Maternal Child Nursing Chapter 40 Respiratory Dysfunction

1, 3, 5 The most important nursing Intervention for a child with LTB is continuous and vigilant assessment. The nurse can take appropriate measures if the airway narrows due to inflammation of the mucosal lining. Thus the nurse can prevent the condition from worsening. Assessment of the respiratory status using pulse oximetry is necessary. This device is useful and commonly used for monitoring oxygenation status. In addition, therapy should be provided based on the nurses' observations and assessments as well as the child's response to it, and tolerance of procedures. These therapies relieve stress, restlessness, and irritability of the child. Though the trend is to provide early intubation to the child based on the nursing observations it is done by the primary health care provider. Mostly oral steroids are provided for relief and prescribed by the primary health care provider and not by the nurse.

A 3-year-old child is diagnosed with acute laryngotracheobronchitis (LTB). The graduate nurse asks for help from the senior nurse as the child is extremely restless. What should the senior nurse advise the graduate nurse about managing the care of this child? Select all that apply. 1 "Continuously observe and assess the child's respiratory status." 2 "Plan for immediate intubation or tracheostomy during an examination." 3 "Pulse oximetry should be assessed often to monitor oxygenation status." 4 "Oral steroids should be prescribed and given to treat and manage croup." 5 "Therapy should be adapted based on the child's response and tolerance."

1 The medication in a metered-dose inhaler is sprayed into the spacer. The child can then inhale the medication without having to coordinate the spraying and breathing. A nebulizer is a mechanism used to administer medications, but it cannot be used with metered-dose inhalers. A peak expiratory flow meter is a measure of pulmonary function not related to medication administration. Chest physiotherapy is unrelated to medication administration.

A 4-year-old boy needs to use a metered-dose inhaler to treat asthma. He cannot coordinate the breathing to use it effectively. The nurse should suggest that he use a: 1 spacer. 2 nebulizer. 3 peak expiratory flow meter. 4 trial of chest physiotherapy

2 When reassessing the infant's condition, re-check the previously abnormal value that correlates with the physiological system or anatomical area where the intervention was done. Because an infant this age is an obligatory nose breather, when the nose is congested with secretions the respiratory rate can increase substantially. In this case, the respiratory rate increased to far above normal for an infant this age. The values of the oxygenation saturation and the heart rate are reflective of the increased respiratory rate needed because of the secretions, which are thick and "bubbling" when RSV is present. The nurse will need to listen to lung sounds, but the best action to evaluate the effectiveness of suctioning is to obtain a respiratory rate following the suctioning activity. Similarly, the nurse will recheck oxygen saturation and heart rate to denote clinical response to therapy.

A 6-month-old infant with respiratory syncytial virus (RSV) has the following vital signs: temperature 100.4 (ax), pulse 140, respiration 68, oxygen saturation 92%, and has just had his or her nose bulb suctioned. What action should the nurse take to best determine the effectiveness of the suctioning? 1 Recheck the oxygenation saturation. 2 Recount the respirations. 3 Listen to the lung sounds. 4 Recount the heart rate.

4 By humidifying the inspired air, the membranes inflamed by the infection and dry air are soothed. The size of the droplets is too large to liquefy secretions. No additional oxygen is provided with humidified air. The humidity has no effect on ventilation.

A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because this environment facilitates: 1 liquefying secretions. 2 improving oxygenation. 3 promoting ventilation. 4 soothing inflamed mucous membrane.

4 Palivizumab (Synagis) is available as a lyophilized powder form. It is administered within6 hours of being reconstituted with sterile water. This is done because it is free of any preservatives, so microbial decomposition or undesirable chemical changes may occur.Palivizumab is a monoclonal antibody and hence it is not mixed with another antibody, but only with sterile water. Moreover, direct administration of the lyophilized powder form of palivizumab is impossible. It needs to be transformed to a liquid state. The nurse should not reconstitute the medication with normal saline. It must be reconstituted with sterile water. This is because it might change it chemical form or become infested with microorganism as it has no preservatives.

A child born before 32 weeks of gestation is prescribed to have palivizumab (Synagis) monthly to prevent hospitalization associated with respiratory syncytial virus (RSV). How should the nurse administer the medication to the child? 1 Administer intramuscularly by admixing water and antibody. 2 Administer directly with a sterile syringe by the intramuscular route. 3 Administer within 24 of hours of being reconstituted with normal saline. 4 Administer within 6 hours of being reconstituted with sterile water.

