Health Promotion
What is lead poisoning in pediatrics usually from?
from ingesting chips of lead-based paint. it is often a chronic condition, which builds up in red blood cells and ultimately bones over a long time making them brittle.
When is the deltoid used for injections?
After the child is over 18 months of age
IM Injections for Children
1 ml or less vastus lateralis needle length
What is a live attenuated vaccine?
1) Uses live weekend microbes (mutated microbes), which more closely mimics the actual infection. 2) Lifelong immunity is often achieved with 1-2 booster vaccines. Ex: MMR, TB, Chickenpox
What are the recommendations for daily activity for children?
60 minutes per day of vigorous activity that increases heart rate and good nutrition
After airway, breathing, and circulation have been assessed and stabilized, which intervention should the nurse implement for a child diagnosed with encephalitis? assist with lumbar puncture and give reassurance Obtain a throat culture and begin antibiotics Perform initial and serial neurological assessments Administer antibiotics and antipyretics
A child that is having neurological problems, initial and serial neurological assessments would be priority nursing intervention for monitoring for change. Change in level of consciousness is key to watch for.
The nurse is assessing a 3-week-old with suspected bacterial-meningitis. Isolation and respiratory precautions have already been initiated. which clinical assessment by the nurse would warrant immediate intervention: Neonate irritability Neonate has a rectal temperature of 100.6 Neonate is quieter than usual Neonate has respiration of 24 breaths per minute
The respiration rate is too low. A normal respiration rate for a neonate is 30-60 breaths per minute due to them being immature and will usually double due to illness. If no immediate intervention the neonate will have respiratory distress and if still not treated will go into respiratory arrest. Any respiratory distress is an emergency.
When teaching a parent of an infant about immunizations, which statements made by the mother would indicate correct understanding of the information? SELECT ALL THAT APPLY Select one or more: a. Immunizations should start when my baby is 6 months old. b. Immunizations will help protect my baby from some communicable diseases. c. If my baby has a fever, immunizations that are scheduled might be delayed. d. When my baby gets the IPV, I must stay away from immunocompromised people.
b. Immunizations will help protect my baby from some communicable diseases. Correct c. If my baby has a fever, immunizations that are scheduled might be delayed. Correct
A nurse is preparing to administer immunizations to a 6-month-old infant. Which interventions should the nurse implement? SELECT ALL THAT APPLY Select one or more: a. assess the deltoid muscle b. parent education regarding possible side effects c. select a needle of adequate length d. ask the parent how they would like to assist
b. parent education regarding possible side effects Correct c. select a needle of adequate length Correct d. ask the parent how they would like to assist Correct
Which psychological effect would the nurse recognize as a possible effect from obesity during adolescence? Select one: a. feelings of contempt for thin peers b. accurate body image but self-deprecating attitude c. poor body image d. sexual promiscuity
c. poor body image Correct
The nurse would expect a 20-month-old to be able to complete which activity to establish good oral hygiene? Select one: a. utilizes fluoride toothpaste b. brush teeth independently c. allows parent to brush front teeth only d. choose between 2 soft bristle toothbrushes
d. choose between 2 soft bristle toothbrushes Correct
What is child maltreatment?
intentional abuse or neglect that endangers the well-being of anyone under the age of 18. Considered one of the most significant problems affecting children.
What was the first vaccine created?
small pox vaccine
Which treatment would the nurse anticipate for a 2-week-old boy diagnosed with PKU? There is no treatment or special diet A high phenylalanine diet A low phenylalanine diet The mother would be advised not to breast feed
Children with PKU are missing an enzyme phenylalanine hydroxylase controlling the conversion of phenylalanine to tyrosine. So to keep from getting brain damage you must limit the amount of phenylalanine in the diet.
What is the treatment for lead poisoning in children?
Chelation therapy removes lead from the blood
When should oral care begin?
During infancy using a washcloth on the gums and progressing.
Which signs and symptoms would the nurse expect to assess in a child with rheumatic fever? joint pain in ankles and knees Negative Group A beta streptococcal culture Large red bulls-eye appearing rash Stiff neck with photo phobia
Joint pain/arthritis is the most common symptom of rheumatic fever. 60-80% first attacks and is in two or more large joints like ankle, knee, wrist, or elbow.
What are common reactions to immunizations?
Local tenderness erythema swelling fatigue low-grade fever Decreased appetite irritability
What are contraindications of immunizations?
Sever febrile illness Decreased immunity Allergic reaction
A child is diagnosed with erythema infectionism (Fifths Disease) You observe the mother crying and she says,"I am afraid. Will my unborn child die? I have a planned cesarian section next week." which statement by the nurse would be most therapeutic? Let me get a physician to come and talk with you I understand, I would be afraid too. Would you like me to call your obstetrician to have you seen as soon as possible? I understand you are afraid. Can we talk about your concerns?
The most therapeutic response is that "I understand you are afraid...." This allows the acknowledgement of her fears and allow her to discuss concerns and you can address any misconceptions.
What are barriers to childhood obesity?
Finance Time environment Community Institution Psychological
What is the most common chronic disease in children?
