Peds Study Guide Final Exam

nephrotic syndrome signs and symptoms

-Proteinuria, lipiduria, cast-Massive edema-Sudden increase in girth

Legg-Calve-Perthes Disease treatment

-activities variable based on clinical presentation -primary focus: relieve pain, maintain the femoral head in the proper position, and improve ROM -PT may be required intermittently for stretching, splinting, crutch training, aquatic therapy, traction, and exercise -Orthotic devices and surgical intervention may be indicated depending on classification and severity of the condition

Bronchiolitis treatment

-supportive: nebulizer, hydration -high risk pt: maybe Ribavirin, RSV prophylaxis w/ Respi-Gam or Synagis

bacterial menigitis

-sx- symptoms present 1-2 days after infection. Bulging fontanel. altered mental status, vomiting, stiff neck. Rash= N. meningitides. more neutrophils -dx-1st CT, 2nd LP- CSF= pressure high, high WBC, protein, low glucose -tx- >3 months= Vanco +Cefotaxime if under 1 month add Gentamycin

passive immunity

An individual does not produce his or her own antibodies, but rather receives them directly from another source, such as mother to infant through breast milk

muscular dystrophy overview

-Largest group of inherited muscular diseases in children -Lead to progressive degeneration of skeletal muscles -Gradual degeneration of muscle fibers, progressive weakness, and wasting of skeletal muscles

Snellen eye chart

eye chart used by eye care professionals and others to measure visual acuity.

epiglottitis

-very ill appearance-sudden and high fever-severe sore throat-4 ds (drooling, dysphagia, dysphonia distressed inspiratory air movement-stridor)-restless and anxiety-tripid-tachypnea and tachycardia

Persistent Pulmonary Hypertension of the Newborn (PPHN)

persistent pulmonary hypertension which causes cyanosis

assessment of duchenne muscular dystrophy

-Most severe MD in childhood - most common MD in childhood -Inherited as a sex -linked recessive trait -Only occurs in boys -Symptoms usually apparent by 3 years of age -Life expectancy reaches into early adulthood

The nurse is teaching an inservice program to a group of nurses on the topic of children diagnosed with sickle cell anemia. The nurses in the group make the following statements. Which statement is most accurate regarding sickle cell anemia?

"If the trait is inherited from both parents the child will have the disease."

A mother calls the clinic because her 2-year-old daughter has a rectal temperature of 37.8C (100F). She wonders how high a fever should be before she should give medications to reduce it. What is the best response by the nurse?

"In a normal healthy child, if your child is not uncomfortable, fevers less than 39C (102.2F) do not require medication."

The nurse is providing discharge instructions for a child who has suffered a head injury within the last 4 hours. The nurse will recognize the need additional teaching when the mother states:

"My child should sleep for at least & hours without arousing after we get home."

During a well-child examination which of the following comments made by the parent would indicate the possibility of a growth hormone deficiency?

"My child wears out his clothes before he outgrows them."

A 3-day-old infant presenting with physiologic jaundice is hospitalized and placed under phototherapy. Which response indicates to the nurse that the parent needs more teaching?

"My infant has a serious liver disease."

Meningococcal vaccine

- Recommended that this vaccine be given to children who are 11 through 12 years of age and then given a booster dose at age 16.

During the health interview, the mother of a 4-monthold says. "I'm not sure my baby is doing what he should be." What is your best response?

"Tell me more about your concerns."

The mother of a 3-month-old boy asks nurse about starting solid foods, What is the most appropriate response by the nurse?

"The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

A child is home with the caregivers following a treatment for a head injury. If the child makes which of the following statements, the caregiver should contact the care provider.

"You look funny. Well, both of you do. I see two of you."

RSV nursing interventions

*place Pt in private room or cohort patient *suction PRN, maintain humidity and provide O2 to eep sats >90*feed small,frequent amounts or manage IV fluids *Keep head elevated at all times *don't assign the same Nurse to Pt with RSV and another rish HD *dont assign pregnant nurse if Pt is receiving ribavirin

Strep throat signs and symptoms

- Red painful pharynx - Swollen lymph nodes - Abscesses on tonsils - Malaise -Headache -Strawberry look to the tongue

diagnostics of duchenne muscular dystrophy

-Hx and physical findings -Muscle bx shows fibrous degeneration and fatty deposits -EMG shows dec in amplitude and duration of motor unit potentials -Serum CK levels extremely high-Genetic analysis (girls can be carriers)

The nurse is caring for a child who is in status epilepticus. The child weighs 33 lbs. The medication order reads: Diazepam 3 mg IV push now. Per the pediatric Dosage Handbook, the recommended dose is 0.1 to 0.3 mg/kg dose. Diazepam is supplied as 5 mg/ml. How many milliliters will the nurse administer? Round to the nearest 10.