1, 5 The nurse should advise the parent and child to discard the old toothbrushes and replace them with new ones after they have been taking antibiotics for 24 hours. This will prevent the spread of causal organism. Orthodontic appliances should be washed thoroughly because they may harbor the organisms. It is necessary that parents and other household members avoid close contact with the sick child or share personal items with the child during the illness, not after it is cured.Maintaining fluid intake or consuming nutritional food is not a precautionary measure. It is done to prevent dehydration and to provide the child with the right amount of nutritional needs. Steps such as application of cold or warm compresses to the neck and gargling with warm saline are done to provide relief. This is not a precautionary measure.

A child has Group A Beta-hemolytic streptococcal or GABHS infection of the upper airway. What precautionary measures should the nurse ask the child and the parents to take after the child is cured? Select all that apply. 1 "Discard old toothbrushes and replace them with new ones." 2 "Maintain adequate fluid intake and consume nutritional foods." 3 "No close contact with the sick child and do not share the personal items." 4 "Apply cold or warm compresses to the neck and gargle with warm saline." 5 "Wash the orthodontic appliances thoroughly as per expert advice."

1, 2 Hospitalization is usually recommended to the parents of a child with bronchiolitis if they have acute respiratory distress and it is impossible to provide adequate hydration to the child at home. Another reason for hospitalization would be if the child has an underlying or debilitative lung or heart condition. Such conditions increase the probability of morbidity in the patient. The nurse would need to take measures to resuscitate the patient. Repeated coughing episodes and intermittent fever are mild discomforts. It can be treated with humidified oxygen, adequate fluid intake, airway maintenance, and medications. It is not necessary to hospitalize the child. Low-grade fever and conjunctivitis are the common symptoms of the disease and not deciding factors for hospitalization. Similarly slight lethargy, poor feeding, and irritability are the symptoms seen in the infants when the disease progresses.

A child has bronchiolitis and the primary health care provider has prescribed the child to be treated by humidified oxygen and medications at home. The concerned parents ask the nurse whether their child needs hospitalization. What symptoms should the nurse teach the parents to report to the primary health care provider? Select all that apply. 1 Acute respiratory distress and inadequate hydration 2 An underlying or debilitating lung or heart condition 3 Repeated coughing episodes and intermittent fever 4 Low-grade fever and the development of conjunctivitis 5 Slight lethargy, poor feeding, and irritability

3 The nursing care for a child with pulmonary edema is the same as that for a child with an acute respiratory condition. The nurse should monitor pulse oximetry and all the vital signs closely. The results need to be reported to the primary health care provider. Tracheotomy is a surgery in which an incision on the anterior part of neck is done by a certified primary health care provider. Tracheotomy may be required for children with craniofacial syndromes. In addition, it is not necessary to administer vaccines for pulmonary edema. Therapy usually includes peak end-expiratory pressure (PEEP) via continuous positive airway pressure and intubation. Moreover, allergy testing is not prescribed by nor performed by the nurse.

A child is diagnosed with pulmonary edema and suffering from acute tachydysrhythmia. What should the nurse include in the plan of care as the most important intervention? 1 Administer vaccine 2 Execute tracheotomy 3 Monitor pulse oximetry 4 Perform allergy test

1, 3, 5 Tuberculosis (TB) is an infectious condition. It is essential for the nurse to confirm whether the child has come in contact with people or agents from where the child might have contracted the disease. The nurse should ask the child and the parents whether any of the family members have ever had the disease. The nurse should also ask whether the child has recently traveled to any high-risk countries. The nurse should also check if the child has a caretaker who recently suffered tuberculosis. Studies have revealed that there is high prevalence in regions such as Asia, Africa, Latin America, and countries of the former Soviet Union. Drug susceptibility testing and having any other contagious diseases are not related to having tuberculosis.

A child presents with a persistent fever, cough, and mild tightness in the chest. What are the most appropriate questions that the nurse should ask to determine the risk of latent tuberculosis infection (LTBI) in the child? Select all that apply. 1 "Did any of your family members ever have tuberculosis disease?" 2 "Did your child ever suffer from any contagious infectious diseases?" 3 "Did your child recently travel to any of the high risk countries?" 4 "Did your child undergo any drug susceptibility testing in clinic?" 5 "Did your child have a caretaker who has had tuberculosis recently?"

