neuro prepu
The nurse is reviewing discharge planning instructions with the parents of a child who had a ventriculoperitoneal (VP) shunt placed. Which statement by the parents requires further follow-up by the nurse?
"Our child may have occasional lethargy."
A toddler is prescribed amoxicillin for bilateral otitis media. The parent reports that the toddler refuses to take the oral medication. The nurse knows that more education is needed when the parent makes which statement?
"I will shake the medication well, and draw up the medication to the top of the syringe. My spouse and I will hold our toddler down and force the medication down his throat."
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?
"I will use Visine drops in his infected eye to help reduce redness."
The nurse is caring for an infant who is at risk for increased intracranial pressure. What statement by the parent would alert the nurse to further assess the child's neurological status?
"She has been irritable for the last hour....seems like she is just upset for some reason."
The nurse receives a call from the parent of a 4-month-old infant who underwent endoscopic surgery for craniosynostosis 2 months earlier. The parent reports that the infant's skin appears red on the both temples. How should the nurse respond?
"Your infant should be evaluated in person, because a new helmet may be needed."
A 3-month-old infant is diagnosed with mild craniosynostosis. When teaching the parents about treatment, which information would the nurse likely include?
"Your infant will need to wear a helmet after the defect is corrected for most hours of the day."
The nurse is caring for a 4-year-old client presenting to the emergency department with suspected meningitis. What will the nurse include in the plan of care? Select all that apply.
-Assess the client using the pediatric Glasgow Coma scale (GCS). -Provide fever management. -Administer IV antibiotics as -prescribed. -Institute seizure precautions.
The nurse is preparing a presentation for a group of parents at a local elementary school about seizures. Which information would the nurse likely include when describing this topic?
-Generalized seizures involve a loss of consciousness -Focal seizures may or may not involve a type of movement -Seizures are classified by the area of the brain affected
The nurse is caring for a hospitalized infant at risk for developing increased intracranial pressure. Which assessment finding(s) would the nurse communicate to the health care provider for further intervention? Select all that apply.
-Increased head circumference -Pulse rate of 60 beats/min and -Regular -Vomiting -Parent states, "My infant does not act right."
The nurse is caring for a toddler who was just diagnosed with a hearing impairment. What would the nurse expect to assess in the child?
A delay or lack of clear, understandable speech pattern
A 4-year-old child is brought to the emergency department after being in a motor vehicle accident. The child experienced head trauma in the accident. When assessing the child, which will be the first change noted in the presence of increasing intercranial pressure?
Change in level of consciousness
The nurse is assessing a child with a suspected traumatic brain injury. The child is disoriented to place and time, but not person, and is having difficulty following commands. The nurse would use which terminology to document the child's level of consciousness?
Confusion
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?
Conjunctivitis
The nurse is providing care to an infant with microcephaly. When reviewing the prenatal and birth history, the nurse would identify the mother's exposure to which infection as a potential contributing factor?
Cytomegalovirus
The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highest priority?
Risk for injury
The nurse is performing a neurologic assessment on a 7-month-old infant. Which task should the nurse perform last?
Elicit the gag reflex
A nurse is administering ear drops to a 7-year-old girl. What should the nurse do?
Pull the pinna of the ear up and back to straighten the external ear canal
The nurse is performing discharge teaching with the parents of a 3-month-old infant with deformational plagiocephaly (DP). Which statement by the parents requires further follow-up by the nurse?
"We do not have a bassinet, so we will use a car seat."
The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?
"I hate to think that I will need to be worried about my child having seizures for the rest of his life."
The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond?
"I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection."
A 1-year-old has just undergone surgery to correct craniosynostosis. When talking with the parents, which of the following would be most appropriate?
"Now that the surgery was successful, do you have any questions?"
A child presents to the pediatrician's office for a routine visit. The parent tells the nurse that the child has been having frequent headaches recently. Which statement by the parent requires immediate follow-up by the nurse?
"The headaches usually occur in the morning and sometimes there is vomiting."
A nurse is providing discharge teaching to the parents of a child hospitalized with hydrocephalus, who had a ventriculoperitoneal (VP) shunt placed. The nurse should intervene if the parents make which statement?
"We expect our child to continue engaging in normal activities, including sports."
An infant is diagnosed with nasolacrimal duct obstruction. The nurse is instructing the parents on how to perform lacrimal massage. The nurse determines the need for additional teaching based on which statement by the parents?
