Pedi blue print 1 GI and GU

When doing the first assessment of a male newborn, the nurse notes that the scrotum is large, edematous, and pendulous. What should this be interpreted as?

A normal finding

Children with biliary atresia may have difficulty absorbing vitamins

A, D, E, and K, AND NEED MORE OF THEM

What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)?

It is characterized by presence of Gower sign, a waddling gait, and lordosis.

What statement is an advantage of peritoneal dialysis compared with hemodialysis?

It is easy to learn and safe to perform.

A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?

It is essential because it will be an adjustment.

The nurse has a 2-year-old boy sit in tailor position during palpation for the testes. What is the rationale for this position?

It prevents cremasteric reflex.

A nurse is admitting an infant with biliary atresia. Which is the earliest clinical manifestation of biliary atresia the nurse should expect to assess?

Jaundice

What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning?

Keep an accurate record of intake and output.

An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?

Keep buttons, beads, and other small objects out of his reach

The nurse is caring for an infant who had surgical repair of a tracheoesophageal fistula 24 hours ago. Gastrostomy feedings have not been started. What do nursing actions related to the gastrostomy tube include?

Leave the tube open to gravity drainage.

What is a strategy used to minimize scarring with burn injury in a child?

Limitation of period without pressure to areas of scarring

What should the nurse consider when providing support to a family whose infant has just been diagnosed with biliary atresia?

Liver transplantation may be needed eventually.

What diet is most appropriate for the child with chronic renal failure (CRF)?

Low in phosphorus

What procedure is most appropriate for assessment of an abdominal circumference related to a bowel obstruction?

Marking the point of measurement with a pen

What do the clinical manifestations of minimal change nephrotic syndrome include?

Massive proteinuria, hypoalbuminemia, and edema

What condition is often associated with severe diarrhea?

Metabolic acidosis

What physiologic state(s) produces the clinical manifestations of nervous system stimulation and excitement, such as overexcitability, nervousness, and tetany?

Metabolic and respiratory alkalosis

The nurse is caring for an 18-month-old child with rotavirus. What clinical manifestations should the nurse expect to observe?

Mild fever and vomiting followed by onset of watery stools

What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?

Multiple stresses are placed on children with ESRD and their families because childrens lives are maintained by drugs and artificial means.

A child is admitted with bacterial gastroenteritis. Which lab results of a stool specimen confirm this diagnosis?

Neutrophils and red blood cells

In preparing to give enemas until clear to a young child, the nurse should select which solution?

Normal saline

The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

Notify practitioner.

After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?

Notify the practitioner.

Which best describes acute glomerulonephritis?

Occurs after a streptococcal infection

The nurse is conducting an admission assessment on a school-age child with acute renal failure. Which are the primary clinical manifestations the nurse expects to find with this condition?

Oliguria and hypertension

Which statement best characterizes hepatitis A?

Onset is usually rapid and acute.

The nurse is caring for a child after a cleft palate repair who is on a clear liquid diet. Which feeding device should the nurse use to deliver the clear liquid diet?

Open cup

Which therapeutic management should the nurse prepare to initiate first for a child with acute diarrhea and moderate dehydration?

Oral rehydration solution (ORS)

Which observation made of the exposed abdomen is most indicative of pyloric stenosis?

Palpable olive-like mass

Which is an advantage of peritoneal dialysis?

Parents and older children can perform treatments.

An infant is brought to the emergency department with dehydration. Which physical assessment finding does the nurse expect?

Poor skin turgor

Which is a high-fiber food that the nurse should recommend for a child with chronic constipation?

Popcorn

A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

Prevent abdominal distention.

Surgery is performed on a child to correct cryptorchidism. The parents understand the reason for the surgery if they tell the nurse this was done to do what?

Prevent damage to the undescended testicle.

What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease?

Protecting the skin around the colostomy

One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation?

Rectal bleeding

Which is an objective of care for a 10-year-old child with minimal change nephrotic syndrome?

Reduce excretion of urinary protein.

