Pediatric Emergencies

A nurse is providing care to a child diagnosed with septic shock. The nurse believes the child's condition is progressing to decompensated shock. What significance does the nurse's belief have on the child's condition?

Additional measures are necessary to meet the child's metabolic requirements

A child has fallen from a swing at the playground and the parent states that the child became groggy. After assessing a child's airway, breathing, and circulation (ABCs), what would the nurse do next?

Assess the level of consciousness

A 6-year-old girl in shock is receiving dobutamine. What would the nurse most likely do?

Monitor for ventricular arrhythmias.

A child is experiencing shock. Which assessment is essential for the nurse to complete to tell if the child is able to compensate?

Monitor the blood pressure

The nurse is preparing to administer dobutamine to a child in the emergency department. What consideration(s) will the nurse take into account for this medication? Select all that apply.

Titrate infusion depending on blood pressure and cardiac output. Monitor for ventricular arrhythmias. Administer by central line if possible.

The nurse is preparing to open the airway of an unconscious child with a suspected cervical spine injury. What action will the nurse take?

Use the jaw-thrust maneuver

A 4-year-old girl is brought to the emergency room following ingestion of large amounts of acetaminophen (Tylenol). Which of the following interventions does the nurse expect?

administration of acetylcysteine

A community health nurse is planning a class on water safety for families. What information is important for the nurse to include in the class? Select all that apply.

The family needs to maintain fencing around pools to deter unsupervised swimming. It is important for adult supervision at poolside at all times. Personal floatation devices are recommended for children riding in boats.

The health care team is performing cardiopulmonary resuscitation on a child following a suspected poisoning. Which action by the nurse would indicate that CPR is warranted?

The nurse assesses the child's heart rate at 45 and begins chest compressions

The nurse is assessing a 10-year-old child with tachypnea and increased work of breathing. Which finding demonstrates the child is in the late stages of shock?

hypotension and capillary refill time greater than 5 seconds

Cardiopulmonary resuscitation (CPR) is in progress on an 8-year-old boy who is in shock. Which nursing intervention is priority?

inserting an intraosseous needle via the femoral route

The nurse is assessing a child in the pediatric inpatient unit and notes mottling of the child's lower extremities. Which nursing action(s) is appropriate at current? Select all that apply.

Monitor the child's oxygen saturation via pulse oximetry. Assess for signs of hypothermia and monitor the child's temperature.

A 3-year-old child has sustained injuries from a fall. Once the airway is secured, which of the following interventions would be done next?

Stabilizing the cervical spine

A nurse is providing care to a 10-year-old child hospitalized after a near-drowning incident. The child is awake and alert, and vital signs are within normal parameters. The child has a mild, productive cough and has been placed on supplemental oxygen via nasal cannula. The child's parent asks the nurse "Why does my child need to be hospitalized? My child seems ok." Which is the nurse's best response?

"Your child's heart and lungs should be monitored for changes for 6 to 8 hours."

The nurse is preparing to administer naloxone to a child in the emergency department. What consideration(s) will the nurse take into account while administering this medication? Select all that apply.

Opioid's effects outlast naloxone's therapeutic effects. May repeat as necessary for opiate-induced apnea.

A child is hospitalized with a diagnosis of anaphylactic shock secondary to an allergic reaction to an insect bite. In providing care to the child, what should the nurse prioritize

administration of intravenous fluids

A nurse is providing care to a child hospitalized with sepsis. The nurse suspects the child's condition has progressed to septic shock, and the child is showing signs of decompensation. Which assessment finding supports the nurse's suspicion?

altered neurologic status

The PNP is describing the different categories of shock and the events that occur with each. The PNP determines that the teaching was successful when the group identifies the events of distributive shock. Place the events below in the order from first to last that would demonstrate successful teaching.

massive vasodilation decreased peripheral vascular resistance relative hypovolemia decreased venous return decreased stroke volume and cardiac output insufficient organ perfusion

A child experiencing shock has received three boluses of normal saline solution. Which assessment will the nurse make to determine if the child is responding to the fluids?

peripheral and central pulses

A child's parent calls the clinic nurse and states, "My child just drank an unknown amount of a cleaning solution. What should I do?" Which statement by the nurse is best?

"You need to hang up with me and call the poison control center now."

The nurse is caring for a 7-year-old child who exhibits symptoms of anaphylactic shock after being stung by a bee. The nurse notes that the child's lips are swelling. The nurse hears audible wheezing with dyspnea. Which intervention will the nurse perform first?

Place an endotracheal tube insertion tray at bedside.

A child is brought to the emergency department after being submerged for an undetermined amount of time in the family pool. Resuscitative efforts have resulted in a normal heart rate, but the child remains intubated on respiratory support and has not regained consciousness. Which potential complication will have the greatest effect on the child's outcome?

atelectasis

A 13-year-old adolescent has had a near-drowning experience. The nurse notices the client has labored breathing and a cough. What is the priority intervention?

Administer 100% oxygen by mask

The nurse is caring for a 3-year-old child who ingested a dangerous amount of amitriptyline, a tricyclic agent. What will the nurse include in the child's plan of care? Select all that apply.

Administer sodium bicarbonate as prescribed, Monitor for lethargy, Perform continuous EKG monitoring

The nurse is preparing to administer atropine to a 4-year-old child in the emergency department. What consideration(s) will the nurse take into account for this medication? Select all that apply.

Do not mix with sodium bicarbonate. Monitor heart rhythm. Atropine causes pupil dilation.

A nurse is creating a plan of care for a child hospitalized after accidentally ingesting the parent's prescription opioid. Which outcome is the best indicator that the plan of care was successful?

The child maintains effective gas exchange

The nurse is providing support to the parents of a 10-year-old boy receiving emergency care. The boy is their foster child. Which statement by the nurse would be most effective?

"You can hold your child's hand while this is going on."

A toddler is brought to the emergency department after sustaining a life-threatening injury. During an assessment, the nurse utilizes the Glasgow Coma Scale. The toddler's score is 7. Based on this score, what inference can the nurse make about the child?

It will be necessary to intubate the child

A 3-year-old girl had a near-drowning incident when she fell into a wading pool. Which intervention is the highest priority?

Suction the upper airway to ensure airway patency

A nurse is providing care for a toddler who ingested an unknown amount of acetaminophen. Which intervention will the nurse prioritize?

Administer activated charcoal

The nurse plans to educate the parents of a child experiencing septic shock about the purpose of administering dobutamine intravenously to their child. What would the nurse include in this educational plan?

Dobutamine is used to improve cardiac contractility

A child is in shock and requires IV fluids but establishing an IV site has been difficult. Peripheral sites have been unsuccessful to establish the IV. Which location would be the most appropriate site for the nurse to establish IV access?

intraosseous