Pediatric Test 2
PCV (pneumococcal)
2 months 4 months 6 months 12-15 months
IPV (polio)
2 months, 4 months, 6-18 months, 4-6 years
3.Suggestive of CF
A sweat test is performed on an infant with a suspected diagnosis of cystic fibrosis (CF). The nurse reviews the results of the test and notes that the chloride level is 40 mEq/L (40 mmol/L). How should the nurse interpret this finding? 1.A negative test 2.A positive test 3.Suggestive of CF 4.An unrelated finding
ASD, VSD, PDA
Acyanotic- Increased pulmonary blood flow
patent ductus arteriosus (PDA)
Assessment findings of an infant admitted to the hospital reveal a machinery-like murmur on auscultation of the heart and signs of heart failure. The nurse reviews congenital cardiac anomalies and identifies the infant's condition as which disorder? Refer to figure (the circled area) to determine the condition.
Hib
H. influenza type B -protects against bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis
Unable to arouse Acidosis Pale Cool extremities No Urine Weak pulses Low BP Profound Tachycardia and Tachypnea
Late signs of shock
MMR
Measles, mumps, rubella given around 12-15 months
Transposition of great vessels Total anomalous pulmonary venous connection Truncus arteriosus
Mixed cardiac defects
2.Maintains adequate cardiac output
Prostaglandin E1 is prescribed for a child with transposition of the great arteries. The mother of the child is a registered nurse and asks the nurse why the child needs the medication. What is the most appropriate response to the mother about the action of the medication? 1.Prevents blue (tet) spells 2.Maintains adequate cardiac output 3.Maintains an adequate hormonal level 4.Maintains the position of the great arteries
Flu
Recommended annually for children 6months-18 years
Hep B
Recommended that newborns receive vaccine before discharge.
Group A Streptococcus
Scarlet fever is a ___ bacteria infection.
increased pulmonary vascular congestion. A PDA allows blood to flow from the aorta (high pressure) to the pulmonary artery (low pressure). If the PDA stays open, increased pulmonary vascular congestion can occur. The increased pulmonary vascular congestion is the primary complication; pulmonary infection may occur, but it is not the priority complication. A PDA involves a left-to-right shunt of blood. The decreased workload on the left side of the heart is not a priority complication of a PDA.
Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of pulmonary infection. right-to-left shunt of blood. increased pulmonary vascular congestion increased pulmonary vascular congestion.
1. Acute pain
The nurse is providing care to a child admitted for acute otitis media. What is the nurse's priority concern for this child? 1.Acute pain 2.Problems with skin integrity 3.Risk for interrupted breathing patterns 4.Mucous membrane dryness and cracking.
3.12 months
The nurse should expect to administer the first dose of the measles, mumps, and rubella (MMR) vaccine at which age? 1.2 years 2.4 years 3.12 months 4.22 months
4.A severe febrile illness
The nursing student is assigned to administer immunizations to children in a clinic. The student should question whether to administer immunizations to a child with which condition? 1.A cold 2.Otitis media 3.Mild diarrhea 4.A severe febrile illness
an allergy to gelatin, eggs, or neomycin
What allergies should the nurse assess for before giving MMR vaccine?
Chloride level lower than 40mmol/L
What is a negative sweat test result?
A chloride level higher than 60mmol/L
What is a positive sweat test result?
Aortic stenosis- Obstructive mixed
What is the defect?
Pastia's sign
a rash seen in scarlet fever that will blanch with pressure except in areas of deep creases and the folds of joints
Hep A
spread through close physical contact and by eating or drinking contaminated food or water. Signs and Symptoms- Abrupt onset of fever, malaise, anorexia, nausea, abdominal discomfort, dark urine, and jaundice. Recommended for children beginning at 1y/o -2 dose series, second dose given 6 months later.
Laryngotrachiobronchitis (Croup)
the inflammation of the larynx, trachea, and bronchi - cool mist treatment is given
2, 4, and 6 months of age; at 15 to 18 months of age; and at 4 to 6 years of age
When is DTaP administered, normally?
