EXAM 2 - Immunizations, Skin and Communicable Disease Quiz
A 12-month-old infant has become immunosuppressed during a course of chemotherapy. What information regarding the measles, mumps, and rubella (MMR) vaccine should the nurse, preparing for the infant's discharge, give the parents?
Infants who are receiving chemo should not be given these vaccines. Rational: The MMR vaccine is composed of live attenuated virus and irs administration could be life threatening for an immunosuppressed child.
When should an immunosuppressed child receive the MMR vaccine?
When the infant reaches 12 to 15 months of age and if the blood values have returned to normal.
What is the recommended rx for otitis media in a 10 month old who is not severely ill vs severely ill ?
analgesics such as acetaminophen or ibuprofen to relieve discomfort antibiotics therapy when the infant has a fever or is in sever pain. Rational: antibiotics are NOT effective in children younger than 2 if the child is not severely ill.
A school-aged child is brought to the emergency department with partial- and full-thickness burns of the lower extremities. The practitioner writes multiple prescriptions. What is the nurse's priority intervention?
starting an IV line w/ large-bore cath Rational: bc of the location and degree of burns , an IV line for fluid restoration and access for pain meds is the priority to prevent hypovolemic shock insertion of a urinary cath is secondary intervention after fluids
A 5-year-old-child is undergoing chemotherapy. The mother tells the nurse that the child is not up to date on the required immunizations for school. What is the best response by the nurse?
This isnt the best time to finish the immunizations bc your child's immune system is suppressed. Rational: Chemo compromises the immune system so vaccines can be administered after chemo completion
A nurse explains to the mother of a 1-year-old with a history of frequent ear infections that the primary cause of otitis media in young children is what?
An Obstructed eustachian tube Rational: this impairs drainage and creates negative pressure; when the tube opens up, bacteria are pulled into the middle ear.
Which parental statement indicates correct understanding for the prevention of sunburn for a toddler-age client?
I will use a sunscreen q/ SPF of 30 or higher for my kiddo. Rational: important to keep them out of the sun from 10 am to 2pm, wear a ballcap, reapply sunscreen, make sure child is dressed in cotton clothing with a tight weave.
Iv fluids for a sever burn are administered at a rate to keep the child's urine output at ___ mL/kg of body weight per hour to reflect adequate tissue perfusion.
1 mL/kg/hr
To evaluate kidney function, the nurse must accurately measure the hourly urine output of a 1½-year-old toddler weighing 22 lb (11 kg) who has been admitted with extensive burns. What is the minimum safe output per hour for a child this age?
10 to 20 mL Rational: minimum safe urine output for a 1 1/2 year old toddler is 1 mL/kg/hr. The toddler should be excreting 11mL/hr which is the minimum safe output of 10-20mL/hr
Urine output range of 21 to 40 mL/hr is the minimum safe output for children who weigh .... and are ... years old
21 to 40 kg and are 5 to 11 years old
A parent of a 7-year-old child asks a nurse how to tell the difference between measles (rubeola) and German measles (rubella). What should the nurse tell the parent differentiates rubeola from rubella?
High fever and Koplik sports Rational: s/s of rubeola (measles) include high fever, photophobia, Koplik spots (white patches on the mucus membrane of the oral cavity), and rash. s/s of Rubella (German measles) usually does not cause high fever, runs 3-6 day course, and never causes Koplik spots
A 4-year-old child is being transported to a trauma center for treatment of a partial- and full-thickness burn injury that is estimated as covering more than 40% of the body. The nurse anticipates that which treatment will be prescribed initially?
Insertion of a Foley cath. Rational: so urine output can be accurately measured on an hourly basis.
The parent of a 10-month-old infant with otitis media tells the nurse in the pediatric clinic that this is the baby's third episode in 3 months. The infant is tugging at the ear but is not acutely ill. What factor should the nurse consider before responding?
The eustachian tube is short and horizontal Rational: the anatomical difference in young children permits easier migration of the microorganisms from the oral cavity into the middle ear, predisposing them to ottis media.
A nurse in the pediatric clinic is teaching a mother how to care for her infant who has eczema. What is most important for the nurse to teach the mother?
preventing secondary infections Rational: skin integrity of children w/ eczema is compromised by constant scratching and children are prone to strep and staphylococcal infections.