0.6 mL I first checked to make sure the dose was safe:14.97 kg * .3mg/kg/dose = 4.5mg max doseOrdered is 3mg --> dose is safe 3mg * 1mL/5mg = 0.6 mL

RSV signs and symptoms

1)nasal discharge 2)cough 3)mild fever 4)dyspnea 5)nasal flaring 6)retraction 7)possible cyanosis

You are caring for a 4-year-old with acute lymphoblastic leukemia. The child weighs 38 lbs. The medication order reads: ondansetron 2.6 mg IV every 8 hours for chemotherapy-related nausea/vomiting. Ondansetron is supplied as 4mg/2ml. How many milliliters will you administer? Round to the nearest tenth.

1.3 mL

2-6 month Hgb

10.7-17.3

2-8 weeks Hgb

12.5-20.5

Birth -2 weeks Hgb

14.5-24.5

Platelet Counts Birth-2weeks

150-450

Hib vaccine schedule

1st 2 months, 2nd 4 months, 3rd 6 months

Measles, Mumps, Rubella (MMR)

2 doses 1. 12-15 months 2. @ 4-6 years

Hep A vaccine schedule

2 doses; 1. 2-24 months 2. 6-12 months later

Pneumococcal (PCV) vaccine

2, 4, 6 months 12-15 months

Tyler is an 18 month old toddler, weighing 24 lbs., who was recently prescribed amoxicillin for an ear infection. The order reads 80-90mg/kg/day divided in doses every 12 hours for 10 days.

490.5 mg q12 hours

6 months- 1 year Hgb

9.9-14.5

Ages that receive DTaP.

<7 years old; Boosters for 11 & 12 yr/old

You are providing teaching about accidental poisoning to the family of a 3-year-old. You understand that a child of this age is at increased risk of accidental ingestion due to which sensory alteration?

A less discriminating sense of taste

rheumatic fever

A bacterial infection that can be carried in the blood to the joints caused by Streptococcus pyogenes

At a well-child visit, hydrocephalus may be suspected in an infant if upon assessment the nurse finds:

A rapid increase in head circumference

Respiratory Syncytial Virus (RSV)

A virus that causes an infection of the lungs and breathing passages; can lead to other serious illnesses that affect the lungs or heart, such as bronchiolitis and pneumonia. RSV is highly contagious and spread through droplets.

A 3-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding?

Heart Murmur

A 2 day old infant was just diagnosed with aortic stenosis. What is the most likely nursing assesment finding?

Heart murmur

You are caring for a child who has just been admitted to the pediatric unit with sickle cell crisis. He is complaining that his right arm and leg hurt. What is the priority nursing intervention?

Administer pain medication every 3 hours intravenously until pain is controlled

Following surgery for the insertion of a shunt for hydrocephalus, the infant demonstrated irritability. high-pitched cry, elevated pulse rate, adn temperature of 40C (104F). These symptoms are consistent with which of the following postoperative complications?

Infection

A 5-year-old has been diagnosed with Wilms tumor. What is the priority nursing intervention?

Avoid palpating the child's abdomen.

A child has been admitted in renal failure. The nurse would expect to find:

Azotemia and oliguria

Hep B vaccine

Birth within 12 hours, then 1-2 months but before 6 weeks then 2-4 weeks after that, then 8 weeks after that.

The nurse is assessing a child with acute post-streptococcal glomerulonephritis. Which client symptoms would the nurse anticipate during the assessment? Select all that apply.

Abdominal pain Hypertension Crackles

The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria VS -99 (F), 39.2 (C), 92, 22, 142/92 Mild edema Which disease condition does the nurse anticipate?

Acute glomerulonephritis

Which situation would cause the nurse to become concerned about possible hearing loss?

An 8-month-old who says only "da".

