PEDS

After teaching nursing students about childhood exanthems, the instructor determines that the teaching was successful when the students identify what as the primary cause? Fungi Bacteria Viruses Parasites

Viruses Explanation: Most childhood exanthems are caused by viruses.

The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed? "Acetaminophen or ibuprofen can be given to help with pain." "Family members should wear a mask when coming to visit us." "Antibiotics are needed to help our child recover from rubella." "Our child is contagious for 1 week after the rash appeared."

"Antibiotics are needed to help our child recover from rubella." Explanation: Rubella (German measles) is caused by the rubella virus. Children will be contagious for 1 week before to approximately 1 week after the rash appears. Acetaminophen or ibuprofen can be given to help with pain or fever, and the child will be on droplet precautions (mask) while in the hospital.

The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101°F (38.3°C). Which statement by a parent indicates an understanding of fevers and their management in the ill child? "We've had to wake him up in the night to give him more medicine to reduce his temperature." "My wife and I have been using cold water and washcloths on him because of the fever." "Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection." "We've been giving him a little extra acetaminophen to help bring his fever down."

"Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection." Explanation: Fevers can be protective and can help the body fight the infection. Fevers slow down bacterial or viral growth. Mismanaging fevers include inappropriate dosing of antipyretics, awakening a child at night to administer antipyretics, and using cold water or sponging the child with alcohol to reduce the temperature.

The nurse is caring for a child diagnosed with hand-foot-mouth disease. When educating the family about this disease, which education by the nurse is most important? "You can give acetaminophen every 4 to 6 hours for pain." "Hand-foot-mouth disease is associated with a high fever." "The lesions should disappear in a few days without scarring." "Make sure your child drinks plenty of nonirritating fluid."

"Make sure your child drinks plenty of nonirritating fluid." Explanation: Children with hand-foot-mouth disease can experience dehydration related to the high fever, anorexia, and painful mouth lesions. The nurse should educate the family to provide nonirritating fluids to encourage the child to drink to avoid dehydration. Hand-foot-mouth disease is associated with a high fever, and parents can provide acetaminophen. The lesions should disappear in a few days; however, the most important education is aimed at prevention of dehydration.

The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother? "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." "Infants are unable to develop antibodies to protect them from diseases so they must be immunized." "The antibodies the fetus gets from the mother are in the placenta, so after birth they are no longer available to the infant." "The immunities that the infant is born with are not for the same diseases they will be immunized against."

"The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." Explanation: During fetal life, the mother's antibodies cross the placenta, giving the fetus a temporary immunity against certain diseases. This immunity is present at birth and decreases during the first year of life. In the meantime, the infant begins developing antibodies to fight against pathogens and disease. In addition, during the first year of life immunizations are started to help the infant develop protection against certain diseases.

The nurse is providing teaching to the parents of a child with varicella. Which statement by the parents indicates the teaching was successful? "The lesions should eventually form soft crusts that drain." "We should apply alcohol to the lesions every 4 hours." "We need to make sure that our child washes their hands frequently." "If our child has a fever, we can give them some aspirin."

"We need to make sure that our child washes their hands frequently." Explanation: The child with varicella needs to wash their hands frequently with antibacterial soap to reduce bacterial colonization. A cool bath with soothing colloidal oatmeal may aid the skin discomfort. Alcohol would be too drying to the skin. Acetaminophen, not aspirin, should be used to reduce fever. The lesions should eventually crust over. Soft crusts with drainage may suggest an infection.

The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply. The parents state, "We will be sure to finish any antibiotic if our child is sent home with a prescription." The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing." The parents wear a respiratory mask when entering their child's room. The parents remove their personal protective equipment (PPE) at the door before exiting, then wash their hands. The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection."

- the parents state, " we should postpone immunizing our 5-year-old since there has been contact with the infection" - the parents state, "we have been limiting our child's fluids to help decrease the amount of coughing." Explanation: All close contacts who are younger than 7 years of age and who are unimmunized or underimmunized should have pertussis immunization initiated or the series completed according to the recommended dosing schedule. Fluids should be increased in order to help thin secretions and prevent dehydration during the infection. The parents are correct in removing their PPE at the door and washing their hands when leaving the room, and wearing a mask. All antibiotics should be finished in order to treat the infection adequately and prevent immunity to antibiotics.

