Peds Exam 3

What dietary instructions should the nurse give to parents of a child in the oliguria phase of acute glomerulonephritis with edema and hypertension? (Select all that apply.)

-Moderate sodium restriction -Limit foods high in potassium

What dietary instructions should the nurse give to parents of a child with minimal change nephrotic syndrome with massive edema? (Select all that apply.)

-No salt added at the table -Restriction of foods high in sodium

The nurse is caring for a child with secondary hypertension. What renal disorders are associated with secondary hypertension? (Select all that apply.)

-Renal tumor -Hydronephrosis -Glomerulonephritis

An adolescent is being placed on a calcium channel blocker. What should the nurse inform the adolescent with regard to this medication? (Select all that apply.)

-The medication may increase heart rate. -The medication may cause constipation. -The medication may cause peripheral edema.

The clinic nurse is assessing a child with a heavy ascariasis lumbricoides (common roundworm) infection. Which assessment findings should the nurse expect? (Select all that apply.)

-anorexia -irritability -intestinal colic -enlarged abdomen

The nurse is administering a unit of blood to a child. What are signs and symptoms of a transfusion reaction? (Select all that apply.)

-chills -shaking -flank pain -sudden severe headache

The clinic nurse is evaluating causes for iron deficiency due to impaired iron absorption. What should the nurse recognize as causes for iron deficiency due to impaired iron absorption? (Select all that apply.)

-chronic diarrhea -lactose intolerance -inflammatory bowel disease

What signs and symptoms are indicative of a urinary tract disorder in the childhood period (2 to 14 years)? (Select all that apply.)

-fatigue -growth failure -blood in the urine

What signs and symptoms are indicative of a urinary tract disorder in the neonatal period (birth to 1 month)? (Select all that apply.)

-frequent urination -poor urinary stream -failure to gain weight

What activity should the school nurse recommend for a child with hemophilia A? (Select all that apply.)

-golf -jogging -swimming

The nurse is teaching an adolescent with hypertension foods recommended on the DASH diet. What foods should the nurse include in the teaching session? (Select all that apply.)

-green beans -low fat yogurt -whole grain bread

The nurse is caring for a child after cardiac surgery. What interventions should the nurse implement with regard to chest tubes placed to a water-seal drainage system? (Select all that apply.)

-maintain sterility -Check for tube patency. -Do not interrupt the water-seal drainage system.

What are signs and symptoms of anemia? (Select all that apply.)

-pallor -fatigue -muscle weakness

What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)

-pallor -poor feeding -excessive thirst -frequent urination

The clinic nurse is evaluating causes for iron deficiency caused by inadequate supply of iron. What should the nurse recognize as causes for iron deficiency caused by an inadequate iron supply? (Select all that apply.)

-prematurity -excessive milk intake -severe iron deficiency in the mother

An adolescent is being placed on an ACE inhibitor. What should the nurse inform the adolescent with regard to this medication? (Select all that apply.)

-stay well hydrated -Avoid rapid position changes. -Side effects may include a cough.

The nurse is teaching a parent of an infant to limit the amount of formula to encourage the intake of iron-rich food. What amount should the nurse teach to the parent?

1000 ml

The clinic nurse is evaluating lab results for a child. What recorded hemoglobin (Hgb) result is considered within the normal range?

12 g/dl normal range: 11.5-15.5

What drug is an angiotensin-converting enzyme (ACE) inhibitor?

Captopril (Capoten)

The clinic nurse is evaluating lab results for a child. What recorded hematocrit (Hct) result is considered within the normal range?

40% normal range: 35%-45%

The nurse is preparing to admit a child to the hospital with a diagnosis of acute poststreptococcal glomerulonephritis. The nurse understands that the peak age at onset for this disease is what?

5-7 years

A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?

90 beats/min

What child has a cyanotic congenital heart defect?

A 2-month-old infant with tetralogy of Fallot

When giving instructions to a parent whose child has scabies, what should the nurse include?

Be prepared for symptoms to last 2 to 3 weeks.

What explanation provides the rationale for why iron-deficiency anemia is common during infancy?

Cow's milk is a poor source of iron.

What measure of fluid balance status is most useful in a child with acute glomerulonephritis?

Daily weight

The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose and draws up 4 ml of the drug. The most appropriate nursing action is which?

Do not give the dose; suspect a dosage error.

The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA?

Each sibling has a 25% chance of having SCA.

What is an appropriate nursing intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal edema?

Elevate the scrotum with a rolled washcloth.

What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls?

Ensure clear liquid intake of 2 L/day.