A 4-year-old child is having a vision screening performed. Which screening chart would be best for determining the child's visual acuity?

Allen Figures

RSV treatment

Alleviate symptoms; maintain hydration; acetaminophen, if necessary. Administration of oxygen.

When providing atraumatic care to a child, which action would be the most appropriate?

Allowing the parents and children an informed choice about being together

Which child has the highest risk of urinary tract infection?

An 18-year-old female who is sexually active

The RN is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention?

Apply topical antifungal cream

The nurse is caring for a child who has had diarrhea and vomiting for the past several days. What is the priority nursing assessment?

Assess circulation and perfusion

You are caring for a child after a cardiac catheterization. What is the nursing priority?

Assess extremity distal to the insertion site for temperature and color

A child on he pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WBC 24,000, and platelets 20,000. What is the priority nursing assessment?

Assess for bruising or bleeding

A child with leukemia has the following lab results: Hgb 8.0, Hct 24.2, WBC 8,000, platelets 150,000. What is the priority nursing assessment?

Assess for pallor, fatigue, and tachycardia. Hgb and hct indicate anemia

The nurse is caring for a child in the emergency department who was bitten by the family dog, who is fully immunized. What is the priority nursing action?

Assess the depth and extent of the wound

The nurse is caring for orthopedic children who are in the postoperative period following spinal fusion. What is the most appropriate activity to delegate to unlicensed assistive personnel?

Assist with log-rolling the children every 2 hours.

When working with children and families, which is a critical strategy for promoting therapeutic communication?

Attentive listening

The nurse is caring for a 14-year-old boy with type 1 DM. He takes NPH insulin every morning at 7:30 AM. Which assessment data will the nurse use to evaluate the therapeutic effectiveness of the medication?

Blood glucose level at 1630 NPH is a long-acting insulin used to lower blood glucose levels. Its peak action is at 2 to 4 hours with a duration of 10 to 16 hours. Blood glucose monitoring provides evaluation of the therapeutic effectiveness.

You are caring for a 15-year-old boy with type 1 DM. He takes NPH insulin every morning at 7:30 AM. Which assessment data will you use to evaluate the therapeutic effectiveness of the medication?

Blood glucose level at 4:30pm

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which of the following clinical manifestations was likely noted in this child?

Bloody urine

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend?

Baseball

In addition to the child's history, symptoms, and blood studies, what information helps to confirm the diagnosis of leukemia?

Bone marrow aspiration

Which of the following is consistent with increased ICP in the child?

Bulging fontanel

A 6-month-old infant with RSV bronchiolitis is in respiratory distress. The baby has copious secretions, increased work of breathing, cyanosis, and a respiratory rate of 78. What is the most appropriate Initial nursing Intervention?

Suction secretions, provide 100 oxygen via mask, and anticipate respiratory failure.

To detect complications as early as possible in a child with meningitis who's receiving I.V. fluids, monitoring for which condition should be the nurse's priority?

Cerebral edema

A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action?

Check with the prescriber to see if an alternative form can be used

Varicella Vaccine

Children 12-15 months who have not had varicella Booster at 4-6 Years old

A child is diagnosed with bacterial meningitis. The nurse would suspect which abnormality of cerebrospinal fluid (CSF)?

Cloudy appearance

A child has a closed fracture of the right radius, with slight ecchymosis below the elbow. She complains of extreme pain. Her right hand is cooler than her left and she cannot extend the fingers of her hand because they "burn." She is probably experiencing:

Compartment syndrome

acute renal failure

Condition that occurs when something, such as a blockage, toxins, or sudden loss of blood flow causes a change in the filtering function of the kidneys

A sleeping 5-month-old is being held by the mother when you come in to do a physical examination. what assessment should be done initially?

Counting the heart rate

A 9-month-old infant's mother is questioning why cows milk is not recommended in the first year of ife as it is much cheaper than formula. What rationale does the nurse include in their response?

Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant

A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate?

Creatinine clearance rate

interventions for epiglottitis

DO NOT EXAMINE THROAT-monitor resp. status-don't provoke crying, try to keep child calm-meds as prescribed-hydration via IV-emotional support for the child and family-palivizumab prophylaxis (rsv vaccine)-prepare for emergency trach

A 5-year-old who had a renal transplant 9 months ago and has no history of chickenpox presents to the pediatric clinic for his vaccinations. Which is the most appropriate set to give?

