Chapter 23 LCHS
A 10-year-old child is brought to the emergency department by the rescue squad from the scene of a house fire. The child is confused and agitated. Which action by the nurse is the priority for this child?
Give the child 100% oxygen.
The nurse is caring for a child with bronchopulmonary dysplasia receiving furosemide (Lasix). Which finding would lead the nurse to conclude the child has a side effect of this drug?
Hypokalemia
A 4-year-old girl is brought to the emergency department. She has a "frog-like" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. Which nursing action is the priority for this patient?
Maintain the airway.
A 5-year-old child is brought into the clinic by a parent, who reports the child has a "sore throat." Which assessment finding would require immediate notification to the health-care provider?
Strawberry-colored tongue
The mother of a child diagnosed with influenza in the emergency department last night calls the family practice clinic to ask if she can give the child store-brand "flu medicine." Which response by the nurse is the most appropriate?
You must make sure it does not contain salicylates (aspirin)
A nurse is assessing a 10-year-old child with asthma. The child and parents report daily symptoms, but the child only wakes up coughing once or twice a week, uses an albuterol (Ventolin) inhaler daily, and is occasionally prevented from participating in physical activity by symptoms. What asthma severity classification does the nurse assign to the child?
moderate persistent
A 7-year-old child is brought to the clinic with what the parent describes as "tonsillitis." The child has a moderate fever, foul breath, and dysphagia, and occasionally spits up lumps of foul-smelling material. Which medication does the nurse prepare to instruct the parents on based on the child's symptoms?
Clindamycin (Cleocin)
11. The pediatric clinic nurse cares for many children with viral upper respiratory infections. Which seasonal characteristics of these infections would the clinic nurse include when educating parents? (Select all that apply.)
*Adenovirus is very prevalent in the winter. *Coronavirus is commonly seen in the spring. *Infections with parainfluenza are seen in autumn. *Rhinovirus is more common in the early fall.
A 2-year-old child has croup. Which nursing interventions are appropriate for this child? (Select all that apply.)
*Administering racemic epinephrine (Microenfrin) *Applying oxygen via an oxygen tent
The nursing student reads the diagnosis of a lower respiratory infection in a patient's chart. The student knows that the lower respiratory system is composed of which structures? (Select all that apply.)
*Alveoli *Bronchi *Lungs
3. The pediatric nurse is providing care to a neonate diagnosed with cystic fibrosis. When discussing the clinical manifestations of this disease process, which topics will the nurse include in the teaching session? (Select all that apply.)
*Anemia *Malnutrition "Meconium ileus *Rectal prolapse
Parents of a 3-year-old call the clinic and ask for information on sinusitis. Which symptoms will the nurse include in the explanation to the parents? (Select all that apply.)
*Cough worse when lying down *periorbital swelling *post nasal drip
A parent brings a 2-year-old child to the clinic, reporting that the child has an ear infection. Which assessment information leads the nurse to suspect a diagnosis of bacterial otitis media?
Acute otalgia. Fever of 104°F (40°C) Poor feeding Rubbing the ear
A nurse is planning a seminar to address asthma in the community. To have the greatest impact, which demographic group should the nurse target?
African American children
Which statement by the nursing student indicates a correct understanding of the anatomy and physiology of the respiratory system?
Air passes through the trachea into the bronchus.
A nurse is caring for a child who has a chest tube. After ambulating and returning the child to bed, the nurse notes that the child has dyspnea and decreasing oxygen saturation readings. Which nursing action is the priority?
Assess the tubing for kinks.
A new nurse in the emergency department is examining a 4-year-old child who is sitting upright, is drooling, and is restless. Which action by the new nurse causes an experienced nurse to intervene?
Attempts to assess throat with a tongue blade
A 3-year-old child is brought to the emergency department with sudden onset of hoarseness, wheezing, and cough. The child has a history of asthma, but the parent is worried about an aspirated toy part. Which action by the nurse would quickly differentiate between the two?
Auscultate lungs for unilateral wheezing.
The parent of a 7-month-old baby who has been diagnosed with influenza asks the nurse if the baby can have Tamiflu (oseltamivir). Which response by the nurse is the most appropriate?
"Children younger than 1 year old cannot take this medication,"
The mother of a 5-year-old girl describes her daughter's symptoms to the nurse in the emergency room. She states that her daughter has had "a dry, hacking cough for the past 3 days that gets worse during the night." She further states that "now she is coughing up phlegm." Which discharge instruction does the nurse plan to provide?
"Do not be surprised if she vomits her secretions."
An 11-year-old child who has a history of asthma is brought to the family practice clinic by a parent who reports that the child has white plaque over the inside of the mouth and coating the tongue. Which question by the nurse would elicit the most useful information?
"Do you rinse your mouth after using your inhaler?"
The parents of a child diagnosed with cystic fibrosis (CF) consult the nurse, stating they want to have more children but are worried about subsequent children also having the disease. Which information does the nurse provide the parents?
