Toddler
A toddler in the pediatric intensive care unit is on a ventilator. One of the nurses asks what should be done when condensation collects in the ventilator tubing. How should the nurse manager respond? Notify the physician assistant. Decrease the amount of humidity. Empty the fluid and reconnect the tubing to the ventilator. Measure the fluid and mark it on the intake and output record.
Empty the fluid and reconnect the tubing to the ventilator. The correct course of action is to empty the fluid from the tubing and reconnect it because accumulated fluid may flood the trachea. Removing condensation from the tubing does not require help from a physician assistant; the nurse or respiratory therapist, depending on hospital protocol, is responsible for this remedial action. Humidity is necessary to preserve moisture in the respiratory tract. The amount of condensation is irrelevant in terms of recording intake and output.
A toddler has frequent temper tantrums. The parents ask a nurse how to limit this acting-out behavior. What should the nurse recommend? Ignore the tantrum whenever possible. Restrain the child whenever a tantrum begins. Move the child to a quiet area as soon as a tantrum begins. Visit the clinic to request medication to control the tantrum.
Ignore the tantrum whenever possible. Ignoring the temper tantrum as long as the child is not causing self-harm avoids reinforcement of the behavior. The parents should remain nearby to provide a sense of security. Restraining the child will probably worsen the behavior associated with the tantrum. Moving the child to a quiet area may be impossible; tantrums often involve lying on the floor, kicking, and screaming loudly. Medication is not the treatment of choice.
What does the nurse state is the cause of frequent upper respiratory tract infections in toddlers? Stress Unhealthy diet Lack of exercise Immature immune system
Immature immune system Infants and toddlers are at risk for upper respiratory tract infections as a result of frequent exposure to other children, an immature immune system, and exposure to second-hand smoke. Stress, unhealthy diet, and lack of exercise predispose young and middle-age adults to multiple cardiopulmonary risk factors.
After many episodes of otitis media a 3-year-old child is to undergo myringotomy and have tubes implanted surgically. What should the nurse include in the discharge preparation for this family? Keep the child at home for 1 week. Insert earplugs during the child's bath. Apply an ointment to the ear canal daily. Use cotton swabs to clean the inner ears.
Insert earplugs during the child's bath. Water in the ears after myringotomy may be a source of infection. There is no reason that the child cannot be around other children, because there is no infectious process. Applying an ointment to the ear canal daily will clog the ear canal and serves no purpose. Cotton swabs may be used occasionally in the outer ear, but should not be inserted into the ear.
A mother tells her neighbor, a nurse, that her toddler has been found to have parasites (worms) and that the whole family will need to be treated. She asks the nurse what kind of worm it is. What is the most likely type of worm infestation? Tapeworm ( Taenia) Pinworm ( Enterobius) Roundworm ( Ascaris) Hookworm ( Ancylostoma)
Pinworm ( Enterobius) Pinworms can spread from person to person when transferred to the mouth by way of contaminated food, toys, or linens. Tapeworms are acquired from undercooked meat and do not spread from person to person. Roundworms require a dirt cycle to become infectious and do not spread from person to person. Hookworms are acquired from direct contact with contaminated soil, usually when someone goes barefoot.
Which statement is true regarding the importance of play for children? Pretend play hampers the cognitive development of children. Playing is important because it helps children to release frustration. Children should be introduced to reality if they have imaginary playmates. Children should completely avoid television, electronic games, and computer programs.
Playing is important because it helps children to release frustration. Playing serves as a medium for children to release frustration. Pretend play allows children to learn to understand others' points of view, develop skills in solving social problems, and become more creative. Some children have imaginary playmates. Imaginary playmates are a sign of health and help children to distinguish between reality and fantasy. Television, videos, electronic games, and computer programs support development and the learning of basic skills. There should be limited use of these for preschoolers, but these need not be completely avoided. On the other hand, television, electronic games, and computer programs have lasting negative effects on a toddler's language development, reading skills, and short-term memory.
A toddler receives a gastrostomy tube feeding every 4 hours. What is the priority nursing intervention for this child? Opening the tube 1 hour before feeding Keeping the child lying flat during the feeding Flushing the tube with normal saline after the feeding Positioning the child on the right side after the feeding
Positioning the child on the right side after the feeding Positioning the child on the right side after feeding facilitates digestion because the pyloric sphincter is on this side and gravity aids emptying of the stomach. The feeding may be started immediately after the tube is opened. Keeping the child lying flat during the feeding may result in aspiration; the child's head and torso should be elevated. If the gastrostomy tube is flushed before or after a feeding, water, not normal saline, is used.
