vSim for Nursing: Pediatric Case 3: Eva Madison

A nurse is making patient assignments for the next shift. The nurse should assign Eva to the same cohort or group of patients as which of the following?

Another child with gastroenteritis.

The nurse is admitting a 5-year-old with severe gastroenteritis and dehydration to the hospital. Which of the following nursing interventions has the highest priority?

Assess Eva's heart rate, skin turgor and last urine output.

The nurse would expect which of the following to be elevated in a preschool-aged patient with moderate dehydration?

Serum Sodium Urine Specific Gravity BUN Creatinine

A 5-year-old patient admitted with dehydration secondary to diarrhea and vomiting is placed on isolation precautions until the source of gastrointestinal distress is determined. Which of the following isolation types would be most appropriate for this patient?

Contact

The Nurse is caring for a preschool-aged patient admitted with dehydration. Which of the following measurements is the best indicator of fluid status in this patient?

Daily Weight

The nurse is providing Eva's mother with discharge instructions regarding diet progression. Which of the following responses from Eva's mother indicates that teaching has been effective?

Eva should drink an oral rehydration solution in small amounts until she is ready to progress to a regular diet.

The nurse is obtaining a health history for a patient showing signs of dehydration. Which of the following are considered risk factors for dehydration? (select all that apply)

Excessive Burns Diabetic Ketoacidosis Vomiting

A nurse caring for a 5-year-old patient admitted with dehydration has an order to collect a stool specimen to test for ova and parasites. The patient is ambulatory and has a recent history of vomiting and diarrhea. What is the best method to use to collect the stool specimen from this patient?

Have the patient urinate first and then place a clean container under the seat at the back of the toilet to collect a specimen.

A nurse is explaining contact precautions to the caregiver of a child admitted with gastroenteritis and dehydration. Which of the following statements by the caregiver indicates that teaching has been effective?

I need to wear gloves and a gown when I am in my child's room and discard them in the trash when I am leaving the room.

The nurse is reviewing a teaching handout with Eva's mother on home care of a child with dehydration, which includes information about when it is necessary to return to see the healthcare provider. Which of the following responses by Eva's mother indicates that teaching has been effective?

If Eva has diarrhea or vomiting or doesn't pee, or feels worse, the provider needs to see her.

The nurse is caring for a 5-year-old patient with dehydration and hypovolemic shock. The patient received a 400mL bolus of normal saline over 15minutes. On reassessment which of the following findings would indicate the patient's condition is improving?

Increased urine output.

A 5-year-old admitted with dehydration has an order for a urinalysis. What is the best and most appropriate way for the nurse to collect the urine specimen?

Midstream Clean Catch

A 5-year-old patient comes into the emergency room with a 3-day history of vomiting and diarrhea. The patient weighed 21.8 kg 1 month ago at a well-child checkup and now weighs 20.5 kg. The nurse knows that the patient would be classified as having which of the following levels of dehydration?

Moderate Dehydration

What is the daily oral fluid maintenance requirement in milliliters for a patient weighing 45lbs?

1510mL

The nurse is caring for 5-year-old Eva admitted with dehydration for intravenous rehydration. Eva's mother must leave the bedside to provide care for another child at home and asks whether the nurse can find something for the patient to play with while unsupervised. Which of the following toys would be most appropriate to provide Eva with?

A simple jigsaw puzzle

The nurse is teaching Eva how to properly prevent the spread of infection. Which of the following would be the most developmentally appropriate language to include in the nurse's teaching?

Sing "Happy Birthday" to make sure you wash your hands for the right amount of time.

Eva's mother asks why the healthcare provider ordered a stool sample. Which of the following responses by the nurse demonstrates the most likely rationale for the stool sample given Eva's condition?

The lab will check to stool for parasites to see if that is why Eva is having diarrhea.

The nurse is preparing a 5-year-old patient for a clean-catch urine specimen collection. Which of the following demonstrates that the nurse understands developmentally appropriate communication?

Your mommy will use a special wipe to clean your bottom and then will catch your pee-pee in a cup when you go potty.

The nurse is assessing a 5-year-old patient with a several-day history of vomiting and diarrhea. Which of the following signs would indicate that the patient is severely dehydrated? (select all that apply.)

Cool, mottled extremities Deeply sunken orbits

Eva Madison vSim

ID Self Wash Hands ID Relatives ID Child Ask about Allergies NIBP Continuous Pulse Ox Assess Respirations Assess Pain using FACES scale Assess Mucous Membranes Assess IV site Administer fluids as ordered Obtain Stool Sample Obtain Urine Specimen Auscultate Lungs Assess Temperature Provide Pt Education Provide Relatives Education Call Provider --Handoff Patient, End Sim