1 Warm or cool mist provides relieve from hoarseness and laryngeal discomfort related to respiratory tract infections. It helps alleviate the inflammation along the lining of the respiratory tract. Use of steam vaporizers at home is often not recommended because of potential hazards related to its use. There is also limited evidence to support its effectiveness. Fluids and foods are given to the child to promote hydration and nutrition. Fluids and foods do not reduce the infection-related discomfort. Similarly, examination of the epiglottis should be done by an experienced individual to prevent airway compromise. Parents would not be able to recognize the difference. Sterile suction equipment is also to be used by the nurse to attain aseptic environment and prevent the spread of infectious organisms. Moreover, it does not reduce discomfort in the child.

A child presents with hoarseness and laryngeal discomfort due to a respiratory tract infection. The parents ask the nurse about nursing care at home to make the child more comfortable. What is the most appropriate response by the nurse? 1 "Use warm or cool mist under parental supervision. It will soothe inflamed membranes." 2 "Use steam vaporizers in your home. It will provide relief to the inflamed membranes." 3 "Administer fluid and food, as well as carry out postural drainage to prevent infection." 4 "Assess the epiglottitis and keep an aseptic environment using sterile suction equipment."

4 The PEFR measures the maximum amount of air that can be forcefully exhaled in one minute. This can provide an objective measure of pulmonary function when compared to the child's baseline. Diagnosis of asthma is made on the basis of clinical manifestations, history, and physical examination. The causes of asthma are inflammation, bronchospasm, and obstruction. Some of the triggers of asthma are identified with allergy testing.

A child with asthma is having pulmonary function tests. The purpose of the peak expiratory flow rate (PEFR) is to: 1 confirm the diagnosis of asthma. 2 determine the cause of asthma. 3 identify "triggers" of asthma. 4 assess the severity of asthma.

1, 3, 5 Nursing care of a child with a chest tube requires constant assessment of the respiratory status to ensure that the chest tube is in position. In addition to this, the nurse needs to monitor proper functioning of the chest tube and the drainage device. This includes monitoring drainage, so that it is not impeded. The vacuum setting should be correct and the tubing should be free of kinks. Moreover, chest tube insertion site should always have intact dressing. It can be adjusted per the child's requirement but it should remain in place. The nurse does not prescribe medicines to the child. this is done by the primary health care provider. Pneumococcal conjugate vaccine is administered as a prevention measure. It is approved for use in the children who are aged 6 weeks to 71 months. It is done to protect against 13 pneumococcal serotypes that cause pneumonia.

A child with bacterial pneumonia is prescribed antibiotics as well as supplemental oxygen. The child also requires sufficient fluids. In addition to this, the child has chest tube to remove air from the intrathoracic space. What should the nurse include in the plan of care of this child? Select all that apply. 1 Carefully assess the respiratory status. 2 Prescribe medicine for fever and shallow respirations. 3 Monitor functions of chest tube and drainage device. 4 Administer a dose of pneumococcal conjugate vaccine. 5 Monitor chest tube insertion site to ensure patency.

1, 3, 4 The senior nurse should instruct the graduate nurse to always follow certain precautionary measures when caring fora child with bronchiolitis. It is advisable not to use corticosteroids and antihistamines regularly for the treatment of the child. This is because these medicines are effective in controlled studies but not recommended for routine use. In the child with bronchiolitis, routine chest percussion and postural drainage are also not done. The child only requires periodic suctioning of nasal secretions. Giving large amounts of fluid by mouth is not advisable as well. This is because of tachypnea, weakness, and fatigue.Intravenous fluids are used until the acute stage of the disease has passed. The nurse can administer humidified O2 in concentrations sufficient to maintain adequate oxygenation at or above 90%. This is measured by pulse oximetry.

A child with bronchiolitis is kept under the care of a graduate nurse. The new nurse needs to be educated about precautionary measures of such condition. What precautionary instructions about nursing care management should the senior nurse provide? Select all that apply. "You should not: 1 "Routinely administer corticosteroids and antihistamines." 2 "Give humidified O2 when oxygen saturation is above 90%." 3 "Administer large amount of fluids through the mouth." 4 "Routinely perform chest percussion and postural drainage." 5 "Obtain pulse oximetry for children with bronchiolitis."