2, 4, and 6 months of age and at 12 to 15 months of age
When is Hib administered?
administered at 2, 4, and 6 months of age and at 4 to 6 years
When is IPV (polio vaccine) administered?
tachypnea, poor feeding, and diaphoresis during feeding
Early symptoms of HF
3.Administer the medication. The apical pulse rate for a 1-year-old infant is 90 to 130 beats/min. Because the apical rate is normal, the remaining options are incorrect.
A 1-year-old infant with a diagnosis of heart failure is prescribed digoxin. The nurse takes the apical pulse for 1 minute before administering the medication and obtains a result of 102 beats/minute. What is the nurse's best action? 1.Retake the apical pulse. 2.Withhold the medication. 3.Administer the medication. 4.Notify the primary health care provider.
2.Decreased wheezing
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1.Warm, dry skin 2.Decreased wheezing 3.Pulse rate of 90 beats per minute 4.Respirations of 18 breaths per minute
1.Pastia's sign 3.White strawberry tongue 4.Edematous and beefy-red pharynx
A child diagnosed with scarlet fever is being cared for at home. The home health nurse performs an assessment on the child and checks for which clinical manifestations of this disease? Select all that apply. 1.Pastia's sign 2.Koplik's spots 3.White strawberry tongue 4.Edematous and beefy-red pharynx 5.Petechial red, pinpoint spots on the soft palate 6.Small red spots with a bluish-white center and a red base located on the buccal mucosa
2.MMR (measles, mumps, and rubella) Known altered immunodeficiency from long-term immunosuppressive therapy is a contraindication to MMR immunization because a live vaccine is given.
A child is scheduled to receive immunizations. The child's mother reports to the nurse that the child has been receiving long-term immunosuppressive therapy. The nurse prepares the scheduled immunizations knowing that which vaccine is contraindicated? 1.Hepatitis B 2.MMR (measles, mumps, and rubella) 3.Hib (Haemophilus influenzae type b) 4.DTaP (diphtheria, tetanus, and acellular pertussis)
3.A history of anaphylactic reaction to neomycin
A child is scheduled to receive inactivated poliovirus vaccine (IPV), and the nurse who is preparing to administer the vaccine reviews the child's record. The nurse questions the administration of IPV if which is documented in the child's record? 1.Recent recovery from a cold 2.A history of frequent respiratory infections 3.A history of anaphylactic reaction to neomycin 4.A local reaction at the site of injection of a previous IPV
4."The infectious period begins 1 to 2 days before the onset of the rash and ends about 5 days after the onset of the lesions and crusting of the lesions."
A child is seen in a health care clinic, and a diagnosis of chickenpox is confirmed. The mother expresses concern for two other children at home and asks the nurse if the child is infectious to the other children. Which response by the nurse is most appropriate? 1."The infectious period occurs after the lesions begin." 2."The infectious period begins with the onset of the rash." 3."The infectious period is not known, and it is possible that the children may develop the chickenpox within the next 2 weeks." 4."The infectious period begins 1 to 2 days before the onset of the rash and ends about 5 days after the onset of the lesions and crusting of the lesions."
3."I need to place a piece of transparent cellophane tape lightly over the anal area as soon as my child awakens and bring it to the clinic for examination."
A child is seen in the health care clinic, and the nurse suspects the presence of pinworm infection (enterobiasis). The nurse instructs the mother as to how to obtain a cellophane tape rectal specimen. Which statement by the mother indicates an understanding of the correct procedure to obtain the specimen? 1."I need to collect the specimen after I give my child a bath." 2."I need to collect the first bowel movement of the day and place it in a sealed container." 3."I need to place a piece of transparent cellophane tape lightly over the anal area as soon as my child awakens and bring it to the clinic for examination." 4."I need to place a piece of transparent cellophane tape lightly over the anal area after my child has a bowel movement and bring it to the clinic for examination."
2. Airborne Rubeola is transmitted via airborne particles or direct contact with infectious droplets.
A child with rubeola (measles) is being admitted to the hospital. In preparing for the admission of the child, the nurse should plan to place the child on which precautions? 1.Enteric 2.Airborne 3.Protective 4.Neutropenic
4.The communicable period is 1 to 2 days before the onset of the rash to 6 days, when crusts have formed.