What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?

Reduced serum albumin

The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

Reduction of edema

A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action? or The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?

Refer him for immediate medical evaluation.

Which is an important nursing consideration in the care of a child with celiac disease?

Refer to a nutritionist for detailed dietary instructions and education.

A 7-year-old child with acute diarrhea has been rehydrated with oral rehydration solution (ORS). The nurse should recommend that the childs diet be advanced to what kind of diet?

Regular diet

During the first few days after surgery for cleft lip, which intervention should the nurse do?

Remove restraints periodically to cuddle infant.

A nurse is receiving report on a newborn admitted yesterday after a gastroschisis repair. In the report, the nurse is told the newborn has a physicians prescription for an NG tube to low intermittent suction. The reporting nurse confirms that the NG tube is to low intermittent suction and draining light green stomach contents. Upon initial assessment, the nurse notes that the newborn has pulled the NG tube out. Which is the priority action the nurse should take?

Replace the NG tube and continue the low intermittent suction.

Which pathogen is the viral pathogen that frequently causes acute diarrhea in young children?

Rotavirus

What is a significant secondary prevention nursing activity for lead poisoning?

Screening children for blood lead levels

A child with corrosive poisoning is being admitted to the emergency department. What clinical manifestation does the nurse expect to assess on this child?

Severe burning pain in the mouth, throat, and stomach

Which is the most common cause of acute renal failure in children?

Severe dehydration

A school-age child with chronic renal failure is admitted to the hospital with a serum potassium level of 5.2 mEq/L. Which prescribed medication should the nurse plan to administer?

Sodium polystyrene sulfonate (Kayexalate)

An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?

Stimulate adaptation of the small intestine

What test is used to screen for carbohydrate malabsorption?

Stool pH

Which type of hernia has an impaired blood supply to the herniated organ?

Strangulated hernia

Cellulitis is often caused by:

Streptococcus or Staphylococcus organisms.

Which therapeutic management treatment is implemented for children with Hirschsprung disease?

Surgical removal of affected section of bowel

What statement best describes Hirschsprung disease?

The colon has an aganglionic segment.

The parents of a newborn with an umbilical hernia ask about treatment options. The nurses response should be based on which knowledge?

The defect usually resolves spontaneously by 3 to 5 years of age.

The nurse is teaching student nurses about newborn screening. Which statement made by the student indicates understanding of the teaching?

The initial specimen should be collected as close to discharge as possible.

A toddlers mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurses response should be based on which premise?

The location needs to be confirmed by radiographic examination.

Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their childs cleft lip. Which statement should the nurse give as a response?

The malformation occurs at approximately 5 weeks of gestation; there is no known way to prevent this.

The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?

The object may be lodged in the esophagus.

A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?

Thicken feedings and enlarge the nipple hole.

A 4-month-old infant has gastroesophageal reflux (GER) but is thriving without other complications. Which should the nurse suggest to minimize reflux?

Thicken formula with rice cereal.

Identification and treatment of cryptorchid testes should be done by age 2 years. What is an important consideration?

Treatment is necessary to maintain the ability to be fertile when older.

Which clinical manifestation would be seen in a child with chronic renal failure?

Unpleasant uremic breath odor

A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena, the passage of black, tarry stools, suggests bleeding from which area?

Upper gastrointestinal (GI) tract

Urethral opening along ventral surface of penis is known as epispadias.

Urethral opening along ventral surface of penis is known as epispadias.

A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition?

Urinary tract infection (UTI)

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurses best response?

Urine output will increase.

An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child?

Varicella-zoster immune globulin

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

Visible peristalsis and weight loss

Which is a major complication in a child with chronic renal failure?

Water and sodium retention

Parents of a child undergoing an endoscopy to rule out peptic ulcer disease (PUD) from H. pylori ask the nurse, If H. pylori is found will my child need another endoscopy to know that it is gone? Which is the nurses best response?

We can collect a stool sample and confirm that the H. pylori has been eradicated.

