Chapter 35- Key Pediatric Nursing Interventions
The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? A) Rectus femoris B) Vastus lateralis C) Dorsogluteal muscle D) Deltoid
B) Vastus lateralis
The nurse is providing care for a 10-year-old girl who has required multiple venipunctures and a computed tomography (CT) scan in a single day. The girl has expressed no fear or need for comfort. How should the nurse respond? A) "Tell me about your day today." B) "Are you doing okay?" C) "Are you feeling okay?" D) "You have done really well today."
A) "Tell me about your day today."
The nurse is choosing a vein to insert a peripheral IV for a 2-year-old child. Which of the following sites would be appropriate? Select all answers that apply. A) Hand veins B) Feet veins C) Jugular vein D) Forearm veins E) Scalp veins F) Vena cava
A) Hand veins B) Feet veins D) Forearm veins E) Scalp veins
The nurse is teaching the student nurse the factors that affect the pharmacodynamics of the drugs they are administering. Which of the following is a factor affecting this property of drugs? A) Immature body systems B) Weight C) Body surface D) Body composition
A) Immature body systems
The nurse is caring for a 6-year-old child who has multisystem trauma due to a motor vehicle accident. The child is receiving total parenteral nutrition (TPN). Which of the following is a recommended nursing intervention for children on TPN? A) Initially, check blood glucose levels frequently, such as every 4 to 6 hours, to evaluate for hyperglycemia. B) Be vigilant in monitoring the infusion rate, change the rate as necessary, and report any changes to the physician or nurse practitioner. C) If for any reason the TPN infusion is interrupted or stops, begin an infusion of a 10% saline at the same infusion rate as the TPN. D) Administer TPN continuously over an 8-hour period, or after initiation it may be given on a cyclic basis, such as over a 12-hour period during the night.
A) Initially, check blood glucose levels frequently, such as every 4 to 6 hours, to evaluate for hyperglycemia.
The nurse is administering a crushed tablet to an 18-month-old infant. Which of the following is a recommended guideline for this intervention? A) Mix the crushed tablet with a small amount of applesauce. B) Place the crushed tablet in the infant's formula. C) Mix the crushed tablet with the infant's cereal. D) Crushed tablets should only be mixed with water.
A) Mix the crushed tablet with a small amount of applesauce.
The nurse is preparing to administer insulin to a diabetic child. Which of the following would be the recommended route for this administration? A) Subcutaneous B) Intradermal C) Intramuscular D) Oral
A) Subcutaneous
The nurse is preparing to administer medication to a child with a gastrostomy tube in place. Which of the following is a recommended guideline for this procedure? Select all answers that apply. A) Verify proper tube placement prior to instilling medication. B) Mix liquid medications with a small amount of water and add directly into the tube. C) Mix powdered medications well with cold water first. D) Crush tablets and mix with warm water to prevent tube occlusion. E) Open up capsules and mix the contents with warm water. F) Flush the tube with water after administering medications.
A) Verify proper tube placement prior to instilling medication. D) Crush tablets and mix with warm water to prevent tube occlusion. E) Open up capsules and mix the contents with warm water. F) Flush the tube with water after administering medications.
The nurse is preparing to administer a medication to a 5-year-old who weighs 35 pounds. The prescribed single dose is 1 to 2 mg/kg/day. Which of the following is the appropriate dose range for this child? A) 8 to 16 mg B) 16 to 32 mg C) 35 to 70 mg D) 70 to 140 mg
B) 16 to 32 mg
The nurse is caring for children who are receiving IV therapy in the hospital setting. For which of the following children would a central venous device be indicated? A) A child who is receiving an IV push B) A child who is receiving chemotherapy for leukemia C) A child who is receiving IV fluids for dehydration D) A child who is receiving a one-time dose of a medication
B) A child who is receiving chemotherapy for leukemia
The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a tube. The nurse is reviewing interventions to promote growth and development. Which of the following responses from the mother indicates a need for further teaching? A) "I will give him a pacifier during feeding time." B) "We need to keep feeding time very quiet." C) "We need to make sure he doesn't lose the desire to eat by mouth." D) "Sucking produces saliva, which aids in digestion."
B) "We need to keep feeding time very quiet."
The nurse is caring for an 8-year-old girl who requires medication that is only available in an enteric tablet form. The nurse is teaching the mother how to help the girl swallow the medication. Which of the following statements indicates a need for further teaching? A) "I can encourage her to place it on the back of her tongue." B) "I can pinch her nose to make it easier to swallow." C) "We cannot crush this type of pill as it will affect the delivery of the medication." D) "We can place the tablet in a spoonful of applesauce."
B) "I can pinch her nose to make it easier to swallow."
The nurse is providing teaching on how to administer nasal drops. Which of the following responses by the parents indicates a need for further teaching? A) "We need to be careful not to stimulate a sneeze." B) "She needs to remain still for at least 10 minutes after administration." C) "Our daughter should lie on her back with her head hyperextended." D) "We must not let the dropper make contact with the nasal membranes."
B) "She needs to remain still for at least 10 minutes after administration."