A mother brings her 6-year-old child to the clinic because the child has developed a rash on the trunk and scalp. The mother reports that the child has had a low-grade fever, has not felt like eating, and has been tired. The child is diagnosed with chickenpox. The mother inquires about the communicable period associated with chickenpox, and the nurse bases the response on which statement? 1.The communicable period is unknown. 2.The communicable period ranges from 2 weeks or less to 4 weeks. 3.The communicable period is 10 days before the onset of symptoms to 15 days after the rash appears. 4.The communicable period is 1 to 2 days before the onset of the rash to 6 days, when crusts have formed.
3.28.8 mcg
A pediatric client weighing 7.2 kg with ventricular septal defect repair is placed on a maintenance dosage of digoxin. The dosage is 8mcg/kg/day. The pediatrician prescribes the digoxin to be given twice daily. The nurse prepares how many mcg of digoxin to administer to the child at each dose? 1.12.6 mcg 2.21.4 mcg 3.28.8 mcg 4.32.2 mcg
4.Apply the lotion liberally to the body and head, avoiding the eyes and mouth.
A school-age child is seen in the primary health care provider's office for complaints of intense itching mostly at night. The primary health care provider makes a diagnosis of scabies and prescribes permethrin for treatment of the skin condition. Which at-home instruction should the nurse provide to the mother? 1.Retreatment is recommended the next day. 2.The child's bedding and clothing should be washed in cold water. 3.Leave the lotion on throughout the day and rinse off within 6 hours. 4.Apply the lotion liberally to the body and head, avoiding the eyes and mouth.
He reports that he occasionally feels "lightheaded" when getting out of a chair during the course of the school day in some of his classes.
An adolescent is being treated for new-onset hypertension with medication. Firs line therapy previously tried was with dietary management but the decision has now been made to start oral medications. Which complaint if provided by the patient would indicate a potential concern? - Patient states that he is no longer losing weight after being on the medication for one week's time. - Patient states he is maintaining his oral intake of 8 glasses of water a day. - He is taking the medication in the evening rather than taking the medication in the morning as prescribed as he thinks that he feels better and has less side effects. - He reports that he occasionally feels "lightheaded" when getting out of a chair during the course of the school day in some of his classes.
•Tachycardia •Sweating •Low Urine Output •Fatigue/Lethargy •Pale •Weak Pulses •Decrease BP •Weight loss
Bad Pump Signs
3.Prepare the child for a chest radiograph. The patient already has a patent airway. The next step is to prepaire for a chest radiograph
The emergency department nurse is caring for a child with suspected epiglottitis and has ensured that the child has a patent airway. Which action is the next priority in the care of this child? 1.Prepare the child for tracheotomy. 2.Prepare to administer epinephrine. 3.Prepare the child for a chest radiograph. 4.Assist the primary health care provider with intubation.
2.The mother pulls the earlobe down and back.
The nurse is caring for a 2-year-old child with an ear infection who requires the administration of antibiotic eardrops. The nurse observes the mother administering the eardrops to the child. Which observation by the nurse indicates that the mother is performing the procedure correctly? 1.The mother pulls the earlobe up and back. 2.The mother pulls the earlobe down and back. 3.The mother holds the child in a sitting position. 4.The mother must wear gloves to administer the medication.
Tetrology of fallot and tricuspid atresia
Cyanotic- Decreased pulmonary blood flow
Irritability Decrease LOC Normal or Low BP Decrease output Bounding or normal pulses Mild Tachycardia 3-4 CRF
Early signs of shock
4.Preventing secondary infection of the lesions
Nursing care of the infant with eczema should focus on which action as a priority nursing intervention? 1.Keeping the infant content 2.Maintaining adequate nutrition 3.Applying antibiotic ointment to lesions 4.Preventing secondary infection of the lesions
Coarction of the aorta/ aortic stenosis Pulmonary stenosis
Obstructive Defects
Tachypnea Dyspnea Retractions Exercise intolerance Coughing Wheezing Grunting
Pulmonary Congestion Left Sided Failure Signs
Increase in weight Hepatomegaly Peripheral edema Periorbital edema Ascites Neck vein distention
Systematic Congestion Right Sided Failure Signs
ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy
Tetralogy of Fallot includes what four defects?