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include:

cleansing the suture line, supine and side-lying positions, arm restraints.

When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is:

congenital heart disease.

Nursing care of the newborn with oral candidiasis (thrush) includes:

continuing medication for a prescribed number of days.

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:

elevating the head but give nothing by mouth.

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include:

encouraging and helping mother to breastfeed.

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be:

encouraging her to express her feelings.

The nurse must suction a child with a tracheostomy. Interventions should include:

ensuring each pass of the suction catheter should take no longer than 5 seconds.

A child is admitted with acute glomerulonephritis. The nurse should expect the urinalysis during this acute phase to show:

hematuria, proteinuria.

Pyloric stenosis can best be described as:

hypertrophy of the pyloric muscle.

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child should begin with:

intravenous (IV) fluids.

Invagination of one segment of bowel within another is called:

intussusception.

An important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS) is to:

make a follow-up home visit to parents as soon as possible after the childs death.

An infant with pyloric stenosis experiences excessive vomiting that can result in:

metabolic alkalosis.

A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is:

necessary because it will be an adjustment.

The nurse is caring for a newborn with hypospadias. His parents ask if circumcision is an option. Which is the nurse's best response?

"Circumcision is an option, but it cannot be done at this time."

The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

-Passage of red, currant jellylike stools -Tender, distended abdomen -Sudden acute abdominal pain

The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time?

30 minutes before breakfast

At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?

4 oz/day

Which clinical manifestation would be the most suggestive of acute appendicitis?

Abdominal pain that is most intense at McBurney point

Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?

Be persistent through 10 to 15 minutes of food refusal.

After a tonic-clonic seizure, what symptoms should the nurse expect the child to experience?

Lethargy and confusion

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. What should nursing care include?

Raise the patients head and give nothing by mouth.

The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?

The child has a disorder that causes a deficient immune system.

The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

The urethral opening is along the ventral surface of the penis.

What major complication is associated with a child with chronic renal failure?

Water and sodium retention

Caring for the newborn with a cleft lip and palate before surgical repair includes:

providing satisfaction of sucking needs

A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with GER. The purpose of this is to:

reduce gastric acid production.

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:

teaching family signs of central venous catheter infection.

A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. The nurses best response should be that the:

urinary output will increase.

One of the clinical manifestations of chronic renal failure is uremic frost. Which best describes this term?

Deposits of urea crystals on skin

A child is receiving vincristine (Oncovin). The nurse should monitor for which side effect of this medication?

Diarrhea

Which is an important nursing consideration when caring for an infant with failure to thrive?

Establish a structured routine and follow it consistently.

The nurse observes that a newborn is having problems after birth. What should indicate a tracheoesophageal fistula?

Excessive frothy saliva

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?

FLACC tool

Which condition in a child should alert a nurse for increased fluid requirements?

Fever

A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition?

Foreign body in the nose

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of:

Down syndrome.

What should preoperative care of a newborn with an anorectal malformation include?

Gastrointestinal decompression

Which is a parasite that causes acute diarrhea?

Giardia lamblia

A 4-month-old infant is discharged home after surgery for the repair of a cleft lip. What should instructions to the parents include?

Give pain medication to the infant to minimize crying.

In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?

Have siblings examined for VUR.

What is a clinical manifestation of acetaminophen poisoning?

Hepatic involvement

Which vaccine is now recommended for the immunization of all newborns?

Hepatitis B vaccine

A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect?

Hirschsprung disease

The nurse is conducting a staff in-service on common problems associated with myelomeningocele. Which common problem is associated with this defect?

Hydrocephalus

A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss. Which type of dehydration is this infant experiencing?

Hypertonic

A child with acetylsalicylic acid (aspirin) poisoning is being admitted to the emergency department. What early clinical manifestation does the nurse expect to assess on this child?

Hyperventilation

Hypospadias refers to the urethral opening, not to the size of the penis

Hypospadias refers to the urethral opening, not to the size of the penis

What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

Hypotonic dehydration

A school-age child with diarrhea has been rehydrated. The nurse is discussing the childs diet with the family. Which statement by the parent would indicate a correct understanding of the teaching?