1, 3, 5, 6 A soft to liquid diet is advised for a child who has recently undergone a tonsillectomy. The child can also use a cool-mist vaporizer to keep the mucous membranes moist during periods of mouth breathing. In addition, warm salt-water gargles and analgesic-antipyretic drugs such as acetaminophen (Tylenol) to promote comfort. The child is always discouraged from blowing their nose and coughing, as these activities may aggravate the trauma of the surgery site and cause bleeding.

A child with tonsillitis requires nursing care. The child has recently undergone a tonsillectomy. What should the nurse include in the plan of care in order to minimize the risk of bleeding during the post-operative period? Select all that apply. 1 Give the child a soft or a liquid diet. 2 Advise the child to blow the nose. 3 Instruct the child how to use a cool-mist vaporizer. 4 Instruct the child to cough frequently. 5 Instruct on warm salt-water gargles. 6 Provide analgesic-antipyretic drugs.

3 Vitamins A, D, E, and K are the fat-soluble vitamins that need to be supplemented in higher doses. Vitamin C is not one of the fat-soluble vitamins. Vitamin D also needs to be supplemented. Vitamin C and folic acid are not fat soluble.

Because the absorption of fat-soluble vitamins is decreased in children with cystic fibrosis, supplementation of which vitamins is necessary? 1 C, D 2 A, E, K 3 A, D, E, K 4 C, folic acid

4 Thick mucous secretions are the probable cause of the multiple body system involvement. There is an identified autonomic nervous system anomaly, but it is not hypoactivity. The sweat glands are not hyperactive. The child loses a greater amount of salt because of abnormal chloride movement. Children with cystic fibrosis have thick mucous gland secretions. The viscous secretions obstruct small passages in organs such as the pancreas.

Cystic fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is: 1 atrophic changes in the mucosal wall of intestines. 2 hypoactivity of the autonomic nervous system. 3 hyperactivity of the sweat glands. 4 mechanical obstruction caused by increased viscosity of mucous gland secretions.

4 Children with Group A ß-hemolytic streptococci (GABHS) infection are at risk for acute rheumatic fever and acute glomerulonephritis. Otitis media and diabetes insipidus are not sequelae to GABHS. Otitis media and diabetes insipidus are not sequelae to GABHS. Children are at risk for glomerulonephritis, not nephritic syndrome.

It is important that a child with Group A ß-hemolytic streptococci (GABHS) infection be treated with antibiotics to prevent: 1 otitis media. 2 diabetes insipidus. 3 nephrotic syndrome. 4 acute rheumatic fever.

2 Cool mist is recommended to provide relief. The child does not have a temperature to manage. Because the child is not having difficulty breathing, the nurse should teach the parents the signs of respiratory distress and tell them to come to the emergency room if they develop. Cough suppressants are not indicated. These symptoms are characteristic of laryngotracheobronchitis, not epiglottitis.

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C. The nurse suspects croup and should recommend: 1 controlling fever with acetaminophen and calling if the cough gets worse during the night. 2 trying a cool-mist vaporizer at night and watching for signs of difficulty breathing. 3 trying over-the-counter cough medicine and coming to the clinic in the morning if there is no improvement. 4 admitting to the hospital and observing for impending epiglottitis.

3 Tonsillitis refers to inflammation in the tonsils or masses of lymphoid tissues located in the pharyngeal cavity. Several pairs of tonsils are located in the area encircling the nasal and oral pharynx, known as the Waldeyer tonsillar ring. The palatine tonsils are located on either side of the oropharynx behind and below the pillars of the fauces or opening from the mouth. The surface of the palatine tonsils is usually visible during oral examination. The pharyngeal tonsils are located above the palatine tonsils on the posterior wall of the nasopharynx. The lingual tonsils are located at the base of the tongue. The tubal tonsils are found near the posterior nasopharyngeal opening of the eustachian tubes, and are not part of the Waldeyer tonsillar ring.

The nurse is assessing a child who is undergoing treatment for tonsillitis. The nurse needs to assess for enlargement of the palatine tonsils. In which anatomic area should the nurse expect to locate the palatine tonsil? 1. Found near the posterior nasopharyngeal opening of the eustachian tubes. 2. Located on the posterior wall of the nasopharynx. 3. Either side of the oropharynx behind and below the pillars of the fauces or opening from the mouth. 4. Located at the base of the tongue.

