Peds

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The following are true regarding AED use in pediatrics: The child must be 1 year of age The AED may be used only if the patient has no heart rate The AED is safe for prehospital use All of the above

All of the above

A child will receive IV immunoglobulin (IVIG). The nurse assesses the child every 15 minutes for the first hour of infusion for symptoms of anaphylaxis. Which symptom(s) would indicate to the nurse that anaphylaxis is occurring? Select all that apply. 1. The child's face is flushed. 2. The child's temperature begins to elevate. 3. The child's blood pressure begins to elevate. 4. The child appears increasingly anxious. 5. Inspiratory wheezes are heard on auscultation.

2. The child's temperature begins to elevate. 5. Inspiratory wheezes are heard on auscultation. Explanation: IVIG infusion can cause many side effects such as anaphylaxis. Once the infusion is started, the nurse needs to monitor the vital signs and assess for signs of anaphylaxis every 15 minutes for the first hour and then every 30 minutes thereafter. The nurse would assess for facial flushing, urticaria, dyspnea, shortness of breath, wheezing, chest pain, fever, chills, increased anxiety, and hypotension. The blood pressure would decrease, not increase. Decreased blood pressure could be a sign of anaphylactic shock.

What would be most appropriate to use to help maintain a patent airway in an infant experiencing a respiratory emergency? A) Neck hyperextension B) Head tilt-chin lift technique C) Jaw-thrust maneuver D) Small towel under shoulders

D) Small towel under shoulders Explanation: The infant will benefit from a small sheet or towel folded under the shoulders. This facilitates keeping the infant's airway in the sniff position as recommended by the American Heart Association's Basic Cardiac Life Support guidelines.*The head tilt-chin lift technique is appropriate to open the airway of a child older than age 1 year if a cervical spine injury is not suspected.* The jaw-thrust maneuver is used if there is concern about the cervical spine.

When the nurse is caring for a child presenting with a traumatic injury, which action is priority? Perform a primary assessment Notify the primary health care provider Ensure the code cart is available Apply an oxygen saturation monitor

Perform a primary assessment Explanation: The nurse would perform a primary assessment. When assessing a child with a traumatic injury, airway (A), breathing (B), and circulation (C) are assessed first: assess the patency of the airway and establish the effectiveness of breathing, term-8examining the child's respiratory effort, breath sounds, and color; evaluate the circulation, noting pulse rate and quality and observing the color, skin temperature, and perfusion. Once this is accomplished, the nurse would notify the health care provider and apply monitors as needed. The nurse should ensure a code cart is available before the start of the shift.

Applying a towel roll under an infant's shoulders will help maintain a patent airway during an emergency. True False

True

The most common cause of profound bradycardia is respiratory compromise, hypoxia, and shock. True False

True

Hypovolemia is the most common cause of shock in children.20sec True False

True Hypovolemic shock is the most common type of shock in children

The LEAN mnemonic is used to remember what medications can be given via an endotracheal tube. True False

True. Use the mnemonic LEAN (lidocaine, epinephrine, atropine, and naloxone) to remember which drugs may be given via the endotracheal route.

A child, accompanied by a parent, is brought to the emergency department after sustaining an injury from a fall. The nurse is assessing the child. Which question is important for the nurse to ask the parent first? "Does your child have any allergies?" "How did your child get hurt?" "Did your child lose consciousness?" "What time did the injury occur?"

"How did your child get hurt?" Explanation: As part of the assessment, it is most important for the nurse to find out how the child was hurt, which will provide information on the type of injury. This will allow the nurse and other health care providers to prioritize interventions and treatments. Once the nature of the injury is determined, the nurse can inquire about the timeline, whether there was loss of consciousness, and the existence of medication allergies.

What would the nurse do first for a 5-year-old girl with profound bradycardia? A) Provide oxygen at 100% B) Administer epinephrine as ordered C) Use warming blankets D) Perform gastric lavage

A. A) Provide oxygen at 100% The most common cause of profound bradycardia is respiratory compromise, hypoxia, and shock; thus, oxygenation and ventilation are the priorities.*If the bradycardia persists, the next step would be to administer epinephrine or atropine as ordered.Hypothermia or toxic ingestion can cause bradycardia. Treating the underlying problem will relieve the bradycardia.