I should have my child eat a normal diet with easily digested foods for the next 48 hours. or Easily digested foods

Parents are switching their toddler, who has met the weight requirement, from a rear-facing car seat to a forward-facing seat. The nurse should recommend the parents place the seat where in the car?

In the middle of the rear seat

Nutritional management of the child with Crohn disease includes a diet that has which component?

Increased protein

A nurse is conducting an in-service on childhood gastrointestinal disorders. Which statement is most descriptive of Meckel diverticulum? or What statement is most descriptive of Meckel diverticulum?

Intestinal bleeding may be mild or profuse.

The nurse is doing a prehospitalization orientation for a 7-year-old child who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that she will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is:

an appropriate part of the childs preparation.

Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies that are being treated with antihistamines. The nurse should suspect that the constipation is most likely caused by:

antihistamines.

Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include:

avoidance of eye contact.

Which is instituted for the therapeutic management of minimal change nephrotic syndrome?

Corticosteroids

An infant is born with a gastroschisis. Care preoperatively should include which priority intervention?

Covering the defect with a sterile bowel bag

The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

Covering the intact bowel with a nonadherent dressing to prevent injury

During the physical examination of an adolescent with significant weight loss, what finding may indicate an eating disorder?

Erosion of tooth enamel

The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply?

Acute hypertension is a concern that requires monitoring.

The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

Additional surgery may be necessary to achieve continence.

The nurse is caring for a newborn who has just been diagnosed with tracheoesophageal fistula and is scheduled for surgery. Which should the nurse

Administer intravenous fluids and antibiotics.

The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. Which is appropriate to relieve the abdominal discomfort?

Allow to assume position of comfort.

The nurse is notified that a 9-year-old boy with nephrotic syndrome is being admitted. Only semiprivate rooms are available. What roommate should be best to select?

An 8-year-old boy with a fractured femur

Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The nurse should further ask the parents if the toddler has which associated factor that is causing the acute diarrhea?

Antibiotic therapy

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Assessing bowel function

What is the most frequent cause of hypovolemic shock in children?

Blood loss

A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?

Bowel cleansing

What are possible premature infant complications from oxygen therapy and mechanical ventilation?

Bronchopulmonary dysplasia and retinopathy of prematurity

The nurse is explaining to a parent how to care for a school-age child with vomiting associated with a viral illness. Which action should the nurse include?

Brush teeth or rinse mouth after vomiting.

The nurse is caring for a child with acute renal failure. Which clinical manifestation should the nurse recognize as a sign of hyperkalemia?

Cardiac arrhythmia

An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for ?

Central venous catheter infection, electrolyte losses, and hyperglycemia

The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease foods that can exacerbate acid reflux. What foods should be included in the teaching session? (Select all that apply.)

Citrus Spicy foods Peppermint

What clinical manifestation should be the most suggestive of acute appendicitis?

Colicky, cramping, abdominal pain around the umbilicus

What is a significant common side effect that occurs with opioid administration?

Constipation

A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solutions (ORS). The childs mother calls the clinic nurse because he is also occasionally vomiting. The nurse should recommend which intervention?

Continue to give ORS frequently in small amounts.

The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest?

Corn on the cob with butter

The nurse is preparing to admit a 2-month-old child with hypertrophic pyloric stenosis. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

Weight loss Projectile vomiting The infant is hungry after vomiting

A nurse is admitting a child with Crohn disease. Parents ask the nurse, How is this disease different from ulcerative colitis? Which statement should the nurse make when answering this question?

With Crohns the inflammatory process involves the whole GI tract.

What is oral candidiasis (thrush) in the newborn?

Yeastlike fungal infection of mucous membranes that is relatively common

The parents of an infant with a cleft palate ask the nurse, What follow-up care will our infant need after the repair? Which is an accurate response by the nurse?

Your infant will need follow-up with audiologists and orthodontists.