Lauren's peds quizlet
After a tonsillectomy and adenoidectomy, which finding should alert the nurse to suspect early hemorrhage in a 5-year-old child? a. drooling of bright red secretions b. pulse rate of 95 bpm c. vomiting of 25 mL of dark brown emesis d. BP of 95/56 mm HG
a. drooling of bright red secretions
A nurse is planning care for a 12-year-old with rheumatic fever. The nurse should teach the parents to: a. observe the child closely b. allow the child to participate in activities that will not tire him c. provide for adequate periods of rest between activities d. encourage someone in the family to be with the child 24 hours a day
c. provide for adequate periods of rest between activities
What type of diet should the nurse teach the parents to give an older infant with cystic fibrosis? a. low-protein diet b. high-fat diet c. low-carbohydrate diet d. high-calorie diet
d. high-calorie diet
A 15-year-old has been admitted to the hospital with the diagnosis of acute lymphocytic leukemia. Which signs and symptoms require the most immediate nursing interventions? a. fatigue and anorexia b. fever and petechiae c. swollen neck lymph glands and lethargy d. enlarged liver and spleen
Answer: b. fever and petechiae Rationale: fever and petechiae associated with acute lymphocytic leukemia indicate a suppression of normal WBC's and thrombocytes by the bone marrow an put the client at risk for other infections and bleeding
The nurse is reinforcing home-care instructions to the parents of a 3-year-old child with scabies. Which statement by a parent indicates the need for further teaching? 1."I understand that I need to leave the scabicide on for 4 hours before washing it off." 2."I will need to seal up all my child's nonwashable toys in a plastic bag for at least 4 days." 3."I realize that everyone who has come in contact with my child will need to be treated for scabies." 4."I know I need to wash all the clothing and bedding in hot water with detergent and dry in a hot dryer."
1."I understand that I need to leave the scabicide on for 4 hours before washing it off." The treatment for scabies involves applying a scabicide to cool, dry skin at least 30 minutes after bathing, which needs to be left on the skin for 8 to 14 hours, then washed off. The other statements are correct.
The school nurse prepares a list of home care instructions for the parents of school children who have been diagnosed with pediculosis capitis (head lice). Which should be included in the list? Select all that apply. 1.Siblings may also need treatment. 2.Use antilice sprays on all bedding and furniture. 3.Use a pediculicide shampoo and repeat treatment in 14 days. 4.Grooming items such as combs and brushes should not be shared. 5.Launder all the bedding and clothing in hot water and dry on high heat. 6.Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.
1.Siblings may also need treatment. 4.Grooming items such as combs and brushes should not be shared. 5.Launder all the bedding and clothing in hot water and dry on high heat. 6.Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits. Bedding and linens should be washed with hot water and dried on a hot setting. Thorough home cleaning is necessary to remove any remaining lice or nits. Siblings may need to be treated and combs and brushes may need to be discarded or soaked in boiling water for 10 minutes. Antilice sprays are unnecessary. Additionally, they should never be used on bedding, furniture, or a child. The pediculicide product needs to be used as prescribed, and the parents are instructed to follow package instructions for timing the application and for contraindications for their use in children.
The nurse obtains a health history from a mother of a 15-month-old child before administering a measles, mumps, and rubella (MMR) vaccine. Which is essential information to obtain before the administration of this vaccine? 1.A recent cold 2.Allergy to eggs 3.The presence of diarrhea 4.Any recent ear infections
2.Allergy to eggs Before the administration of a measles, mumps, and rubella vaccine, a thorough health history needs to be obtained. The MMR vaccine is used with caution in a child with a history of allergy to gelatin or eggs because the live measles vaccine is produced by chick embryo cell culture. The MMR vaccine also contains a small amount of the antibiotic neomycin
The nurse assists with providing an instructional session to parents regarding impetigo. Which statement by a parent indicates the need for further teaching? 1."It is extremely contagious." 2."It is most common during humid weather." 3."Lesions are most often located on the arms and chest." 4."It begins in an area of broken skin, such as an insect bite."