The nurse is triaging a child diagnosed with poliomyelitis. After ensuring appropriate precautions are in place, what will the nurse do next? Place the child on bed rest. Administer an antipyretic. Begin physical therapy. Auscultate the child's lungs.

Auscultate the child's lungs. Explanation: Because poliomyelitis can cause motor paralysis of the respiratory muscles, assessing respiratory status is priority. Once the nurse has ensured respiratory function is intact, the nurse can place the child on bed rest, administer an antipyretic, and begin physical therapy.

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? Antiviral medications can be prescribed. Antibiotic therapy may be initiated. Encourage rest and relaxation. Range of motion to prevent contractures.

Encourage rest and relaxation. Explanation: Rubella infection is usually mild and self-limited. The care given is normally supportive. Rest is encouraged. Medications administered are normally limited to antipyretics and analgesics. Antibiotic and antiviral therapies are not normally included in the plan of treatment. Range of motion is not needed as mobility of the client is not limited.

The nurse is preparing to administer acetaminophen to a 4-year-old child to provide comfort. Which precaution is specific to antipyretics? Ensure proper dose and interval. Warn of possible drowsiness. Check for medicine allergies. Take the entire course of medication.

Ensure proper dose and interval. Explanation: It is very important to ensure that the proper dose is given at the proper interval because an overdose can be toxic to the child. Concerns with allergies and taking the entire, prescribed dose are precautions when administering antibiotics and all medications. Drowsiness is not a side effect of antipyretics.

The nurse is caring for a 5-year-old girl with scarlet fever. Which intervention will most likely be part of her care? Palpating for and noting enlarged lymph nodes. Exercising both standard and droplet precautions. Monitoring for changes in respiratory status. Teaching proper administration of penicillin V.

Explanation: Penicillin V or erythromycin is the preferred antibiotic for treatment of scarlet fever. Scarlet fever transmission is airborne, not via droplet. Lymphadenopathy occurs with cat scratch disease and diphtheria. Close monitoring of airway status is critical with diphtheria because the upper airway becomes swollen.

What is the leading cause of neonatal sepsis and death? Neisseria meningitidis Epstein-Barr virus infection cytomegalovirus infection Group B streptococcus

Group B streptococcus Explanation: Sepsis is a systemic overresponse to infection. It is very serious and can produce septic shock and death. In infants under the 3 months of age the most causative agents are group B streptococcus, Escherichia coli, Staphylococcus aureus, enteroviruses, and the herpes simplex virus. Any time a febrile, ill-appearing neonate is seen, a full septic work-up is done. Neonates have the poorest outcomes from sepsis. Neisseria meningitidis is one cause of sepsis in older children. The Epstein-Barr virus is a herpes virus that causes mononucleosis. The cytomegalovirus is a common herpes virus. It is spread through bodily fluids and is not necessarily a concern unless the person is immunocompromised or is pregnant.

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period? Prodromal period Convalescent period Incubation period Illness period

Incubation period Explanation: Infection occurs when an organism invades the body and multiplies, causing damage to the tissue and cells. The infectious process goes through four stages. The incubation period is the first stage of the infectious disease. It is the time between the invasion of an organism and the onset of symptoms of infection. The prodromal period is the time from the onset of nonspecific symptoms to specific symptoms, for example, cold/flu-like symptoms before Koplik spots occur in measles. The illness is the time during which symptoms of the specific illness occur. The convalescent stage is the time when the acute symptoms disappear.

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child? Fifth disease Mumps Mononucleosis Measles

Mumps Explanation: Mumps begins with a fever, headache, anorexia, and malaise. Within 24 hours an earache occurs. When pointing to the site of pain, however, the child points to the jawline just in front of the earlobe. Mumps is contagious 1 to 7 days prior to the onset of symptoms and 4 to 9 days after the parotid swelling begins. Fifth disease is also known as the "slapping disease," as the rash on the cheeks look like someone slapped the child's face. Measles does not involve parotid swelling or earaches. Mononucleosis does involve swollen lymph nodes but they are in the neck and the axillary area.