A nurse anticipates that an 18-month-old child who does not have hearing loss has acquired a vocabulary sufficient to enable him to communicate. What communication behavior should the nurse expect when assessing the 18-month-old toddler? Saying about 10 words Pointing while grunting Using four-word sentences Making babbling sounds
Saying about 10 words A vocabulary consisting of 8 to 10 words with telegraphic speech is expected of an 18-month-old toddler. Children with a hearing impairment communicate by pointing and grunting because they have not acquired the rudiments of language. Using four-word sentences is typical of a 3-year-old child. Babbling is the expected communication for an 8-month-old infant, even one with moderate hearing loss.
A 2-year-old toddler requires close supervision to protect against potential accidents. The nurse teaches a class for parents about the learning style of toddlers. How do toddlers learn self-protection? Through trial-and-error strategies By imitating playmates and siblings By obeying orders from mother and father By playing with age-appropriate toys and puzzles
Through trial-and-error strategies The toddler is developing autonomy, is curious, and learns self-protection from experience. Toddlerhood play is parallel play, not interactive, play. The struggle for autonomy at this age limits learning from siblings, even though the toddler attempts to copy their behavior. The toddler is still learning from experiences, not from others. The toddler is still attempting to distinguish the self as separate from the parents; the struggle for autonomy limits learning from parents. Toddlers learn gross and fine motor skills as they play with their toys, not self-protection.
A nurse in the pediatric clinic is taking the health history of a toddler with an exacerbation of eczema. What are the nurse's priority assessments of the child? Increase in appetite Wearing cotton clothes Tolerance of new foods Exposure to a viral infection Recent contact with someone with eczema
Wearing cotton clothes Tolerance of new foods Eczema is a common manifestation of allergies in the young child and is often related to foods and clothing. Wearing cotton clothing indicates that the parents understand and are trying to minimize their child's allergic reaction. Tolerance of new foods is a positive sign that the child is outgrowing some food allergies. Appetite does not play a role in the occurrence of eczema. Eczema is an allergic manifestation; it is not contagious.
A toddler with a history of enlarged lymph nodes, prolonged fever that is unresponsive to antibiotics, erythema of the extremities, and a rash is admitted to the pediatric unit with a diagnosis of Kawasaki disease. What does the nurse suspect was essential in confirming this diagnosis? An increased antistreptolysin O (ASO) titer A combination of signs A low-grade temperature An increased sedimentation rate
A combination of signs The diagnosis is based on the presence of five of six specific signs: fever, trunk rash, enlarged cervical lymph nodes, bilateral congestion of the conjunctiva, edema, and redness of the extremities. Increased ASO titer is associated with streptococcal infection. Pronounced fever is a sign of Kawasaki disease. Increased sedimentation rate is not specific to Kawasaki disease; the sedimentation rate increases in the presence of inflammation.
Which should the nurse anticipate when assessing a toddler-age client's respirations? Dyspnea Tachypnea Nasal breathing Abdominal breathing
Abdominal breathing Respirations for the toddler-age client continue to be abdominal during the toddler-age years. Respirations are normal; therefore, the nurse does not anticipate tachypnea or dyspnea. Nasal breathing is not expected when assessing the respirations of the toddler-age client.
The nurse is assessing a toddler with a diagnosis of pinworms. What complication of pinworm infestation, although rare, should the nurse be aware of? Hepatitis Stomatitis Pneumonitis Appendicitis
Appendicitis Pinworms, which attach themselves to the bowel wall in the cecum and appendix, can damage the mucosa, causing appendicitis. Pinworms do not migrate to the liver. Although pinworms (and their ova) are ingested by mouth, they do not attach themselves there; inflammation of the mouth is not a complication of pinworm infestation. Pinworms do not migrate to the respiratory system.
Which assessment data would cause the nurse to initiate treatment for a potential aspirin overdose for a toddler-age child who presents in the emergency department (ED)? Emesis Nausea Tinnitus Ecchymosis Hypoventilation
Emesis Nausea Tinnitus Emesis, tinnitus, and nausea are all early clinical manifestations of acute aspirin poisoning; therefore, it would be appropriate for the nurse to initiate treatment for an aspirin overdose. Ecchymosis is a late symptom associated with a chronic aspirin overdose. Hyperventilation, not hypoventilation, would support the initiation of treatment for an aspirin overdose.
