PEDS

A 40 lb child hospitalized for a vaso-occlusive sickle cell crisis is receiving IVF at maintenance and a half. The hourly IV rate should be how many ml/hr* Do not put any words in the answer.Round to first decimal place at the end.

88.1

A hemophilac is receiving pain medication for joint bleeding and sweting. Which order should be questioned by nurse*

Acetylsalicylic acid (aspirin)

When assessing a child for possible congenital heart defects, where would the nursemeasure BP?

All four extremities.

Which of the following assessment are included in Glassgow Coma Scale (GCS)? SATA

Eye opening; verbal response; motor response

When caring for the infant with gastroschisis or omphalocele, which of the following is the priority assessment finding?

Fluid fluctuation and hypothermia.

The mother of a newborn asks the nurse what is generally done for the infant club foot deformity. Which is the best response by the nurse.

He may were cast for a period of time. You may also have him wear special shoes.

The nurse would expect which of the following as a hallmark symptoms of a brain tumor in a child?

Headache in late in the day; Vomiting in the morning

What is the priority nursing intervention for a child hospitalized with hemarthrosis secondary to hemophilia?

Immobilization of the affected joints

Which change in serum lab values would most likely indicate the onset of osteomyelitis?

Increase erythrocyte sedimentation rate (ESR).

What is the best nursing response to a mother who asks if her 5 months old can have cow's milk?

Infants younger than 1yr needs iron rich formula to get adequate iron

When an adolescent with a new diagnosis of Ewing sarcoma asks the nurse about treatment, the nurse's response should be based on which information * SATA

Management include chemotherapy, surgery, and radiation. This type of tumor invades the bone. Affected bones such as ribs and proximal fibula may be removed to excise the tumor.

Which of the following orders should the nurse question when caring for a child following pull through for Hirschsprung's disease?

Monitor rectal temperature every 4 hours

All of the following interventions in caring for a newly admitted child with meningitis except:

Monitoring hourly oxygen saturation.

Which of the following is an early sign of increased intracranial pressure in a 10-year- old child?

Mood swings

Which of the following is included in the Glasgow Coma Scale (GCS)? SATA

Motor response Eye-opening Verbal response

A nurse is conducting discharge and teaching to parents about the care of their infant after cardiac surgery. This nurse instructs the parents to notify the physician if which of the following occurs* SATA

New or less frequent coughing, turning blue or bluer than normal, temperature above 37.7

Which nursing action will best meet the developmental needs of a 10 day old during the first fewdays after surgical repair for a tracheoesophageal fistula?

Offering her a pacifier to provide nonnutritive sucking.

The nurse is interviewing parents of a 4-year-old experiencing enuresis. What principles determine priority in the nurse's communication with the family?

Physiological causes of enuresis should be ruled out

An infant has following heart defects, ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy. What is the priority nursing action when the infant hasan increased respiratory rate and becomes cyanotic?

Place child in knee- chest position

What is the priority intervention when caring with tumor who is schedule for surgery?

Place the child in high fowlers position to ease respiratory efforts

A parent present with reflux.........

Preserving heart and lung function

Strategies for nursing care related to the nonsurgical management of scoliosis in an adolescent are primarily directed towards what goals?

Promoting healthy body image and self-esteem

Which of the following is the primary nursing intervention to bacterial endocardia among children with a congenital heart defect?

Question parent of high-risk children about prophylactic antibiotics

A toddler with a ventricular septal defect (VSD) has had several episodes of congestive heart failure (CHF). What assessment is most useful to determine her cardiac status in relationship to theCHF?

Recent fluctuation in weight.

A child presents with symmetrical muscle weakness to the lower extremities. Awadding wide based gait, and a positive Gower's sign. Discharge teaching should includepromptly calling the physician for which problem ?

Respiratory infection

Home care of Duchenne Muscular Dystrophy should include introduction to promptly report which of the following*

Respiratory infection

A patient with inflammation of the synovium of upper and lower extremities, as well as joint effusion and articular cartilage. What should be reduced in discharge planning?

Routine ophthalmologic examination to assess for visual problems.

When examining an infant during a well child visit, the nurse finds bright red peritoneal inflammation with satellite lesions which spread to the abdomen. This is most likely caused by which of the following problems?