The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take? Clean the rash with rubbing alcohol. Obtain an electrocardiography (ECG). Place the child on contact precautions. Notify the primary health care provider.

Notify the primary health care provider. Explanation: The nurse would suspect the child has Lyme disease and notify the health care provider for additional testing and potential antibiotic therapy. Precautions are not indicated for clients with Lyme disease. An ECG would only be needed if cardiac symptoms were noted. It is recommended to clean the site of the tick bite with rubbing alcohol when the tick is removed, not at a later time.

When the health care provider looks in a child's mouth during a sick-visit examination, the parent exclaims: "The tongue is bright strawberry red! It was not like that yesterday." The health care provider would most likely prescribe which medication based on the probable diagnosis? Steroids to decrease the inflammation Acetaminophen to decrease the throat pain Erythromycin to prevent the spread to siblings Penicillin to prevent acute glomerulonephritis

Penicillin to prevent acute glomerulonephritis Explanation: A "strawberry tongue" is a classic sign of scarlet fever. Penicillin is prescribed to treat the beta-hemolytic group A streptococcal infection and to prevent the complication of developing acute glomerulonephritis and rheumatic fever. Erythromycin can be used to treat the disease if the child is allergic to penicillin. Antibiotics are not given prophylactically to siblings. The disease is spread via droplets, so keeping the siblings away from the infected child and handwashing are the best preventive measures. Acetaminophen can be administered for fever control. It works systemically and has very little, if any, affect locally. Antibiotics are the mainstay of treatment. Steroids are used infrequently.

A nursing instructor is teaching students about the chain of infection. What does the instructor tell students is responsible for allowing the pathogen to enter? Means of transmission Portal of entry Portal of exit Reservoir

Portal of entry Explanation: The chain of infection is the process by which organisms are spread. An infectious agent is any organism capable of causing an infection. It can be bacteria, viruses, or fungi. The reservoir is the place where these organisms thrive and reproduce. After reproduction, the organism must leave the reservoir. This area is the portal of exit. Pathogens can be transmitted via either direct or indirect methods. Direct method would be close contact with the infected person. Indirect transmission occurs with things like droplets in the air (e.g., sneeze, cough). The portal of entry is the way for a pathogen to enter the body. It can be through inhalation, ingestion, or breaks in the skin. Any person who cannot resist the pathogen is the susceptible host.

The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used? Using an automatic lancet device on the heel. Puncturing a vein on the dorsal side of the hand. Accessing an indwelling venous access device. Administering sucrose prior to beginning.

Puncturing a vein on the dorsal side of the hand. Explanation: The usual sites for obtaining blood specimens are veins on the dorsal side of the hand or the antecubital fossa. Administration of sucrose prior to beginning helps control pain for young infants. Accessing an indwelling venous access device may be appropriate if the child is in an acute care setting. An automatic lancet device is used for capillary puncture of an infant's heel.

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? An enanthematous rash Severity of the sore throat White exudate on the tonsils Red, strawberry tongue

Red, strawberry tongue Explanation: The characteristic assessment finding that distinguishes scarlet fever from other disorders is the appearance of the red, strawberry tongue. Sore throat, an enanthematous and exanthematous rash, and white exudate on the tonsils are also seen with scarlet fever, but it is the strawberry tongue that helps to confirm the diagnosis.

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect? Pertussis Scarlet fever Diphtheria Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA)

Scarlet fever Explanation: Scarlet fever typically is associated with a sore throat, fever greater than 101° F (38.9° C), and the characteristic rash on the face, trunk, and extremities that looks like sunburn but feels like sandpaper. CAMRSA is typically manifested by skin and tissue infections. Diphtheria is characterized by a sore throat and difficulty swallowing but fever is usually below 102°F (38.9°C). Airway obstruction is apparent. Pertussis is characterized by cough and cold symptoms that progress to paroxysmal coughing spells along with copious secretions.

What is a true statement regarding varicella zoster virus infection? It is transmitted by fecal-oral route. Secondary bacterial infections of the skin can occur. It tends to be more severe in children. The incubation period is 7 days.

