NSG 242 Chapter 33: Caring for Children in Diverse Settings

The nurse is providing care for a hospitalized child who is scheduled to receive morning medications. Place the statements in order that the nurse will state them, beginning with what the nurse will say first during the medication administration. Use all options. "You are doing great today. Would you like to play a game now?" "Hello, I am going to be your nurse for today." "Would you like your medicine before or after your mom helps you take a bath?" "It is time for you to take your morning medications."

"Hello, I am going to be your nurse for today." "It is time for you to take your morning medications." "Would you like your medicine before or after your mom helps you take a bath?" "You are doing great today. Would you like to play a game now?"

The nurse is educating the parents of a 7-year-old boy scheduled for surgery to help prepare the child for hospitalization. Which statement by the parents indicates a need for further teaching? "We should talk about going to the hospital and what it will be like coming home." "We should visit the hospital and go through the preadmission tour in advance." "It is best to wait and let him bring up the surgery or any questions he has." "It is a good idea to read stories about experiences with hospitals or surgery."

"It is best to wait and let him bring up the surgery or any questions he has."

The nurse is documenting the child's intake. The child ate 4 cups of ice during this shift. How many cups of fluid did the child ingest? 4 cups of fluid 1 cup of fluid ½ cup of fluid 2 cups of fluid

2 cups of fluid

Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission? Discourage questions so as to not frighten the child. Tell the child that the procedure will not hurt because we have "magic medicine." Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening. Since the family is Hispanic, all preparation needs to be in Spanish.

Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening.

The nurse has applied a restraint to the child's right wrist to prevent the child from pulling out an intravenous line. Which assessment findings ensure that there is proper circulation to the child's right arm? Select all that apply. Capillary refill is less than 2 seconds in upper extremities bilaterally. Fingers are pink and warm bilaterally. Lungs are clear throughout. Radial pulses are easily palpable bilaterally. Bowel sounds are present in all four quadrants.

Capillary refill is less than 2 seconds in upper extremities bilaterally. Fingers are pink and warm bilaterally. Radial pulses are easily palpable bilaterally.

The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client? Determine how much the child knows and is capable of understanding. Teach technical terminology to the caregivers so they will understand what is being said postoperatively. Keep the child away from any food or drinks to ensure the child is NPO. Explain how the therapeutic plan can be used in preparing the child for surgery.

Determine how much the child knows and is capable of understanding.

The parents of an adolescent recently diagnosed with cancer voice concern about how both the adolescent and the younger siblings ages 7, 10, and 12 are dealing with the disease. What advice can be offered by the nurse? Select all that apply. Avoid making changes to the home routine. Limit the information given to the siblings to avoid promoting fear. Encourage family counseling. Encourage counseling for the adolescent diagnosed with cancer. Openly talk about the disease and related treatments with all the children in the family.

Encourage family counseling. Encourage counseling for the adolescent diagnosed with cancer. Openly talk about the disease and related treatments with all the children in the family.

When preparing the care plan, the nurse includes interventions to provide care for toddlers that are developmentally appropriate in maintaining healthy growth and development. Upon reviewing this care plan, which interventions should the nurse consider removing? Select all that apply. Encourage the parents to increase the amount of time away from the toddler to ensure independence. Make choices for the toddler in order to decrease stress on the child due to hospitalization. Plan for and educate the parents to expect regressive behaviors in the toddler. Inform the parents to expect more temper tantrums from the child while hospitalized. Maintain the normal home routine such as when the child normally eats or goes to bed.

Encourage the parents to increase the amount of time away from the toddler to ensure independence. Make choices for the toddler in order to decrease stress on the child due to hospitalization.

A preschooler is admitted to the pediatric floor for dehydration and is frightened. Which nursing intervention would be least effective in alleviating the child's anxiety? Assign the child to the same nurse each day. Encourage a caregiver to stay with the child when possible. Explain all procedures using medical terminology. Allow the child to handle the blood pressure cuff before using it.

Explain all procedures using medical terminology.

A nurse is admitting a 7-year-old child to the pediatric unit of the hospital. While the nurse is showing the child and parents the room and explaining where things are, the child becomes upset and frightened. What is the best action by the nurse? Keep on showing and explaining to the parents and do not include the child. Tell the child that there is nothing to be afraid of and that nobody will hurt the child during hospitalization. Go slowly with the acquaintance process. Ask the parents to leave the room while explaining procedures to the child.

Go slowly with the acquaintance process.

A 10-year-old boy who had an appendectomy had expressed worry that following the procedure he would have lots of pain. Two days after the procedure the child is claiming he is having no pain. Which nursing intervention should the nurse prioritize when assessing this child? Tell him to let you know if he begins to feel pain. Explain to his caregiver that his pain level shows he is getting better quickly. Observe him for physical signs which might indicate pain. Ask him to show you his pain level using the color pain scale.

Observe him for physical signs which might indicate pain.

The nurse is preparing a postsurgical care plan for an infant girl located on a general hospital unit that only occasionally admits children. To ensure the infant's safety, what should the nurse include in the plan? Place the infant in a room close to the nurses' station. Place the infant in a room with an ambulatory adolescent. Ask the family to stay with the infant at all times. Put the infant in a carrier and bring her to the nurses' station.