"The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent? 1."The immunization schedule will need to be altered." 2."The child should not receive any hepatitis vaccines." 3."The child will receive all of the immunizations except for the polio series." 4."The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
3.Subcutaneously in the outer aspect of the upper arm
The clinic nurse prepares to administer a measles, mumps, and rubella (MMR) vaccine to a 5-year-old child. The nurse should administer this vaccine by which method? 1.Subcutaneously in the gluteal muscle 2.Intramuscularly in the deltoid muscle 3.Subcutaneously in the outer aspect of the upper arm 4.Intramuscularly in the anterolateral aspect of the thigh
Handwashing
The most important prevention method for the spread of any communicable disease is - Hand washing - immunizations as secondary prevention - use of appropriate broad spectrum antibiotics - isolation from infectious agents
4.In the morning, when the child awakens
The mother of a preschooler who attends day care calls a clinic nurse and tells the nurse that the child is constantly scratching the perianal area and that the area is irritated. The nurse suspects the possibility of pinworm infection (enterobiasis) and instructs the mother to obtain a rectal specimen by a tape test. At what time should the nurse tell the mother to obtain the specimen? 1.After bathing 2.After toileting 3.When the child is put to bed 4.In the morning, when the child awakens
4.Avoid allowing the children to share drinking glasses or eating utensils because the disease is transmitted through saliva.
The nurse is caring for a child with a diagnosis of roseola. The nurse provides instructions to the mother regarding prevention of the transmission to siblings and other household members. Which instruction should the nurse provide? 1.Isolate the child from others for 2 weeks because the virus is transmitted by breathing and coughing. 2.Wash sheets and towels used by the child separately in bleach to prevent spread of the infection to others. 3.Have the child use a separate bathroom for urination and bowel movements to prevent the spread of infection. 4.Avoid allowing the children to share drinking glasses or eating utensils because the disease is transmitted through saliva.
1.Mask and gloves - test may include gown for contact precautions
The nurse is caring for a hospitalized child with a diagnosis of measles (rubeola). In preparing to care for the child, which supplies should the nurse bring to the child's room to prevent transmission of the virus? 1.Mask and gloves 2.Gown and gloves 3.Goggles and gloves 4.Gown, gloves, and goggles
2."I will apply cool, moist soaks every 4 hours."
The nurse is collecting data on a child with a 1-week-old cat scratch injury. While assessing the scratch, the nurse notes redness, heat, swelling, and red streaking surrounding the area. The child states that the scratch hurts. Cellulitis is diagnosed. When providing home care instructions, which statement by the mother indicates a need for further teaching? 1."The child should rest in bed." 2."I will apply cool, moist soaks every 4 hours." 3."I should take the child's temperature and watch for a fever." 4."The affected extremity should be elevated and immobilized."
Immunizations
The nurse is concerned with the prevention of communicable disease. Primary prevention results from - Immunizations - early diagnosis - strict isolation - treatment of disease
4."You will need to prevent any of the fluid from the blisters from coming into contact with your other children."
The nurse is counseling the young mother of a small child recently diagnosed with impetigo. The nurse should make which statement that provides the best information about impetigo? 1."The main treatment while your daughter has impetigo will be to force fluids." 2."Your daughter probably caught the impetigo because you don't wash her hands enough." 3."There is no risk of passing impetigo to the other children once you begin the prescribed antibiotics." 4."You will need to prevent any of the fluid from the blisters from coming into contact with your other children."
1.Assess for allergies. 2.Verify the prescription. 3.Obtain an immunization history. 4.Obtain the consent from the parents. 5.Check the lot number and expiration date.
The nurse is preparing to administer a vaccine to a pediatric client. What actions are essential for the nurse to perform prior to administering the vaccination? Select all that apply. 1.Assess for allergies. 2.Verify the prescription. 3.Obtain an immunization history. 4.Obtain the consent from the parents. 5.Check the lot number and expiration date.