DTap, IPV

An adolescent who is a competitive swimmer comes to the emergency department complaining of localized aching pain in his shoulder. He states, "I've been practicing really hard and long to get myself ready for my meet this weekend." The area is tender to the touch. The nurse determines that the adolescent is most likely experiencing which type of pain

Deep Somatic Pain

A child is admitted to the unit with acute renal failure (ARF). When reviewing the history, the nurse notes a history of all the following medical conditions. Which is the most likely to have precipitated the onset of ARF?

Dehydration

A parent is asking how she can help her son deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse?

Demonstrate love and acceptance at home.

When planning education for a child and parents, what is the first step you as a nurse, should take?

Determine the child's and family's learning needs and styles

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by:

Developing a sense of worth and competence

What approach by the nurse would most likely encourage a child to cooperate with an assessment of physical and developmental health?

Explain what is going to happen in words the child can understand

Screening for scoliosis should initially be done

During the school-age years

The nurse is caring for a child with cerebral palsy who requires a wheelchair to attain mobility. Which intervention would help the child achieve a sense of normality?

Encourage after-school activities within the limits of the child's abilities.

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?

Eyes

trust vs mistrust stage

Erikson's stage in the first year of life, where infants decide whether the world is friendly or hostile. They decide depending on whether they can trust that their basic needs will be met.

Which of the following organisms is the most common cause of UTI in children?

Escherichia coli

An 11-year-old male is diagnosed with mild hemophilia. Upon assessment, the nurse documents the following factor level for this category of hemophilia:

Factor level of 5% to 50%

An infant is diagnosed with a urinary tract infection. What corroborating finding would the nurse expect on assessment?

Failure to thrive

rheumatic fever signs and symptoms

Fever; painful, tender, red or hot joints; fatigue; painless nodules underneath the skin; dyspnea; painless, ragged rash; and jerky body movements (St. Vitus dance) could all be signs and symptoms of rheumatic fever.

The nurse is caring for a child with leukemia. Which nursing intervention would be the highest priority for this child?

Following guidelines for protective isolation

A 7-year-old child with cerebral palsy has been admitted to the hospital. Which information is most important for the nurse to obtain in the history?

Functional status related to eating and mobility

When monitoring the blood glucose level of a 9-year-old child with type 2 DM, your reading is 50mg/dL. Which is the most appropriate action?

Give the child 4 oz of orange juice

When monitoring the blood glucose level of a 12-year-old child with type 2 DM, your reading is 50 mg/dL. Which is the most appropriate action?

Give the child 4 oz of orange juice The child's glucose level is too low. Orange juice will provide quick sugar to raise the child's blood glucose level. Increased exercise would be contraindicated since it would lower blood glucose even further.

Nephrotic syndrome is caused by damage to which part of the nephron?

Glomerulus

When reviewing the urinalysis of a client with acute glomerulonephritis, the nurse would expect to note:

Hematuria

The mother of a 3-year-old concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response?

Hesitancy and disfluencey are normal during this period of development

Side effect of erythropoietin

Hypertension

The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. Which finding is documented?

Hypospadias

The nurse is caring for a 2-year-old with myelomeningocele. When teaching about care related to neurogenic bladder, what response by the parent would indicate that additional teaching is required?

I know it will be important for me to catheterize my child for the rest of her life.

Bronchiolitis

Inflammation of the bronchioles that usually occurs in children younger than 2 years and is often caused by the respiratory syncytial virus.

The nurse is caring for a child who has received significant partial-thickness burns to the lower body. What is the priority assessment in the first 24 hours after injury?

In the child with a serious burn, fluid balance is of priority importance in the first few days of care.

Signs of impending respiratory failure

Increased respiratory rate or bradypnea nasal flaring use of accessory muscles cyanosis

A 6-month-old infant is admitted to the hospital with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. The priority nursing intervention would be:

Initiate appropriate isolation precautions and begin intravenous antibiotics.

Which statement indicates the best sequence for the nurse to conduct an assessment in a nonemergency situation?

Introduce yourself, ask about any problems, take a history, and do the physical examination

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?

Irritability, fever, and vomiting

The pediatric nurse understands that the concepts related to shaken baby syndrome include: (Select all that apply.)

