chapter 17 PREP U
speech therapy
The nurse is caring for a child who had a cochlear implant. Which of the following is most important for the parents to follow up with?
The child's father smokes. The child's older siblings have been diagnosed with acute otitis media in the past. The child shares a bedroom at home with 3 siblings. The family home is occupied by 10 family members.
The nurse is caring for a child who has been diagnosed with acute otitis media three times in the past year. Which factors noted in the medical record would be considered contributing factors to this condition? Select all that apply.
It is caused by chronic otitis media or another infection.
The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss?
improvement of the child's language and speech development
The nurse is caring for a child who has had persistent otitis media effusions and is scheduled to have pressure equalizing tubes placed in 3 days. What should the parents observe after the tubes have been placed?
Refer the child to a pediatric ophthalmologist
A child with poor eye alignment cannot establish single binocular vision but has double vision. Which nursing action is most appropriate for this client?
"I should continue to breastfeed my son because it lowers the incidence of acute otitis media."
The nurse has finished teaching the parents of a 10-month-old male ways to prevent another acute otitis media (AOM) infection. Which statement by the mother indicates she has the correct understanding of the information provided?
"Don't use anything that touches her face."
The school nurse is educating the parents of a child with infectious conjunctivitis. Which comment provides the most value for prevention?
inflamed conjunctivitis mild pain
A mother brings her child to the health care clinic because she thinks that the child has conjunctivitis. Which assessment findings would lead the nurse to suspect bacterial conjunctivitis? Select all that apply.
Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment.
A neonate has been diagnosed with a herpes simplex viral infection of the eye. The nurse will prepare to administer:
Amblyopia
A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition?
8-month-old who has just begun to inspect her own hand.
A nurse is assessing infants for visually related developmental milestones. The infant who is showing a delay in meeting an expected milestone is the:
importance of patching as prescribed.
The nurse is educating the parents of a 4-year-old boy with strabismus. Teaching for the parents would include the:
washing hands frequently
The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder?
"We need to raise the volume of our voices significantly so he can hear us."
The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed?
"It's an overgrowth of retinal blood vessels."
The nurse is educating the parents of a premature newborn diagnosed with retinopathy of prematurity. Which comment will be part of the information provided?
Otitis media
The nurse is teaching young parents on the proper techniques for feeding young children who are bottle-fed. The nurse should instruct the parents to feed the children in an upright position in order to prevent:
intact extraocular movements
A nurse is examining a child who has sustained blunt trauma to the eye area. The nurse suspects a simple contusion based on what finding?
Orienting the child to where furniture is placed in the room.
A nurse is caring for a visually impaired 10-year-old child. The nursing intervention with the highest priority for this child during the admission process would be:
Delayed growth and development.
A nurse is caring for a visually impaired 20-month-old who has not begun to walk. An appropriate nursing diagnosis for this child would be:
"Has your child been reporting any blurred vision?" "Has your child's school work remained good?" "Does your child report a headache when reading?" "Have you noticed your child squinting?"
A parent brings the child for a well-child visit. During the visit, the parents state the child appears to not be seeing well. To obtain information needed to aid in a diagnosis, which question(s) should the nurse ask the parents? Select all that apply.
Place ice on the eye for 20 minutes/off the eye for 20 minutes for 24 hours.
A parent calls the nurse triage line to say the child accidentally got hit in the eye and the parent believes the child will have a black eye. Which instruction is important for the nurse to provide this parent?
The frequency of otitis media is reduced in breastfed infants.
A parent of a newborn asks the nurse if there is any way to prevent acute otitis media. What would the nurse state to the parent?
Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose.
A school child has epistaxis. The school nurse appropriately intervenes by:
The child cries out when the ear is grasped.
The nurse is performing a physical assessment for an 8-year-old child with an earache. Which sign or symptom indicates external otitis (acute otitis externa or swimmer's ear)?
surgery
A child has recently been diagnosed with cataracts. The treatment for cataracts is:
visual acuity of 20/100
The nurse is caring for a newborn and knows that his vision, unlike his hearing, is not fully developed. Which aspect of the child's vision would the nurse expect to be similar to his father's vision?
