EAQ Pediatric Gas Exchange

Which physiologic responses to bronchiolitis would the nurse expect to observe in the pediatric intensive care unit? Select all that apply. One, some, or all responses may be correct. A. Wheezing B. Bradycardia C. Sternal retractions D. Nasal flaring E. Prolonged expiratory phase

A. Wheezing C. Sternal retractions D. Nasal flaring E. Prolonged expiratory phase

A 4-month-old infant is admitted with a diagnosis of bronchiolitis. Which feeding recommendation would the nurse give the mother? A. Withhold feedings at this time B. Offer Pedialyte or other clear liquid C. Offer up to 4 oz (120 mL) of formula. D. Feed baby cereal followed by formula

A. Withhold feedings at this time

Which nursing care plan is indicated for a child admitted to the hospital with pneumonia? A. Rest B. Exercise C. Nutrition D. Elimination

A. Rest

Which clinical finding of an 8-year-old child with a history of asthma requires immediate intervention? A. Barrel chest B. Audible wheezing C. Heart rate of 105 beats per minute D. Respiratory rate of 30 breaths per minute

B. Audible wheezing

Which potential consequence of repeated infections should the nurse consider when caring for a child with cystic fibrosis? A. Increased irritability B. Development of diabetes C. Impaired academic ability D. Depression of bone marrow

B. Development of diabetes

Which statement will the nurse include when teaching the family of a child with asthma about peak flow meters (PFMs)? A. "This device measures the peak amount of air that your child can inhale." B. "This device will improve medication delivery to the lungs when it's used with an inhaler." C. "Your child should make sure to use a short-acting bronchodilator before using the PFM." D. "A PFM can help you identify when asthma is getting worse even before your child has symptoms."

D. "A PFM can help you identify when asthma is getting worse even before your child has symptoms."

Which inpatient admission orders for a child with viral pneumonia would the nurse question? A. Encourage oral fluids B. Chest physiotherapy twice a day C. Start IV fluids D 5% 0.45% NS at 80 mL/h D. Aspirin 325 mg every 4 hours prn for fever higher than 101.4°F (38.6°C)

D. Aspirin 325 mg every 4 hours prn for fever higher than 101.4°F (38.6°C)

Which pathophysiological process would the nurse expect to account for growth failure in a 4-year-old child with newly diagnosed cystic fibrosis? A. Impaired digestion and absorption because of the lack of pancreatic enzymes B. Dyspnea and shortness of breath, which cause anorexia and disinterest in food C. Increased bowel motility and diarrhea, which lead to inadequate absorption of nutrients D. Pulmonary obstruction, which causes an oxygen deficit and inadequate tissue nourishment

A. Impaired digestion and absorption because of the lack of pancreatic enzymes

An infant is admitted to the pediatric unit with bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions would the nurse provide for the infant? Select all that apply. One, some, or all responses may be correct. A. Limiting fluid intake B. Instilling saline nose drops C. Maintaining droplet precautions D. Nasal suctioning to remove mucus E. Administering inhaled bronchodilators

B. Instilling saline nose drops C. Maintaining droplet precautions D. Nasal suctioning to remove mucus

Which treatment would the nurse anticipate for an infant admitted with bronchiolitis caused by respiratory syncytial virus (RSV)? A. Humidified cool air and adequate hydration B. Postural drainage and oxygen by hood C. Bronchodilators and cough suppressants D. Corticosteroids and broad-spectrum antibiotics

A. Humidified cool air and adequate hydration

A child with status asthmaticus is admitted to the pediatric intensive care unit. Which would the nurse include in the plan of care as the child starts to recover from the episode? A. Maintain the high-Fowler position B. Restrict fluids to two thirds of the usual intake C. Keep droplet precautions in place for 24 hours D. Administer the prescribed prophylactic antibiotic

A. Maintain the high-Fowler position

A male adolescent with cystic fibrosis, whose parents are both carriers of the disease, asks the nurse, "When I have children, could they have cystic fibrosis like me?" Which information would the nurse consider before responding? A. Men with cystic fibrosis usually are sterile, although sexual function is not affected B. Men with cystic fibrosis generally have a 50% chance of having children with the disease. C. Women will pass this disease to their children because it is carried on the sex chromosome. D. Women have a 25% chance of passing the disease to their children if their parents are carriers.

