peds chapter 14

The nurse notes that a child with a swallowing difficulty is receiving a continuous tube feeding. The child is very active and the feeding frequently gets interrupted because the tube becomes disconnected. What should the nurse discuss with the healthcare provider about the tube feeding? Select all that apply. a. The nurse should ask the HCP if the client could receive TPN b. the nurse should ask the HCP if the client could receive boluses rather than continuous tube feedings c. the nurse should ask the healthcare provider if the client could receive the tube feedings during the night rather than continuously during all hours d. the nurse should ask the HCP if the client could be given oral rather than tube feedings e. the nurse should ask the HCP if the client should be given a sedative in order to prevent disruption of the tube feedings.

B, C

The nurse is caring for a child who is receiving TPN for failure to thrive. Which nursing action might the nurse take to prevent complications from this therapy? a. adhere to clean technique when caring for the catheter and administering TPN b. ensure that the system remains an open system at all times c. secure all connections and open the catheter during tubing and cap changes d. use occlusive dressings and chlorhexidine-impregnated sponge dressings

D

the nurse is caring for a 14-year-old with a gastrostomy tube. The girl has skin breakdown and irritation at the insertion site. Which would be the most appropriate method to clean and secure the gastrostomy tube? a. make sure the tube cannot be moved in and out of the child's stomach b. use adhesive tape to tape the tube inlace and prevent movement c. place a transparent dressing over the site whether there is drainage or not d. if any drainage is present, us a presplit 2 x 2 and play is loosely around the site

D

The nurse is preparing to administer medication to a child with a G tube in place. What is a recommended guideline for this procedure? Select all that apply. a. verify proper tube placement prior to instilling medication b. mix liquid medications with a small amount of water and add directly into the tube c. mix powdered medications well with cold water first d. crush tablets and mix with warm water to prevent tube occlusion e. open up capsules and mix the contents with warm water f. flush the tube with water after administering medications

a, d, e, f

the nurse is teaching the student nurse the factors that affect pharmacodynamics of the medications being administered. What is a factor affecting this property of medication in children? a. immature body systems b. weight c. body surface d. body composition

a. immature body systems

The nurse is administered a crushed tablet to an 18-month-old infant. What is a recommended guideline for this intervention? a. mix the crushed tablet with a small amount of applesauce b. place the crushed tablet in the infant's formula c. mix the crushed tablet with the infant's formula d. crushed tablets should only be mixed with water

a. mix the crushed tablet with a small amount of applesauce

The nurse is caring for an 8-year-old girl who requires medication that is only available in an enteric tablet form. The nurse is teaching the mother how to help the girl swallow the medication. Which statement indicates a need for further teaching? a. I can encourage her to place it on the back of her tongue b. I can pinch her nose to make it easier to swallow c. we cannot crush this type of pill as it will affect the delivery of the medication d. we can place the tablet in a spoonful of applesauce

b. I can pinch her nose to make it easier to swallow

the nurse is providing teaching for the mother of an infant who receives all of his nutrition through a NG feeding tube. The nurse is reviewing interventions to promote growth and development. Which response from the mother indicates a need for further teaching? a. I will give him a pacifier during feeding time b. We need to keep feeding time very quiet c. We need to make sure he doesn't lose the desire to eat by mouth d. Sucking produces saliva, which aids in digestion

b. We need to keep feeding time very quiet

The nurse is providing teaching on how to administer nasal drops. Which response by the parents indicates a need for further teaching? a. we need to be careful to not stimulate a sneeze b. she needs to remain still for at least 10 minutes after administration c. our daughter should lie on her back with her head hyperextended d. we must not let the dropper make contact with the nasal membranes

b. she needs to remain still for at least 10 minutes after administration

the nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? a. rectus femoris b. vastus lateralis c. dorsogluteal muscle d. deltoid

b. vastus lateralis

The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The safe dose for children is 50 to 100mg/kg/day divided in doses administered every 6 hours. What would be the low single safe dose and high single safe dose per day for this child? a. 50 to 100 mg per dose b. 100 to 500 mg per dose c. 500 to 1,000 mg per dose d. 1,000 to 5,000 mg per dose

c. 500 to 1,000 mg per dose

The nurse is checking placement on a child's feeding tube. When the pH is checked, it is 5.3. What action by the nurse is indicated? a. remove the tube b. document the findings as normal c. contact the health care provider d. reevaluate the pH again in 2 hours

c. contact the health care provider

A nurse has just administered medication via an orogastric tube. What is the priority nursing action following administration? a. check tube placement b. retape the tube c. flush the tube d. remove the tube

c. flush the tube

The nurse is administering acetaminophen PRN to a 9-year-old child on the pediatric ward of the hospital. Which answers reflect nursing actions that follow the rules of the rights of pediatric medication administration? Select all that apply. a. the nurse identifies the child by check the name on the child's chart b. the nurse makes sure the medication is given within the hour of the ordered time c. the nurse checks the documented time of the last dosage administered d. the nurse calculated the dosage according to the child's weight e. the nurse explains the therapeutic effects of the medication to the child and parents f. the nurse administers the medication even though the child is adamant about not taking it

c. the nurse checks the documented time of the last dosage administered d. the nurse calculates the dosage according to the child's weight e. the nurse explains the the therapeutic effects of the medication to the child and parents

After administering eye drops to a child, the nurse applies gentle pressure not the inside corner of the eye at the nose for which reason? a. to promote dispersion over the cornea b. to enhance systemic absorption c. to ensure the medication stays in the eye d. to stabilize the eyelid

c. to ensure the medication stays in the eye

when describing the differences affecting the pharmacokinetics of drugs administered to children, which would the nurse include? a. oral drugs are absorbed more quickly in children than adults b. absorption of intramuscularly administered drugs is fairly constant c. topical drugs are absorbed more quickly in young children than adults d. absorption of drugs administered by subcutaneous infection is increased

c. topical drugs are absorbed more quickly in young children than adults

the nurse is administrating a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate? a. direct the liquid toward the anterior side of the mouth b. keep the child's hands away from the oral syringe when squirting the medication c. give all the drug in the syringe at one time with one squirt d. allow the child time to swallow the medication in between amounts

d. allow the child time to swallow the medication in between amounts

The nurse caring for a 6-year-old client enters the room to administer an oral medication in the form of a pill. The dad at the bedside looks at the pill and tells the nurse that his daughter has a hard time swallowing pills. What is the best response by the nurse? a. ask the child to try swallowing the pill and offer a choice of drinks to take with it b. crush the pill and add it to applesauce c. request that the healthcare provider prescribe the medication in liquid form d. call the pharmacy and ask if the pill can be crushed

d. call the pharmacy and ask if the pill can be crushed