Place the infant in a room close to the nurses' station.

A school-aged child is hospitalized and is in contact isolation and must remain in his room. Which activity could the nurse use to entertain the client to reduce his sense of loneliness? Play "I Spy" with items in his room. Make a contest out of seeing how many words the child can make out of the letters from his name. Make a lunch-bag puppet and play pretend games with it. Bring a large-piece puzzle in for the child to put together.

Play "I Spy" with items in his room.

The nurse is providing home care for a 4-year-old girl with a chronic respiratory illness. What would be a case management activity? Scheduling intravenous and respiratory therapy services needed by the child. Teaching the grandmother how to do chest physiotherapy. Assessing the cleanliness of the home. Establishing eligibility for a Medicaid waiver.

Scheduling intravenous and respiratory therapy services needed by the child.

A 6-year-old with leukemia is placed on reverse isolation. What nursing actions could prevent depression and loneliness in this client? Select all that apply. Spend extra time to talk while in the room. Read a story while in the room. Do all nursing tasks at one time. Play a game while in the room. Quickly exit the room when possible.

Spend extra time to talk while in the room. Read a story while in the room. Play a game while in the room.

The hospital nurse is providing discharge instructions to the caregivers of a 10-year-old child with a new prosthetic limb. Which finding will cause the nurse to contact the primary health care provider? The child was diagnosed with hypothyroidism as an infant. The child is being discharged home with the caregiver. The child's white blood cell (WBC) count is 9,000/mm3 (9 x 109/L). The child's blood pressure is 115/75 mm Hg.

The child is being discharged home with the caregiver.

The nurse is caring for a 7-year-old boy in a body cast. He is shy and seems fearful of the numerous personnel moving in and out of his room. How can the nurse help reduce his fear? Remind the boy he will be out of the hospital and going home soon. Encourage the boy's parents to stay with him at all times to reduce his fears. Write the name of his nurse on a board and identify all staff on each shift, every day. Tell him not to worry; explain that everyone is here to care for him.

Write the name of his nurse on a board and identify all staff on each shift, every day.

A nurse who has worked in a variety of settings over the past several years is trying to determine what setting she would most like to work in now. The nurse is very organized, works well in an autonomous environment, and prefers one-on-one care. Which setting would best fit this nurse's needs? physician's office health department home health school nurse

home health

A school-aged child needs to have an IV started. Where would be the best place for the nurse to perform this procedure? in the child's room, ensuring privacy in the playroom where there are distractions in a treatment room off the floor in a procedural suite

in a treatment room

What will the nurse view as best maintaining normalcy in the life of a 10-year-old boy who is experiencing a lengthy hospitalization? keeping up with his schoolwork watching daytime television playing board games with the child life specialist writing down his oral intake on the day and evening shifts Choosing the time of his bath or shower

keeping up with his schoolwork

The nurse is caring for a child admitted to the hospital. The child's mother had to go home to take care of her other children. The child has become quiet, is not crying and is refusing to eat. The nurse would document the child is in which stage of separation anxiety? first stage second stage third stage fourth stage

second stage

The nurse is developing a preoperative plan of care for a 2-year-old toddler. The nurse will focus attention to which of the toddler's age-related fears? lack of trust separation anxiety loss of control loss of independence

separation anxiety

The nurse is caring for several families in the home care setting. What additional team member will the nurse have available to assist in the home setting? surgical care interns unlicensed assistive personnel an infectious disease specialist an emergency medicine provider

unlicensed assistive personnel

A nurse caring for a 5-year-old who had abdominal surgery yesterday is trying to teach the child how to take deep breaths. The best way that the nurse can accomplish this is by: teaching pursed-lip breathing. using a pinwheel. using a spirometer. using a flow meter.

using a pinwheel.

The nurse is providing care for a hospitalized child who is scheduled to receive morning medications. Place the statements in order that the nurse will state them, beginning with what the nurse will say first during the medication administration. Use all options. "You are doing great today. Would you like to play a game now?" "It is time for you to take your morning medications." "Would you like your medicine before or after your mom helps you take a bath?" "Hello, I am going to be your nurse for today."

"Hello, I am going to be your nurse for today." "It is time for you to take your morning medications." "Would you like your medicine before or after your mom helps you take a bath?" "You are doing great today. Would you like to play a game now?"

A nurse is preparing to admit a child for a tonsillectomy. How should the nurse establish rapport? "Let's take a look at your tonsils." "Do you understand why you are here?" "Are you scared about having your tonsils out?" "Tell me about your cute stuffed dog."

"Tell me about your cute stuffed dog."

The nurse is preparing to admit a 4-year-old who will be having tympanostomy tubes placed in both ears. Which strategy is most likely to reduce the child's fears of the procedure? "The doctor is going to insert tympanostomy tubes in your ears." "Don't worry, you will be asleep the whole time." "Let me show you how tiny these tubes are." "Let me show you the operating room."

"Let me show you how tiny these tubes are."

The nurse is caring for a preschooler who is hospitalized with a suspected blood disorder and receives an order to draw a blood sample. Which approach is best? "I need to take some blood." "We need to put a little hole in your arm." "I need to remove a little blood." "Why don't you sit on your mom's lap?"

"Why don't you sit on your mom's lap?"