Jarring motion causes tearing of the nerve fibers of the brain After this injury infants may have seizures, lethargy, and respiratory difficulties Infants are susceptible to injury due to their neck muscles being weak Vision impairment or loss of hearing may result from this injury

What vaccines should pregnant women or immunocompromised people not receive?

Live Vaccines (e.g. MMR)

A varsity high-school wrestler presents with a "rug burn" type of rash on his shoulder that is not healing as expected, despite use of triple antibiotic cream. Two other wrestlers on his team have a similar abrasion. What infection should the nurse be most concerned about, based on the history?

MRSA

The nurse is caring for a 5-year-old child with a congenital heart anomaly causing chronic cyanosis. When performing the history and physical examination, what is the nurse least likely to assess?

Obesity and overeating

what meds to avoid with ARF

NSAIDs, Statins, diabetes medicines-metformin, methotrexate

Pulmonic Stenosis (PS)

Narrowing at the entrance to the pulmonary artery that decreases Blood flow

The nurse is caring for a hospitalized 30-month-old who is resistant to care, Is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as:

Normal because the child is hospitalized and out of their routine

The nurse is reviewing lab work prior to shift handoff on a client with a subnormal urine output. Which is the nurse most correct to report?

Oliguria

A 3-year-old complains of extreme pain when the tragus is touched. Though not diagnostic, this sign is most indicative of which disorder?

Otitis externa

A 4-year-old complains of extreme pain when the tragus is touched. Though not diagnostic, this sign is most indicative of which disorder?

Otitis externa

Cystic Fibrosis Treatment

PERT (Pancreatic enzyme replacement therapy)High protein diet, high kcal, unrestricted fat, liberal in salt Medication aimed at relieving symptoms and complications such as antibiotics, bronchodilators, & pain relievers

You are admitting a child with a swollen elbow. The medical record indicates a history of multiple bruising. Which of the following labs heightens your suspicion for hemophilia?

PTT 73 seconds

A 2-year-old has been prescribed eye patching for strabismus 6 hours per day. What teaching does the nurse provide for the mother?

Patching is necessary to strengthen vision in the weaker eye.

glomerulonephritis signs and symptoms

Pink or cola-colored urine from red blood cells in your urine (hematuria)Foamy urine due to excess protein (proteinuria)High blood pressure (hypertension)Fluid retention (edema) with swelling evident in your face, hands, feet and abdomen

The nurse is caring for an infant who has undergone surgery for infantile glaucoma. What is the priority nursing intervention?

Place elbow restraints on the child

A child is admitted with acute renal failure (ARF) and a serum potassium of 6.0 mEq/L The nurse would plan which of the following as a priority action?

Place the child on a cardiac monitor

A 10-year-old child is admitted to the hospital due to history of seizure activity. As his nurse

Place the child on his side and open his airway

While assessing a 4-month-old infant, the nurse notes that the baby experiences a hypercyanotic spell. What is the priority nursing action?

Place the infant in a knee-to-chest position.

Which of the following signs and symptoms are characteristic of Minimal Change Nephrotic Syndrome (MCNS)?

Poor appetite, proteinuria, edema

A 3-month- old infant presents with a history of vomiting after feeding. The plan for the infant is to rule out GER. What information from the history would lead the nurse to believe that this infant may need further intervention.

Poor weight gain

A boy with Duchenne muscular dystrophy is admitted to the pediatric unit. He has an ineffective cough. Lung auscultation reveals diminished breath sounds. What is the priority nursing intervention?

Position for adequate airway clearance.

A 14-year-old boy with sickle cell anemia is admitted with severe pain in his abdomen and legs. He asks you why he is receiving oxygen when he is not having any breathing problems. You state the therapeutic action of oxygen is to:

Prevent further sickling.

A 10-year-old child is admitted to the hospital due to history of seizure activity. As his nurse, you are called into the room by his mother, who states he is having a seizure. What would be the priority nursing intervention?

Prevention of injury by placing the child on his side and opening his airway.

Justin, age 10 has a diagnosis of rheumatic fever and has missed school for a week. What is the most likely cause of this problem?

Previous streptococcal throat infection

When administering ear drops to a 2-year-old, which action would be most appropriate?

Pull the pinna of the child's ear down and back.