"We will press on the outer corner of the eye for several seconds."
A 6-year-old child is brought to the urgent care clinic. After interviewing the parents and assessing the child, the nurse suspects viral conjunctivitis. After explaining the treatment plan, the parents ask the nurse, "When can our child go back to school?" Which response by the nurse would be appropriate?
"You will need to wait until the eye is completely clear."
The nurse is teaching a group of parents in the community about accident prevention. When describing accidental head trauma resulting in traumatic brain injury (TBI), the nurse would focus safety education on which age group(s)?
-Toddlers -Adolescents
During physical assessment of a 2-year-old child, the nurse suspects that the child may have a cataract in one eye based on assessment of which of the following?
Absence of the red reflex
The eyes of a 9-year-old who suffered a head injury are crossed. In addition to checking intracranial pressure (ICP), which of the following would the nurse most likely do?
Assess the child's level of consciousness
Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis?
Avoid making noise when in the child's room
The nurse is assessing a 9-year-old child who is suspected of having meningitis. The nurse assesses the child for meningeal irritation using the Kernig sign. Which result would the nurse interpret as positive?
Child reports pain behind the knee when leg is extended
A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?
Decrease environmental stimulation
A parent of a 2-year-old toddler is concerned that the toddler has a hearing deficit because the toddler does not interact with others. After further testing, a diagnosis of hearing loss is confirmed. Which nursing instruction will be beneficial?
Enroll the toddler in early preschool education with others of the same age
A child is brought to the emergency department and is experiencing status epilepticus. The nurse would expect to administer which treatment as first-line therapy?
Lorazepam
The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure?
Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention
The nurse is performing a neurological assessment on a child. The previous examination noted the child to be alert but answering questions inappropriately. In this exam, the child only responds to vigorous stimuli. Which action should the nurse take first?
Notify the health care provider
A nurse suspects that a child has developed pneumococcal meningitis based on assessment of which of the following?
Nuchal rigidity
Which of the following would a nurse assess in a child with pneumococcal meningitis?
Nuchal rigidity
A nurse has received the above hand-off report for a client hospitalized with blunt head trauma following a motor vehicle accident. What is the nurse's priority in providing care for the client?
Observe for behavioral changes.
A nurse is providing care to a child with strabismus. The nurse understands that the most common treatment for this condition would be which of the following?
Occlusion therapy
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?
Place ice on the eye for 20 minutes/off the eye for 20 minutes for 24 hours
A nurse is preparing a presentation on neurologic development in children. What information should the nurse include in the presentation?
Poverty and caregiver mental illness are shown to contribute to developmental delays in children
To give eardrops to a 4-year-old child, what would be the best technique to use?
Pull the pinna of the ear up and back
The nurse is planning care for a preschool-age child diagnosed with bacterial meningitis. What should the nurse identify as a priority goal for this client's care?
Reduce the pain related to nuchal rigidity
A child with poor eye alignment cannot establish single binocular vision but has double vision. Which nursing action is most appropriate for this client?
Refer the child to a pediatric ophthalmologist
A child has been diagnosed with strabismus. After further examination, the client is told that the resting position of the right eye is convergent. The nurse further explains that this means which of the following?
The resting position of the eye is turned in
The nurse is caring for a 10-year-old child with bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick, yellow discharge. What should the nurse teach the parents about the care of the eye?
Wipe the drainage away from the inner to the outer canthus of the eye
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?
"Tell me more about this drainage."
A nurse on the neurology unit is monitoring an 8-year-old child admitted with seizures. The child experiences a prolonged tonic-clonic seizure. The nurse should first ___ followed by ___
-Ensure proper oxygenation -Administer IV or I'M benzodiazepine
A nurse is caring for a 1-year-old child with a head injury. The child was previously unconscious but is now alert and oriented. Oral feedings are prescribed. The nurse determines that the child's risk for aspiration is low based on the presence of which reflex(es)?
-Gag -Cough -Swallow
A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included?
-Oxygen gauge and tubing -Suction at bedside -Padding for side rails
The nurse is preparing to administer a prescribed medication to a 5-year-old child with a neurologic disorder. The medication has not been tested in children. Which action(s) will the nurse take?
-Teach the child's parents how to use an oral syringe -Question why the medication is prescribed -Administer the medication after referencing a drug guide