3."Lesions are most often located on the arms and chest." Impetigo is most common during the hot and humid summer months. It begins in an area of broken skin, such as an insect bite. It may be caused by Staphylococcus aureus, group A β-hemolytic streptococci, or a combination of these bacteria. It is extremely contagious. Lesions are most often located around the mouth and nose, but they may be present on the extremities
The nurse prepares to administer a measles, mumps, and rubella (MMR) vaccine to a 5-year-old child. How should the nurse plan to administer the vaccine? 1.Intramuscularly in the deltoid muscle 2.Subcutaneously in the gluteal muscle 3.Subcutaneously in the outer aspect of the upper arm 4.Intramuscularly in the anterolateral aspect of the thigh
3.Subcutaneously in the outer aspect of the upper arm MMR is administered subcutaneously in the outer aspect of the upper arm. Each child should receive two vaccinations, the first between 12 and 15 months of age and the second between 4 and 6 years or 11 and 12 years.
An infant is suspected to be human immunodeficiency virus (HIV) positive, and the nurse provides information to the parents about the care of their infant. Which indicates to the nurse that the parents need further teaching about the care of their HIV-positive infant? 1.The parents ask about a prescription for an antiretroviral medication. 2.The parents are able to verbalize signs and symptoms of failure to thrive. 3.The parents plan to use rice cereal to help with watery stools when they occur. 4.The parents state they will not allow anyone with a cold to hold and kiss the baby.
3.The parents plan to use rice cereal to help with watery stools when they occur. If an infant is having diarrhea, the parents need to seek medical attention because this could be the beginning of an opportunistic infection. Self-treatment is not encouraged. Asking for antiretroviral therapy, understanding signs and symptoms of failure to thrive, and being protective of an immunocompromised infant are evidence of understanding the needs of the infant.
The school nurse notes that the child has a rash and suspects that it is caused by erythema infectiosum (fifth disease). The nurse bases this determination on the observation that the rash results in which appearance? 1.Rose-pink maculopapules 2.Pruritic macule-to-papules 3.Pinkish red maculopapules 4.A "slapped-face" appearance
4.A "slapped-face" appearance The classic rash of erythema infectiosum, or fifth disease, is the erythema on the face. The discrete rose-pink maculopapular rash is the rash of exanthema subitum (roseola). The highly pruritic profuse macule-to-papule rash is the rash of varicella (chickenpox). The discrete pinkish red maculopapular rash is the rash of rubella (German measles)
The nurse provides instructions to the mother of a child with impetigo regarding the application of antibiotic ointment. The mother asks the nurse when the child can return to school. Which response by the nurse is appropriate? 1.Ten days after using the antibiotic ointment 2.One week after using the antibiotic ointment 3.As soon as the antibiotic ointment is started 4.Forty-eight hours after using the antibiotic ointment
4.Forty-eight hours after using the antibiotic ointment The child should not attend school for 24 to 48 hours after the initiation of systemic antibiotics or for 48 hours after the use of the antibiotic ointment. The school should be notified of the diagnosis.
The mother of a toddler with mumps asks the nurse what she needs to watch for in her child with this disease. The nurse bases the response on the understanding that mumps is which type of communicable disease? 1.Skin rash caused by a virus 2.Skin rash caused by a bacteria 3.Respiratory disease caused by virus involving the lymph nodes 4.Respiratory disease caused by a virus involving the parotid gland
4.Respiratory disease caused by a virus involving the parotid gland Mumps is caused by a paramyxovirus that causes swelling from the parotid gland, causing jaw and ear pain. It is transmitted via direct contact or droplets spread from an infected person, salive from infected saliva, and possibly by contact with urine. Airborne and contact precautions are indicated during the period of communicability.