A child presents with a 3-day history of fever, prioritize for immediate reporting to the provider abdominal pain, occasional vomiting, and decreased oral intake. Which finding would the nurse

Rebound tenderness and abdominal guarding

The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says. sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information?

Receptive language normally develops earlier than expressive language

The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information?

Receptive language normally develops earlier than expressive language.

A neonate should be evaluated by a provider if which signs and symptoms are present?

Rectal temperature above 38C (100.4F)

Babinski reflex

Reflex in which a newborn fans out the toes when the sole of the foot is touched

The mother of 6-month-old girl is concerned about her daughter getting a urinary tract infection. What should the nurse mention to the mother to help prevent this condition?

Report any abnormally colored urine to the child's primary care provider

Of the following, which is the priority nursing intervention for the child with Duchenne's muscular dystrophy?

Respiratory Status

Which of the following signs and symptoms of increased intracranial pressure (IICP) after head trauma would appear first?

Restlessness and confusion

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?

Risk for infection

Rotavirus vaccine

Rotarix 2 Doses at 2&4 months or RotaTeq 3 doses 2,4,6 months

An infant boy is at your facility for his initial health supervision visit. He is 2 weeks old and responds to a bell during his exam. You review all his birth records and find no documentation that a newborn hearing screen was performed. What is the best action you should take?

Schedule the infant immediately for newborn hearing screening

When giving parents guidance for the adolescent years, the nurse would advise the parents to: (Select all that apply.)

Screen all of his or her friends Accept the adolescent as a unique individual Respect the adolescent's Listen and try to be open to the adolescent's views

Polio Vaccine (IPV)

Series of 4 (2, 4, 6 months and 6 years)

A nurse is examining a boy with cerebral palsy. He has hypertonic muscles and abnormal clonus in his legs and walks on his toes. Which of the following is the type of cerebral palsy that this boy is demonstrating?

Spastic

A 10 year old girl has just been diagnosed with End Stage Renal Failure (ESRF). The nurse gives the child instructions in which foods to avoid including:

Spinach

Which assessment finding is considered normal in children?

Split S2 and sinus arrhythmia

A child with cancer is receiving chemotherapy, and his mother is concerned that the nausea and vomiting associated with chemotherapy are reducing his ability to eat and gain weight appropriately. What is the most appropriate nursing action?

Start antiemetic drugs prior to the chemotherapy infusion.

compartment syndrome

Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue.

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action?

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

A 4-year-old girl presents with recurrent urinary tract infection. A prior workup did not reveal any urinary tract abnormalities. What is the priority nursing action?

Teach appropriate toileting hygiene

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which fact a greater likelihood in the child?

The child has a greater risk for trauma to the kidney

The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history?

The child recently had an ear infection. Explanation: In the child with acute glomerulonephritis, presenting symptoms appear 1 to 3 weeks after the onset of a streptococcal infection, such as strep throat, otitis media, tonsillitis, or impetigo. There is not a family history of the disorder, a history of congenital concerns or defects, nor asthma in children with acute glomerulonephritis

When caring for a child who has a diagnosis of acute glomerulonephritis, which nursing interventions would most likely be included in the child's plan of care? Select all that apply.

The nurse administers diuretics. The nurse administers antihypertensive. The nurse weighs the child every day using the same scale. The nurse dipsticks the child's urine to test for protein.

The parents of an infant who just had a ventriculoperitoneat shunt inserted for hydrocephalus are concerned about the infant's prognosis and ongoing care. The nurse should explain that:

The shunt will need to be revised as the child gets older

The nurse is caring for a child with cystic fibrosis who receives pancreatic enzymes. Which statement by the child's mother indicates an understanding of how to administer the supplemental enzymes?

The enzymes should be given at the beginning of each meal and snack.

You are caring for a child with cystic fibrosis who receives pancreatic enzymes. Which statement by the child's mother indicates an understanding of how to administer the supplement enzymes?

The enzymes should be given at the beginning of each meal and snack."

When compared with adults, why are infants and children at an increased risk for head trauma?

The head of the infant and young child is large in proportion to the body and neck muscles are not well developed.

Compared with adults, why are infants and children at an increased risk for infection and communicable diseases?

The infant has had limited exposure to disease and is losing the passive immunity acquired from maternal antibodies

A 2-year-old is having a temper tantrum. What advice should the nurse give the mother?