The nurse is administering intravenous immune globulin (IVIG). The nurse assesses vital signs and for adverse reactions every 15 minutes for the first hour of administration. After the first hour, the nurse most likely would continue to assess the child at which frequency? A) Every 30 minutes B) Every 45 minutes C) Every 60 minutes D) Every 2 hours

C) Every 60 minutes

A group of students are working on a presentation for a local health fair about safety for children. When developing this presentation, the students would address what cause as the most common in pediatric injury? A) Sports B) Firearm use C) Falls D) Automobile accidents

C. Falls are the most common cause of pediatric injury.

The nurse recognizes that most common cause of resp arrest involving the upper airway is: RSV and Croup Asthma exacerbation and Pnuemonia Pneumothorax and Bronchiolitis Croup and Epiglottitis

Croup and Epiglottitis

While providing care to a 5-month-old girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. Which response by the parents indicates a need for further teaching? A) "She cannot have any cow's milk." B) "I should continue breastfeeding until at least 6 months." C) "Peanuts in any form should be avoided." D) "Any kind of fruit is acceptable."

D) "Any kind of fruit is acceptable."

10 yo boy presents for injuries sustained from a fall. What would be the most important to gather during the health hx. Medical History Home Medications How the accident occurred Allergies

How the accident occurred

A 10-year-old boy who was in a car wreck has been brought to the emergency room for evaluation. He appears to have suffered abdominal trauma due to his seat belt. He has tenderness in the left upper quadrant of the abdomen, especially on deep inspiration. Given these circumstances, the nurse should suspect injury to which of the following organs? a) Spleen b) Pancreas c) Liver d) Stomach

Spleen In children, the spleen is the most frequently injured organ when there is abdominal trauma, because it is usually palpable under the lower left rib. Frequent causes of injury are inappropriately applied seat belts in automobiles, handlebar injuries in bicycle accidents, or skateboard or snowboard accidents. The child will have tenderness in the left upper quadrant, of the abdomen, especially on deep inspiration, when the diaphragm moves down and touches the spleen.

A 9-year-old boy nearly drowned when he fell through the ice while skating on a pond. The child is exhibiting bradycardia. Which of the following would the nurse expect to implement to resolve the child's bradycardia? a) Providing 100% oxygen via face mask b) Administering epinephrine as ordered c) Giving intravenous isotonic fluids d) Using a convective air warming blanket

Using a convective air warming blanket Bradycardia may be resolved by addressing the underlying condition—in this case by relieving hypothermia with a convective air warming blanket. Providing 100% oxygen and then administering epinephrine are primary and secondary treatments for arrhythmias. Giving fluids is an intervention for collapsed rhythms and hypovolemic shock.

The nurse is preparing to present an educational session on pediatric cardiopulmonary arrests. The nurse will include which statement in the teaching? "Most pediatric arrests stem from airway and breathing issues." "Obtaining an automated external defibrillator (AED) is vital to survival." "Activate the emergency response system first in an unwitnessed event." "Start cardiopulmonary resuscitation (CPR) in an infant if the heart rate is below 75 beats per minute."

"Most pediatric arrests stem from airway and breathing issues." Explanation: Most pediatric arrests are related primarily to airway and breathing, and usually only secondarily to the heart issues. This information guides the nurse to always assess the airway first in case of an emergency involving cardiopulmonary arrest. While obtaining an AED is important, pediatric arrests are more often respiratory related instead of cardiac. In an unwitnessed event, CPR should be started first. The emergency response system is first activated when the event is witnessed. CPR should be started when an infant's heart rate is less than 60 beats per minute.

The child has been unresponsive to antibiotics for suspected strep throat. What medication(s) does the nurse anticipate?60sec Aspirin, Acetaminophen, and IVIG Metoprolol, Warfarin, and Digoxin Ibuprofen, Ampicillin, and Aspirin Bicillin, Acetaminophen and Vancomycin

Aspirin, Acetaminophen, and IVIG

Foods that should be avoided in the first year of life include:20sec Kiwi, cows milk, peanuts, shellfish Banana, apples, and green beans Breastmilk, peanuts and tree nuts Prepared baby food, formula and eggs

Kiwi, cows milk, peanuts, shellfish During the first few years of life, the most common food allergens are milk, eggs, peanuts, tree nuts, fish and shellfish, wheat, and soy.


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