Secondary bacterial infections of the skin can occur. Explanation: Varicella zoster virus infection carries with it the complication of a secondary bacterial infection of the skin. The lesions are intensely pruritic, making the child want to scratch the lesions and opening them to a variety of organisms to invade. The incubation period is 10 to 21 days. It is transmitted by direct contact with the vesicles and by airborne route. It tends to be more severe in adolescents and adults.

A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder? The child has had 8 ounces of formula in the past 24 hours. The child cries when his mother is not in sight. The child's birth history indicates he was born at 42 weeks' gestation. The child has had 7 wet diapers in the past 24 hours.

The child has had 8 ounces of formula in the past 24 hours. Explanation: Sepsis is a systemic overresponse to infection resulting from bacteria and viruses, which are the most common fungi, viruses, rickettsia, or parasites. It can lead to septic shock, which results in hypotension, low blood flow, and multisystem organ failure. Signs of sepsis include a lack of appetite, lethargy, hypotonia, and temperature elevations.

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child? The nurse will administer antibiotics. The nurse will encourage bed rest. The nurse will administer oxygen. The nurse will monitor caloric intake.

The nurse will administer oxygen. Explanation: The major complication of pertussis (whooping cough) is pneumonia and respiratory complications. Oxygen, bed rest, and monitoring for airway obstruction are nursing interventions. The highest priority is administering oxygen to maintain adequate oxygenation of cells.

An adolescent comes to the clinic and is diagnosed with syphilis. The nurse discusses the treatment plan with the adolescent. In addition to medication, what instruction will the nurse give the adolescent? Syphilis is a reportable disease. Limit the number of sexual partners. How the infection will progress if not treated. The sexual partners need to be tested.

The sexual partners need to be tested. Explanation: Syphilis is a sexually transmitted infection. It can be experienced by both men and women. The primary infection is treated with benzathine penicillin G injection. This will cure the infection. If not treated, the infection can develop into secondary, later, or tertiary stages. At the tertiary stage, the disease cannot be treated or reversed. The most important thing for the adolescent to understand besides the treatment is that all sexual partners need to be evaluated and treated. Otherwise, the disease will just continue to spread among all the partners. Additional teaching for this adolescent includes condom use and limiting the number of sexual partners.

A nurse is assessing a child with a tick-borne disease. What finding would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain spotted fever? malaise headache absence of rash fever

absence of rash Explanation: Both Rocky Mountain spotted fever and ehrlichiosis are manifested by fever, headache, and malaise. However, there is rarely a rash with ehrlichiosis, which helps to differentiate it from Rocky Mountain spotted fever.

The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is: penicillin griseofluvin acyclovir ceftriaxone

acyclovir Explanation: The drug acyclovir is useful in relieving or suppressing the symptoms of genital herpes.

When caring for a child diagnosed with West Nile virus, the nurse will question which prescription from the primary health care provider? amoxicillin 40 mg/kg/day orally every 8 hours acetaminophen every 4 to 6 hours PRN fever Place client on fall precautions. Monitor the client's cardiac status.

amoxicillin 40 mg/kg/day orally every 8 hours Explanation: West Nile virus is transmitted to humans primarily through the bite of infected mosquitoes and manifestations include: fever, weakness, fatigue, balance problems, memory impairment, headache, myocarditis, hepatitis, myositis and orchitis, and rhabdomyolysis. Treatment is symptomatic. Since this is a viral illness, antibiotics would not be given and the nurse would question such prescriptions. It is appropriate to give acetaminophen for the fever or pain; place on fall precautions due to fatigue, balance problems, and weakness; and monitor the cardiac status for the development of myocarditis.

Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)? an 18-month-old child receiving chemotherapy over 5 days a 1-year-old receiving oral amoxicillin for otitis media a 3-year-old child with malnutrition and poor weight gain a 2-year-old child with HIV being discharged later that day

an 18-month-old child receiving chemotherapy over 5 days Explanation: The children at highest risk for contracting a hospital-acquired infection include children younger than 2 years of age, children with a nutritional deficit, those who are immunosuppressed, those who have indwelling vascular lines or catheters, are receiving multiple antibiotic therapy, or who remain in the hospital for longer than 72 hours. To determine the child at greatest risk, count risk factors and determine which child has the most risk factors.

