UWorld Pediatrics: Auditory/Visual/Urinary

What is the correct way to move a 2 year olds ear to open the ear canal?

Pull pinna down and back in infant and toddlers

The nurse is performing an assessment on a 2-year-old with otitis media. Which of the following actions would be appropriate?

1) Do not insert speculum into bony inner part of ear 2) Encourage parents to have their children vaccinated against pneumonia and flu 3) Inspect tympanic membrane for redness, perforation, and bulging 4) Wait until the end of the assessment to perform the ear part

Which assessment findings should the nurse anticipate in a child with suspected acute otitis media (AOM)?

1) Pulling on the ear 2) Restlessness and irritability 3) Refusal to eat - severe pain with pressure on tragus is seen in otitis externa when pulling on pinna.

The nurse has assessed 4 children. Which finding requires immediate follow-up with the health care provider?

A child with a surgical repair of hypospadias earlier today with no urinary output in 2 hours - Hypospadias, a condition in which the urethral opening is on the underside of the penis, is surgically corrected by rerouting the urethra and inserting a temporary stent to aid healing. Urinary output is closely monitored postoperatively to ensure patency.

What is strabismus?

a disorder involving misalignment of the eyes caused by a congenital defect or acquired weakness of an eye muscle. - One eye may appear deviated inward (esotropia) or outward (exotropia). - When the visual axes are not in alignment, the brain perceives 2 images (diplopia) and suppresses the weaker image to compensate

What is hemolytic uremic syndrome?

A life-threatening complication of Escherichia coli diarrhea and results in red cell hemolysis, low platelets, and acute kidney injury. - Hemolysis results in anemia, and low platelets manifest as petechiae or purpura.

A 2-year-old is suspected of having retinoblastoma. The nurse recognizes which sign as being most characteristic of this disease?

Absence of red reflex - Retinoblastoma is a malignancy of the eye typically diagnosed in children under age 2. The pupil will reflect a white color, and the child will not have the normal red eye reflex. Treatment may include radiation therapy or enucleation (removal of the eye).

What is nephrotic syndrome and what is it characterized by?

Characterized by increased permeability of the glomerulus to proteins (eg, albumin, immunoglobulins, natural anticoagulants). Loss of albumin in urine leads to hypoalbuminemia; this causes decreased plasma oncotic pressure, which allows fluid to leak out of the vascular spaces. Reduced plasma volume (hypovolemia) activates kidneys to retain salt and water (via the renin-angiotensin-aldosterone system).

What do patients experience during nephrotic syndrome?

Clients experience generalized edema, weight gain, loss of appetite (from ascites), and decreased urine output.

What are the clinical signs of hemolytic uremic syndrome?

Clinical features include anemia (pallor), low platelets (petechiae and purpura), and acute kidney injury (low urine output).

What is the best way to test the eye sight of a 3-4 month old?

Following a target, usually a bright-colored object or a human face, is a method of testing visual acuity and fixation in infants.

The nurse is admitting a 4-year-old diagnosed with Wilms tumor. The child is scheduled for a right nephrectomy in the morning. Which action is a priority in the preoperative care plan?

Instructions to not palpate the abdomen

What are the 4 classic signs of nephrotic syndrome?

Massive proteinuria - caused by increased glomerular permeability Hypoalbuminemia - resulting from excess protein loss in the urine Edema - specifically periorbital and peripheral edema and ascites; caused by low serum protein and albumin as fluid is pulled into interstitial spaces and body cavities Hyperlipidemia - related to increased compensatory protein and lipid production by the liver

What is myopia?

Myopia, or nearsightedness, is reduced visual acuity when viewing objects at a distance. - Clients with myopia often need to hold objects near their face or sit near objects to see clearly.

A nurse is caring for a 2-year-old with a new diagnosis of strabismus. Which intervention should the nurse anticipate?

Patching the stronger eye - One common treatment is to strengthen the muscles of the weaker eye by wearing a patch over the stronger eye or using special corrective lenses. If nonsurgical methods are unsuccessful, surgical intervention to shorten or reposition an eye muscle for more effective movement may be required.

The nurse assesses a pediatric client who was diagnosed with diarrhea caused by Escherichia coli. The nurse is most concerned with which finding?

Petechiae noted on the trunk

A 1-year-old child who goes to day care is recovering from an episode of otitis media. Which intervention is most important for the nurse to recommend to the parents in order to prevent recurrence?

Smoking cessation by the parents - Key interventions for prevention include avoiding exposure to tobacco smoke, obtaining routine immunizations, and discontinuing use of a pacifier after age 6 months.

How is vision tested in newborns?

The corneal light reflex is tested by shining a light held 16 in (40.6 cm) from the child's eyes. Although this is not the best option, it can be used to test vision in newborns. - The nurse observes blink response, alertness, and following the light to the middle.

A nurse is caring for a child with acute glomerulonephritis. Frequent monitoring of which of the following is a priority?

blood pressure - Acute glomerulonephritis is most often caused by recent streptococcal infection. Nursing care is focused on monitoring vital signs (particularly blood pressure) and fluid status, avoiding salt in the diet, and conserving energy.

How are children tested for color vision deficits?

by looking at cards one at a time