Peds 10

An excessive dose of a vitamin is generally defined as ___ or more times the recommended dietary allowance

10

It has been postulated that ___ % of all SIDS deaths could be prevented with prenatal maternal smoking cessation

12

colic

Paroxysmal abdominal pain

To prevent plagiocephaly, nurses should teach parents to do what when infants are awake?

Place the infant in a prone position

Once the diagnosis of colic is established, what is the most important nursing intervention?

Reassuring both parents that they are not doing anything wrong and that the infant is not experiencing any physical or emotional harm

Identify the three management goals in treating protein and energy malnutrition that occurs as a result of persistent diarrhea

Rehydration with an oral rehydration solution that also replaces electrolytes Administration of medications such as antibiotics and antidiarrheals Provision of adequate nutrition by either breastfeeding or a proper weaning diet

What three safety measures should the nurse discuss with parents of an infant being monitored at home for apnea?

Removing leads from the infant when not attached to the monitor Unplugging the power cord from electrical outlet when not plugged into the monitor Using safety covers on electrical outlets

regurgitation

Return of undigested food from the stomach

What is the primary management of failure to thrive?

Reversing the cause of the growth failure

Children who have one parent with a food allergy have a ___ % or greater risk of developing the allergy

50

What are common manifestations of lactose intolerance?

Abdominal pain, bloating, flatus, diarrhea

In most children, anaphylactic food reactions do not begin with skin signs, such as hives, red rash, and flushing. Rather, the reactions mimic what condition?

An acute asthma attack (wheezing, decreased air movement in airways, dyspnea)

What should the nurse avoid saying to parents after a SIDS death?

Anything that suggests they are responsible for the infant's death

Vitamin ___ supplementation is recommended if the breastfeeding mother's intake of the vitamin is inadequate or if she is not taking vitamin supplements

B12

What interventions can the nurse offer that might help with the colic symptoms?

Changing the formula or eliminating cow's milk protein from breastfeeding mothers, adding a chamomile tea at the onset of crying (with caution, because the risks associated with this are unknown), and behavioral interventions (massage infant's abdomen, respond immediately to crying, swaddle infant, change environment, add a pacifier)

Identify four populations at risk for vitamin D deficiency, or rickets

Children exclusively breastfed by mothers who have an inadequate intake of vitamin D or children who are breastfed longer than 6 months without adequate maternal vitamin D intake or supplementation Children with dark skin pigmentation who are exposed to minimal sunlight because of socioeconomic, religious, or cultural beliefs or housing in urban areas of high pollution Children with diets that are low in sources of vitamin D and calcium Individuals who use milk products not supplemented with vitamin D (e.g., yogurt, raw cow's milk) as the primary source of milk

What two regimens are used in the treatment of recurrent apnea (without an underlying organic problem)?

Continuous home monitoring of cardiorespiratory rhythms In some cases, the use of methylxanthines (respiratory stimulant drugs, such as theophylline or caffeine)

In the United States, protein and energy malnutrition is seen in children and adolescents with specific illnesses or diseases. Provide some examples of these illnesses or diseases

Cystic fibrosis; renal dialysis; gastrointestinal malabsorption; or acute illnesses, such as prolonged, untreated anorexia nervosa

spitting up

Dribbling of unswallowed formula

Differentiate between a food allergy and food intolerance

Food allergy, or hypersensitivity, is a reaction involving immunologic mechanisms, usually immunoglobulin E (IgE); the reactions may be immediate or delayed and mild or severe, such as anaphylactic reaction Food intolerance, on the other hand, refers to reactions involving known or unknown nonimmunologic mechanisms; lactose intolerance is an example of a reaction that looks like allergy but is due to deficiency of the enzyme lactase

Malnutrition is a major health problem in the world for children under 5 years of age. What are the two major causes of this problem?