Amblyopia
The nurse is screening a 4-year-old girl for vision problems. What problem could result in loss of vision?
increase hydration quiet activity after surgery avoid getting water in the ear when taking a bath
patient has pressure equalizing tubes. how do you care for it?
Infantile glaucoma
A 1-year-old comes to the clinic for a routine visit. The eye examination reveals an enlarged, edematous, and hazy cornea. The child appears sensitive to light. What should the nurse suspect?
Infants have horizontally placed Eustachian tubes.
A 1-year-old female has been diagnosed with her fourth ear infection since birth. The nurse understands that children are more susceptible to ear infections than adults because of which anatomical difference?
Using a hair dryer on cool to dry the ears.
A 10-year-old client has just been treated for external otitis (acute otitis externa or swimmer's ear) and now the nurse is teaching the boy and his parents about prevention. Which recommendation should the nurse include?
Use analgesics as prescribed.
A 16-year-old child has experienced a small corneal abrasion. What will be included in the plan of treatment?
The child's vision is unaffected. The sclera is red.
A 16-year-old girl is brought to the emergency department after a fight. Her sclera is red. Scleral hemorrhage is suspected. Which findings are in support of this potential diagnosis? Select all that apply.
Most of these conditions will spontaneously resolve.
A 4-month-old infant is seen at the ambulatory care clinic and diagnosed with nasolacrimal duct obstruction. The mother asks what can be done. What information should be included in the information provided to the parent?
relieving the child's pain
A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority?
covering the good eye with a patch using corrective lenses (glasses) administering atropine
A 5-year-old child is diagnosed with amblyopia. What treatment option(s) is helpful? Select all that apply.
The child reports having frequent headaches. The child's mother shares that her child has difficulty reading. When reading a selected passage, the child reports seeing double letters.
A 9-year-old child has been diagnosed with impaired accommodation. When reviewing the child's responses during the assessment, the nurse understands that which finding is consistent with this disorder? Select all that apply.
"Contact lenses may be considered for a child of this age."
A 9-year-old child has been diagnosed with myopia. Corrective lenses have been prescribed. The parents question if the child can have contact lenses. Which response by the nurse is best?
"Now I know why when she is working on puzzles she says her eye is sleepy."
The caregiver of a 2-year-old child tells the nurse, "They told me my daughter has an eye disorder called hyperopia." Which statement made by the mother indicates she has an understanding of this child's current condition?
"tell me more about this drainage."
The mother of a 10-day-old infant reports her baby has been having "lots of eye discharge." What is the best initial response by the nurse?
astigmatism
The mother of a school-age child brings the child to the clinic for evaluation because he is having difficulty reading. His last visual screening was normal. He also reports headaches and dizziness. What would the nurse suspect?
asymmetric corneal light reflex.
After conducting vision screening and examination of a preschooler, the nurse suspects amblyopia based on:
Place the child close to the blackboard.
After performing eye tests, the school nurse notes a child has symptoms of myopia. Which recommendation will the nurse make to the child's teacher?
"We won't know the baby's eye color until he's at least 6 months old."
After teaching a group of new parents about their newborns' eyes and vision, which statement by the group indicates effective teaching?
The shorter and wider eustachian tubes of an infant increase the risk.
After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful?
refractive errors
After teaching a group of students about visual disorders, the instructor determines that the teaching was successful when the students identify what as the most common cause of visual difficulties in children?
The facial bruising should clear up in about 3 weeks.
An adolescent is brought to the ambulatory care clinic after being hit in the eye during a sporting event. There is no serious damage but the adolescent has a "simple contusion" and scleral hemorrhage. What information should be provided?
Administer acetaminophen (Tylenol) to relieve discomfort.
An infant has acute otitis media. Which of the following would be the most important for the nurse to teach the parents?
A preoperative injection of atropine
An infant is born with congenital glaucoma. The infant is scheduled for surgery to relieve this condition at age 2 days. Which prescription should the nurse question for the infant?
absent red reflex
An infant is diagnosed with a congenital cataract. What would the nurse expect to assess?
