Chapter 40: Respiratory Dysfunction peds q

Asthma in infants is usually triggered by:

A viral infection Viral illnesses cause inflammation that causes increased airway reactivity in asthma.

A child is diagnosed with influenza, probably type A disease. Management includes:

Amantadine hydrochloride to reduce symptoms

Decongestant nose drops are recommended for a 10-month infant with an upper respiratory tract infection. Instructions for nose drops should include

Avoiding use for more than 3 days. to avoid rebound congestion

Skin testing for tuberculosis (the Mantoux test) is recommended:

Periodically for children who reside in high-prevalence regions.

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend:

Swimming.

Which intervention for treating croup at home should be taught to parents?

Take the child outside.Taking the child into the cool, humid, night air may relieve mucosal swelling and improve symptoms

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?

Before chest physiotherapy (CPT). Bronchodilators should be given before CPT to open bronchi and make expectoration easier

Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible?

Carotid

Which statement is characteristic of acute otitis media (AOM)?

It is treated with a broad range of antibiotics.

A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma?

There is heightened airway reactivity.

Cystic fibrosis is suspected in a toddler. Which test is essential in establishing this diagnosis?

A sweat chloride test result greater than 60 mEq/L is diagnostic of CF

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests:

Asthma.

An infant's parents ask the nurse about preventing otitis media (OM). What should the nurse recommend?

Avoid tobacco smoke.

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following?

Cluster care to conserve energy Administration of antibiotics

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?

Complete obstruction If a child has acute epiglottitis, examination of the throat may cause complete obstruction and should be performed only when immediate intubation can take place.

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup?

It is marked by a harsh, metallic, barky cough; sore throat; inspiratory stridor; and hoarseness.

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug:

May cause voice alterations.

The earliest recognizable clinical manifestation of cystic fibrosis (CF) is:

Meconium ileus.

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop:

Slowed growth.

Which vitamin supplements are necessary for children with cystic fibrosis?

Vitamins A, D, E, and K Fat-soluble vitamins are poorly absorbed because of deficient pancreatic enzymes in children with cystic fibrosis; therefore, supplements are necessary

Amantadine hydrochloride may reduce symptoms related to influenza type A if

administered within 24 to 48 hours of onset

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this child's care?

Monitor arterial blood gases.

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:

Monitor pulse oximetry.

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system?

Mucus and edema obstruct small airways. The airway in infants and young children is narrower, not wider, and respiratory distress can occur quickly because mucus and edema can cause obstruction to their small airways.

An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole (Bactrim) is prescribed. Which statement made by the parent indicates a correct understanding of the instructions?

"I should administer all the prescribed medication."

Parents have understood teaching about prevention of childhood otitis media if they make which statement?

"We will be sure to keep immunizations up to date."

Abdominal thrusts (the Heimlich maneuver) are recommended for airway obstruction in children older than:

1 year.

nurse is interpreting the results of a tuberculin skin test on an adolescent who is HIV positive. Which induration size indicates a positive result for this child 48 to 72 hours after the test?

5 mm who travel to high-prevalence TB regions of the world are positive when the induration is 10 mm Children 4 years of age or older without any risk factors are positive when the induration is 20 mm.

Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by:

A feeling of fullness in the ear.

It is generally recommended that a child with acute streptococcal pharyngitis can return to school:

After taking antibiotics for 24 hours

A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of:

Bronchitis.

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?

Diet should be high in carbohydrates and protein. Children with CF require a well-balanced, high-protein, high-calorie diet because of impaired intestinal absorption.

B-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action?

Dilate the bronchioles

A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?

Dyspnea

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care

Encourage infant to drink 8 ounces of formula every 4 hours. Institute cluster care to encourage adequate rest. Place on noninvasive oxygen monitoring.

An appropriate nursing intervention when caring for a child with pneumonia is to:

Encourage rest.Lying on the affected side may promote comfort by splinting the chest and reducing pleural rubbing.

Which type of croup is always considered a medical emergency?

Epiglottitis is always a medical emergency needing antibiotics and airway support for treatment

Which information should the nurse teach workers at a day care center about respiratory syncytial virus (RSV)?

Frequent hand washing can decrease the spread of the virus. It is acquired mainly through contact with contaminated surfaces. RSV can live on skin or paper for up to 1 hour and on cribs and other nonporous surfaces for up to 6 hours.

When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to:

Give small amounts of favorite fluids frequently to prevent dehydration.

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)?

If it is present in a child, both parents are carriers of this defective gene.

The parent of an infant with nasopharyngitis should be instructed to notify the health care professional if the infant:

Shows signs of an earache.

A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition?

Sinusitis

Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing should include:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

Which statement best describes why children have fewer respiratory tract infections as they grow older?

Repeated exposure to organisms causes increased immunity.

Which information should the nurse teach families about reducing exposure to pollens and dust

Replace wall-to-wall carpeting with wood and tile floors. Use an air conditioner. Put dust-proof covers on pillows and mattresses.

The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that

lifesaving measures are necessary based on: Inability to speak.

Which consideration is the most important in managing tuberculosis (TB) in children?

pharmacotherapy Drug therapy for TB includes isoniazid, rifampin, and pyrazinamide daily for 2 months and 2 or 3 times a week for the remaining 4 months

nurse encourages mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible.rationale for this action is

primarily mother's presence reduce anxiety ease the child's respiratory efforts.