Inadequate food intake, diarrhea (gastroenteritis)

List nine elements of the nursing assessment that would be noted regarding colic

Infant's diet Diet of the breastfeeding mother Time of day when attacks occur Relationship of the attack to feeding times Presence of specific family members during attacks and those family members' habits, such as smoking Activity of caregiver before, during, and after the crying Characteristics of the cry Measures used to relieve the crying and their effectiveness The infant's stooling, voiding, and sleep patterns

What is the rationale for informing the local utility company and rescue squad of the home monitoring?

Inform the utility company so that if there is a power outage, emergency power may be provided. Notify the rescue squad so that if the infant stops breathing, they will be aware of the problem and may respond more quickly to a call

Parents have brought their 6 months old daughter in for a 1 week follow up for treatment of diaper dermatitis. The parents state that they have followed all directions but that it just doesn't seem to be getting any better. The nurse examines the infant and finds no resolve of the condition. Based on this finding, the nurse suspects that a. the infant may also have a Candida infection. b. additional teaching may be needed for the parents in order to validate that they followed through with instructions. c. suggest to the parents that a heat lamp maybe needed to resolve the problem. d. have the parents continue their treatment as it may take more than 1 week to resolve.

a. the infant may also have a Candida infection.

Macrominerals refer to those minerals with daily intake requirements greater than 100 mg. Which is a macromineral? a. Iron b. Calcium c. Fluoride d. Selenium

b. Calcium

A child relates that every time he eats a certain food, he gets a stomachache. No other discernable physical symptoms have been correlated with the food intake. Based on this information, the nurse would suspect that the child may be exhibiting? a. Food refusal behavior b. Food intolerance c. Food allergy d. Food preference

b. Food intolerance

A newborn who is suspected of having atopy would most likely have which diagnostic finding? a. Small for gestational age (SGA) b. Increased levels of IgE in umbilical cord blood c. No family history of allergies d. Precipitous delivery

b. Increased levels of IgE in umbilical cord blood

Which intervention lowers the risk of sudden infant death syndrome (SIDS)? a. Keeping the window open if one is smoking near the infant. b. Placing the infant in the supine position for sleeping. c. Letting the infant sleep with the parents instead of alone in the crib. d. Making certain the infant is kept very warm while sleeping.

b. Placing the infant in the supine position for sleeping.

The parents of a 5-month-old child complain to the nurse that they are exhausted because the infant still wakes up as often as every 1 to 2 hours during the night. When the child awakens, they change the diaper and the mother nurses the child back to sleep. Which should the nurse suggest to help the parents deal with this problem? a. Put the child in the parents' bed to cuddle. b. Start putting the infant to bed while still awake. c. Allow the infant to cry for 30 minutes, and then rock the infant back to sleep before putting the infant back in the crib. d. Give the infant a bottle of formula instead of breastfeeding so often at night.

b. Start putting the infant to bed while still awake.

The nurse is providing education to parents of an infant diagnosed with colic. What would the nurse include in the discharge teaching? a. The child will have to be watched for gastrointestinal issues in the future. b. The symptoms of colic typically disappear by 3 months of age. c. Providing juice at the start of the fussy period will help decrease the length of the crying episodes. d. The feeding method needs to be changed to a hypoallergenic formula.

b. The symptoms of colic typically disappear by 3 months of age.

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant? a. Vitamin B b. Vitamin D c. Vitamin C d. Vitamin K

b. Vitamin D

Infants most at risk for sudden infant death syndrome (SIDS) are those. Select all that apply. a. Who sleep supine b. Who sleep prone c. Who were preterm d. With prenatal drug exposure e. With a cousin that died of SIDS

b. Who sleep prone c. Who were preterm d. With prenatal drug exposure

A 1-month-old infant is admitted to the hospital for failure to thrive (FTT) secondary to a cardiac condition. Based on the nurse's knowledge of the different types of FTT, this type of FTT is categorized as a. nonorganic. b. organic. c. idiopathic. d. generalized.

b. organic.