Touching the child lightly before speaking
The nurse can assist a child who has a mild hearing loss and reads lips to adapt to hospitalization by:
"We will plan on administering acetaminophen (Tylenol) for pain."
The nurse has completed postoperative discharge teaching to the parents of a child who has had a tonsillectomy. The nurse will know the parents understand the teaching if they state:
photophobia
Assessment of a child leads the nurse to suspect viral conjunctivitis based on what finding?
"I will use Visine drops in his infected eye to help reduce redness."
The nurse has finished teaching the mother of a 5-year-old male diagnosed with bacterial conjunctivitis how to manage her son's infection at home. Which statement by the mother would indicate a need for further education?
During this procedure, small tubes are inserted into the tympanic membrane.
In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure?
Lack of depth perception (stereopsis)
In examining the vision of a 9-year-old girl, the nurse notices that she frequently reaches either too far or not far enough when attempting to take an object from the nurse's hand. Which condition does the nurse suspect?
Apply hot, moist compresses to the affected area.
The 12-year-old child has developed a stye. Which may be included in the child's care?
amblyopia is correctable if the child is properly treated before 6 years of age.
When teaching a parent about amblyopia, it would be most important to explain that:
give ibuprofen and Tylenol
a 7 month old has acute otitis media. how do you educate the parents to treat it?
corneal light reflex
patient is cross eyed, what is the first test you would use to test if the patient has strabismus?
viral conjunctivitis
photophobia and tearing in both eyes
reassessing for language acquisition
the nurse is caring for a 2 year old girl with persistent otitis media with effusion. which intervention is most important for the developmental health of the child?
squinting
what do you see if a child has myopia?
The ability to discriminate colors is completed by birth
A group of students are reviewing information about the differences in the hearing and vision capabilities of a child when compared to an adult. The students demonstrate a need for additional study when they identify what as one of the differences?
Staphylococcus aureus
A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause?
moderate loss
A nurse is reviewing the medical record of a child with hearing loss and notes that the child's hearing loss is in the range 40 to 60 decibels (dB). The nurse interprets this as indicating what level of hearing loss?
Goniotomy
An infant is diagnosed with infantile glaucoma. When developing the plan of care for the infant, for what would the nurse expect to prepare the infant and family?
Complete the entire course of antibiotics.
A child has been diagnosed with group A beta-hemolytic streptococcus (GABHS) infection of the throat. The nurse should teach the parents to:
"We should use ice intermittently for the first 24 hours." "When we apply ice to the eye, it should only be for about 20 minutes at a time." "It will likely take about 3 weeks or so for all of that bruising to go away."
A school-age child was admitted to the emergency department following a simple contusion to the eye from playing baseball. The nurse has given discharge instructions to the parents. Which comment(s) by the parents indicate they understood the discharge teaching? Select all that apply.
Stye
A young child in the clinic reports pain and has redness on the lid of the right eye. Upon further examination, the nurse notices swelling in the preauricular lymph node along with tenderness. What should the nurse suspect?
"I will continue to use eye drops until the redness is gone." "Our child can go back to school in 4 hours, after that thick yellow drainage is gone."
A child has been diagnosed with bacterial conjunctivitis. Which statement(s) by the child's parent indicates the need for further education? Select all that apply.
"The tubes remain in place for 6 to 12 months until they come out by themselves."
A child having tympanostomy tubes placed asks, "How and when will the tubes be removed?" What is the nurse's best response?
Encourage the parents to apply ice to the area for 20 minutes at a time for the first 24 hours.
A child is being prepared for discharge after sustaining a simple contusion of the eye. Which advice would the nurse expect to include in the discharge instructions?
"Do you see the ball in the outfield when playing baseball?" "How far away do you have to hold a book to read?" "Do images look blurry when you play video games?"
A child comes to the clinic with a report of having trouble seeing. The nurse inspects the eyes and obtains a history from the child about the vision. Which question(s) will help the nurse determine if the child may have a refractive error? Select all that apply.
The child reports seeing double. The pupils are dilated to 8 cm. There is redness of the sclera and conjunctiva. Nystagmus is noted on eye examination.