A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child's prognosis is related to what factor?

Response to steroid therapy

The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?

Restricting fluids

The school reviewed the pediculosis capitis (head lice) policy and removed the "no nit" requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school?

The child can remain in school with treatment done at home.

The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?

The child has a disorder that causes a deficient immune system.

The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern?

The child needs opportunities to play with peers.

The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?

We know that roundworm can be transmitted from person to person."

A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after administration of prednisone. The nurse realizes further teaching is required if the parents state what?

We understand our child will not be able to attend school, so we will arrange for home schooling."

What causes warts?

a virus

The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?

urinary stasis

The nurse is preparing an airborne infection isolation room for a patient. Which communicable disease does the patient likely have?

varicella

Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?

vesicle

What clinical manifestation is a common sign of digoxin toxicity?

vomiting

Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what?

wheezing

A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38° C (100.4° F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother?

Immediately bring the child to the clinic for evaluation.

What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?

Immune complex formation and glomerular deposition

A child with severe anemia requires a unit of red blood cells (RBCs). The nurse explains to the child that the transfusion is necessary for which reason?

Increase her energy so she will not be so tired.

What nutritional component should be altered in the infant with heart failure (HF)?

Increase in calories

What is the primary treatment for warts?

local destruction

What urine test result is considered abnormal?

pH 4.0

What condition occurs when the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?

sickle cell anemia

An adolescent is being placed on a beta-blocker. What should the nurse inform the adolescent with regard to this medication? (Select all that apply.)

-Medication may cause fatigue. -Side effects may include impotence. -Side effects may include bradycardia.

Congenital defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to accomplish what?

Promote development of normal body image.

The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?

"I should not add additional salt to any of my child's meals."

What interventions should the nurse anticipate being administered to a child with supraventricular tachycardia (SVT)?

-Applying ice to the face -Administration of adenosine (Adenocor) -Having the child perform a Valsalva maneuver

The nurse is preparing to admit a 5-year-old child who developed lesions of varicella (chickenpox) 3 days ago. Which clinical manifestations of varicella should the nurse expect to observe? (Select all that apply.)

-Elevated temperature -Vesicles surrounded by an erythematous base -Centripetal rash in all three stages (papule, vesicle, and crust)

The nurse is planning care for a child with chickenpox (varicella). Which prescribed supportive measures should the nurse plan to implement? (Select all that apply.)

-Administration of acyclovir (Zovirax) -Administration of acetaminophen (Tylenol) for fever -Administration of diphenhydramine (Benadryl) for itching

The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?

2-3years

The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination?

After 6 months

What statement best identifies the cause of heart failure (HF)?

Consequence of an underlying cardiac defect

The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?

Intense perianal itching

What should the nurse explain about ringworm?

It is spread by both direct and indirect contact.

What preparation should the nurse consider when educating a school-age child and the family for heart surgery?

Let the child hear the sounds of a cardiac monitor, including alarms.

The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply?

Acute hypertension is a concern that requires monitoring.

The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

Additional surgery may be necessary to achieve continence.

What information should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?

Adequate dosage will turn the stools a tarry green color.

What nursing consideration is important when suctioning a young child who has had heart surgery?

Administer supplemental oxygen before and after suctioning

What type of drug reduces hypertension by interfering with the production of angiotensin II?

Angiotensin-converting enzyme (ACE) inhibitors

What cardiovascular defect results in obstruction to blood flow?

Aortic stenosis

In which condition are all the formed elements of the blood simultaneously depressed?

Aplastic anemia

Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infant's status, which finding is indicative of achieving this goal?

Appropriate weight gain for age

The nurse is preparing a community outreach program about the prevention of iron-deficiency anemia in infants. What statement should the nurse include in the program?

Breast milk or iron-fortified formula should be used for the first 12 months.

In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan?

Check for moist mucous membranes.

What statement best describes iron deficiency anemia in infants?

Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.

What physiologic defect is responsible for causing anemia?

Decreased oxygen-carrying capacity of blood

For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?

Diuresis occurs as urinary protein excretion diminishes

A child has been diagnosed with scabies. Which statement by the parent indicates understanding of the nurse's teaching about scabies?

Everyone who has been in close contact with my child will need to be treated."

The nurse is teaching parents about administering digoxin (Lanoxin). What instructions should the nurse tell the parents?

Give the medication at regular intervals.

A child with hemophilia A is scheduled for surgery. What precautions should the nurse institute with this child?

Handle the child gently when transferring to a cart.

In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?

Have siblings examined for VUR.

A child with sickle cell disease is in a vasoocclusive crisis. What nonpharmacologic pain intervention should the nurse plan?

