Carman Essentials of Pediatric Nursing 3rd Ed - Ch. 1 Introduction to Child Health and Pediatric Nursing

A nurse is considering employment in a practice that promotes family-centered care. When considering this position, the nurse recognizes that this philosophy will: a. embrace teaching the parents to manage the health care needs of their child. b. promote the involvement of the child and parents as members of the health care team. c. focus primarily on the use of herbal remedies to manage health concerns. d. consider the wishes of the child as the leading force in planning care.

B Family-centered care involves a mutually beneficial partnership between the child, the family, and health care professionals. It applies to the planning, delivery, and evaluation of health care for children of all ages in any setting.

A child's parents have stated that they are adamantly opposed to a transfusion of packed red blood cells for their daughter, despite her critically low hemoglobin level. What action should the nurse perform first? a. Provide health education about the need for the transfusion while remaining nonjudgmental b. Explore the rationale for the refusal by dialoguing with the parents c. Describe the relationship between the daughter's health and the recommended treatment d. Collaborate with the primary care provider to present alternatives

B It is important not to make assumptions about a parent's refusal of care for a child. The exact rationale for the refusal must be assessed before alternatives can be presented or education provided.

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of the child's condition and care. Which intervention is least important for empowering these health care consumers? a. Teaching the parents how to perform chest physiotherapy b. Educating the parents about the lung transplant list c. Keeping the family apprised of all developments in care d. Locating the best deal on a high-frequency chest compression vest

D Helping the family save money on therapy equipment is a consumer assistance activity, but it does not empower these health care consumers. The pediatric nurse is uniquely positioned to empower this family by performing the role of educator regarding therapy, by being an advocate regarding their wishes to get a lung transplant, and by keeping them informed as equal partners in family-centered care.

Which child represents an increasingly common pediatric medical scenario currently present in the United States? a. 9-year-old girl diagnosed with type 2 diabetes b. 13-year-old boy admitted with a fall-induced fractured femur c. 4-year-old girl diagnosed with non-Hodgkin lymphoma d. 5-hour-old neonate diagnosed with Tetralogy of Fallot

A The incidence of diabetes is rising in the United States. This is not noted to be the case with congenital anomalies, trauma, or lymphoma.

The nurse is updating the records of a 10-year-old girl who had her appendix removed. Which action could jeopardize the privacy of the child's medical records? a. Changing identification and passwords monthly b. Letting another nurse use the nurse's log-in session c. Closing files before stepping away from computer d. Printing out confidential information for transmittal

B It is important to log-off whenever leaving the computer. The person that shares the nurse's log-on session may get called away from the computer leaving the nurse responsible for any breech in security. Keeping IDs and passwords confidential is basic computer security. E-mail is not a safe way to transmit confidential information for transmittal. Printing is safer. Closing client files before stepping away from the computer helps ensure privacy.

Which nursing activity requires the pediatric nurse to implement the ethical principle of nonmaleficence? a. Encouraging an adolescent client to take ownership of her health status independent of her parents b. Weighing the potential harm caused by a child's chemotherapy with its potential benefits c. Mediating between a father, who wants his infant circumcised, and the mother who is opposed d. Providing empathic, holistic care to a family who has just learned that their child's prognosis is poor

B Questions of risks versus benefits often require the care team to examine options in the light of nonmaleficence; that is, the responsibility to avoid undue harm. Encouraging an adolescent to take ownership of her health will likely involve the principle of autonomy. Mediating in a family dispute or providing empathic care is less likely to involve the principle of nonmaleficence.

The nurse is assessing a 9-year-old boy during a back-to-school check-up. Which finding is a factor for childhood injury? a. Records show child weighed 2,450 g at birth b. Mother reports she has abused alcohol and drugs c. The parents adopted the boy from Guatemala d. Mother reports the child is hostile to other children

B One of the factors associated with childhood injuries is parental drug or alcohol abuse. This is the leading cause for child mortality. Low-birth-weight babies are at higher risk for infant mortality. Foreign-born adoption is a factor for childhood morbidity. The child's hostility toward other children may be an environmental or psychosocial factor for childhood morbidity.