Scabies

In decreasing the use of infection for acne, the nurse should include which of the following information when counseling female adolescent?

She can be required to use contraceptive even if not currently sexually active

The parent with a child with aplastic anemia is discussing her child's care. Which statement indicated further teaching?

She loves raw carrots and broccoli especially with ranch dressing.

Parent of a 10 month old ask why their child has experienced a febrile seizure. What is the correct response by the nurse*

They occur when the body temperature exceeds 38.3 degrees Celsius.

Parents of a 10-month-old ask why their child has experienced a febrile seizure. What is the correct response by the nurse?

They occur when the temperature rises quickly

A well-nourished 18 month old child with no history of gastrointestinal problems is brought to the emergency department. She presents with intense crying and a rigid abdomen with a palpablesausage shape mass. Which initial orders would be expected?

Vital sign every 4 hours, guiac stools, and saline or air enema.

An infant with congestive heart failure is receiving digoxin. What does the nurse recognize as a sign of digoxin toxicity?

Vomiting

A child with sickle cell disease is experiencing mild to moderate pain while at school. The school nursemay provide pain medication and which of the following treatment?

Warm moist pack to painful area.

A nurse caring for a child with rehydration knows the most reliable data inassessment of rehydration status is?

weight loss

Parents of a newborn diagnosed with hypoplastic left heart syndrome are having a difficult time understanding the course of treatment. What information does the nurse need to reinforce regarding the course of treatment for this type of defect?

Maintain a PDA pharmacologically until several staged repairs are completed over time.

Nursing care for the infant who has myelomeningoceles repair should include which intervention?

Measurement of head circumference.

Which assessment finding is indicative of a surgical complication for the child who is one day post-op for a ventriculoperitoneal (VP) shunt revision?

Mild incisional pain Hyperactive bowel sounds Upper congestion Increased left

An infant with hydrocephalus for surgical placement of a verticuloperitoneal shunt. Post nursingcare should include which of the following?

Monitor closely for the sign of infection .

An 88lb child hospitalized for vaso-occlusive sickle cell crisis is receiving IV fluids at maintenance and a half. The hourly IV rate should be 118.8ml/hr. Put only numbers in the blank.

118.8

A patient with a VSD is placed on a maintenance dose of digoxin elixir, the dose is0.07mg/kg/day. And the patient's weight is 7.2kg. The physician orders the digoxin to be given BID. The pt. will receive 0.5mg each dose? (2cd decimal)

0.25

A patient with a VSD placed on a maintenance dose of digoxin. The dose is 0.07mg/kg/day and the patient's weight is7.2 kg.the phycian orders the digoxin to be given BID. The patient will receive 0.25 mg each dose. Round up to thesecond decimal place.

0.25 mg

Correction of hypospadias should take place by what age?

1 year of age

A 7 year old with sickle cell presents in the ED with complaints of pain in the knees, elbows,and throughout the body. The current vital signs are T-39.1C, P-104, RR- 24, BP- 90//68, 02- 91% onRA. Which intervention should the ED nurse implements first?

A Request arterial blood gas STAT

Atopic dermatitis (eczema) in infant is which of the following?

Associated with allergies and has a hereditary tendency

A child with a brain tumor is undergoing radiation therapy. The nurse should include whichinformation in the discharge instruction to the child parents * SATA

Avoid excessive exposure to the sun; plan for adequate rest periods for the child. A darkening of skin receiving radiation is expected.

A 10 yr old with osteosarcoma has recently undergone inducing of chemotherapy. Whatinstruction does the nurse provide regarding prevention of infection?

Bath daily to decrease bacterial count.

The nurse understands that a young adolescent with a spinal curve of 35 degree is best treated by which of the following?

Bracing and exercise.

Parents of an infant diagnosed with cerebral palsy ask the nurse how severs a handicap their child will have. The best response by the nurse is

Children with CP vary in symptoms and severity but can be helped with intervention.

What instruction would the nurse include in teaching plan regarding oral care of a child receiving chemotherapy?

Clean teeth with a soft toothbrush

A nurse assessing a 6 month old suspected of having cerebral palsy would most likely exhibit.