A child comes to the clinic with an eye injury. The nurse conducts an assessment of the eye. Which assessment finding(s) would require the nurse to seek a referral for the child to obtain immediate care by an ophthalmologist? Select all that apply.
"Benzocaine drops should be placed in your ear to numb it and reduce pain."
A child diagnosed with acute otitis media has been given a prescription for benzocaine. The nurse is correct when she makes which statement?
Purulent drainage is a common symptom. It is highly contagious. Warm compresses are used to remove crusts that form on the eyes.
A child diagnosed with conjunctivitis is being seen in the pediatric clinic. Which statements are correct regarding conjunctivitis? Select all that apply.
wearing ear plugs when swimming
What would the nurse include when teaching parents how to prevent otitis externa?
Reassessing for language acquisition
The nurse is caring for a 2-year-old girl with persistent otitis media with effusion. Which intervention is most important to the developmental health of the child?
The eustachian tube in the infant is straighter and wider than in the adult.
The nurse is discussing the ears and hearing in a child with a group of peers. Which statement is most accurate related to this topic?
ensuring the protective eye patch is securely in place
The nurse is providing immediate postoperative care for a 3-month-old who had a cataract removed. Which intervention would be the priority?
"A brief hearing loss after the infection is an abnormal development."
The nurse is providing teaching to the parent of a 4-year-old child being treated for otitis media. When discussing the condition, the parent indicates an understanding of the information provided when making which statement?
The parents perform hand hygiene. The parents use the forefinger or little finger to push on top of the bone. The parents use the finger to gently push in and up. The parents gently push downward along the side of the nose.
The nurse is providing teaching to the parents of an infant diagnosed with nasolacrimal duct obstruction. The parents are to massage the nasolacrimal duct daily. The parents correctly demonstrate the procedure by performing massage in what order?
The right eye appears larger than the left
The nurse is reviewing the history and performing a physical assessment on a 6-week-old infant. The nurse notes glaucoma in the health care provider notes. Which physical assessment finding is congruent with the diagnosis?
Recently helped clean the basement
The nurse is taking a health history for a 9-year-old child with conjunctivitis. Which finding would suggest that this is allergic conjunctivitis?
being of African American heritage
The nurse is taking a health history for a 9-year-old girl. Which finding would alert the nurse to a possible risk factor specifically associated with visual impairment?
dehydration
The nurse is taking care of a child who had a tonsillectomy. The nurse should observe the child for which of the following during the postoperative period?
A nursing instructor is teaching about eye disorders in childhood. Which statement made by a student indicates a need for further instruction?
"Cataracts are only present in adults."
"He should wear earplugs when swimming in a pool or a lake."
A child with persistent otitis media with effusion is to undergo insertion of pressure-equalizing tubes via a myringotomy. The child is to be discharged later that day. After teaching the parents about caring for their child after discharge, which statement indicates that the teaching was successful?
"Once the drainage is gone, he can go back to school."
A child is diagnosed with bacterial conjunctivitis and is prescribed topical antibiotic therapy. The child's mother asks when he can return to school. Which response by the nurse would be most appropriate?
Keeping ear canals dry
A child returns to the clinic after an episode of external otitis (acute otitis externa or swimmer's ear) that has resolved. What would the nurse emphasize as the priority for preventing future episodes?
Explaining instructions using simple and specific terms the child understands Allowing the child to explore the postoperative equipment with his hands Using the child's body parts to refer to the area where he may have postoperative pain
A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. What would be most appropriate for the nurse to include in the child's plan of care? Select all that apply.
shouting
A nurse is preparing a presentation for a group of parents who have children with significant visual impairment. Which action would the nurse be least likely to include as an example of a self-stimulatory action?
Proper handwashing can prevent the spread of the common cold.
A nurse who is planning to teach school-age children about the "common cold" should include the information that:
Interference with vision Interference with hearing
A nursing student is doing a clinical rotation on a pediatric floor and is learning about normal growth and development. What can impact normal growth and development? Select all that apply.
"The diagnosis means unwanted fluid is within the middle ear space, and there may or may not be an infection present."