Which child will the nurse identify as at greatest risk for developing a urinary tract infection? a 1-year-old formula-fed male an 8-month-old bottle-fed female with HIV a 2-year-old male with otitis media a 6-month-old breastfed female

an 8-month-old bottle-fed female with HIV Explanation: Factors that make an individual more prone to a urinary tract infection include young age, female gender, and immunosuppression. Infants who are formula-fed are at greater risk than infants who are breastfed. To determine the child at greatest risk, the nurse should count risk factors and determine which child has the most risk factors.

A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves: enterovirus. protozoa. bacteria. herpes virus.

bacteria. Explanation: Neonatal sepsis can be caused by viruses such as herpes simplex or enteroviruses and by protozoa (e.g., oxoplasma gondii). However, bacteria are typically the culprits.

A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders? eosinophils monocytes lymphocytes neutrophils

eosinophils Explanation: Eosinophils function to combat allergic disorders and parasitic infestations. Neutrophils function to combat bacterial infections. Lymphocytes function to combat viral infections. Monocytes function to combat severe infections.

A child has been brought to the pediatric clinic. The assessment reveals the child has a temperature of 100.9°F (38.3°C), as well as a rash that is pink and has raised areas. When the area is palpated, the skin blanches. Which disease is most associated with these findings? varicella zoster rubeola exanthem subitum rubella

exanthem subitum Explanation: Exanthem subitum or sixth disease is a member of the herpes viruses. It presents with a pinkish rash that may be flat or raised. The rash area blanches when palpated. A maculopapular rash that begins on the face and spreads head to foot is consistent with rubella. Rubeola presents with bright red spots with blue-white centers on mucous membranes, mainly on the buccal mucosa. It looks like tiny grains of white sand surrounded by a red ring. Varicella zoster presents with erythematous macules that evolve to papules and then form clear, fluid-filled vesicles.

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as: pityriasis rosea. rosacea. enterovirus. fifth disease.

fifth disease. Explanation: Erythema infectiosum is also known as "fifth disease." It starts with a fever, headache, and malaise. One week later, a rash appears on the face. A day later, the rash appears on the extensor surfaces of the extremities. One more day later, the rash appears on the trunk and flexor surfaces of the extremities. Pityriasis rosea is a skin rash that begins with a large spot on the chest, abdomen, or back that is followed by a pattern of small lesions. It is self-limiting and can be treated with steroid creams. Rosacea is a chronic inflammatory skin condition that causes redness to the face. An enterovirus infection can many times cause the same symptoms as the common cold or it can include the respiratory system. It is contagious.

A 6-year-old child is being treated for a parasitic infection. When reviewing results from the child's white blood cell count, which finding would be anticipated? reduced neutrophil levels elevated monocytes increased eosinophil levels reduced basophil levels

increased eosinophil levels Explanation: Eosinophils are the first line of defense against parasitic infections and allergic reactions and will be elevated. Monocytes are a second line of defense and will be elevated in response to leukemias, lymphomas, and chronic inflammation. Basophils respond to allergic disorders and hypersensitivity reactions. Neutrophils are the first line of defense upon invasion of bacteria, fungus, cell debris, and other foreign substances.

The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is: penicillin acyclovir ceftriaxone griseofluvin

penicillin Explanation: Syphilis responds to one intramuscular injection of penicillin G benzathine; if the child is sensitive to penicillin, oral doxycycline, tetracycline, or erythromycin can be administered as alternative treatment.

A child is diagnosed with scarlet fever. History reveals that the child has no known drug allergies. When preparing the child's plan of care, the nurse would anticipate administering which agent as the drug of choice? erythromycin clarithromycin trimethoprim-sulfamethoxazole penicillin V

penicillin V Explanation: Penicillin V is the antibiotic of choice. In those sensitive to penicillin, erythromycin may be used. Trimethoprim-sulfamethoxazole and clarithromycin are not used.