Delay or failure to control head and roll over.

Nurse understand that children with cerebral Palsy (CP) are often at risk for nutritional deficits because they have which of the following problems?

Difficulty controlling the muscles of chewing and swallowing.

Which is the priority nursing action when caring for a child who is experiencing a seizure?

Document the seizure actively observe.

A 5 year old child having frequent invasive procedures such as lumbar puncture and bone marrow aspiration most likely will express has emotion through which of the following?

Dramatic play using a doll and medical equipment.

The nurse is caring for a neonate with frothy saliva and unexplained cyanosis. What should nurse care include ?

Elevate head, giving nothing by mouth

What is the nursing care for neonate with forthy saliva, and unexplained cynosis. What should nursing care include?

Elevate head, giving nothing by mouth.

A child is diagnosed with osteomyelitis after a fracture of the humerus. Which is nurse priority intervention?

Encourage compliance with antibiotic therapy.

Which of the following is the priority nursing intervention when a child is unconscious after a fall?

Establish adequate airways

An appropriate nursing intervention when caring for an unconscious child would be which of the following?

Establish adequate airways.

Parent with school age child with hemophilia ask the nurse. "which sports are recommended for children with hemophilia? Which sport does the nurse recommend? SATA

Swimming, Bowling, Golf

The priority nursing care for a child with Transposition of the great vessels would include which of the following?

Taking vital sign and administering medication on a routine schedule.

Which of the following is the most important information to be included in the discharge planning for an infant with an gastroesophageal reflux?

Teach the patient how to do infant CPR?

The nurse should include which of the following intervention when preparing a 4 yr old for a diagnostic procedure?

Tell the child procedures are never a form of punishment.

When introducing hospital equipment to preschooler who seems afraid, the nurse' s approach should be based on which of the following principles?

The child may think that all of the equipment is alive.

Which of the following information should the nurse include when teaching parents about caring for their 4 month old with hip dysplasia who is in a Pavlik harness*

The harness provides reduction of the hips by maintaining the flexion and external rotation.

The nurse is caring for a 10 year old child who had an infected ventriculoperitoneal shunt removed 2 days ago She has been talkative and extremely interactive. During the afternoon the nurse observes her lying in her bed, quiet and not answering questions. The priority nursing intervention would be?

?

Which strategy is appropriate when feeding the infant with severe congenital heart disease?

Limit the duration of the feeding to no longer than 20 to 30 minutes.

A newborn is suspected of having a coarctation of the aorta. What finding does the nurse expect when measuring four extremity blood pressure?

Lower pressure in the legs than the arms

Nursing interventions for a 1 month old with biliary atresia awaiting a liver transplant should include which expected outcome?

Adequate nutrition with vitamin and relief of symptoms.

Nursing intervention for a 1-month-old infant with biliary atresia awaiting a liver transplant should include which expected outcomes?

Adequate nutrition with vitamins and relief of symptoms

A 7 year old with sickle cell present in the ED with complains of pain in knees, elbows, and throughout body. The current vital signs are: Temperature 38.1, pulse 104, respiration 24, BP 90/68, pulse 0% 91% on RA. Which intervention should the ED nurse implement first?

Administer oxygen through nasal cannula.

Before giving a dose of digoxin, the nurse checked an infant heart rate and it was 114 beats per minute. What should the nurse donext?

Administer the digitalis dose as ordered

A parent of a child with bilateral atresia questions the nurse as to the reason for their child being administered phenobarbital. The best explanation would include what information?

An action of the medication is bile acid binding which aids in decreasing pruritus

A child present with failure to thrive abdominal distention, vomiting, and constipation alternating with explosive watery diarrhea. When the child is not having diarrhea, what is the expected appearance of the stools?

Foul smelling pettets or ribbon like.

A newborn present with a right lower extremity that has a rigid mid foot, planter flexion, and varus deviation of the ankle. The child will undergo serial casting for several months. Which of the following statements made by the parents indicates in understanding of the treatment plan?

I monitor the temperature of the foot often to make sure that toes feel normal.

