Pediatrics and Public Health - Vaccinations, etc.

The parents of a child, recently adopted internationally, asks the nurse why it is recommended that their child be screened for intestinal parasites. What would be the best response by the nurse?

"Children with intestinal parasites often exhibit no signs or symptoms, so a screening is recommended."

The nurse is discussing Varicella immunization with a mother of a 13-month-old. The mother is reluctant to vaccinate because she feels it is "not necessary." Which comment by the nurse will be most persuasive for immunization?

"Children not immunized are at risk if exposed to the disease."

The grandmother of a child born at 32 'gestation to a teen mother is tearful. She worries her grandchild will have developmental problems. What response by the nurse is most appropriate?

"The risks of developmental concerns are heightened for your grandchild." Children born to teen mothers and those who are born at a gestation of 33 weeks or less have an increased risk for experiencing developmental delays.

The nurse is discussing measles, mumps, and rubella vaccination with a mother who is concerned about using the combined vaccine for her 12-month-old. Which statements by the nurse will be most helpful to the mother in accepting the vaccine?

"The vaccine is shown to be effective and safe and will reduce the number of injections your child will need."

The nurse will use the Denver Articulation Screening for children in what age range?

2 1/7 to 7 years The Denver Articulation Screening is designed for children 2 ½ to 7 years to identify difficulty in producing word sounds (articulation). It is standardized, easy to administer in a brief time and meant only for English-speakers

The nurse is caring for a variety of pediatric clients in the community health clinic. Which client is the nurse most concerned with being at risk for iron-deficiency anemia?

A 16-year-old, pregnant for the first time and lives with her parents The adolescent is at risk for iron-deficiency anemia due to the growth spurt, and the pregnant adolescent is at higher risk due to the needs of the developing baby.

Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer?

Artificially acquired active immunity It develops through vaccine administration of an antigen that stimulates the child's body to produce antibodies against that antigen (pathogen) and to remember the antigen should it reappear. Natural immunity is produced through natural invasion of an antigen (pathogen). Natural and artificial passive immunity involves providing antibodies to fight a pathogen rather than expecting the child's body to produce them

The mother of a 5-year-old with eczema is getting a check-up for her child before school starts. Which action should the nurse take during the visit?

Assess how the family is coping with the chronic illness Before considering corticosteroid therapy, need to assess current treatment effectiveness first.

The nurse is caring for a family and their internationally adopted child. The parents indicate the child was adopted and brought to the United States 7 days ago. What recommendation would the nurse give the family?

Complete a comprehensive health screening within the next week

Infants born to mothers who are HbsAg-positive need to receive the hepatitis B immunoglobulin (HBIg) within how many hours?

HBIg needs to be given within 12 hours.

A nurse asking questions during an infant's health surveillance visit has the mother tell her: "My baby was premature and weighed 3 pounds at birth." The medical record provides an Apgar score of 5 at 5 minutes and indicates the child received gentamicin in the neonatal intensive care unit (NICU). What should the nurse consider as the greatest risk for this child?

Hearing deficit The greatest risk is for a hearing deficit. All factors point in that direction: low birth weight, Apgar less than 6 at 5 minutes, and having received an ototoxic medication. This child should have had a hearing evaluation prior to discharge from the NICU and now should be screened periodically at well-child visits. This premature infant is also at risk for anemia, hypertension, feeding problems, visual defects, and gross motor problems that would not be of the same concern in the full-term child.

Parents report that their neonate received intravenous antibiotics while in the newborn nursery. The nurse recognizes this as a potential risk factor for which health problem?

Hearing impairment The child's hearing is at risk. Determining which antibiotics were administered will be helpful in evaluating the risk. Certain antibiotics are ototoxic. These require regular follow-up to check the child's hearing ability. Having received antibiotics should not increase the risk for the other health problems.

The nurse will record what information about each vaccine after immunizing a child? Select all that apply.

Manufacturer of vaccine Site and route of vaccine administration Lot number and expiration date of vaccine

The nurse working with children and families knows there are certain universal screening tests all children should receive. Which tests are included in this group? Select all that apply.

Phenylketonuria Auditory brain stem response Phenylketonuria (PKU) and auditory brain stem response (ABSR) tests are used universally (throughout the entire population regardless of individual risk). The Denver II is one of several developmental screening exams that can be used between birth and age 6 years. Screening for hyperlipidemia and lead occurs in those children with risk factors (selective screening).

The nursing staff at the clinic are discussing the best way to encourage cooperation from young pediatric clients during screenings. Which suggestion would be appropriate?

Purchase stickers or make coloring pages to be given to the children after the screening is completed.

While enrolled in a geography course, a student nurse learns that diarrheal illness is deadly for large numbers of infants in Third World countries. What vaccine will this nursing student identify as part of the solution to this problem?

Rotavirus (RV) Rotavirus is a very common cause of gastroenteritis among young children that spreads readily via the fecal-oral route. The disease is most severe in children between 4 and 23 months, causing severe, watery diarrhea that results in dehydration

A nurse is conducting visual acuity screening for a 6-year-old child. Assessment reveals that the child knows the alphabet. Which tool would be most appropriate for the nurse to use to screen this child's vision?

Snellen eye chart The Snellen letter eye chart may be used for children age 6 or older who know the alphabet. The "tumbling E" chart is appropriate for children who do not yet know the alphabet but who can follow instructions to indicate the direction that the arms of the "E" are pointing.