A toddler has been diagnosed with otitis media with effusion. The parents tell the nurse, "We really don't understand what that diagnosis means." How should the nurse respond?
how to administer the ear drops
A toddler is diagnosed with acute otitis media and prescribed antipyretics and numbing ear drops. Which instruction is most important to teach the parents about treatment?
Conjunctivitis
A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client?
"We will need to change the batteries daily for optimal performance of the hearing aid." "We will need to clean the hearing aids once a week."
The nurse is assisting the parents of a school-age child with new hearing aids. Which comments by the parents indicate the need for clarification by the nurse? Select all that apply.
atopic dermatitis
The nurse is caring for a 10-year-old with allergic conjunctivitis. The nurse would be alert to the child's increased risk for what issue?
Identify oneself to let the child know the nurse is there before touching the child. Allow the child additional time to think about a response to a question. Explain what individuals are doing.
The nurse has recently admitted a child with visual impairment to the pediatric unit. Which intervention(s) should the nurse implement? Select all that apply.
Encourage the children to drink generous amounts of fluids. Restrict the children to quiet activities after surgery. Avoid getting water in their ears during bath time.
The nurse has taught a group of parents how to care for their children who have just had tympanostomy tubes inserted. The nurse will know the parents understand how to care for their child's tympanostomy tubes if they: (Select all that apply.)
"Cold packs will be most helpful in treating this infection." "I'm glad this is not contagious. Otherwise, I would be worried that my child's other eye might get infected."
The nurse in the clinic is providing discharge instructions to the parent of a toddler with conjunctivitis. Which comments by the parents require further instruction? Select all that apply.
"I will need to apply heat to the eye four times a day."
The nurse in the emergency department is caring for a child who has a simple contusion of the right eye following a motor vehicle accident. Upon discharge to home, which response by the parents requires further clarification?
Pharyngitis caused by group A beta-hemolytic streptococcus
The nurse is admitting a patient to the adolescent unit. During the history and physical, the nurse records the following symptoms: abrupt onset, tonsillar exudate, painful cervical lymphadenopathy, anorexia, nausea, vomiting, abdominal pain, severe sore throat, headache, malaise, fever, and petechial mottling of soft palate. The nurse suspects the patient has which of the following?
scleral hemorrhage.
The nurse is assessing a 13-year-old boy with an eye injury. The nurse determines that evaluating pupillary response to light and accommodation is not appropriate based on the suspicion of a:
The infant does not imitate facial expressions.
The nurse is assessing a 5-month-old infant. What would cause the nurse to be concerned about a possible visual impairment?
administering antibiotics as soon as they're available
The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39°C (102.2°F). Which intervention would the nurse expect to implement?
Assessing the child for asymmetric corneal light reflex.
The nurse is caring for a 24-month-old boy with regressed retinopathy of prematurity. Which intervention is priority for this child?
Teaching the parents how to gently massage the duct
The nurse is caring for a 3-month-old with nasolacrimal duct obstruction. Which intervention would be most appropriate for the nurse to implement?
promoting eye safety
The nurse is caring for a 3-year-old boy with amblyopia. Which intervention would be most appropriate to include in the child's plan of care?
Shaking the head and pulling the ear
The nurse is caring for a 6-month-old infant diagnosed with otitis media. Which clinical manifestation would likely have been noted in this child?
use his name before touching him
The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child?
Educating parents on how to use prescribed atropine drops.
The nurse is caring for a 7-year-old child in an outpatient clinic. The child is diagnosed with amblyopia that is unrelated to other disorders. Which intervention should be most helpful at this time?
Have the ear rechecked every 4 weeks.
The nurse is caring for a child diagnosed with otitis media with effusion (OME). Which information is most important for the nurse to teach the parents?
"I know it is difficult but it's not unusual for children with genetic disorders to have ear structure problems. This will help prevent future ear infections."
The nurse is caring for a male toddler with the genetic disorder of muscular dystrophy. The child has had numerous ear infections and is scheduled for pressure-equalizing (PE) tubes surgery. The parents state, "As if our child's muscular dystrophy isn't enough, now he has to endure ear surgery." What is the best response by the nurse?