2."She can receive it when she is 12 months old."
The nurse is providing anticipatory guidance to the mother of a 10-month-old child. The mother asks how soon her daughter will be able to receive the chickenpox (varicella) vaccine. What is the best nursing response? 1."She will receive it today." 2."She can receive it when she is 12 months old." 3."She can receive it any time before her first birthday." 4."She will receive it before entry into kindergarten, at 4 to 6 years of age."
3."Precautions are indicated during the period of communicability." Mumps is transmitted via direct contact with or droplet spread from an infected person. Droplet precautions are indicated during the period of communicability (immediately before and after swelling begins); therefore, all other options are incorrect.
The nurse provides instructions to the mother of a child with mumps regarding respiratory precautions, and the mother asks the nurse about the length of time required for the respiratory precautions. The nurse should make which statement to the mother? 1."Precautions are not necessary once the swelling appears." 2."Precautions are not necessary before the swelling begins." 3."Precautions are indicated during the period of communicability." 4."Precautions are indicated for 20 days following the onset of parotid swelling."
4.Vacuum floors, play areas, and furniture to remove any hairs that might carry live nits.
The school nurse prepares a list of home care instructions for the parents of schoolchildren diagnosed with pediculosis capitis. Which instruction should the nurse include in the list? 1.Soak combs and brushes in warm water. 2.Use anti-lice sprays on all bedding and furniture. 3.Take all bedding and linens to the cleaners to be dry cleaned. 4.Vacuum floors, play areas, and furniture to remove any hairs that might carry live nits.
activity intolerance, chest pain, and dizziness when standing for long periods.
What are signs of aortic stenosis?
1. Acute 2. Subacute 3. Convalescent
What are the three stages of Kawasaki disease?
Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate. This is the nurse's first action. If a dysrhythmia is occurring, the radial pulse rate may be lower than the apical pulse rate. This may be indicated after conferring with the practitioner. The radial pulse rate needs to be compared with the apical pulse rate. It does not need to be counted for 1 minute five times. Only one nurse is needed to carry out this action.
What is an important nursing responsibility when a dysrhythmia is suspected? - Order an immediate electrocardiogram. - Count the radial pulse every 1 minute for five times. - Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate. - Have someone else take the radial pulse simultaneously with the apical pulse.
Transposition of the great arteries
What is considered a mixed cardiac defect? Pulmonic stenosis Transposition of the great arteries Atrial Septal Defect Patent Ductus arteriosus
Pulmonary stenosis- obstructive mixed
What is the defect?
Tetrology of Fallot- cyanotic •VSD •Pulmonary Stenosis •Overriding Aorta •Right Ventricular Hypertrophy
What is the defect?
Total Anomalous Pulmonary Venous Connection- Mixed
What is the defect?
Transposition of the great vessels- Mixed
What is the defect?
Tricuspid Atresia- cyanotic
What is the defect?
Truncus arteriosus- Mixed
What is the defect?
Ventral Septal Defect (VSD)- acyanotic
What is the defect?
1.A mask and pair of goggles Ribavirin is administered via hood, face mask, or oxygen tent. Some caregivers experience headaches, burning nasal passages and eyes, and crystallization of soft contact lenses as a result of administration of ribavirin
Which supplies should the nurse obtain for the administration of ribavirin to a hospitalized child with respiratory syncytial virus (RSV)? 1.A mask and pair of goggles 2.Isolation gown and sterile gloves 3.An intravenous (IV) pole and hood 4.Intramuscular (IM) syringe and needle
Cystic Fibrosis
a chronic multisystem disorder (autosomal recessive trait disorder) characterized by exocrine gland dysfunction. The mucus produced by the exocrine glands is abnormally thick, tenacious, and copious, causing obstruction of the small passageways of the affected organs, particularly in the respiratory, gastrointestinal, and reproductive systems.
Aortic Stenosis
a narrowing or stricture of the aortic valve, causing resistance to blood flow in the left ventricle, decreased cardiac output, left ventricular hypertrophy, and pulmonary vascular congestion.