A nurse is obtaining a history from the parents of a child diagnosed with an infection. The parents report that the child started running a fever a couple of days ago and that he "just didn't seem like himself." Then this morning, the child started having yellow-green discharge from the nose. The nurse would identify the child has just completed which stage of an infectious disease? convalescence incubation prodrome illness

prodrome Explanation: The child is in the prodrome stage of the infection. Prodrome refers to the time from the onset of nonspecific symptoms—such as fever, malaise, and fatigue—to more specific symptoms. Incubation refers to the time from the entrance of the pathogen into the body to the appearance of the first symptoms. The illness stage is the time during which the child demonstrates signs and symptoms specific to an infection type. Convalescence refers to the time when the acute symptoms of the illness disappear.

The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention? reservoir portal of exit susceptible host mode of transmission

reservoir Explanation: The reservoir is the place where a microorganism grows and reproduces. Dressings left unchanged leave a dark, warm, moist environment for microorganisms to thrive. Covering the mouth and using personal protective equipment are ways to control portals of exit. Modes of transmission can be controlled with handwashing and personal protective equipment. The susceptible host is the person who is susceptible to developing an infection. Promotion of natural defenses is a good way to prevent infection.

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of: osteomyelitis. impetigo. scarlet fever. pneumonia.

scarlet fever. Explanation: Group A streptococcal pharyngitis can progress to scarlet fever with the rash appearing in about 12 hours after the onset of the disease. Group A streptococcal pharyngitis is not associated with pneumonia. Impetigo is a group A strep infection involving the skin. Osteomyelitis can occur with an infection by group B streptococcus.

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?

urine output of 10 ml over 3 hours Explanation: Children with sepsis will show alteration in temperature, heart rate, respiratory rate, and white blood cell count. Septic shock with organ dysfunction is more serious and can be manifested by decreased urine output.

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next? Arms Stomach Neck Legs

Neck Explanation: Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach.

The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first? Initiate antibiotic therapy. Obtain urine specimen for analysis. Obtain blood cultures. Initiate intravenous therapy.

Obtain blood cultures. Explanation: When treating a child suspected of having an infection, the blood cultures must be obtained first. The administration of antibiotics may impact the culture's results. A urine specimen may be obtained but is not the priority action. Intravenous fluids will likely be included in the plan of care but are not the priority action. Reference:

A 10-year-old child has an unknown infection and will need to provide a urine specimen for culture and sensitivity. To assure that the sensitivity results are accurate, which step is most important? Collect three specimens on three different days. Obtain specimen before antibiotics are given. Ensure that the specimen is obtained from proper area. Use aseptic technique when getting the specimen.

Obtain specimen before antibiotics are given. Explanation: In order to ensure a successful culture, the nurse must determine if the child is taking antibiotics. Throat cultures require specimens taken from the pharyngeal or tonsillar area. Stool cultures may require three specimens, each on a different day. The nurse would use aseptic technique when getting a blood specimen as well as the urine, but antibiotics cannot be received by the child prior to the test being done.

A child has been having episodes of diarrhea. The health care provider prescribes stool collection to assess for parasites. Before obtaining the stool specimen, what question should the nurse ask? "Has your child taken any antidiarrheal medications containing loperamide?" "Has your child taken any antidiarrheal medications today?" "Have you given your child any antidiarrheal medication containing bismuth?" "How many doses of antidiarrheal medications have you given your child in the last 24 hours?"

"Have you given your child any antidiarrheal medication containing bismuth?" Explanation: Stool specimens are collected to detect whether bacteria or parasites have infected the intestines. To be accurate, they must be free of urine, water and toilet paper and be obtained on freshly passed stool. The administration of mineral oil, barium and bismuth will interfere with the detection of parasites. It is, therefore, important for the nurse to ascertain if any of these products have been used. If so, collection of the specimen should be delayed for 7 to 10 days. Bismuth is found in the over-the-counter product trade name Pepto-Bismol. Loperamide is the main ingredient in the over-the-counter antidiarrheal Immodium. Having had an antidiarrheal product without bismuth would not interfere with the collection of the samples. It might, however, take longer to collect the samples because of waiting for a bowel movement to occur.

An adolescent comes to the emergency room with high fevers, chills, rigors and sweats. Malaria is suspected. When taking the health history, what question should the nurse ask first? "Are there days your symptoms are worse?" "When did your symptoms begin?" "Is anyone else in your household sick?" "Have you traveled outside North America?"