The triage nurse in the emergency department must prioritize the children waiting to be seen. Which child is in the GREATEST need of emergency medical treatment? a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling b. a 3-year-old with a fever of 100 F (37.8 C), a barky cough, and mild intercostal retractions c. a 4-year-old with a fever of 101 F (38.3 C), a hoarse cough, inspiratory stridor, and restlessness d. a 12-year-old with a fever of 104 F (40 C), chills, and a cough with thick yellow secretions
Answer: a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling Rationale: this child is exhibiting signs and symptoms of epiglottitis, which is a medical emergency
A child with cystic fibrosis has been admitted to the pediatric unit. What type of diet should the nurse request for the client? a. high-fat, high-carbohydrate b. high-calorie, high-protein c. high-calorie, high-carbohydrate d. high-carbohydrate, high-protein
Answer: b. high-calorie, high-protein Rationale: necessary to ensure adequate growth
A 12-year-old with rheumatic fever has a history of long-term aspirin use. Which client statement MOST indicates that the client is experiencing a serious adverse reaction to aspiration? a. "I hear ringing in my ears" b. "I put lotion on my itchy skin" c. "My stomach hurts after I take that medicine" d. "These pills make me cough"
a. "I hear ringing in my ears"
Nursing care management of the child with bacterial meningitis includes which interventions? Select all that apply. a. administration of IV antibiotics b. intravenous fluids at 1.5 times maintenance c. decreasing environmental stimuli d. neurologic checks every 4 hours e. administration of IV anticonvulsants
a. administration of IV antibiotics c. decreasing environmental stimuli d. neurologic checks every 4 hours
A 3-month-old infant with meningococcal meningitis has just been admitted to the pediatric unit. Which nursing intervention has the HIGHEST priority? a. instituting droplet precautions b. administering acetaminophen c. obtaining history information from the parents d. orienting the parents to the pediatric unit
a. instituting droplet precautions
The nurse is monitoring an infant with meningitis for signs of increased ICP. The nurse should assess the infant for which signs or symptoms? Select all that apply. a. irritability b. headache c. mood swings d. bulging fontanelle e. emesis
a. irritability d. bulging fontanelle e. emesis
A child with cystic fibrosis is receiving gentamicin. Which nursing action is most appropriate? a. monitoring intake and output b. obtaining daily weights c. monitoring the client for indications of constipation d. obtaining stool samples for hemoccult testing
a. monitoring intake and output
A teaching care plan to prevent transmission of respiratory syncytial virus (RSV) should include what information? Select all that apply. a. the virus can be spread by direct contact b. the virus can be spread by indirect contact c. palivizumab is recommended to prevent RSV for all toddlers in daycare d. the virus is typically contagious for 3 weeks e. older children seldom spread RSV f. frequent hand-washing helps reduce the spread of RSV
a. the virus can be spread by direct contact b. the virus can be spread by indirect contact f. frequent hand-washing helps reduce the spread of RSV
A nurse is teaching the parents of a pre-schooler about the possibility of postoperative hemorrhage after a tonsillectomy and adenoidectomy. When should the nurse explain that the risk of bleeding is the greatest? a. 1-3 days post-op b. 4-6 days post-op c. 7-10 days post-op d. 11-14 days post-op
c. 7-10 days post-op
A child seen in the clinic is found to have rubeola (measles) and the mother asks the nurse how to care for the child. Which instruction should the nurse provide to the mother? 1.Keep the child in a room with dim lights. 2.Give the child warm baths to help prevent itching. 3.Allow the child to play outdoors because sunlight will help the rash. 4.Take the child's temperature every 4 hours and administer 1 baby aspirin for fever.
1.Keep the child in a room with dim lights. A nursing consideration in rubeola is eye care. The child usually has photophobia, so the nurse should suggest that the parent keep the child out of brightly lit areas. Children with viral infections are not to be given aspirin because of the risk of Reye's syndrome. Warm baths and the sun will aggravate itching. In addition, the child needs to rest
A child is diagnosed with scarlet fever. The nurse collects data regarding the child. Which is characteristic of scarlet fever? 1.Pastia's sign 2.Abdominal pain and flaccid paralysis 3.Dense pseudoformation membrane in the throat 4.Foul-smelling and mucopurulent nasal drainage
1.Pastia's sign Pastia's sign is a rash seen among children with scarlet fever that will blanch with pressure, except in areas of deep creases and in the folds of joints. The tongue is initially coated with a white furry covering with red projecting papillae (white strawberry tongue). By the fourth to fifth day, the white strawberry tongue sloughs off and leaves a red, swollen tongue (strawberry tongue). The pharynx is edematous and beefy red in color.