"Each child has a 25% chance of inheriting the disease."
An infant is being discharged from the hospital after treatment for respiratory syncytial virus (RSV). The infant still has some mild respiratory distress at times. Which discharge instruction is the priority for this infant?
"Feed baby small amounts while she is sitting up."
A nurse is educating the parents of a 5-year-old with bacterial otitis media. Which discharge instruction is most important?
"Give the full course of antibiotics even if she is better."
A nurse is teaching the parents of a 10-year-old child diagnosed with cystic fibrosis. Which instruction by the nurse is most appropriate?
"Preventing respiratory infections is crucial for quality of life."
The pediatric nurse describes the effects of cystic fibrosis on the body systems to the parents of a child recently diagnosed with the disease. Which statements does the nurse include to the parents? (Select all that apply.)
*Increased mucus obstructs the airways, and stasis of fluid causes infections. *Pancreatic ducts are often blocked by mucus, leading to poor nutrition. *Reproduction is affected, as ovarian ducts and the vas deferens are occluded. *Thick mucus affects several body systems, preventing some organs from working.
The nurse is assessing a patient diagnosed with cystic fibrosis. Which findings support the patient's diagnosis? (Select all that apply.)
*Protuberant abdomen *Wasted buttocks
The nurse is caring for a child who experiences frequent ear infections. The child's mother wants to know why this is occurring. Which anatomical differences in the pediatric patient increase the risk for otitis media? (Select all that apply.)
*impaired drainage *shorter, horizontal Eustachian tubes *typical lying down position of infants *underdeveloped cartilage lining
A nurse is providing anticipatory guidance to parents of a toddler. Which objects does the nurse include as a frequent cause of aspiration? (Select all that apply.)
Balloons Hot dog bits Peanuts Popcorn
A 2-year-old child in a pediatric unit accidentally swallows a loose toy part and begins to exhibit signs of choking and wheezing. The pediatric nurse begins the Heimlich maneuver. After performing abdominal thrusts, what action does the nurse take next?
Continue until the object is dislodged or the child becomes unconscious.
Four children are in the pediatric clinic waiting to be seen. Which patient should the nurse see first? A. Afebrile, parent reports harsh barky cough B. Pulling on ear, temperature 103°F (39.5°C) C. Salty-tasting sweat, poor weight gain D Wheezing, retracting, no wet diapers today
D=Wheezing, retracting, no wet diapers today
The pediatric nurse examines a neonate and documents that the baby is pink in color when crying but turns bluish when quiet. Which question would be most appropriate to ask the parent?
Does the baby have trouble when eating?"
A child is admitted after a severe asthma attack. Respiratory status is stable at this time. Which is the priority intervention for this child?
Ensuring hydration
The pediatric nurse is observing a student nurse teach a child how to use a peak flow meter. Which instruction by the student requires intervention by the pediatric nurse?
Exhale for as long as you can to empty your lungs
A father calls the pediatric clinic to report that his child was diagnosed with influenza at an urgent care facility yesterday and was prescribed oseltamivir (Tamiflu). The father worries that the dose of 75 mg twice a day is too high. He reports that his child weighs 90 lb (40.9 kg). Which response by the nurse is best?
No, that is an appropriate dose for your child.
The nurse suspects a pediatric patient is experiencing acute respiratory distress syndrome (ARDS). What laboratory finding correlates to this condition?
PCO2 of 88 mm Hg
A child is admitted to the pediatric unit with respiratory syncytial virus (RSV). Which action by the nurse is best for infection control?
Place the child in isolation precaution
A child had a tonsillectomy this morning. What action by the nurse is most important for the child's safety?
Position the child on her side.
A father brings his 1-year-old son to the clinic and states that when he kisses the child's cheek, it tastes salty. Which diagnostic test does the nurse educate the father on based on the father's statement?
Quantitative sweat chloride test
A 1-year-old child has the following arterial blood gas values (ABGs): pH: 7.28, PCO2: 58 mm Hg, PO2: 77 mm Hg, HCO3: 14 mEq/L, O2 saturation: 88%. Which interpretation of the results by the nurse is the most accurate?
Respiratory acidosis
A school-age child has asthma and lives in a home where both parents smoke. The nurse has provided extensive education to the parents on the dangers of second-hand smoke. Which assessment by the nurse indicates that goals for a family nursing diagnosis have been met?
Significant decrease in asthma "attacks" over a year
The pediatric nurse explains to the parents of a 1-year-old patient with pneumonia that the differences between the adult's and child's respiratory system affect function and subsequent respiratory conditions. Which difference does the nurse include in the discussion with the patient's parents?
The larynx and the glottis are higher in the younger child's neck.
A pediatric clinic nurse teaches parents how to care for their toddler who has nasal congestion. What anatomical difference between children and adults is a concern with congestion in children?
The narrow trachea can become obstructed easily.