1, 2, 5 Adequate fluid intake is encouraged by offering small amounts of favorite fluids at frequent intervals. Oral rehydration solutions, such as Infalyte or Pedialyte, should be considered for infants, and water or a low-carbohydrate (≤5 g per 8 oz) flavored drink should be considered for older children. Sports drinks and energy drinks are not recommended for oral rehydration. Fluids with caffeine (tea, coffee) should be avoided because they may act as diuretics and promote fluid loss.

The nurse is caring for a 13-month-old patient with dehydration and diarrhea. What beverages does the nurse use to rehydrate the infant? Select all that apply. 1 Oral rehydration solutions 2 Water 3 Sports drink 4 Green tea 5 Low-carbohydrate drin

1, 2, 4 The nurse should obtain a throat swab for culture or perform rapid antigen testing. The laboratory test will help in confirming the pathogen causing the nasopharyngitis. The nurse should also instruct the parents about administering oral antibiotics and antipyretics as prescribed by the primary health care provider. The nurse should ask the parents to administer the medications in liquid form. It may be effective in decreasing the throat pain.This is done to make the parents aware of the correct administration and dose of oral medication. Parents are educated about the hazards of aspiration, so the child becomes aware of the dangers of trauma to the trachea from sharp objects. However, this is not a related nursing Intervention for a child suffering from nasopharyngitis. Similarly, blood glucose level monitoring is done for a child with diabetes mellitus. It is not related to nasopharyngitis.

The nurse is caring for a child that has a persistent cough for two days and a fever of over 38.3° C. What should be included in the nursing Interventions if the primary health care provider suspects nasopharyngitis? Select all that apply. 1 Obtain throat swab for culture or perform rapid antigen testing. 2 Instruct the parents to administer oral antibiotics as prescribed. 3 Educate parents singly or in groups about hazards of aspiration. 4 Obtain a prescription to administer antipyretics when needed. 5 Educate the parents about monitoring the blood glucose level.

1 The nurse should place the child on his or her abdomen to facilitate drainage of the secretions. Psychological preparation of the child is done before the surgery. It is not necessary after the surgery to facilitate drainage of secretions. Routine suctioning is usually avoided, but when it is performed, it is done carefully to prevent trauma to the oropharynx. The child should not be advised to sit up and blow their nose. This can cause bleeding to the surgical site.

The nurse is caring for a child who has recently undergone a tonsillectomy. What steps should the nurse take to facilitate drainage of the secretions? 1 Place the child on the abdomen. 2 Provide psychological preparation. 3 Apply careful suctioning if necessary. 4 Have the child sit up and blow the nose.

1 Children are especially prone to fluid and electrolyte deficits when they have respiratory tract infections because they have a higher body fluid content than adults. Frequent vomiting and fever further aggravates the problem as the child dehydrates easily. It is necessary that the nurse encourages the child to drink a solution high in electrolytes such as infalyte or pedialyte. The family may be informed about disease prevention as a precautionary measure but it is not an immediate step for a child who is vomiting frequently.Secretions, tissues, or blood specimens need to be obtained for laboratory testing to identify infective organisms. This is not necessary as the child has already been identified to be suffering from a respiratory tract infection. Parents are asked to hold the child and stay with them to provide support and reduce anxiety.

The nurse is caring for a child who presents with a respiratory tract infection and is febrile. The child has also been vomiting frequently. What should be the most immediate nursing care action? 1 Administer an infalyte or pedialyte solution. 2 Educate the parents on disease prevention. 3 Get secretions, tissues, or blood specimens. 4 Ask parents to provide comfort to the child.

1, 3, 5 The most important Nursing Intervention for the child with LTB is observation and accurate assessment of the respiratory status. The nurse can detect airway obstruction early if it is noticed that the child has an increased pulse and respiratory rate. In addition, the child often has substernal, suprasternal, and intercostal retractions, flaring nares, and increased restlessness.This occurs due to inflammation of the mucosal lining of the larynx and trachea, which causes a narrowing of the airway. Hence, the child inspires air past the obstruction and into the lungs, producing the characteristic inspiratory stridor. Symptoms such as red and distinctively large throat and cherry red, edematous epiglottis are visible when the child is suffering from epiglottitis and not LTB. Usually, children do not suffer from epiglottitis and LTB simultaneously.

