CMS PEDS
Administer humidified oxygen, suction the nasopharynx as needed
A caring for a child who has bronchiolitis. Which of the following actions should the nurse take?
Decreased urine output, increased body temperature, altered sensorium (confusion)
A nurse is assisting with data collection from a preschooler who has major burns and suspected septic shock. Which of the following findings should the nurse expect?
Restlessness, tachycardia, diaphoresis
A nurse is assisting with the care of a child who is experiencing respiratory distress. Which of the following findings are manifestations of respiratory distress?
Initiate a high protein, high calorie diet
A nurse is assisting with the care of a school age child who has a major burn. Which of the following actions should the nurse take?
Morphine sulfate IV via continuous infusion
A nurse is assisting with the care of an adolescent who has a major burn and is experiencing severe pain. Which of the following prescriptions should the nurse expect for management of the adolescent's pain?
speech delays
A nurse is caring for a 2 year old chid who has had three ear infections in the past 5 months. Which of the following complications is the child at risk for developing long term?
Initiate oral rehydration therapy
A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an appropriate action for the nurse to take?
Unconsciousness- hypoventilation and increased PaCo2 levels allow for rapid progression into conscious state. Use the lowest level of oxygen necessary to maintain adequate SaO2
A nurse is caring for a child who is receiving oxygen. The nurse should identify which of the following findings as oxygen toxicity?
Apply cool wet compresses to the affected area
A nurse is caring for a school-age child who has a minor burn. Which of the following actions should the nurse take?
"Your child could experience transient hearing loss"
A nurse is caring for a toddler who has has rhinitis, cough, and diarrhea for 2 days. The toddlers tympanic membrane has an orange discoloration and decreased movement. Which of the following statements should the nurse make?
cholesterol and triglycerides
A nurse is caring for an adolescent who has acne and a prescription for isotretinoin from a dermatologist, Which of the of the following lab findings should the nurse plan to monitor?
Apply a sterile, moist dressing on the sac
A nurse is caring for an infant who has myelomeningocele and is scheduled for surgery. Which of the following actions should the nurse take?
Elbow restraints, nothing by mouth
A nurse is caring for an infant who is postop follwoing cleft lip and palate repair. Which of the following actions should the nurse take?
Hemoglobin elctrophoresis
A nurse is caring for an infant whose screening test reveals that he might have sickle cell disease. Which of the following tests should be performed?
Wheezing, retraction of sternal muscles, agitation, nasal flaring
A nurse is collecting data from a child who has asthma. Which of the following findings should the nurse identify as indicating the child's respiratory status is deteriorating?
Hoarseness and difficulty speaking, difficulty swallowing, drooling, dry barking, cough and stridor (inspiratory)
A nurse is collecting data from a child who has epiglottitis. Which of the following findings should the nurse expect?
Generalized distribution of lesions, papules, crusting lesions
A nurse is collecting data from an infant who has eczema. Which of the follwing findings shoud the nurse expect?
Pencil-like marks, blisters on the soles of feet, pimples on trunk
A nurse is collecting data from an infant who has scabies. Which of the following findings should the nurse expect?
Place the child in upright position, monitor position, monitor oxygen saturation, administer brochodilators
A nurse is contributing to the plan of care for a child who has asthma. Which of the following interventions should the nurse recommend during an asthma exacerbation?
Implement reverse isolation precautions, administer tetanus toxoid vaccine if more than 5 years, use client-designed equipment
A nurse is contributing to the plan of care for an adolescent who has a major burn. Which of the following interventions should the nurse recommend?
Family of asthma, family history of allergies, exposure to smoke, low birth weight
A nurse is discussing risk factors for asthma with group of parents. Which of the following conditions should the nurse include?
Rotavirus (RV) Dtap, Hib, PCV13, IPV (polovirus)
A nurse is planning to administer recommended immunizations to a 2 month old infant. Which of the following vaccines should the nurse plan to give?
Provide sucrose solution on the pacifier
A nurse is preparing to administer immunizations to a 4 month infant. Which of the following actions should the nurse take to provide atraumatic care?
Zero meteerbefore each use, perform 3 attempts
A nurse is reinforcing teaching with a child who has asthma about how to use a peak flow meter. Which of the following information should the nurse include?