A 2 month old infant being treated for bacterial meningitis has developed syndrome of inappropriate Antidiuretics hormone (SIADH) what signs and symptoms would this patient present with? SATA

Increased blood pressure High level of antidiuretic hormone (ADH) Sodium level <125 mEq/L

Surgery for patient ductus arteriosus is performed to prevent which situation?

Increased pulmonary vasculture

The nurse assessing a child with acute post-streptococcal glomerulonephritis would be alert for which of the following findings?

Increased temperature

A school aged child with scabies received 2 treatments of Nix (permethrin 5%). The mother reports that she does not think treatment have worked because the child is experiencing a rash and itching. What should be the nurse's response?

Itching may last after mites have been eliminated use soothing lotions and avoid scratching

Which nursing assessment is used to detect early sign of worsening condition in the child with head injury?

Level of consciousness.

Home care teaching for the mother of a 14 month old newly diagnosed with iron deficiency anemia should include which of the following?

Limit cow's milk intake to less than 24 ounces per day.

The nurse working with a child on a pediatric unit receive a lab report which show an absolute neutrophil court (ANC) ofless than 500 cubic milimeter. The lab result tells the nurse which of the following?

Normal body flora can put the child at risk for serious life threating bacterial infection

The nurse is caring for a 10 year old child who had an infected verticuloperitoneal shunt removed 2days ago. She has been talkative and extremely interactive. During the afternoon, the nurseobserves her lying in her bed, quite not answering questions. The priority nursing intervention would be.

Notify the physician immediately with the findings.

Which of the following would the nurse recommend as the most appropriate play activity for a 4-year-old child in spica cast?

Playing with Duplos (large Legos)

A child with hypoxia secondary to cardiac defect is at risk for cerebrovascular accidents (strokes). Which of the following helps to decrease this risk?

Prevent dehydration.

The initial post operative care of the infant with a cleft lip repair will include the protection of incision and which other intervention *

Preventive measures such as comforting to decrease the infant crying.

A three months old has failure to thrive, excessive inability, frequent coughing, checking with feeding and frequent spittingup. What should be included in nursing care?

Small, frequent feeds with frequent burping.

A 3 year old child is hospitalized after a near drowning accident. The child's mother complains to the nurse, this seems unnecessary when he is perfectly fine. The nurse's best reply would be which of the following?

The reason for this is that complications could still occur within 72 hours

The parents with 9 year old with a seizure disorder express concern for their child's difficulty focusing and reports of outburst at school. The client is..................................................... What isthe nurse best response*

The serum drug levels need to be evaluated.

Which of the following is imperative to do at the hospital for a child who has survived a near drowning in cold water

Use blanket, heat packs, and a variety of other methods to warm the child and maintain organ.

A 9-month-old infant is diagnosed with mild (grade 11) vesicoureteral reflux (VUR). Home care instruction for this client would include which intervention?

Use of prophylactic antibiotics

The nurse assessing a newborn auscultates a continues machinery like murmur.This finding is associated with which congenital heart defect?

Ventricular septa defect

A 2 day old infant in the nursery is acyanotic, but has tachypnea, dyspnea, retraction, wheezing, and grunting. What is the expected cardiac diagnosis?

Ventricular septal defect.

Which statement would indicate to the nurse that the parents of a child with Hemophilia A need further teaching?

We gave our child Pepto-Bismol for his stomachache

The nurse is educating the family of a 3-year-old after the cardiac catheterization. Which statement by the patient demonstrates understanding?

We must keep the leg straight for 4-6 hours '

As the nurse teaches parents of a child with leukemia about home care which of the following statement is correct*

Yours sons temperature should be taken daily while he is on chemotherapy.

Parents of a newborn diagnosed with hypoplasia cleft heart syndrome are having adifficult time understanding the course of treatment. Which information does the nurse need to reinforce regarding the cause of treatment for this type of defect?

a POA pharmacological until several staged repairs are completed over time

Which of the following symptoms would be apparent with a child who has been admitted with a possible pyloric stenosis? SATA

a) Progressive projectile vomiting; b) Non bile stained vomits.

A parent of a child with biliary atresia questions the nurse as to the reason for child being administeredphenobarbital? The best explanation would include what information?

an action of the medication is bile acid binding which aids decreasing pruritus