The nurse is caring for a child with acute laryngotracheobronchitis (LTB). What assessment findings noted by the nurse would warrant immediate notification of the primary health care provider? Select all that apply. 1 Increased pulse and increased respiratory rate 2 The throat is reddened, swollen, and enlarged 3 Substernal, suprasternal, or intercostal retractions 4 The epiglottis is edematous and is cherry red 5 Flaring of the nares and increased restlessness

2 Antibiotics are not indicated unless there is a secondary infection and the source of the problem is in the copious nasal secretions, which will be cultured. Because the respiratory rate is so high (even higher than a newborn's), it would be dangerous to feed this infant because of potential aspiration. An oxyhood is used for neonates in the neonatal intensive care unit (NICU) for oxygen, not for 6-month-old infants. The amount of oxygen is too high for this infant and an infant nasal cannula would be used, not a pediatric cannula, which is used on children, not infants.

The nurse is caring for a newly admitted 6-month-old with suspected respiratory syncytial virus (RSV) with these vital signs: temperature 101.2 (ax), pulse 130, respiration 56, and oxygen saturation of 89% on room air. What activities would the nurse anticipate doing within the first three hours of admission? 1 Administer intravenous (IV) antibiotics and obtain a throat culture. 2 Obtain a culture of the nasal secretions and calculate the infant's fluid requirements. 3 Give the infant his or her usual oral feedings and place the infant in an oxyhood. 4 Place the infant on airborne precautions and place a pediatric nasal cannula running at 2L/min of oxygen.

2, 4, 5 The child with nasopharyngitis can be treated at home. The child needs rest, lots of fluids, and a humidified environment. This provides comfort and adequate hydration. The child should also have cough suppressants with dextromethorphan if prescribed by the primary health care provider. It treats the condition of dry cough and irritation of the nose and throat. There is no effective vaccine available for nasopharyngitis condition. It is not advised to administer medicines that have 22% alcohol to a child. It causes adverse effects like confusion, hyperexcitability, dizziness, nausea, and sedation.

The nurse is caring for an older child with nasopharyngitis. The nurse observes that the child also has a fever, dry cough, and irritation of the nose and throat. What should the nurse convey to the parents about managing the care of the child at home? Select all that apply. 1 "You should bring the child to the clinic for needed vaccinations." 2 "Your child should be given plenty of rest, and lots of fluids." 3 "Your child must have cough suppressants with 22% alcohol." 4 "You can use a humidified environment for the child if possible." 5 "You can give cough suppressants with dextromethorphan."

1, 2, 5 Parents are encouraged to reduce risk factors for AOM by breastfeeding infants for at least the first 6 months of their life. This prevents the occurrence of AOM and reduces any risks. The parents are also informed to discontinue the use of pacifier after six months and prevent the child from getting exposed to second-hand smoke for the same reason. Analgesics are used to treat mild pain in the ear when the child has AOM. It is a treatment measure not a preventative measure. Similarly, the parents have to clean the external ear of their child by using sterile cotton swabs to drain the fluid in the ear but they never go inside the ear canals. It is a treatment measure advised with topical antibiotic treatment.

The nurse is educating new parents on how to prevent the occurrence of acute otitis media (AOM) in the child. What preventive measures does the nurse include in the teaching? Select all that apply. 1 Breastfeed the infants for at least 6 months. 2 Discontinue use of the pacifier after 6 months. 3 Give the child analgesic drugs as prescribed. 4 Clean the ear canals with sterile cotton swabs. 5 Preventing exposure to second hand smoke

1, 3 The nurse should instruct parents and children to perform frequent and regular hand hygiene with soap and water. It is also important to avoid hand-to-eye and hand-to-mouth contact. This prevents the spread of respiratory tract infections in children. The children and parents or other family members should cover their mouth while coughing to prevent cross-contamination. Secretions must be safely disposed to prevent spreading the illness to other members. Antibiotic or antiviral medications are administered when the child is suffering from the infection. This treats the condition, but it does not prevent the spread of the disease. The nurse monitors the secondary complications such as hypoxia to prevent the condition from getting worse. It is not done to prevent the spread of infection. Use of steam vaporizers at home is often discouraged because of the hazards related to its use. Moreover, it is used to relieve discomfort and is not used to prevent the infection.

The nurse is teaching a group of children and their parents about ways to prevent the spread of respiratory tract infections. What should the nurse ask the parents to do in order to prevent the spread of such infection? Select all that apply. 1 "Perform frequent hand hygiene and avoid hand-to-mouth contact." 2 "Administer any antibiotic or antiviral medications as prescribed." 3 "Cover mouth when coughing and safely dispose of the secretions." 4 "Monitor for any signs of secondary complications, such as hypoxia." 5 "Use steam vaporizers to help soothe the inflamed membranes."