"Have you traveled outside North America?" Explanation: Malaria comes from a bite of Anopheles species of mosquito. The infection produces high fevers, chills, rigors, sweats, headaches and arthralgia. If the disease is suspected, it would be most important for the nurse to know if the adolescent had traveled to any areas in Africa, Asia or South America, where the type of mosquitoes are found that produce malaria. All of the other questions are appropriate, but they are not as important as the travel, which could help lead to a definitive diagnosis.

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? "Herpes zoster is a reactivation of a previous varicella zoster infection." "Your child must have been exposed to someone with herpes zoster." "Children who are immunocompromised are more likely to contract shingles." "Handwashing is an effective way to prevent the spread of infectious disorders."

"Herpes zoster is a reactivation of a previous varicella zoster infection." Explanation: Herpes zoster (shingles) is reactivation of the latent varicella zoster (chickenpox) infection that occurs during times of immunosuppression and aging. Although it is possible to contract the varicella zoster virus from a person with herpes zoster or varicella zoster, a child diagnosed with herpes zoster has already been exposed to varicella zoster. Handwashing will not directly prevent herpes zoster.

The nurse is providing education to the parents of a 5-year-old with a fever. Which statements indicate the need for further instruction? Select all that apply. "Sponging my child with cold water can be a soothing way to manage the fever." "Fever has many therapeutic properties." "Ibuprofen has been shown to be more beneficial than acetaminophen when managing a fever." "I can administer two baby aspirin tablets to my child every 4 to 6 hours for the fever." "I should use a cooling fan in my child's room to keep the fever down."

"I can administer two baby aspirin tablets to my child every 4 to 6 hours for the fever." "Sponging my child with cold water can be a soothing way to manage the fever." "I should use a cooling fan in my child's room to keep the fever down." Explanation: Aspirin should be avoided in children with fever. It may be associated with Reye syndrome. Activities that result in over-cooling or chilling such as using fans and cold baths should be avoided.

A child has been diagnosed with hookworm. The nurse is teaching the parent about the treatment for the condition. Which statement made by the parent confirms that further education is needed? "I should have my child eat more foods with iron." "My child can play outside bare footed when treatment is done." "The medications should be taken for 2 weeks." "I should have my other children tested."

"My child can play outside bare footed when treatment is done." Explanation: Hookworms are found in soil, especially in areas with warmer climates. They enter the body through the skin, pores and hair follicles. The treatment is with the drug albendazole. The duration is from 7 to 14 days of treatment. Most importantly, besides medication, good handwashing and sanitation practices are needed. Children should wear shoes and not go barefoot outside since the worms can enter through the soles of the feet. The worms attach themselves to the walls of the small intestine where they feed and reproduce. This can cause anemia. The child's diet should include foods high in iron or iron supplements. All children who are suspected or at high risk should be evaluated for hookworms.

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse? "The pathogens cause an overproduction of proinflammatory cytokines. These cytokines are responsible for the clinically observable effects of the sepsis." "Sepsis results in systemic inflammatory response syndrome (SIRS) due to infection." "The pathophysiology of sepsis is complex." "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."

"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys." Explanation: Keeping the answer to what sepsis is will help the parents understand the pathophysiology. While all answers are correct, the response: "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys" provides the most understandable explanation and addresses the parent's question

The parents of a 3-year-old child report he was exposed to pertussis 2 days ago. They are concerned and ask the nurse how long it will take until he becomes ill if he indeed contracted the infection. What response by the nurse is indicated? "The signs of disease will be noted in 1 to 3 weeks." "It normally takes about 3 weeks before symptoms begin." "If your child had contracted the disease symptoms would have be noted by this time." "If you child has contracted the illness he will become ill in about 2 weeks."

"The signs of disease will be noted in 1 to 3 weeks." Explanation: Pertussis is an acute respiratory disorder characterized by paroxysmal cough (whooping cough) and copious secretions. The disease is caused by Bordetella pertussis. The incubation period is 6 to 21 days, usually 7 to 10 days.

