Reye Syndrome for Peds Nursing

The mother of a 12-year-old with Reye syndrome approaches the nurse wanting to know how this happened to her child, saying, "I never give my kids aspirin!" What could the nurse say to begin educating the woman? a) "Sometimes it's hard to tell what products may contain aspirin." b) "Don't worry; you're in good hands. We have it under control now." c) "Aspirin in combination with the virus will make the brain swell and the liver fail." d) "Do you think that maybe your child took aspirin on his own?"

"Sometimes it's hard to tell what products may contain aspirin." Correct Explanation: Salicylates are in a wide variety of products, so consumers must read the small print very carefully or they will miss the warning. The parent needs to be receptive to further education, and raising the possibility the child was responsible does not accomplish that goal. Don't state the obvious, but also don't minimize the situation. Encouraging the mother to ask for information and offering explanations in terms she will understand are important, but this response does not address the mother's assertion.

Child with Reye syndrome is described in the nurses note as followed: 1200 comatose with sluggish pupils when stimulated demonstrates decerebrate posturing. 1400 unchanged except that now demonstrate decorticate posturing when stimulated the nurse concludes that the child's condition is a. Worsening and progressing to be more advanced stage of the syndrome b. Worsening and the child may likely experience cardiac and respiratory failure c. Improving and progressing to a less advanced stage d. improving of the child postural reflexes are similar

C

The nurse knows further education is needed about reye syndrome when a mother states a. I will have my children immunized against varicella and influenza b. I will make sure not to give my child any products containing aspirin c. I will give aspirin to my child to treat a headache d. children with Reye syndrome are admitted to the hospital

C (asprin products develop Reye Syndrome)

To treat a common manifestation of Reye syndrome which medication with the nurse expect to have readily available a. lasix b. insulin c. glucose d. morphine

C (common manifestation is hypoglycemia)

A 6-year-old has had a viral infection for the past 5 days and is now having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which of the following questions? a) "How high did his temperature rise when he was ill?" b) "Did you use any medications like aspirin for the fever?" c) "Did you give your child any acetaminophen, such as Tylenol?" d) "What type of fluids did your child take when he had a fever?"

"Did you use any medications like aspirin for the fever?" Correct Explanation: Severe and continual vomiting, changes in mental status, lethargy, and irritability are some of the signs and symptoms of Reye syndrome, which can occur as a result of ingesting aspirin or aspirin-containing products during a viral infection. Tylenol is allowed for viral infections in the school-age child. The type of fluids consumed during the illness has nothing to do with Reye syndrome. The temperature rise would be important for a much younger child because of the chance of febrile seizures, but not in this age child.

Seven-year old Isabelle has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when Isabelle first complained of a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which of the following statements would be best for the nurse to say to this mother? a) "This might or might not be a problem. Watch Isabelle for signs of nasal discharge, sneezing, itching of the nose, or dark circles under the eyes. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome." b) "This might or might not be a problem. Watch Isabelle for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome." c) "This is a serious problem. Aspirin is likely to cause Reye syndrome, and Isabelle should be admitted to the hospital for observation as a precaution." d) "This is unlikely to be a problem. Half an aspirin is not enough to cause harm. Reye syndrome generally only develops from prolonged use of aspirin in connection with a virus."

"This might or might not be a problem. Watch Isabelle for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome." Correct Explanation: Reye syndrome usually occurs after a viral illness, particularly after an upper respiratory infection or varicella (chickenpox). Administration of aspirin during the viral illness has been implicated as a contributing factor. As a result, the American Academy of Pediatrics recommends that aspirin or aspirin compounds not be given to children with viral infections. The symptoms appear within three to five days after the initial illness: The child is recuperating unremarkably when symptoms of severe vomiting, irritability, lethargy, and confusion occur. Immediate intervention is needed to prevent serious insult to the brain including respiratory arrest.

The nurse is providing home care instructions to the mother of a child who is recovering from Reye's syndrome. Which of the following home instructions should the nurse provide to the mother? 1. Increase the stimuli in the environment. 2. Give the child frequent small meals, if vomiting occurs. 3. Avoid daytime naps so that the child will sleep at night. 4. Check the child's skin and eyes every day for a yellow discoloration.

4 Rationale: Checking for jaundice will assist in identifying the presence of liver complications, which are characteristic of Reye's syndrome. If vomiting occurs in Reye's syndrome, it is caused by cerebral edema and is a sign of intracranial pressure. Decreasing stimuli and providing rest decrease stress on the brain tissue.

4. The nurse reviews the plan of care for a child with Reye's syndrome. The nurse prioritizes the nursing interventions included in the plan and prepares to monitor for: 1. Signs of hyperglycemia 2. Signs of a bacterial infection 3. The presence of protein in the urine 4. Signs of increased intracranial pressure *Reye's syndrome: exact cause of Reye's syndrome is unknown, although several factors may play a role in its development. Reye's syndrome seems to be triggered by using aspirin to treat a viral illness or infection — particularly flu (influenza) and chickenpox — in children and teenagers who have an underlying fatty acid oxidation disorder

4 Rationale: Intracranial pressure and encephalopathy are major symptoms of Reye's syndrome.

a parent calls the nurse for dosing information for Pepto-Bismol and aspirin for children who are 8 to 9 years old and and are ill. which does the nurse advise select all that apply a. 15ml of pepto bismol after every diarrha stool b. 81 mg baby aspirin every 4 hours c. no medicaitons necessary d. pepto bismol contains aspirin e. diet as tolerated f. reye syndrome is associated with asprin use

c,d,e,f