1, 3, 4 Deficiencies of the immune system place children at risk for infection. Anatomic differences influence the response to respiratory tract infections. The diameter of the airways is smaller in young children, and the distance between structures within the respiratory tract is also shorter, so organisms may move rapidly down the respiratory tract, causing more extensive involvement. Children are often exposed to greater variety of germs than are adults. Lack of vaccination usually leads to polio and other such diseases. Germs do not have any greater affinity for children than for adults.

The nurse is teaching a group of students about pertussis. The nurse says, "Pertussis and several other respiratory infections are common in young children." What represents the possible etiology for that statement? Select all that apply. 1 Children have weaker immune systems. 2 Many children do not get vaccinated. 3 Children have small airways. 4 Children are exposed to more germs. 5 Germs have an affinity for children

1, 4, 5 Well children should keep away from ill children because respiratory infections are very contagious. Used tissues should be immediately thrown into the wastebasket and not allowed to accumulate in a pile. Children should keep away from those who are already infected, not from those who they think might be at risk but are well. Using the same utensils can transfer the infection. Frequent hand washing is done to wash away germs.

The nurse is teaching a group of students about preventing respiratory infections. Which statement by a student suggests a need for additional teaching? Select all that apply. 1 "Playing with ill children is safe." 2 "Do not eat from the utensils of ill children." 3 "Wash your hands as often as possible." 4 "Reuse tissues to cover the mouth when sneezing." 5 "Keep away from children who are at risk.

1 The child is exhibiting signs of increasing respiratory distress suggestive of a pneumothorax. The child needs to be seen as soon as possible. Bronchodilation and carbon dioxide retention would not produce the symptoms listed. The increased viscosity of sputum is characteristic of cystic fibrosis. The change in respiratory status is potentially caused by a pneumothorax.

The parent of a child with cystic fibrosis calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these symptoms are suggestive of: 1 pneumothorax. 2 bronchodilation. 3 carbon dioxide retention. 4 increased viscosity of sputum

1, 2, 4 The nurse needs to observe and study the child's sleep patterns. Some of the important roles of the nurse include inserting the pH probe into the esophagus and ensuring accurate placement by radiography. Tracheotomy is done to the child with craniofacial syndromes. It is a surgery done by the primary health care provider. Blood glucose level monitoring is done for the child with diabetes mellitus. It is not related to sleep-disordered breathing.

The primary health care provider speculates that a child has sleep-disordered breathing and prescribes diagnostic tests. What are the most appropriate interventions by the nurse to aid in diagnosis? Select all that apply. 1 Observe the child's nightlysleep patterns. 2 Insert the pH probe into the esophagus. 3 Plan for thetracheotomy to be done. 4 Ensure accurate placement by radiography. 5 Monitor the patient's blood glucose level.

1, 3, 5 The primary nursing goals for a child admitted for acute otitis media are relieving pain, facilitating drainage, and preventing complications or recurrence of the infection. It is also important to educate the family about this condition and provide them with emotional support. This is done so that the family can continue the after-care support at home. The nurse does not prescribe medicines for this complication. It is done, as required, by the primary health care provider. Surgical incision of the eardrum, known as myringotomy, is also done by the primary health care provider.

What should be included in a plan of care as Nursing Interventions for a child admitted with acute otitis media? Select all that apply. 1 Relieve the pain and facilitate drainage of the ear. 2 Prescribe acetaminophen (Tylenol) for the pain. 3 Prevent complications or recurrence of infection. 4 Perform a surgical incision of the affected eardrum. 5 Educate the family and provide emotional support.

2 Positing the infant in a head-down, face-down position and administering five quick blows between the shoulder blades is the correct initial sequence of actions for an infant with an obstructed airway. The infant needs to receive treatment immediately. Emergency help is called after attempting to remove the obstruction. Mouth-to-mouth resuscitation should not be used. This may push the object farther into the child's respiratory system. If the child's airway is obstructed, the water will not be able to pass. This will increase the risk of aspiration.

When an infant chokes on a piece of food, an immediate intervention is to: 1 have infant lie quietly while a call is placed for emergency help. 2 position the infant in a head-down, face-down position and administer five quick blows between the shoulder blades. 3 administer mouth-to-mouth resuscitation. 4 give water by cup to relieve the obstruction.