Heat to the affected area

A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?

Hematuria and proteinuria

A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The child's care should include which therapeutic interventions?

Hydration and pain management

What medication used to treat heart failure (HF) is a diuretic?

Hydrochlorothiazide (Diuril)

What blood flow pattern occurs in a ventricular septal defect?

Increased pulmonary blood flow

The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration?

Increased red blood cell (RBC) destruction

A 1-year-old has been admitted for complete repair of a tetralogy of Fallot. What assessment finding should the nurse expect to be documented?

Increasing cyanosis

An 18-month-old child has been diagnosed with pediculosis capitis (head lice). Which prescription should the nurse question if ordered for the child?

Malathion (Ovide)

Urinary tract anomalies are frequently associated with what irregularities in fetal development?

Malformed or low-set ears

What do the clinical manifestations of minimal change nephrotic syndrome include?

Massive proteinuria, hypoalbuminemia, and edema

The diagnosis of hypertension depends on accurate assessment of blood pressure (BP). What is the appropriate technique to measure a child's BP?

Measure BP with the child in the sitting position on three separate occasions.

What pain medication is contraindicated in children with sickle cell disease (SCD)?

Meperidine (Demerol)

A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention should occur next?

Minimize energy expenditure to decrease cardiac workload.

What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?

Minimize excretion of urinary protein.

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?

Minimize risk of infection

What rationale explains why prolonged use of oxygen should be discouraged in a child with anemia?

Prolonged use of oxygen can decrease erythropoiesis.

A 5-year-old child is admitted to the hospital in a sickle cell crisis. The child has been alert and oriented but in severe pain. The nurse notes that the child is complaining of a headache and is having unilateral hemiplegia. What action should the nurse implement?

Notify the health care provider.

A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse?

Notify the practitioner because chest syndrome is suspected.

The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurse's initial intervention?

Notify the practitioner of these findings.

A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take?

Obtain the child's blood pressure and notify the health care provider.

Treatment for herpes simplex virus (type 1 or 2) includes which?

Oral antiviral agent

A child with hemophilia A will have which abnormal laboratory result?

PTT (partial thromboplastin time)

The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which knowledge?

Parents need to learn specific, important guidelines for administration of digoxin.

The nurse is caring for a child with hemophilia A. The child's activity is as tolerated. What activity is contraindicated for this child?

Passive range of motion exercises

The nurse is caring for a school-age child with severe anemia and activity intolerance. What diversional activity should the nurse plan for this child?

Playing board or card games

Herpes zoster is caused by the varicella virus and has an affinity for which?

Posterior root ganglia and posterior horn of the spinal cord

Surgery is performed on a child to correct cryptorchidism. The parents understand the reason for the surgery if they tell the nurse this was done to do what?

Prevent damage to the undescended testicle."

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk?

Prevent dehydration.

An infant is diagnosed with transposition of the great vessels. Prostaglandin E1 is given intravenously. The parents ask how long the child will remain on the prostaglandin E1. What is the appropriate response by the nurse?

Prostaglandin E1 will be given continuously until corrective surgery is performed.

The nurse is teaching the family of a child, age 8 years, with moderate hemophilia about home care. What should the nurse tell the family to do to minimize joint injury?

Provide intravenous (IV) infusion of factor VIII concentrates.

The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication?

Pulmonary hypertension

What structural defects constitute tetralogy of Fallot?

Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?

Pulmonary vascular congestion

What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?

Reduced serum albumin

The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

Reduction of edema

A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?

Refer him for immediate medical evaluation.

The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?

Refer the adolescent for immediate medical evaluation.

The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time?

Report data to the practitioner.

Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4° C (101.1° F). What action should the nurse perform?

Report findings to the practitioner.

A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which?

Serum potassium

What condition is the most common cause of acute renal failure in children?

Severe dehydration

The regulation of red blood cell (RBC) production is thought to be controlled by which physiologic factor?

Tissue hypoxia

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse's best response?

Urine output will increase.

An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child?

Varicella-zoster immune globulin

A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what?

Ventricular septal defect

What statement is descriptive of most cases of hemophilia?

X-linked recessive inherited disorder in which a blood clotting factor is deficient

What term is defined as the volume of blood ejected by the heart in 1 minute?

cardiac output

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of what complication?

circulatory overload

What name is given to inflammation of the bladder?

cystitis

Which muscle is contraindicated for the administration of immunizations in infants and young children?

dorsogluteal

A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?

heart failure

Which is usually the only symptom of pediculosis capitis (head lice)?

itching