The tantrum should be ignored as long as the toddler is safe.

Genu valgum (knock knees)

This is a condition in which the knees touch but the ankles do not. Can be normal in children up to age 3.

A 3-year-old child presents with a fever and rash. What following items should the nurse obtain during the health history? (Select all that apply.)

Thorough description and history of the rash Immunization history Exposure to any infectious disease

HPV vaccine

Three doses should be given over a 6 month -interval for females at 11 to 12 years of age (minimum age is 9 years). -The second dose should be administered 2 months after the first dose, and the third dose should be administered 6 months after the first dose. may be given to males starting at age 9 years of age.

Which of these factors contributes to infants' and children's increased risk for upper airway obstruction as compared with adults?

Underdeveloped cricoid cartilage and narrow nasal passages.

Legg-Calve-Perthes Disease

degeneration of femoral head due to avascular necrosis. disease is self limiting and has 4 phases: condensation, fragmentation, re-ossification and remodeling. presents with pain, decreased ROM, antalgic gait, positive Trendelenburg sign. primary treatment focus is to relieve pain and maintain femoral head in proper position.

DTaP vaccine

diphtheria and tetanus toxoids and a cellular pertussis

A 5 year old boy visits the pediatric office with an upper respiratory infection. Which approach would give the nurse the most information about the child's developmental level?

Using a screening tool during a follow up office visit.

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor?

VIII

The nurse is caring for a 2-year old in the hospital, and the mother expresses concern that the toddler will be scared. Which response by the nurse would be most appropriate?

We will do our best to minimize the stress that your child experiences

The nurse is performing education for the parents of an infant with bladder exstrophy. Which statement by the parents would indicate and understanding of the child's future care?

We will need to care for the urinary diversion

When the nurse is caring for a child with hemolytic-uremic syndrome or acute glomerulonephritis and the child is not yet toilet trained, which action by the nurse would best determine fluid retention?

Weigh Child Daily

development of language

Wernicke's area (understanding) develops first, then Broca's area (production)

Which instruction should a nurse give to a client who has a history of urinary tract infection to prevent recurrence?

Wipe from front to back. Encourage fluids throughout the day. Finish all antibiotic prescribed.

Varicella Vaccine and Pregnancy

Women who are not immune to varicella should be immunized in the postpartum period. Instruct client to use reliable form of contraception and avoid pregnancy for 3 months.

strabismus, heterotropia

a condition of eye misalignment caused by intraocular muscle imbalance

cystic fibrosis (CF)

a hereditary disorder of the exocrine glands characterized by excess mucus production in the respiratory tract, pancreatic deficiency, and other symptoms Diagnostic - SWEAT test (measures sodium/chloride in sweat)

visceral pain

a poorly localized, dull, or diffuse pain that arises from the abdominal organs, or viscera

hearing screening

a quick procedure to determine whether a client can be assumed to have normal hearing or needs to be more thoroughly evaluated by an audiologist

strep throat

a sore throat caused by streptococcal bacteria

congenital heart disease

abnormalities in the heart at birth

A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition?

acute glomerulonephritis

A child with leukemia received chemotherapy about 10 days ago. She presents today with a temperature of 100.4F, an absolute neutrophil count of 500, and mild bleeding of the gums. What is the priority nursing intervention?

administer IV antibiotics as ordered

The nurse is caring for a child who has just been admitted to the pediatric unit with sickle cell crisis. He is complaining that his right arm and leg hurt. What is the priority nursing intervention?

administer pain medication every 3h IV until pain is controlled

what foods to avoid with ARF

anything High in potassium, salt/salty, Phosphorus/phosphate, leafy greens and alcohol

A 14 y/o with thalassemia asks for your assistance in choosing her afternoon snack. Which choice is the most appropriate?

apple slices with cheddar cheese

A child on the pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WMC 24,000, and platelets 20,000. What is the priority nursing assessment?

assess for bruising or bleeding

Introduction of solid foods

between 4-6 months of age. Vegetable, fruit, then nuts and other stuff after 1 y/o Be careful not to give these before 1 y/o: -HONEY -Cow's Milk -Hard stuff (nuts, raw carrots etc)