Which strategy might be recommended to increase caloric intake in an infant with failure to thrive? a. Use developmental stimulation by a specialist during feedings. b. Avoid solids until after the bottle is well accepted. c. Be persistent through 10 to 15 minutes of food refusal. d. Vary the schedule for routine activities on a daily basis.

c. Be persistent through 10 to 15 minutes of food refusal.

Which statement best describes colic to parents who are inquiring as to whether their infant is experiencing this alteration? a. The infant will experience periods of abdominal pain, which result in weight loss. b. Periods of abdominal pain and crying occur in infants primarily over age 6 months. c. Infants with colic have paroxysmal abdominal pain or cramping manifested by episodes of loud crying. d. Colic is usually the result of poor or inadequate mothering.

c. Infants with colic have paroxysmal abdominal pain or cramping manifested by episodes of loud crying.

According to evidenced based practice in a recent Cochrane database, which statement is most accurate with regard to the relationship between vitamin A and measles? a. It is correlated with an increased risk of blindness. b. Vitamin A supplementation should not be provided to children who have measles. c. There was no correlation between blindness in children who had measles and who also had vitamin A deficiency. d. Vitamin A supplementation in children with measles will lead to blindness.

c. There was no correlation between blindness in children who had measles and who also had vitamin A deficiency.

Which infant is at risk for developing vitamin D-deficient rickets? a. Lacto-ovo vegetarians b. Those who are breastfed exclusively c. Those using yogurt as a primary source of milk d. Those exposed to daily sunlight

c. Those using yogurt as a primary source of milk

The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb sucking. What should the nurse's reply be based on? a. A pacifier should be substituted for the thumb. b. Thumb sucking should be discouraged by age 12 months. c. Thumb sucking should be discouraged when permanent teeth begin to erupt. d. There is no need to restrain nonnutritive sucking during infancy.

c. Thumb sucking should be discouraged when permanent teeth begin to erupt.

A nurse is providing education to a community group in preparation for a mission trip to a third world country with limited access to protein-based food sources. The nurse is aware that children in this country are at increased risk for a. rickets. b. marasmus. c. kwashiorkor. d. pellagra.

c. kwashiorkor.

The most widely used test in the diagnostic evaluation of apnea of infancy is the ___

cardiopneumogram or pneumocardiogram

In providing nutritional counseling for a family with children, which statement would indicate that the parents need additional teaching with regard to mineral balance? a. "I will give my child fortified milk products and avoid cow's milk." b. "I will avoid giving my children any mineral supplements so as to avoid the possibility of megadoses." c. "Spinach is not a very source of iron when considering mineral balance." d. "I don't have to worry about mineral balance since my child will be following a vegetarian diet."

d. "I don't have to worry about mineral balance since my child will be following a vegetarian diet."

A 3-month-old bottle-fed infant is allergic to cow's milk. Which is the best substitute to teach the parents to use? a. Goat's milk b. Soy-based formula c. Skim milk diluted with water d. Casein hydrolysate milk formula

d. Casein hydrolysate milk formula

A 9-month-old infant is seen in the emergency department after developing urticaric rash with cough and wheezing. When collecting the history of events prior to the sudden onset of the rash with cough and wheezing, the mother states they were "feeding the baby new foods." Which food is the possible cause of this type of reaction in the infant? a. Potatoes b. Green beans c. Spinach d. Peanut butter

d. Peanut butter

A nurse is caring for a 2-month-old exclusively breastfed infant with an admitting diagnosis of colic. Based on the nurse's knowledge of breastfed infants, what type of stool is expected? a. Dark brown and small hard pebbles b. Loose with green mucus streaks c. Formed and with white mucus d. Semiformed, seedy, yellow

d. Semiformed, seedy, yellow

Hypervitaminosis of A and D presents the greatest problems because these ___ vitamins are stored in the body

fat soluble

What vitamin supplement to prevent neural tube birth defects is recommended for all women of childbearing age? What is the daily recommended dose?