Dental carries
What is an inactivated vaccine?
An inactivated vaccine has organisms commonly treated by chemicals to kill the organism, but very little change occurs in the antigens that stimulate protective immunity. Ex: HepA, Flu, Polio
Expected nursing assessments of a newborn with suspected Cystic Fibrosis would include: Observe frequency and nature of stools Provide chest physical therapy Observe for weight gain Assess parent's compliance with fluid restriction
Cystic fibrosis is inherited and often leads to a meconium ileus so assessing stool frequency and consistency is critical.
Which of the following would be the priority teaching to the parent of a child diagnosed with chickenpox (varicella) who was prescribed diphenhydramine (benadryl) for itching? Give a warm bath with mild soap before lotion is applied Avoid caladryl lotion while taking diphenhydramine (benadryl) Apply caladryl lotion generously to decrease itching Give cool shower with mild soap to decrease itching
Caladryl lotion contains diphenhydramine (Benadryl) and the child would be at risk for toxicity if the Caladryl is applied to open lesions therefore it should be avoided when taking Benadryl.
The nurse received a report on a new admission: a 3-year-old with Kawasaki disease, the priority nursing intervention would be: Continuous cardiovascular and oxygen saturation monitoring Vital signs every 4 hours until stable Strict intake and output monitoring hourly. Begin aspirin therapy after fever has resolved
Cardiovascular manifestation is the major complication in pediatric patients. Continuous cardiac monitoring is require to alert the nurse of any complication including decreased oxygen saturation
Which teaching would be important to discuss with a family of a child born with PKU? Studies have shown that children with PKU outgrow the disease Consumption of decreased amounts of protein and dairy products is advised High-Protein and high-dairy products consumption must be maintained Exclusive breastfeeding is encouraged for maximal nutrition for the child.
Many meat and dairy products are restricted or removed all together due to the high amount of phenylalanine. Lifelong dairy restrictions and diet management are going to be necessary.
What if maltreatment occurs and you identify it as a nurse?
Must report! If physical injury you will be able to see a difference in the type of injury the child has to what is reported to have happened. Children will usually not report their parent, and will take responsibility for the injury the parent gave them. We are mandatory reporters of child mistreatment. Work to stop the cycle of abuse!
The parents of a 12-month-old male with HIV are concerned about his receiving routine immunizations. What will the nurse tell them about immunizations: Your child will not receive routine immunizations today Your child will receive the recommended vaccines today; regular immunizations help prevent childhood illnesses Your child is not severely immunocompromised, but I would still be concerned about his receiving them. Let's not give them today Your child may develop infections if he gets his routine immunizations. Your child will not be immunized today.
The nurse should acknowledge the fears of the client and then discuss concerns and clarify misconceptions. Influenza and other vaccines are recommended to prevent infections. The varicella and MMR vaccines are live and should not be given
The mother of an 18-month old is discharged from the hospital after the child has a febrile seizure secondary to exanthem subitum (roseola). On discharge, the mother asks the nurse if her 6-year-old twin will get sick. Which teaching about the transmission of roseola would be the most accurate? The child should be isolated in the home until the vesicles have dried The child does not need to be isolated from other siblings Administer acetaminophen to the older sibling to prevent seizures Monitor other children for seizure development
The rash is pink and maculopapular not vesicular and transmission pathway is unknown. Incubation period is unknown and usually seen in 6 months - 3 years of age children. Isolation of siblings is not necessary.
The mother of a 21-day old male tells the nurse she is residing in a homeless shelter and is concerned about his mild cough, poor appetite, low grade fever weight loss, and irritability over the last 2-weeks. Which nursing intervention would be the nurse's highest priority? Weigh the baby to have an accurate weight using standard precautions Reassure the mother that the baby may only have a cold, which can last a few weeks Immediately initiate droplet face-mask precautions, and isolate the infant Take a rectal temperature while completing the assessment using standard precautions
This child has most likely been exposed to tuberculosis due to living in the shelter. There must be initiation for droplet face-mask precautions and isolation for this situation. The child could also have meningitis which is also precaution for isolation both respiratory and contact.
True or False: If one child is being abused in a family, all children are at risk? Select one: True False
True Correct
Which of the following would be the priority intervention the nurse should initiate for a child suspected of having varicella (chickenpox)? Contact Precautions Contact and droplet respiratory precautions Droplet respiratory precautions Universal precautions and standard precautions
Varicella is highly contagious and both contact and droplet precautions are necessary because the primary source of transmission is secretions of the respiratory tract, direct contact and fomites.
The nurse is teaching a community group about lead poisoning. Which statements made by a parent would indicate understanding? SELECT ALL THAT APPLY Select one or more: a. "High levels of lead might lead to cognitive delays." b. "After age 6 children are generally not tested for lead levels." c. "Since the removal of lead in paint in the 70's, my child is not at risk for lead poisoning." d. "My child might be tested for lead levels at age one and two."
a. "High levels of lead might lead to cognitive delays." Correct b. "After age 6 children are generally not tested for lead levels." Correct d. "My child might be tested for lead levels at age one and two." Correct