"Hearing loss after the tubes are placed may be permanent."
The nurse is caring for a toddler who is scheduled to have myringotomy tubes placed. Which statement by the child's parents indicates a lack of understanding?
The eustachian tube is shorter, wider, and horizontal in younger children.
The nurse is caring for a young child with otitis media. The parent asks the nurse what causes otitis media. Which of the following is the best response by the nurse?
28-weeks'-gestation infant who has been on long-term oxygen and weighed 1,400 grams.
The nurse is caring for four clients. The client with the greatest risk of developing retinopathy of prematurity is the:
Immature emotional behavior
The nurse is developing a plan of care for a 5-year-old child with a severe hearing impairment focusing on psychosocial interventions based on assessment findings. Which behavior would the nurse have most likely assessed?
"Give him a prize when he wears the patch."
The nurse is educating the parents of a 4-year-old boy who has been diagnosed with amblyopia ("lazy eye"). Which comment provides information most helpful for the parents to know?
prevention and treatment of otitis media
The nurse is educating the parents of a 6-year-old child about preventing hearing loss. Which topic will be included in the discussion?
instruct the parents to watch for worsening symptoms
The nurse is examining a 3-year-old boy with acute otitis media who has a mild earache and a temperature of 38.5°C. Which action will be taken?
pain
The nurse is examining a 7-year-old boy with blepharitis. What would the nurse least likely expect to assess?
corneal light reflex test
The nurse is explaining information to the parents of a 3-year-old boy who may have strabismus. The nurse should explain that which examinations will be performed first to find out if he has strabismus?
"Clean the glasses every day with a mild soap and water or commercial cleaning agent."
The nurse is instructing a 7-year-old child and his parents about using his prescribed corrective lenses. What would the nurse include in these instructions?
chalazion
The nurse is instructing the parents of a school-age child with an eye disorder how to care for her eye. Which condition would the nurse explain as resolving by itself without the use of antibiotics?
The child is not making any babbling sounds and the parent reports the child never does. The nurse dropped a metal tray in the room and the infant did not react. The parent reports that the infant does not wake up when the siblings are being loud during nap time. The infant does not turn the head when the nurse stands next to the infant and calls their name.
The nurse is performing the intake assessment of a 6-month-old in the pediatrician's office. The nurse alerts the physician that the child is showing signs of hearing loss based on what assessment findings? Select all that apply.
Otitis media occurs more in the winter months. Otitis media is most common in male children.
The nurse is planning an education program on ear infections in children. What information should be included? Select all that apply.
Assess the child's ability to convey information.
The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?
"A child's vision is not completely developed by this age. Your child might outgrow this nearsightedness."
The nurse is talking with the mother of a 4-year-old boy who will soon be going to a pre-kindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which statement made by the nurse would be most appropriate regarding the child's vision?
astigmatism
The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is:
Bacteria entering through the eustachian tube
The nurse is teaching parents of a 6-year-old child about otitis media (OM). What predisposes the child to OM infections?
encouraging the use of eye protection for sports
The nurse is teaching parents of a 9-year-old girl about the importance of wearing the prescribed glasses. Which subject is least important to promoting compliance?
encouraging the child to keep his hands away from his eyes
The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement?
learning to use facial expressions
The nurse is teaching the parents of a visually impaired infant about development for their child. What education would the nurse add to the standard education on development milestones?
A cover/uncover test.
The nurse suspects that an infant has a visual disorder caused by abnormal musculature. To detect this disorder, the nurse would perform:
8-year-old child who is crying due to ear pain and has a temperature of 103 F (39.4 C) 2-month-old child who is having difficulty sleeping and has a fever of 102.6 F (39.2 C) 5-month-old child who is fussy and pulling at her ears 22-month-old child who is irritable with the presence of purulent drainage from her right ear
The nurse works in a pediatrician office. Which children, who have been diagnosed with acute otitis media, does the nurse expect the physician to treat with antibiotics? Select all that apply.
Teach the parent that cleaning the ears with the swab may scratch the ear canal. Advise the parent that swabs can force the ear wax further down into the ear canal.