A. Men with cystic fibrosis usually are sterile, although sexual function is not affected

The parents of an infant with newly diagnosed cystic fibrosis ask the nurse what causes the foul-smelling, frothy stool. Which response would the nurse provide? A. Undigested fat B. Sodium and chloride C. Partially digested carbohydrates D. Lipase, trypsin, and amylase release

A. Undigested fat

Which physiological alteration would the nurse expect when assessing a 6-month-old infant with bronchiolitis (respiratory syncytial virus)? A. Decreased heart rate B. Inspiratory stridor C. Increased breath sounds D. Prolonged expiratory phase

D. Prolonged expiratory phase

Which action would the nurse include in the plan for care for a 6-month-old infant with respiratory syncytial virus (RSV) who is in respiratory distress? A. Begin a clear fluid diet B. Maintain droplet and contact precautions C. Administer prescribed antibiotic immediately. D. Allow parents and siblings to room in with the infant.

B. Maintain droplet and contact precautions

Which nursing intervention would the nurse provide for a 6-month-old infant with bronchiolitis? A. Discouraging parental visits to conserve energy B. Monitoring skin color, anterior fontanel, and vital signs C. Wearing gown and gloves when providing care D. Promoting stimulating activities to meet developmental needs

B. Monitoring skin color, anterior fontanel, and vital signs

The nurse in the emergency department notes large welts and scars on the back of a toddler who has been admitted for an asthma attack. Which additional information must be included in the nurse's assessment? A. History of an injury B. Signs of child abuse C. Presence of food allergies D. Recent recovery from chickenpox

B. Signs of child abuse

Which intervention would the nurse provide a 3-month-old infant hospitalized with respiratory syncytial virus (RSV)? A. Administering an antiviral agent B. Clustering care to conserve energy C. Administering a bronchodilator every four hours D. Providing an antitussive agent whenever necessary

B. Clustering care to conserve energy

Which pathophysiological process would the nurse recognize as leading to the clinical manifestations commonly seen in cystic fibrosis? A. Airway irritability causes spasms. B. Lung parenchyma becomes inflamed. C. Excessively thick mucus obstructs airways. D. Endocrine glands secrete surplus hormones

C. Excessively thick mucus obstructs airways.

The nurse instructs the parents of an adolescent with asthma on how to reduce the allergens in the child's bedroom. The mother tells the nurse what she plans to do to make the room hypoallergenic. Which idea indicates that further teaching is needed? A. Removing a stuffed animal collection B. Storing off-season clothing in another room C. Covering the mattress with a plastic slipcover D. Using flat outdoor carpeting to cover hardwood floors

D. Using flat outdoor carpeting to cover hardwood floors

A child is prescribed fluticasone after an acute asthma attack. Which instruction would the nurse give the family about the administration of this medication? A. "Fluticasone needs to be taken with food or milk." B. "Fluticasone is primarily used to treat acute asthma attacks." C. "The child should suck on hard candy to help relieve dry mouth." D. "Watch for white patches in the mouth and report to the health care provider."

D. "Watch for white patches in the mouth and report to the health care provider."

A child admitted to the hospital with a diagnosis of status asthmaticus appears to be improving. Which is the most objective way for the nurse to evaluate the child's response to therapy? A. Auscultating breath sounds B.Monitoring the respiratory pattern C. Assessing the lips for decreased cyanosis D. Evaluating the child's peak expiratory flow rate

D. Evaluating the child's peak expiratory flow rate

Which insect or arthropod is the most common allergen for children with asthma? A. Spider B. Centipede C. Carpenter ant D. Household Cockroach

D. Household Cockroach

Which arterial blood gas finding would be expected of a child with an acute asthma exacerbation? A. High oxygen level B. Increased alkalinity C. Decreased bicarbonate D. Increased Carbon dioxide level

D. Increased Carbon dioxide level

Which education would the nurse provide to the parents of a child being discharged after an asthma exacerbation? A. Avoid high-fat foods B. Stay at home for 2 weeks C. Increase protein and calorie intake D. Minimize exertion and exposure to cold

D. Minimize exertion and exposure to cold

An infant with cardiopulmonary disease displays signs and symptoms of bronchiolitis and pneumonia. Which condition would the nurse anticipate when planning care? A. Poliomyelitis B. Pneumococcal infection C. Meningococcal infection D. Respiratory syncytial virus infection

D. Respiratory syncytial virus infection

A 4-month-old infant with severe tachypnea, flaring of the nares, wheezing, and irritability is admitted to the pediatric unit with bronchiolitis. Which clinical finding is associated with possible respiratory failure? A. Expiratory wheezing B. Intercostal retractions C. Fine crackles on deep inspiration D. Sudden absence of breath sounds

D. Sudden absence of breath sounds