The nurse is caring for a 14-year-old boy with a debilitating illness who wants to attend school. Which intervention addresses the child's physical health but not his quality of life? a. Helping the child modify trendy clothing to his needs b. Consulting with the school nurse at the child's school c. Assessing the child's daily oxygen supplement needs d. Adapting technologies for use outside of the home

C Assessing the child's daily oxygen supplement needs addresses the child's physical health but not the contemporary issue of quality of life. Helping the child modify trendy clothing to his needs, consulting with the school nurse, and adapting technologies for use outside of the home will improve the child's quality of life by building independence and self-esteem.

The school nurse is caring for several children who witnessed an 8-year-old girl get hit by a car on the way to school. Which intervention is least important to the nursing plan of care for these children? a. Determining that the children were traumatized by what they saw b. Arranging for counseling for the children who saw the accident c. Including friends of the injured child to receive counseling too d. Making phone calls to the parents of the children counseled

D Making phone calls to the parents of the children who were determined to need counseling is least important to the nursing plan of care. It is, no doubt, mandatory for the nurse to inform and support the parents. However, this intervention is the least important based on the nursing diagnosis of the children's need for counseling, the intervention to arrange for a counselor, and the adaptation of the intervention by providing counseling for the friends of the injured child.

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject least supports the emphasis on preventive care? a. Reminding that child will imitate parents b. Explaining how to toddler proof the house c. Describing self-care for brushing teeth d. Explaining how to teach self-hand washing

A Reminding the mother that the child will imitate her parents may prevent the child from imitating dangerous behavior, but this is less likely to be a danger. Explaining how to toddler proof the house helps prevent injury to the child. Explaining how to teach self handwashing helps to prevent infection. Describing self-care for brushing teeth helps prevent dental caries. These interventions help avoid common health problems.

The nurse is applying the nursing process to the care of a 5-year-old child who has been diagnosed with asthma. Which action should the nurse perform first? a. Identify the nursing diagnoses that are most commonly associated with childhood asthma. b. Teach the child and the caregivers basic strategies for preventing and managing asthma symptoms. c. Interview the child and the caregivers to determine the most common causes of the child's symptoms. d. Collaborate with the child and the caregivers to determine their specific, desired outcomes for care.

C The nursing process always begins with assessment, an activity that would include an interview focusing on precipitating factors. Each of the other listed activities would be performed subsequent to an assessment.

A nurse is reviewing morbidity data related to a recent outbreak of severe influenza in the community. This epidemiologic information will allow the nurse to determine: a. the severity of each child's illness after being diagnosed with influenza. b. the main health factors associated with the development of childhood influenza in the community. c. the role that influenza has played in the deaths of any children in the community. d. what proportion of children in the community have recently been diagnosed with influenza.

D Morbidity is the measure of prevalence of a specific illness in a population at a particular time. It is presented in rates per 1,000 population. It does not address the severity of illness, deaths, or etiologic factors.

The parents of a 12-year-old child preparing to undergo surgery explain to the nurse that their religious beliefs do not allow for blood transfusions. What initial action by the nurse is most appropriate? a. Explain to the parents that the surgeon will make the final decision in the event a blood transfusion is needed by the child b. Ask the child what their preference will be c. Contact the hospital attorney d. Document the parents' requests

D Requests of the parents and child must be documented. The surgeon does not have the automatic authority to override the parents' wishes. The child is under age and does not have decision-making authority.

The nursery nurse is preparing a consent form for the circumcision of a newborn. The mother of the child is 16 years of age. The baby's father is not participating in the care. When planning to complete the surgical consent, which action by the nurse is most appropriate? a. Ask the grandmother of the newborn to sign the surgical consent b. Determine if the baby's father is older than 18 years, and if so ask for him to sign c. Recommend that the court appoint a guardian for the baby d. Ask the baby's mother to sign the surgical consent

D The consent of a parent or guardian is required for completion of a surgical procedure such as a circumcision. The parent in the case is under age. She may, however, consent for health care treatment of her child.