The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The safe dose for children is 50 to 100 mg/kg/day divided in doses administered every 6 hours. What would be the low single safe dose and high single safe dose per day for this child? A) 50 to 100 mg per dose B) 100 to 500 mg per dose C) 500 to 1,000 mg per dose D) 1,000 to 5,000 mg per dose
C) 500 to 1,000 mg per dose
A nurse has just administered medication via an orogastric tube. What is the priority nursing action following administration? A) Check tube placement. B) Retape the tube. C) Flush the tube. D) Remove the tube.
C) Flush the tube.
The nurse is administering immunizations to children in a neighborhood clinic. Which of the following is the most frequent route of administration? A) Oral B) Intradermal C) Intramuscular D) Topical
C) Intramuscular
The nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). Which of the following accurately describes the use of TPN? A) It is used short term to supply additional calories and nutrients as needed. B) It is delivered via the peripheral vein to allow rapid dilution of hypertonic solution. C) It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals. D) It is usually used when the child's nutritional status is within acceptable parameters.
C) It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals.
The nurse is administering Tylenol PRN to a 9-year-old child on the pediatric ward of the hospital. Which of the following reflect nursing actions that follow the rules of the "eight rights" of pediatric medication administration? Select all answers that apply. A) The nurse identifies the child by checking the name on the child's chart. B) The nurse makes sure the medication is given within the hour of the ordered time. C) The nurse checks the documented time of the last dosage administered. D) The nurse calculates the dosage according to the child's weight. E) The nurse explains the therapeutic effects of the medication to the child and parents. F) The nurse administers the medication even though the child is adamant about not taking it.
C) The nurse checks the documented time of the last dosage administered. D) The nurse calculates the dosage according to the child's weight. E) The nurse explains the therapeutic effects of the medication to the child and parents.
After administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason? A) To promote dispersion over the cornea B) To enhance systemic absorption C) To ensure the medication stays in the eye D) To stabilize the eyelid
C) To ensure the medication stays in the eye
When describing the differences affecting the pharmacokinetics of drugs administered to children, which of the following would the nurse include? A) Oral drugs are absorbed more quickly in children than adults. B) Absorption of intramuscularly administered drugs is fairly constant. C) Topical drugs are absorbed more quickly in young children than adults. D) Absorption of drugs administered by subcutaneous injection is increased.
C) Topical drugs are absorbed more quickly in young children than adults.
The nurse is supporting an 8-year-old child who is having blood specimens drawn. Which method would be least appropriate to use for distraction? A) "Squeeze my hand as tight as you can." B) "Look at how many dots there are on the ceiling." C) "Count with me slowly from 1 to 20." D) "It's okay to scream if it hurts."
D) "It's okay to scream if it hurts."
The nurse is preparing a 5-year-old for a radiograph. Which of the following would be the best communication to prepare the child for the procedure? A) "We are going to take some x-rays of your body." B) "We need to look inside at some of your organs." C) "X-rays are not painful; you won't feel a thing." D) "We are going to use a big camera to take pictures inside your body."
D) "We are going to use a big camera to take pictures inside your body."
The nurse is determining the amount of IV fluids to administer in a 24-hour period to a child who weighs 40 kg. How many milliliters should the nurse administer? A) 1,000 mL B) 1,500 mL C) 1,750 mL D) 1,900 mL
D) 1,900 mL
The nurse is administering a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate? A) Direct the liquid toward the anterior side of the mouth. B) Keep the child's hand away from the oral syringe when squirting the medication. C) Give all of the drug in the syringe at one time with one squirt. D) Allow the child time to swallow the medication in between amounts.
D) Allow the child time to swallow the medication in between amounts.
A nurse is caring for a 14-year-old with a gastrostomy tube. The girl has skin breakdown and irritation at the insertion site. Which of the following would be the most appropriate method to clean and secure the gastrostomy tube? A) Make sure the tube cannot be moved in and out of the child's stomach. B) Use adhesive tape to tape the tube in place and prevent movement. C) Place a transparent dressing over the site whether there is drainage or not. D) If any drainage is present, use a presplit 2 × 2 and place it loosely around the site.
D) If any drainage is present, use a presplit 2 × 2 and place it loosely around the site.
The nurse is preparing to administer ear drops to a 6-year-old. To ensure that the medication is instilled properly, the nurse does which of the following? A) Pulls the pinna downward B) Pulls the pinna downward and back C) Pulls the pinna upward D) Pulls the pinna upward and back
D) Pulls the pinna upward and back
The nurse is helping a 14-year old boy who has asthma to administer medication via an inhaler. Which of the following describes a developmentally appropriate nursing intervention for this child? A) Involve the adolescent's parents in the administration of the medication. B) Allow the adolescent to handle a demo inhaler prior to administering the medication. C) Offer the adolescent a special treat if he uses his inhaler correctly. D) Treat the adolescent as an adult when explaining the use of the inhaler.
D) Treat the adolescent as an adult when explaining the use of the inhaler.
The nurse is caring for a child who is receiving total parenteral nutrition (TPN) for failure to thrive. Which of the following nursing actions might the nurse take to prevent complications from this therapy? A) Adhere to clean technique when caring for the catheter and administering TPN. B) Ensure that the system remains an open system at all times. C) Secure all connections and open the catheter during tubing and cap changes. D) Use occlusive dressings and chlorhexidine-impregnated sponge (Biopatch) dressings.
D) Use occlusive dressings and chlorhexidine-impregnated sponge (Biopatch) dressings.