Varicella, pertussis, measles (rubeola)
A nurse is reinforcing teaching with a group of parents about potential complications of communicable diseases. WHich of the following communicable diseases can lead to pneumonia?
Severe abdominal cramping, it can lead to hemolytic uremic syndrome, foodborne
A nurse is reinforcing teaching with a group of patients about E.coli. Which of the following information is an appropriate action for the nurse to take?
"You should give 4-5 injections in one area before switching sites"
A nurse is reinforcing teaching with a school-age child who has DM about insulin administration. Which of the following instructions should the nurse include?
Albuterol
A nurse is reinforcing teaching with an adolescent about the prescribed use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise?
gelatin, neomycin
A nurse is reviewing the allergy history of a child prior to administration of the varicella vaccine. A prior anaphylactic reaction to which of the following is contraindication to this immunization?
Immunizations (primary prevention)
How are communicable diseases prevented?
Analgesics, lozenges, saline rinses
How can a sore throat be managed?
Rinse mouth after inhaler and clean inhaler after each use
How can fungal infections in the oral cavity be reduced when using corticosteriods?
Lateral neck radiograph of the soft tissues
How is epiglottis diagnosed?
Use of OTC medication with 1% permethrin
How is pediculosis captis treated?
Droplet, direct contact and indirect contact
How is pertussis (whooping cough) spread?
Tape Test
How is pinworms (enterobius vermicularis) tested?
< 5 sec for infants and < 10 for children and rest for 30-60sec
How long should the nurse suction for endotracheal or tracheal suctioning?
Every 1-2 hours
How often should a child with asthma be tested?
warm running water once a day
How should DPIs be washed?
10-14 days, administer high doses orally 80-90mg/kg/day in 2 divided doses
How should antibiotics be given?
Trimming toenails straight across with filing edges at the sides
How should foot and nail care be done with a child who has DM?
Throat culture and use a tongue blade
If a child has epiglottis, what should be avoided?
Varicella, MMR
If a child is immunocomprimised and cannot receive live virus vaccines. Which immunizations are contraindicated?
Frequent swallowing, clearing the throat, restlessness, bright red emesis, tachycardic, pallor
What are signs that the child is bleeding after a tonsillectomy?
Skin, reproductive, GI, respiratory and endocrine
What are the body systems that are affected with Cystic Fibrosis?
Rash that is red or brownish-red beginnig in the face spreading downward. spike fever, Koplik spots (tiny white spots) appear in the mouth 2 days before rash
What are the characteristics of measles?
Red rash that starts on the face and spreads to the rest of the body, lasting 2-3 days
What are the characteristics of rubella (German measles)?
Skin ulceration, latex allergy, ICP, bladder issues, orthopedic issues
What are the complications with spina bifida?
Decrased cardiac reserves, pulmonary embolism, pulmonary hemorrhage, end stage kidney disease, osteogenesis imperfecta, ICP
What are the contraindications for coughing for clear secretions?
CBC, electrolytes panels and mono spot test
What are the laboratory tests done for communicable diseases?
Give 1-2 hours before milk, GI upset normal, give with vitamin C, use straw to prevent staining of teeth if liquid form, Ztrack method, expect stools to turn tarry green, store no more than 1 month's supple
What are the nursing actions for iron supplements?
Premature birth, excessive milk intake, malabsorption disorders, poor dietary intake of iron, increased iron requirements (blood loss)
What are the risk factors for iron deficient anemia?
Tachypnea, tachycardia, restlessness, anxiety, pallor, respiratory distress
What are the s/s of hypoxemia?
Otitis media and hearing difficulties
What can a child have when experiencing acute tonsillitis?
Elevated WBC, decreased Hgb, elevated bilirubin and reticulocyte levels and peripheral blood smear shoes sickled cells
What happens to the body during a sickle cell crisis?
Flexion of extremities occuring with deliberate flexion of the child's neck
What is Brudzinski's sign?
Resistance to extension of the child's leg from a flexed position
What is Kernig's sign?