The nurse is caring for a 4-month-old infant with respiratory syncytial virus (RSV). Several clients are being admitted to the unit and assignments are being made. The nurse should question being assigned which newly admitted clients? Select all that apply. 1.The 6-month old with bronchopulmonary dysplasia 2.The 11-month-old client with diarrhea 3.The 16-year-old client taking antibiotics 4.The 1-year-old client taking corticosteroids 5.The 15-year-old with bone marrow suppression
1.The 6-month old with bronchopulmonary dysplasia 4.The 1-year-old client taking corticosteroids Clients with respiratory syncytial virus (RSV) should not be cared for by nurses who are also assigned to clients at high risk for RSV infection. RSV is most dangerous in children between 2 and 7 months of age. Older children and adults do not become as seriously ill. Therefore, the nurse should question being assigned the 6-month-old with bronchopulmonary dysplasia who is more susceptible to serious problems with respiratory infection because the client is between 2 and 7 months of age and already has serious respiratory issues. The 1-year-old taking corticosteroids may have a decreased immune system and be more at risk for serious problems associated with RSV infection; thus, the nurse should question this assignment also. Although the 15-year-old client with bone marrow suppression is at a greater risk for infection and ideally would not be assigned to the nurse taking care of a client with RSV, because of the anatomy of the client's lungs, an infection with RSV would not be as detrimental to this client as it would to an infant with immunosuppression.
The nurse reinforces instructions regarding the use of permethrin 1% to the parents of a child who has been diagnosed with pediculosis capitis. Which statements by the parents indicate they understand the instructions? Select all that apply. 1."We will need to apply another application in 48 hours." 2."The hair should not be shampooed for 24 hours after treatment." 3."The medication can be obtained over the counter in a local pharmacy." 4."The medication is applied to the hair after shampooing and left on for 24 hours." 5."The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out."
2."The hair should not be shampooed for 24 hours after treatment." 3."The medication can be obtained over the counter in a local pharmacy." 5."The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out." Permethrin 1% is an over-the-counter, antilice product that kills lice and eggs with one application and that has residual activity for 10 days. It is applied to dried hair after shampooing and left for 5 to 10 minutes before it is rinsed (not shampooed) out. The hair should not be shampooed for 24 hours after the treatment
A child with rubeola (measles) is being admitted to the hospital. When preparing for the admission of the child, which precautions should be implemented? Select all that apply. 1.Enteric 2.Contact 3.Airborne 4.Protective 5.Neutropenic
2.Contact 3.Airborne Rubeola is transmitted via airborne particles or direct contact with infectious droplets. Airborne precautions and contact precautions are required; a mask and gloves are worn by those who come in contact with the child. Gowns and gloves are not indicated. Articles that are contaminated should be bagged and labeled.
The nurse is caring for a hospitalized child with a diagnosis of rubella (German measles). The nurse reviews the primary health care provider's progress notes and reads that the child has developed Forchheimer sign. Based on this documentation, which should the nurse expect to note in the child? 1.Swelling of the parotid gland 2.Petechiae spots located on the palate 3.A fiery red edematous rash on the cheeks 4.Small blue-white spots noted on the buccal mucosa
2.Petechiae spots located on the palate Forchheimer sign refers to petechiae spots, which are reddish and pinpoint and located on the soft palate. Small blue-white spots noted on the buccal mucosa are known as Koplik's spots seen in rubeola. A fiery red edematous rash on the cheeks, also called "slapped cheeks" is seen in erythema infectiosum. Swelling of the parotid gland is seen in mumps.
A 10-year-old has a 5 lb. of Buck's extension traction on his left leg. What finding should the nurse assess the child for? Select all that apply. a. dryness of the skin, by removing the foam wraps and boot b. alignment of the shoulder, hips, and knees c. frayed rope near pulleys d. correct amount of traction weight on fracture e. pressure on the coccyx
b. alignment of the shoulder, hips, and knees c. frayed rope near pulleys d. correct amount of traction weight on fracture e. pressure on the coccyx
When interviewing the parents of a 2-year-old child, a history of which illnesses should lead the nurse to suspect pneumococcal meningitis? a. bladder infection b. middle ear infection c. fractured clavicle d. septic arthritis
b. middle ear infection