A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent? "Your child may return to school when all of the lesions have crusted over." "Your child may return to school when free of any lesions." "Your child may return to school when there has been no fever for 48 hours." "Your child may return to school when a health care provider has given written permission."

"Your child may return to school when all of the lesions have crusted over." Explanation: Varicella is a highly communicable disease. It is spread via airborne transmission or by direct contact with the nasopharyngeal secretions of an infected person. Varicella is communicable from 1 to 2 days before the rash occurs until all the vesicles have crusted over. The nurse would be correct in telling the parent the child cannot return to school, even though the child is feeling better, until all the vesicles have crusted over. The child does not have to be free of lesions. Being free of fever does not make the child less communicable. The child would not need a permission slip from the health care provider unless this is a specific requirement by the child's school district.

The nurse is talking to the parents of a 2-month-old infant who has been admitted to the hospital with sepsis. The parents report being confused since their older children also had the flu but they recovered without incident. What information can the nurse provide to the parents? Infants have fewer white blood cells available to fight infection. Infants do not have adequate amounts of immunoglobulin G (IgG) to fight infections. Passive immunity does not protect the child from infection if the mother has not had the particular infection. Children this young do not have mature immune systems to fight infection.

- children this young do not have mature immune systems to fight infection Explanation: Sepsis can affect any age group but infants less than 3 months of age have a higher risk. Neonates and young infants have a higher susceptibility due to their immature immune system, inability to localize infections, and lack of immunoglobulin M (IgM), which is necessary to protect against bacterial infections.

A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply. Lyme disease Rocky Mountain spotted fever Ascariasis Scabies Psittacosis

- lyme disease - rocky mountain spotted fever Explanation: Infectious diseases caused by tick bites include Lyme disease and Rocky Mountain spotted fever. Psittacosis is transmitted to children by birds. Ascariasis is a roundworm infection. Scabies is a parasitic infection caused by a female mite.

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply. Contacting the health care provider if there is any area of inflammation that might be a bite. Wearing protective clothing when playing in wooded areas. Dressing the child in dark clothing when going outdoors. Removing ticks by rubbing them away from the skin with a credit card. Inspecting the skin closely for ticks after the child plays in wooded areas.

- wearing protective clothing when playing in wooded areas - inspecting the skin closely for ticks after the child plays in wooded areas - contacting the health care provider if there is any area of inflammation that might be a bite Explanation: The nurse should teach the parents to have the child wear protective clothing and dress the child in light clothing when playing in wooded areas or going outdoors. The parents should inspect the child's skin closely for ticks after being outside in wooded areas and if any ticks are found, remove them with a tweezer, not rub them with a credit card. The parents also should be instructed to contact their health care provider if they notice any area of inflammation that might be a tick bite.

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients? Standard precautions Airborne precautions Droplet precautions Contact precautions

Contact precautions Explanation: Contact precautions means placing the client in an isolation room with limited access, wearing gloves during contact with the client and all body fluids, wearing two layers of protective clothing, limiting movement of the client from the room, and avoiding sharing equipment between clients. Standard precautions are used with every client. They involve good handwashing and the use of gloves for client contact. Airborne precautions are used for diseases where small particles are dispersed in the air. They require that the client be in a negative-pressure room and, in addition to standard personal protective equipment, the mask should be N95 or higher. Varicella would need airborne precautions. Droplet precautions are used for diseases such as pertussis, which produce large droplets. They require standard precautions plus a surgical mask, preferably with a face shield.

The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first? a child with erythema infectiosum experiencing fatigue and confusion a child diagnosed with chicken pox reporting nausea and malaise a child with herpes simplex who is reporting mouth pain and pruritis a child diagnosed with measles experiencing photophobia and coryza

a child with erythema infectiosum experiencing fatigue and confusion Explanation: A child with erythema infectiosum experiencing fatigue and confusion is showing signs of decreased oxygenation, possibly related to aplasia of erythrocytes caused by the virus. A child with signs and symptoms of decreased oxygenation should be seen first. Nausea and malaise are symptoms of chicken pox. A child with herpes simplex will most likely report pain an pruritis. Signs and symptoms of measles include photophobia and coryza.