PEDS CH 21-22
What is the best suggestion by the nurse when parents ask, "When is the best time to begin to prepare a 5-year-old for surgery and hospitalization?"
"About 4 days before surgery"
The anxious parent asks if there is a danger of her 2-year-old child becoming addicted to the opioid pain reliever. What is the nurse's most helpful response?
"Addiction is rare in children when opiates are given for pain."
The nurse instructed an adolescent female about collecting a clean-catch urine specimen. What statement made by the adolescent led the nurse to determine she understood the instructions?
"I clean the perineum from front to back with an antiseptic wipe before I urinate."
Which statement best corresponds to a preschooler's understanding of hospitalization?
"I got sick because I was mad at my brother."
The nurse notices that the mother of a child with cerebral palsy corrects and redoes many of the things the nurse does for her child. What is the nurse's most appropriate response to this mother?
"I'd love for you to share with me some of the special things you do for your child."
The mother of a hospitalized toddler states, "He cries when I visit. Maybe I should just stay away." What is the nurse's best response?
"It is important that you are here. This is a common reaction in children when they are separated from their parents."
A 9-year-old child is preparing for a lumbar puncture. What position will the nurse explain the child will assume for this procedure?
"On your side with the knees bent and the head close to the knees."
What statement by the parent of a hospitalized toddler leads the nurse to determine the parent understands a hospitalized toddler's need for transitional objects?
"This stuffed animal makes him feel secure."
A 4-year-old asks tearfully if the IM injection will hurt. What is the nurse's most effective response?
"Yes. It will sting a little."
Which child would have the most difficulty in coping with separation from parents because of hospitalization?
16 month old child
Which nursing action would facilitate rapport with a child and the child's parents during the admission process?
Answer questions in a calm and matter-of-fact way
What is the best pulse location for the nurse to use when assessing the pulse rate on a 12-month-old infant?
Apical
A 13-year-old girl has been hospitalized for the past week. When discussing the girl's feelings about her illness, what would the nurse expect the girl to express as her biggest concern?
Appearance
What intervention should the nurse implement after topical administration of hydrocortisone cream to the buttocks and abdomen of an infant?
Apply a cloth diaper.
A 3-year-old patient is admitted to the pediatric unit with a fever of 103° F. Which actions will the nurse implement? (Select all that apply.)
Assess level of consciousness- Administer Acetaminophen as ordered- Assess skin turgor
What are the basic fears of a young child being hospitalized? (Select all that apply.)
Body intrusion-Separation-Pain
The nurse shares the information and timelines recorded on the interdisciplinary outline of care for a child. What is this document?
Clinical pathway
The nurse preparing to administer medication to a 2-month-old infant discovers there is no ID bracelet on the child. What should be the next action by the nurse?
Confirm the identity with the charge nurse, make a new bracelet, and give the medicine.
How often should a child who has a continuous intravenous infusion should be assessed?
Hourly
What factor does the nurse explain affects the infant's physiological response to medications?
Immature kidney function
A 4-year-old begins to cry when his mother tells him it is time for his operation. The nurse understands this is an expected reaction. On which particular fear of the preschooler does the nurse base this understanding?
Invasive procedures
The nurse is preparing to start an IV on an infant admitted to the pediatric unit. What intervention is appropriate for the nurse to implement?
Involve the parents
The nurse explains to the parents of a hospitalized child that their child will receive fentanyl for an upcoming procedure. What advantage of fentanyl will the nurse explain?
It has a rapid onset.
When a 2-year-old returns to her hospital room following a diagnostic procedure, her parents are not available, and the child is crying loudly. Which technique is most appropriate to alleviate the child's distress?
Play with the child using pop-up toys.
A 2-year-old child has been crying constantly for his mother since he was hospitalized 3 days ago. What does this behavior suggest?
The toddler feels abandoned by his mother.
Why is a tympanic thermometer considered more accurate than other types of thermometers?
The tympanic membrane shares circulation with the hypothalamus
The parents of a hospitalized toddler are upset because she seems more interested in her toys when they come to visit her. In which stage of separation anxiety is the toddler?
Denial
Which observation on entering the hospital room lets the nurse know that there is a need for the parents to receive safety education to prevent unintentional injury?
Diapers and wipes are stacked at the foot of the crib.
The nurse instructs the mother of a 2-year-old who is taking iron supplements for anemia that some foods reduce the absorption of iron. What would be the best example provided by the nurse?
Egg yolks
What emergency action should be implemented for airway obstruction in the infant?
Five back blows followed by five chest thrusts
A hospitalized toddler was drinking from a cup at home but now refuses to drink from anything except his favorite bottle. What is the most likely reason for this behavior?
He is dealing with the anxiety of hospitalization by regressing.
An 8-year-old child will be hospitalized for several weeks in skeletal traction to treat a fractured femur. What does the nurse realize immobilization in this age-group can generate feelings of in planning care of this child?
Loss of control
Which restraint is most appropriate for the insertion of an intravenous line in a scalp vein of an infant?
Mummy
Which strategy might the nurse use when administering oral medications to a young child who is reluctant?
Offer the child fruit juice after the medication is swallowed.
Which intervention is correct when a nurse is administering a gastrostomy feeding by gravity?
Position the child on the right side after a feeding.
A nurse encourages a school-age child to draw a picture after a painful procedure. What is the best rationale for this nursing intervention?
Providing a way for the child to express his feelings
Informed consent for a minor guarantees that the parent or legal guardian understands what aspect(s) of a procedure? (Select all that apply.)
Purpose of the procedure- That information was given- That the document must be signed and witnessed- Risks associated with the procedure
The pediatric nurse completes an assessment on all patients assigned during evening shift at the hospital. Which patient assessment requires immediate intervention?
School-age child with widening pulse pressure
What should the nurse, preparing to collect an admission history from parents who have recently emigrated from Russia, keep in mind?
Smiling is inappropriate in a serious situation
A 15-year-old patient returns to the pediatric unit following a lumbar puncture. What initial position will the nurse maintain for this patient?
Supine
The parents of a hospitalized 9-month-old infant ask if their preschool child may visit his younger sibling. What understanding would assist the nurse most in formulating a response?
The preschooler needs to visit his infant sister to reassure himself that she is all right.
gentamicin ear drops are prescribed for a 4-year-old child. How would the nurse position the auricle when administering the ear drops?
Up and back
A parent tells the nurse, "I'm not sure how to give this medicine to my infant." How would the nurse teach the parent to best administer an oral suspension?
Use an oral syringe and placing the medication in the side of the infant's mouth
Where is the best site for giving an IM injection to a 15-month-old child?
Vastus lateralis muscle
The mother of a 3-year-old tells the nurse that she will be in to visit tomorrow around 12:00 PM. The next morning, the child asks the nurse, "When is my mommy coming?" What is the nurse's best response?
Your mommy will be here when you have lunch."
