Pediatric Clients Exam #2

A nurse is caring for a child who has a suspected diagnosis of cystic fibrosis. Which of the following diagnostic tests will confirm the diagnosis? 1) Sweat chloride test 2) A sputum culture 3) A stool fat content analysis 4) Pulmonary function tests

Sweat chloride test Clients who have cystic fibrosis have an increase of sodium and chloride in both saliva and sweat. Therefore, a sweat chloride test can definitively confirm a diagnosis of cystic fibrosis.

What is airway resistance?

The ability for the air to move into and out of the airway (nose to oropharynx, pharynx, larynx, and trachea)

What is lung compliance?

The measure of force required to expand the lungs and how easy air goes into lungs (aka pulmonary compliance)

Describe S/S of increased WOB in the peds pt?

s/s respiratory distress- increased HR and RR, nasal flaring, retractions/use of accessory muscles, head bobbing, grunting, decreased O2 sats, wheezing, increased coughing

A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? 1) Check the pulse after medication administration. 2) Take the medication with meals. 3) Rinse the mouth after administration. 4) Limit caffeine intake.

Rinse the mouth after administration. Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in the mouth. Rinsing the mouth after administration can lessen the likelihood of this complication.

A nurse is teaching the mother of a child who has cystic fibrosis and has a prescription for pancreatic enzymes three times per day. Which of the following statements indicates that the mother understands the teaching? 1) "My child will take the enzymes to improve her metabolism." 2) "My child will take the enzymes following meals." 3) "My child will take the enzymes to help digest the fat in foods." 4) "My child will take the enzymes 2 hours before meals."

"My child will take the enzymes to help digest the fat in foods." Pancreatic enzymes help the body to digest fat in foods.

Albuterol Sulfate -What classification? -For what is it given? -When is it delivered

-bronchodilator -asthma -CF -before percussion and postural drainage

serum creatinine

0.1-1.0 (0-18yo)

A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take? 1) Administer a short-acting ß2 -agonist (SABA). 2) Obtain a peak flow reading. 3) Administer an inhaled glucocorticoid. 4) Determine the cause of the acute exacerbation.

Administer a short-acting ß2 -agonist (SABA) When using the urgent versus non-urgent approach to client care, the nurse should determine that the priority action is to administer a nebulized high-dose SABA to relieve bronchoconstriction and improve ventilation.

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? 1) The client holds his breath for 10 seconds after inhaling the medication. 2) The client takes a quick inhalation while releasing the medication from the inhaler. 3) The client exhales as the medication is released from the inhaler. 4) The client waits 10 min between inhalations.

The client holds his breath for 10 seconds after inhaling the medication.

A nurse is providing discharge teaching about nutrition to the parents of a child who has cystic fibrosis (CF). Which of the following responses by the parents indicates an understanding of the teaching? 1) "We will give our child pancreatic enzymes with snacks and meals." 2) "We will restrict the amount of salt in our child's food." 3) "I will limit my child's fluid intake." 4) "I will prepare low-fat meals with limited protein for my child."

"We will give our child pancreatic enzymes with snacks and meals." CF interferes with the availability of pancreatic enzymes necessary for digestion and absorption of nutrients. Therefore, pancreatic enzymes must be taken with all meals and snacks.

Urine Specific Gravity Normal Range

1.005-1.030

Serum Sodium

136-145 (child) - 134-150 (infant)

HCO3 (bicarbonate)

21-28 (adult and child)-16-24 mEq/L

BUN

5-18 mg/dL (infant and child)

A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack? 1) Beclomethasone 2) Salmeterol 3) Formoterol 4) Albuterol

Albuterol Albuterol is an inhaled short-acting beta2 agonist (beta2-adrenergic agonist) used as a rescue medication to relieve an acute asthma attack. Albuterol dilates the airways, decreases wheezing, and improves oxygenation.

How can lung compliance and airway resistance cause increased work of breathing (WOB) in peds pt?

Increased and decreased lung compliance can make it difficult to get air in. Increased airway resistance causes narrowing of airway so air doesn't go in as easily.

A nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy. Which of the following actions should the nurse take? (SATA) 1) Instruct the child that the treatment will last 30 min. 2) Obtain vital signs prior to the procedure. 3) Tell the child to take slow deep breaths. 4) Determine if the child should use a mask 5) Attach the device to an air source.

Obtain vital signs prior to the procedure. Tell the child to take slow deep breaths. Determine if the child should use a mask Attach the device to an air source.