Tremors, tachycardia
What is an adverse effect of taking brochodialators?
used for CB by acting on the skeletal muscle to relax and decreased muscle spasm and spasticity
What is the action for drug baclofen?
Fat soluble vitamins (A,D,E, and K)
What is the deficiency the child has with Cystic Fibrosis?
Pulmonary funtion testing-spirometry
What is the diagnostic testing for asthma?
Baterial-cloudy color, elevated WBC, elevated protein content, decreased glucose content, positive gram strain Viral-clear color, slight elevated protein content, normal glucose content, negative gram stain
What is the difference between CSF analysis of meningitis between viral and bacterial?
60mg/dL >250mg/dL
What is the glucose reading hypoglycemia and hyperglycemia?
Cl- 40 mEq/L Na:70 mEq/L
What is the normal range for Cl- and Na?
4-6% child with DM 6.5-8%
What is the normal range for HbA1c?
Decrease the viscosity of mucus and improves lung function, use 1-2/daily
What is the purpose of dornase alfa?
Obtain cuffed endotracheal tube for the provider
What is the treatment for swallowing paint thinner?
60-100mmHg
What is the vacuum pressure setting for infants and children when suctioning?
Fungal infections of the oral cavity
What kind of complications can occur when using MDIs and DPIs?
High protein and calories with unrestricted fats, 3 meals/day with snacks, vitamin ADEK administration, administer stool softeners or laxatives for constipation, administer pancreatic enzymes (pancreliapse) with meals or within 30 min of eating.
What kind of diet should a child have with Cystic Fibrosis?
red/brown foods, milk based foods, citrus foods. Encourage clear liquids and then soft bland foods
What kind of foods should be avoided after a tonsillectomy?
Hydrocodone
What kind of opiod should be given when a child is experiencing difficulties with drinking fluids due to pain with tonsillitis?
Electroencephalogram (EEG), EKG, serum glucose, blood culture
What kind of prescriptions should the nurse anticipate for and infant who experienced a life-threatening event?
BUN, specific gravity, Hct, Hbg, creatinine
What lab values are elevated during dehydration?
Maintain respiratory isolation for 24 hours after initiation of antibiotic therapy, wear a mask, droplet precautions require private room or room with clients who have similar infection, monitor head circumference, maintain NPO status is pt has decreased LOC, decrease environmental stimuli to prevent seizures.
What nursing care is performed for meningitis?
prone with hips flexed and leg abducted and protect the sac from injury
What positon should a child be in who has spina bifida?
Most effective within 8 hours of ingestion
What should treatment be given with acetaminophen poisoning?
2 months
When is PCV and Hib given to decreases chances of bacterial meningitis?
Reserved for life-threatening complications, severe arthritis, pericarditis and uveitis that provides relief of inflammation and pain ---> increases muscle strength
When is prendisone used?
Birth,1-2 months and 6-18 months
When is the Hepatitis B given?
Short-acting into syringe first then long acting to reduce the risk of introducing the longer-acting insulin into the shorter acting insulin
When mixing insulin, which insulin is drawn up first?
Partial and full thickness wounds
When should silver sulfadiazine and mafenide medication be used?
every 6-8 hours
When should tracheostomy tubes be changed?
Glargine
Which insulin is not compatible with any other insulin and should not be mixed?
Rotavirus- fever, foul-smelling, watery stools, diarrhea5-7 days, vomiting (2 days)
Which viral infection is the most common in children to give diarrhea?
apply moleskin to the edges of the cast - prevents cast from rubbing on skin
a nurse is caring for a child who is in a paster shoulder spica cast. which of the following actions should the nurse take?
check child's position frequently, observe pin sites q4 ensure weights are hanging freely.
a nurse is caring for a child who is in skeletal traction. which of the following actions should the nurse take?
prepare the child for DNA analysis
a nurse is caring for a newborn who has ambiguous genitalia. which of the following actions should the nurse take?
explain to the parents that the issue can self-resolve
a nurse is caring for an infant who has a hydrocele. which of the following actions should the nurse take?
swelling of the face, pallor, fatigue, blood in the urine (not shown in infants. infants have foul-smelling urine.)
a nurse is collecting data from a child who has a UTI. which of the following should the nurse expect?
