PrepU Peds Assignment 6
Kate and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes. Which statement by the nurse is true?
"Kids can usually be managed with an oral agent, meal planning, and exercise."
A 10-year-old boy has been diagnosed with type 1 diabetes mellitus. He is curious about what the cause of his disease is and asks the nurse to explain it to him. What explanation is best?
"Special cells in a part of your body called the pancreas can't make a chemical called insulin, which helps control the sugar level in your blood."
What assessment findings should the nurse expect to find in the examination of a child with Turner syndrome?
A female with short stature and a neck that appears short and webbed
The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which finding would the nurse identify as the hallmark of this condition?
A sausage-shaped mass in the upper midabdomen
The nurse is providing care for a child who has been diagnosed with rickets. What is the nurse's priority intervention?
Administration of adequate vitamin D
Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?
Administration of levothyroxine indefinitely
A nurse is reviewing information about the various types of insulin that are used to treat diabetes mellitus type 1. Integrating knowledge about the duration of action, place these types in the order from shortest to longest duration.
Aspart Regular NPH Glargine
A child has presented to the clinic with diarrhea. The nurse should teach the mother to give which of the following to properly care for her child?
Bananas
A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?
Barium enema
The nurse instructs a preadolescent child with type 1 diabetes mellitus how to self-administer an injection of short-acting and long-acting insulin. Which observation indicates to the nurse that teaching has been successful?
Draws up the short-acting insulin into the syringe first
The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child?
Effortless vomiting just after the child has eaten
A newborn girl is discovered to have congenital adrenal hyperplasia. When assessing her, the nurse would expect to find which physical characteristic?
Enlarged clitoris
A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?
Hirschsprung disease
The nurse is caring for a 10-year-old boy with growth hormone deficiency. Which therapy would you anticipate will be prescribed for him?
Injections of growth hormone
What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy?
It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse.
Shortly after delivery, a newborn is diagnosed with hypocalcemia. What manifestation will the nurse assess in this patient?
Jitteriness
A young child has presented to the pediatric unit with a swollen abdomen, edema, thin patchy hair, and irritability with growth retardation and muscle wasting. The nurse suspects a malnutrition disorder. The nurse identifies this child to most likely have which of the following?
Kwashiorkor
A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant?
Lower right
The nurse is caring for a 3-year-old with repeated diarrhea. The client is listless and clings to the parent. The nurse reviews the labwork which reports a pH- 7.33, HCO3- 21, PaCO2- 42. Which would be documented?
Metabolic acidosis
A group of students are reviewing information about oral diabetic agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver?
Metformin
A school-aged girl with Crohn's disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which would best help her accept the treatment plan?
Provide some time to talk to her several times a day.
A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?
Pyloric stenosis
The nurse is working with a school district to ensure students do not develop food-borne illnesses. Which intervention should the nurse emphasize that supports the 2020 National Health Goals regarding food preparation?
Refrigerate foods promptly.
A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?
Type 1 diabetes mellitus
Which assessment finding would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed?
Vomiting
The nurse is presenting information related to intestinal parasite infections to a group of community health nurses. One member of the group asks the nurse how she might know if a child had a pinworm infestation. The nurse correctly answers this question by stating which of the following?
The primary symptom of pinworms is intense perianal itching.
Pyloric stenosis has been diagnosed in a 3-week-old male infant who has frequent vomiting after feedings. An important preoperative nursing intervention is:
maintaining NPO status while restoring hydration and electrolyte balance.
A newborn is diagnosed with the salt-losing form of congenital adrenogenital hyperplasia. On what should the nurse focus when assessing this client?
Dehydration
A child is admitted with a temperature, 101.2°F (38.4°C); pulse rate 100 beats/min; respirations 24 breaths/min. On admission the pain is localized in right lower quadrant. Legs are drawn up against the abdomen. Bowel sounds are sluggish. Rebound tenderness is present. White blood cell count of 17,000/mm3. Ultrasound confirms appendicitis. Which instruction would the nurse give to the child and the parent?
Do not rub or put pressure on the abdomen.
The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with disorder?
The parents report that their son "can't drink enough water."
The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality?
Currant jelly-like
A 2-month-old infant experiencing severe diarrhea is prescribed intravenous fluid replacement. Before adding potassium to this solution, which assessment should the nurse make?
Ensure that the child is voiding
Noah is an 18-month-old boy who is brought to the emergency department with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that this condition is most likely the result of which of the following?
Gastroesophageal reflux disease
A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next?
Give 10 to 15 grams of a simple carbohydrate.
A child is brought to the clinic experiencing symptoms of nervousness, tremors, fatigue, increased heart rate and blood pressure. Based on this assessment, the nurse would suspect a diagnosis of which condition?
Graves disease
The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents?
Having a wound, ostomy, and continence nurse meet with them
An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care?
He will become fatigued easily.
A nurse is making a home visit to a 12-year-old child with type 1 diabetes and is reviewing insulin administration. The nurse determines that the teaching was successful when the child performs which actions? Select all that apply.
-Draw up the short-acting insulin before the intermediate-acting insulin -Stores the insulin vial at room temperature -Gives the injection at a 45-degree angle
Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply.
-Polyuria -Polydipsia -Polyphagia
The nurse is caring for an infant recovering from surgery for pyloric stenosis. Which nursing diagnosis should the nurse use to guide care during the immediate postoperative period?
Risk for infection of incision line, related to disruption of skin barrier during surgery
A newborn is born with hypothyroidism. A complication of this disorder if it is not recognized and treated is:
cognitive impairment.
In the salt-losing form of congenital adrenal hyperplasia, the most important observation you would make in a newborn would be for:
dehydration.
Insulin deficiency, increased levels of counter regulatory hormones, and dehydration are the primary causes of:
diabetic ketoacidosis.
The nursing diagnosis most applicable to a child with growth hormone deficiency would be:
risk for situational low self-esteem related to short stature.