The parent of a 7-year-old child reports having difficulty cleaning the child's ears with a cotton swab. What information should be provided to the parent? Select all that apply.
"The tubes are inserted into a section of eardrum in which the hearing is not affected."
The parent of a child having tympanoplasty tubes placed asks, "Will my child lose hearing while the tubes are in place?" What is the nurse's best answer?
"I can understand why you think it is a stye, but a stye does not typically cause redness in the eye."
The parent of a preschool-age child tell the nurse, "The pink part of the sac of my child's lower eye has been very red for the past couple of days. I bet it is caused by a stye." How should the nurse respond?
"laser surgery typically isn't done until she's 18 years old."
The parents of a 10-year-old girl with a refractive error ask the nurse about the possibility of laser surgery to correct the vision. Which statement by the nurse would be most appropriate?
"20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns."
The parents of a 4-year-old boy tell the nurse, "We're really worried that our child doesn't have 20/20 vision. It seems that he doesn't always see clearly at a distance." What is the best response by the nurse?
purplish discoloration of eyelid
The parents of a 5-year-old bring their son to the emergency department because of significant eyelid edema. The mother states, "He scratched himself near his eye a couple of days ago while playing outside in the yard." The nurse suspects periorbital cellulitis based on which finding?
"Those behaviors are called blindisms and may indicate your child is trying to communicate with you."
The parents of a blind child are reporting to the nurse that they have noticed their child rocking and bouncing repetitively. The nurse can best explain those behaviors by stating:
"Avoid exposure to cigarette smoke in the car or home." "Discourage the use of earphones being inserted into the ear." "Encourage the child to use earplugs when swimming." "Use diluted rubbing alcohol to dry the ear after swimming."
The parents of a preschool-aged child ask the nurse what can be done to prevent ear infections. What response(s) by the nurse is correct? Select all that apply.
"I can't imagine how difficult this must be. When you're ready I would be happy to arrange a meeting with a support group of other parents with children who have hearing loss."
The parents of a toddler have just learned that their child has profound hearing loss. The parents are very upset and state to the nurse, "It just isn't fair. We did everything right during our pregnancy all the way to this point." How should the nurse respond?
"What you are describing may be what is called myopia."
The parents of an 8-year-old child report that the child's teachers noted the child is having problems seeing the board in school but state they do not understand this since the child is able to read from the computer with no difficulty. Which response from the nurse is most appropriate?
Only the right eye is involved. The drainage is yellow and thick.
The pediatric office nurse notes that several of the young children that are waiting to see the physician may have conjunctivitis. Which findings are consistent with bacterial conjunctivitis? Select all that apply.
Student placement in the room is important but all other teaching methods may remain the same.
The school nurse is instructing the classroom teacher regarding a student newly diagnosed with amblyopia. To prepare for classroom instruction, which concept is most important for the nurse to convey to the teacher?
Low birth weight and early gestation age are risk factors. Oxygen therapy may play an important role in the development of retinopathy of prematurity. Sepsis is a risk factor.
The student nurse is preparing a presentation on retinopathy of prematurity. What information should the nurse include? Select all that apply.
myopia
The vision impairment in which the child can see objects at close range but not at a distance is known as:
Ensuring that the child's environment is familiar and secure Encouraging activities to stimulate development Using touch and tone of voice to demonstrate affection
When developing the plan of care for a child with a visual impairment, what would the nurse include? Select all that apply.
wash hands frequently
the nurse is educating parents of a 5-year-old girl with infectious conjunctivitis about this disorder. which information is most important to provide to prevent the spread of this disorder?
cover/uncover test
what is the screening for strabismus?
steroid drops keep eyes dry; prevent water contact for 5 days pain reducers (Tylenol, Advil) antibiotics/antifungals warm compress or heating pad use alcohol and vinegar mixed
what is the treatment for otitis externa
corneal abrasion
which eye injury would you prescribe antibiotic ointment to?
ishihara
which screen is used to test for color discoloration/color blindness?
bacterial conjunctivitis
yellow exudate with crust in one eye