edema in the ankles, hyperlipidemia, anorexia.
a nurse is collecting data from a child who has nephrotic syndrome. which of the following findings should the nurse expect?
periorbital edema, ill appearance, hypertension.
a nurse is collecting data from a child who has poststreptococcal golmerulonephritis. which of the following manifestations should the nurse expect?
urethral opening on the dorsal surface of the penis
a nurse is collecting data from a male infant who has a epispadias. which of the following findings should the nurse expect?
check for Trendelenburg test - checks for downward tilting of the pelvis on the unaffected side.
a nurse is collecting data from a preschool-age child for developmental dysplasia of the hip. which of the following should the nurse include?
encourage frequent voiding.
a nurse is contributing to the plan of care for a child who has a UTI. which of the following should the nurse reccomend?
offer frequent meals, thicken formula with rice cereal, position infant upright after feedings.
a nurse is reinforcing teaching with the parents of an infant about GERD. ehich of the following interventions should the nurse include?
UTI
a nurse is reviewing the medical record of an infant who has obstructive uropathy. which if the following findings should the nurse expect?
unintentional urination that occurs 2x/week for at least 3 months.
how is enuresis diagnosed?
failure to pass meconium within 24-48 hours after birth, vomiting bile, refusal to eat, abdominal distention, foul-smelling ribbon-like stool.
what are expecting findings for Hirschsprung's disease?
asymmerty of gluteal and thigh, limited hip abduction, shortening of the femur, one leg shorter then the other, positive Trendelenburg sign, walking on toes of foot and limps.
what are findings for developmental dysplasia of the hip?
hirsutism, slowed linear growth, hypertension, GI bleeding, infection, hyperglycemia.
what are the adverse effects of prednisone?
oliguria, edema, hypertension, hematuria, circulatorys congestion, proteinuria related to upper respiratory or strepococcal infection.
what are the common features of acute glomerulonephritis?
recurrent pneunomia, weight loss, failure to thrive, erosion of esophagus.
what are the complications with GERD?
screaming with drawing knees to chest during pain, sausage shaped abdominal mass, red currant jelly stools, distended abdomen.
what are the expected finding of intussusception?
oliguria, tachypnea (metabolic acidosis), edema, drowsiness, cardiac arrhythmia (hyperkalemia), seizures, (hypocalcemia, hyponatremia), abrutpy diuresis
what are the expected findings for acute kidnery disease (AKI)?
pain, pale, paralysis, paresthesia, pulselessness.
what are the five P's?
cloudy, tea colored urine, decreased urine output, irritability, pallor, periorbital edema, facial edema that is worse in the morning and spreads to extremities, mild to severe hypertension, increased specific gravity.
what are the physical findings for acute glomerulonephritis?
extemities, trunk, neck, face, tongue
what body parts are involved in athetoid dyskinetic cerebral palsy?
pharynx, larynx, oral regions related to drooling and speech impairment
what body parts are involved in dystonic cerebral palsy?
desmopressin (ADH), imipramine (tricyclic antidrepressant), oxybutynin chloride (anticholinergics).
what drugs can be used to control enuresis?
high protein, high caloric, low fiber diet, TPN.
what find of diet is enforced with a pt who has Hirschsprung's disease?
caffeine, citrus, peppermint, spicy and fried foods.
what foods should be avoided with GERD?
projectile vomiting, constant hunger, olive-shaped mass in RUQ, failure to gain weight and dehydration.
what is an expected finding for pyloric stenosis?
complication resulting from failure of the omphalomesenteric duct to fuse during development, expected findings are rectal bleeding, abdominal pain and bloody, mucus stools and surgery is needed.
what is meckel's diverticulum?
radiograph of hip and pelvis, MRI - disease that causes necrosis of the femoral head
what is the diagnostic tool used for Legg-Calve-Perthes disease?
restriction of sodium and fluid, restrict high potassium foods, provide small frequent meals.
what is the diet for AGN?
proton-pump-inhibitor (PPI) or H2 receptor antagonist
what medication is used for GERD?
upright with head elevated
what position should the child be in if GERD is evident?
when the curvature is >45
when is spinal fusion with rod placement surgery recommended with a child who has scoliosis?