The nurse is caring for a 14 y/o boy with type 1 DM. He takes NPH insulin every morning at 7:30am. Which assessment data will the nurse use to evaluate the therapeutic effectiveness of the medication?

blood glucose level at 1630

A child with hemophilia fell while riding his bicycle. He was wearing a helmet and did not lose consciousness. He has a mild abrasion on his knee that is not oosing. He is complaining of abdominal pain. What is the priority nursing assessment?

carefully assess his abdomen

Patent Foramen Ovale (PFO) / Atrial Septal Defect (ASD

causes blood to pass through L & R AtriumPFO - unclosed flapsASD - open hole

deep somatic pain

comes from sources such as blood vessels, joints, tendons, muscles, and bone

A mother brings her 6-month-old infant to the clinic. The child has been vomiting since early morning and has had diarrhea since the day before. His temperature is 38C, pulse 140, and respiratory rate 38. He has lost 6 oz since his well-child visit 4 days ago. He cries before passing a bowel movement. He will not breastfeed today. What is the priority nursing diagnosis?

fluid volume deficit related to excessive losses and inadequate intake

When monitoring the blood glucose level of a 12 y/o child with type 2 DM, your reading is 50mg/dL. Which is the most appropriate action?

give the child 4oz of OJ

E. coli

gram negative bacteria

nephrotic syndrome (nephrosis)

group of clinical signs and symptoms caused by excessive protein loss in urine

SYMPTOMS OF GRAFT REJECTION

hypertension, fever, malaise, graft tenderness. treatment- immediately initiate corticosteroids and possible monoclonal antibodies.

walking/stepping reflex

in response to the soles of a baby's feet touching a flat surface, they will attempt to walk; disappears at 2-4 months

glomerulonephritis

inflammation of the glomeruli within the kidney

otitis externa

inflammation of the outer ear

Still's murmur

innocent murmur heard in children

primary goal of treatment for duchenne

maintain function in unaffected muscles as long as possible**supportive

coarctation of the aorta (CoA)

narrowing (coarctation) of the lumen of aorta

aortic stenosis

narrowing of the aortaprevents blood from passing from the Left Ventricle into the aorta, leading to hypertrophy of the Left Ventricle

Genu varum (bowlegs)

normal up to age 3 persistent beyond 3= blount disease (distrubance of medial proximal tibial growth plate)--> surgery

Moro reflex (startle reflex)

occurs when a baby is startled by a loud noise, a sudden movement, or the head falling back. The arms are thrown apart. The legs extend and then flex. A brief cry is common; begins at 28 weeks of gestation

ventricle septal defect

opening between right and left ventricles

neuropathic pain

pain from damage to neurons of either the peripheral or central nervous system

patent ductus arteriosus (PDA)

passageway (ductus arteriosus) between the aorta and the pulmonary artery remains open (patent) after birth

Limb placement reflex

present at birth fades rapidly in early months.

Plantar Grasp Reflex

reaction to stimulation of the sole of the foot that causes the toes of the feet to "grasp"; Disappears at 9 months

A child diagnosed with acute glomerulonephritis will most likely have a history of:

recent illness such as strep throat.

palmar grasp reflex

reflexive curling of the infant's fingers around an object that touches its palm. Disappears by 4-6 months

Tetraology of Fallot (TOF)

set of four congenital heart defects occurring together

You care for a 4-year-old with sickle cell anemia. A physical finding you might expect to see in him is:

slightly yellow sclerae.

Strep Pharyngitis

strep throat

cutaneous pain

superficial pain usually involving the skin or subcutaneous tissue

Ishihara test

tests for color vision

hydronephrosis

the dilation (swelling) of one or both kidneys

Haemophilus influenza type B

this is the most common cause of meningitis and epiglottitis in children over one month of age to 5 yrs old contraindicated <6 wks - >age 5

Physiologic Jaundice of the Newborn

unconjugated hyperbilirubinemia; begins on day three

A young mother brings her new baby, diagnosed with congenital hypothyroidism, to the clinic so she can learn how to administer levothyroxine. The nurse should include which of the following instructions?

use an oral dispenser syringe or nipple to give the crushed medication mixed with a small amount of formula

arteriovenous fistula

ype of vascular access for dialysis; created by surgically connecting an artery to a vein

The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? Select all answers that apply.

• Motor response • Eye opening • Verbal response