UWorld Pediatrics: Immune, Integumentary, Hematological/Oncology

The clinic nurse supervises a student nurse who is preparing to administer routine vaccinations to a child diagnosed with hemophilia. Which instructions should the clinic nurse provide to the student?

- Administer injection SQ - Apply pressure to the site for 5 mins

Which vaccines are not live vaccines?

- Flu type B (hib) - Hep B - PCV

The nurse is caring for a child who has had a tonsillectomy. Which of the following are appropriate nursing interventions?

1) Anticipate ear pain (referred pain from throat) and give acetaminophen 2) Anticipate bad breath 3) Notify HCP about frequent swallowing

A child's arm is burned from accidentally spilling boiling water on it, and the parent calls the clinic. The nearest emergency department is an hour away. Which instructions would be appropriate to give the parent?

1) Briefly soak the arm in cool water 2) Cover the area with a clean, dry cloth 3) Remove clothing, if not stuck to skin, away from burn - avoid applications of medicine and substances on the wound.

The nurse receives 4 prescriptions for a child diagnosed with hemophilia A who was brought to the emergency department following an injury on the school playground. The child has vomited once and has a headache. Which prescription should the nurse carry out first?

Adminster IV factor VIII

Hemo disorder tips

Dehydration is associated with sickle cell not hemophilia A

A child received the varicella immunization. The day after the injection, the parent calls the nurse to say that the child has discomfort, slight redness, and 2 vesicles at the injection site. What instruction would be appropriate for the nurse to provide to this parent?

Discomfort, redness, and vesicles at the injection site are common side effects of the varicella immunization. - Cover the vesicles with a small bandage until they are dry.

The nurse is triaging a 7-year-old with sickle cell crisis. The client is short of breath and vomiting and has severe generalized body and joint pains. Which assessment finding requires the most immediate intervention?

Enlarged spleen on palpation - Splenic sequestration crisis occurs when a large number of "sickled" cells get trapped in the spleen, causing splenomegaly. - This is a life-threatening emergency as it can lead to severe hypovolemic (hypotensive) shock.

A 12-month-old with Kawasaki disease received IV immunoglobulin (IVIG) 2 months ago. The child is in the clinic for follow-up and scheduled immunizations. Which vaccine should be delayed? Select all that apply.

1) MMR 2) Varicella - Live vaccines (eg, varicella, MMR) should be delayed for up to 11 months after IVIG administration as IVIG therapy may decrease the child's ability to produce the appropriate amount of antibodies to provide lifelong immunity.

The clinic nurse is reviewing self-care management of acne vulgaris with an adolescent client. Which client statement indicates a need for further instruction?

I have been scrubbing my face with antibacterial soap twice daily - These soaps dry the skin and are ineffective. - They should wash skin with mild facial cleanser.

The nurse planning teaching for the parents of a child newly diagnosed with hemophilia will include information about which long-term complication?

Joint destruction - This is due to frequent bleeds into the joint spaces. Assisting clients with decreasing the incidence of bleeding episodes and prompt treatment when bleeding occurs can help minimize joint destruction.

The nurse just administered routine immunizations to a healthy 15-month-old. What information should the nurse provide the caregivers before they leave the clinic?

Redness at the injection site and a mild fever are common - Anorexia and fussiness are common for the first 24 hours.

Several 12-month-old infants are brought to the clinic for routine immunizations. Which situation would be most important for the nurse to clarify with the provider before administering the vaccination?

Varicella zoster vaccine for patient recently diagnosed with leukemia - Clients should be assessed for allergies to vaccine components. Immunocompromised clients should not receive live vaccines. Local reactions, minor illness, exposure to an infectious source, and allergies to nonvaccine components are not contraindications to immunization.