folic acid, 0.4 mg/day

Katie, age 16 years, comes into the emergency department with her parents. Katie has broken out in a red, itchy, raised rash over her face, chest, and upper outer thighs. On taking a detailed history, the nurse discovers Katie has recently eaten strawberry shortcake. Her tongue was swelling up and she was complaining of difficulty breathing, so her parents brought her in to the emergency department. Did Katie have a reaction that would be classified as a food allergy or food intolerance?

food allergy

Some parents of infants with failure to thrive are at increased risk for attachment problems because of ___, ___, inadequate ___, and poor ___ as a child

isolation, social crisis, support systems, parenting role models

___ is a common occurrence in underdeveloped countries during times of drought, especially in cultures where adults eat first; the remaining food is often insufficient in quality and quantity for the children

marasmus

Low levels of zinc can cause what condition?

nutritional failure to thrive

Some studies have found that ___ in infants is a protective factor against the occurrence of SIDS

pacifer use

Children receiving high doses of ___ may have impaired vitamin C storage

salicylates

To prevent SIDS, the American Academy of Pediatrics recommends that healthy infants be placed in the ___ position to sleep

supine

It must be stressed that monitors are only effective if they are ___ and there is a ___ to alarms

used, response

An imbalance in the intake of calcium and phosphorous may occur in infants who are given ___ instead of infant formula

whole cow's milk

Describe the appearance of a child with kwashiorkor

Thin, wasted extremities and a prominent abdomen from edema

How do nurses play a critical role in the diagnosis of failure to thrive?

Through their assessment of the interactions among the child, parents, and family

What three things should children with extremely sensitive food allergies do to ensure their safety?

Wear medical identification such as a bracelet Have an injectable epinephrine cartridge (EpiPen) readily available and know how to use it Have a copy of the individualized written treatment plan on hand for prompt diagnosis and treatment

Which food combination will generally provide the appropriate amounts of essential amino acids for an individual who is a vegetarian? a. Grains and legumes b. Grains and vegetables c. Legumes and vegetables d. Milk products and fruit

a. Grains and legumes

Which is the most descriptive of kwashiorkor? a. Kwashiorkor has a multifactorial etiology. b. Kwashiorkor occurs primarily in breastfed infants. c. Kwashiorkor results from excessive amounts of vitamin K. d. Kwashiorkor is related to inadequate calories, not adequate protein.

a. Kwashiorkor has a multifactorial etiology.

The nurse is providing education to a parent of a 10-month-old infant with the diagnosis of cow's milk allergy. What will be included in the teaching? Select all that apply. a. Reading of all food labels to avoid products with milk. b. Use of milk to desensitize the child. c. Introduction of soy-based products to replace milk. d. Signs and symptoms associated with potential accidental ingestion of milk.

a. Reading of all food labels to avoid products with milk. d. Signs and symptoms associated with potential accidental ingestion of milk.

The primary goals in the nutritional management of children with failure to thrive (FTT) are. Select all that apply. a. allow for catch-up growth. b. correct nutritional deficiencies. c. achieve ideal weight for height. d. restore optimum body composition. e. educate the parents or primary caregivers on child's nutritional requirements.

a. allow for catch-up growth. b. correct nutritional deficiencies. c. achieve ideal weight for height. d. restore optimum body composition. e. educate the parents or primary caregivers on child's nutritional requirements.

Why is safety a major area of nursing intervention if the infant is to be monitored at home?

Monitors can cause electrical burns and electrocution

Don and Helen have brought in Kalen, their 2-month-old infant, to see the pediatrician. The parents' chief complaint is that for the past 3 weeks, Kalen has been having loud crying spells that last 4 hours a day. The parents report that Kalen draws his legs up to his abdomen while crying. On further examination, the nurse notes that he is tolerating breast milk and growing at a normal rate for his age. After reviewing the assessment data, the nurse determines that the infant may have colic on the basis of which symptoms?

Loud crying spells lasting for 4 hours for the past 3 weeks; pulling his feet up toward his abdomen; and thriving normally despite the pain reaction