For which clinical manifestation should the nurse monitor the toddler-age client diagnosed with lead toxicity associated with the renal system? Anemia Glycosuria Distractibility Hyperactivity
Glycosuria Glycosuria is a clinical manifestation associated with the renal system that is caused by lead toxicity; therefore, the nurse should include this in the assessment process. Anemia is a clinical manifestation associated with the hematological system. Distractibility and hyperactivity are clinical manifestations associated with the neurological system.
What is the cause of milk anemia in toddlers? Drinking skim milk Drinking whole milk Increased milk intake Increased intake of fruits
Increased milk intake Toddlers who consume more than 24 ounces of milk daily in place of other foods sometimes develop milk anemia because milk is a poor source of iron. Children are usually not offered low-fat or skim milk until age 2 because they need the fat for satisfactory physical and intellectual growth. Toddlers need to drink whole milk until the age of 2 years to make sure that there is adequate intake of fatty acids necessary for brain and neurological development. Other solid food items are necessary for healthy growth and development in toddlers.
At 18 months of age a child born with a cleft lip and palate is readmitted for palate surgery. Why does the nurse teach the parents not to brush their child's teeth immediately after the surgery? The suture line might be injured. A toothbrush might be frightening. The child will probably have no teeth. A toothbrush has not been used before.
The suture line might be injured. A priority during the immediate postoperative period is protecting the surgical site. A toothbrush should be a familiar sight, not a frightening one, to an 18-month-old child. An 18-month-old child has about 16 teeth; although tooth development may not be as expected, there usually are teeth. Brushing the teeth with a soft toothbrush is usually started around 6 months of age.
The mother of a 30-month-old toddler who has been treated for pinworm infestation is taught how to prevent a recurrence. Which statement by the mother indicates that the teaching has been effective? "I'll keep the cat off my child's bed." "I'll disinfect my child's room every 2 days." "We'll need to wash all of our sheets every day." "I need to tell the school nurse to have the toilets cleaned." "I'll have the whole family take the medication again in 2 weeks."
"We'll need to wash all of our sheets every day." "I'll have the whole family take the medication again in 2 weeks." Washing clothing and bed linens daily will help limit transmission. Medications such as mebendazole (Vermox), pyrantel pamoate (Antiminth), and pyrvinium (Povan) are effective but must be repeated in 2 weeks to prevent reinfestation. Cats do not transmit pinworms. Disinfection of surfaces does not help prevent transmission. Toilets are not the usual mode of transmission; the rectal-oral cycle must be completed for infestation to occur.
A nurse is educating the mother of a seven-month-old child about an adequate diet plan for the child. Which statement made by the nurse should be included? "You should provide up to 4 to 6 cups of milk per day." "You should refrain from serving finger food and feed the child." "You should supplement milk with solid food items like vegetables and fruits." "It is preferably to provide low-fat or skimmed milk until the baby is 2 years old."
"You should supplement milk with solid food items like vegetables and fruits." When the child is 6 months old, the mother should start supplementing the child's intake of milk with solid food items to ensure a balanced diet for adequate growth. The intake of milk should be limited to 2 to 3 cups per day because the consumption of more than a quart of milk per day tends to decrease the child's appetite for essential solid foods and results in inadequate iron intake. Serving finger foods to toddlers allows them to eat by themselves and to satisfy their need for independence and control. Small, reasonable servings allow toddlers to eat all of their meals. Children below 2 years of age should not be given low-fat or skimmed milk because the fat is important for the physical and intellectual growth of the child.
A nurse is teaching the parents of a toddler with newly diagnosed celiac disease about the condition. What typical characteristic of this age group makes this child most susceptible to a celiac crisis? Invention Autonomy Narcissism Negativism
Autonomy Autonomy leads to exploration and self-feeding. The child may eat food that is not on the diet, so the parents should be cautioned to keep restricted foods out of their toddler's reach. Although invention, narcissism, and negativism are all common characteristics of the toddler, none leads to the child's eating restricted foods.
An emergency tracheotomy is performed on a toddler in acute respiratory distress from laryngotracheobronchitis (viral croup). What early signs of respiratory distress indicate that it is necessary for the nurse to suction the tracheotomy? Stridor Cyanosis Restlessness Increased pulse rate Substernal retractions
Restlessness Increase pulse rate Restlessness and increased pulse rate are early signs of hypoxia; suctioning is required to keep the airway patent. Stridor, cyanosis, and substernal retractions are late signs of hypoxia; suctioning should be performed before substernal retractions occur.