary refill is normal, what state of dehydration is present?
minimal/none
are antidiarrheal and anti-motility agents recommended for young children with gastroenteritis?
no
should you ever use D5W alone for rehydration in gastroenteritis?
no (would need to give with 1/2NS)
_____ have been shown to be safe and effective in children and can shorten a course of diarrhea
probiotics
you determine that child AB has gastroenteritis with severe dehydration, what are your recommendations?
rehydrate with 20 ml/kg LR or NS, 100 ml/kg ORS over 4 hours or D5W+1/2NS, use ORS for each episode of stool/vomiting, continue breastfeeding, resume age appropriate diet after initial hydration
you determine that child AB has gastroenteritis with mild-moderate dehydration, what are your recommendations?
rehydrate with 50-100 ml/kg ORS over 3-4 hours, use ORS for each episode of stool/vomiting, continue breastfeeding, resume age appropriate diet after initial hydration
you determine that child AB has gastroenteritis with minimal or no dehydration, what are your recommendations?
rehydration is not applicable, use ORS for each episode of stool/vomiting, continue breastfeeding, resume age appropriate diet after initial hydration
when breathing is deep, skin fold has recoil >2 seconds, and capillary refill is prolonged/minimal, what state of dehydration is present?
severe
diagnosis of gastroenteritis is made when diarrhea >3 loose or watery stools/day and assessment of dehydration, ___ ____ for pathogens is not routine
stool testing (only if there is bloody mucus diarrhea or if you suspect C. Diff.)
when starting a child back on their diet after dehydration is corrected in gastroenteritis, what kinds of foods do you recommend?
whatever they will eat as long as you avoid high sugar (high osmolarity solutions)
are antiemetics like ondansetron recommended for children with gastroenteritis?
yes, they can facilitate response to oral rehydration and reduce n/v