Fifth disease (erythema infectiosum)
characterized by the presence of an intense fiery red edematous rash on the cheeks, which gives an appearance that the child has been slapped.
Varicella
first dose recommended at 12-15 months and second dose around 4-6 years old.
Tet Spell
hypercyanotic episodes. These episodes are characterized by increased respiratory rate and depth and increased hypoxia.
Otitis Media
inflammation of the middle ear
Heart Failure
the inability of the heart to pump a sufficient amount of blood to meet the oxygen and metabolic needs of the body.
Diptheria
Signs and Symptoms- Respiratory nasopharyngitis, obstructive laryngotracheitis, vaginal, otic, conjunctival, or cutaneous lesions. Treatment- Single dose of equine antitoxin IV
the child appears normal, but signs of inflammation may be present.
Signs and symptoms of convalescent stage Kawasaki disease
cracking lips and fissures, desquamation of the skin on the tips of the fingers and toes, joint pain, cardiac manifestations, and thrombocytosis occur
Signs and symptoms of subacute stage Kawasaki disease
3.Nothing smaller than the child's elbow should be placed in the ear.
A 10-year-old child complains of ear pain that is aggravated by palpation of the auricle. A foul-smelling, tenacious yellow discharge is noted in the ear canal, and the child is diagnosed with acute otitis externa. In providing information to the child and parent, the nurse emphasizes which information? 1.Dizziness is common with this disorder. 2.Cotton-tipped applicators should be used to clean the ears. 3.Nothing smaller than the child's elbow should be placed in the ear. 4.Biannual ear testing must be done by a special primary health care provider.
2."You can sit next to him and hold his hand through the tent, but he needs to remain inside of it."
A 2-year-old child has been admitted to the hospital for management of pneumonia. The child is placed in an oxygen tent. Taking into consideration the child's age and developmental level and the treatment being administered, which statement is appropriate for the nurse to make to the parents? 1."He can play in the tent with his blocks and plush stuffed animals." 2."You can sit next to him and hold his hand through the tent, but he needs to remain inside of it." 3."At his age, separation anxiety is high, so bringing in the wool blanket that he usually sleeps with is a good idea." 4."Before you leave for the night, it is a good idea to rock him to sleep. He can be out of the tent for up to 60 minutes without any consequences."
1.Bottle-feeding 2.Household smoking 4.Exposure to illness in other children 5.Congenital conditions such as cleft palate (and Down's syndrome) - Pacifier beyond 6 months is a risk factor and allergies are thought to precipitate otitis media
A 4-year-old child is diagnosed with otitis media. The mother asks the nurse about the causes of this illness. Which risk factors should the nurse include in response to this mother? Select all that apply. 1.Bottle-feeding 2.Household smoking 3.A history of urinary tract infections 4.Exposure to illness in other children 5.Congenital conditions such as cleft palate
3."The child should be kept home until the antibiotic eye drops have been administered for 24 hours."
A 7-year-old child is diagnosed with viral conjunctivitis. Antibiotic eye drops are prescribed for the child. When the mother asks the nurse when the child can return to school, what should the appropriate response be? 1."The child can return to school immediately." 2."The child cannot return to school until seen by the health care provider in 1 week." 3."The child should be kept home until the antibiotic eye drops have been administered for 24 hours." 4."The child should be kept home until the antibiotic eye drops have been administered for 72 hours."
MCV4 (meningococcal)
Not recommended for children 9months old to 10 years old routinely receive this vaccine.
3.Conjunctival hyperemia
On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease? 1.Cracked lips 2.Normal appearance 3.Conjunctival hyperemia 4.Desquamation of the skin
Apply the lotion to cool, dry skin at least 30 minutes after bathing. Permethrin is massaged thoroughly and gently into all skin surfaces (not just the areas that have the rash) from the head to the soles of the feet. Care should be taken to avoid contact with the eyes. The lotion should not be applied until at least 30 minutes after bathing and should be applied only to cool, dry skin. The lotion should be kept on for 8 to 14 hours, and then the child should be given a bath. The child should be clothed during the 8 to 14 hours of treatment contact time.
Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? 1.Apply the lotion to areas of the rash only. 2.Apply the lotion and leave it on for 6 hours. 3.Avoid putting clothes on the child over the lotion. 4.Apply the lotion to cool, dry skin at least 30 minutes after bathing.
2. The child had a previous anaphylactic reaction to the vaccine 5. The child has a disorder that caused a severely deficient immune system In addition, live virus vaccines generally are not administered to individuals with a severely deficient immune system, individuals with a severe sensitivity to gelatin, or pregnant women.
The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply. 1.The child has symptoms of a cold. 2.The child had a previous anaphylactic reaction to the vaccine. 3.The mother reports that the child is having intermittent episodes of diarrhea. 4.The mother reports that the child has not had an appetite and has been fussy. 5.The child has a disorder that caused a severely deficient immune system. 6.The mother reports that the child has recently been exposed to an infectious disease.
3. Activity intolerance
The clinic nurse reviews the record of a child just seen by the pediatrician and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder? 1.Pallor 2.Hyperactivity 3.Activity intolerance 4.Gastrointestinal disturbances
The early signs of HF include tachycardia, tachypnea, profuse scalp sweating, fatigue and irritability, sudden weight gain, and respiratory distress
What are the early signs of HF?
The child is 18 months old Lindane is a pediculicide product that may be prescribed to treat scabies. It is contraindicated for children younger than 2 years because they have more permeable skin, and high systemic absorption may occur, placing the children at risk for central nervous system toxicity and seizures. Lindane also is used with caution in children between the ages of 2 and 10 years. Siblings and other household members should be treated simultaneously. Options 2 and 4 are unrelated to the use of lindane. Lindane is not recommended for use by a breast-feeding woman because the medication is secreted into breast milk.
The clinic nurse is reviewing the primary health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? 1.The child is 18 months old. 2.The child is being bottle-fed. 3.A sibling is using lindane for the treatment of scabies. 4.The child has a history of frequent respiratory infections.
3.Notify the PHCP if the child develops abdominal pain or left shoulder pain. Infectious mononucleosis is caused by Epstein-Barr virus. The parents need to be instructed to notify the PHCP if abdominal pain, especially in the left upper quadrant, or left shoulder pain occurs because this may indicate splenic rupture. Children with enlarged spleens also are instructed to avoid contact sports until splenomegaly resolves. Bed rest is unnecessary, and children usually self-limit their activity.
The home health nurse visits a child with infectious mononucleosis and provides home care instructions to the parents. Which instruction should the nurse give to the parents? 1.Maintain the child on bed rest for 2 weeks. 2.Maintain respiratory precautions for 1 week. 3.Notify the PHCP if the child develops abdominal pain or left shoulder pain. 4.Notify the primary health care provider (PHCP) if the child develops a fever.
4.Telling the infant's aunt, who is pregnant, that it is acceptable to visit the infant When an infant is receiving ribavirin, exposure precautions need to be observed. Anyone entering the infant's room should wear a gown, mask, gloves, and hair covering. Anyone who is pregnant or considering pregnancy and anyone with a history of respiratory problems or airway disease should not care for or visit the infant who is receiving ribavirin. Hand washing is absolutely necessary before leaving the room to prevent the spread of germs.
Which action by the parent of an infant with respiratory syncytial virus infection who is receiving ribavirin would indicate a need for further instruction regarding the management of the disease process? 1.Wearing protective garb when visiting the infant 2.Washing the hands before leaving the infant's room 3.Telling a family member who has asthma that he should not visit the infant 4.Telling the infant's aunt, who is pregnant, that it is acceptable to visit the infant
the child has a fever, conjunctival hyperemia, red throat, swollen hands, rash, and enlargement of the cervical lymph nodes
Signs and symptoms of acute stage Kawasaki disease
3.To bring the child to the clinic to be seen by the pediatrician Mumps generally affects the salivary glands, but it can also affect multiple organs. The most common complication is septic meningitis, with the virus being identified in the cerebrospinal fluid. Common signs include nuchal rigidity, lethargy, and vomiting.
A mother of a child with mumps calls the health care clinic to tell the nurse that the child has been lethargic and vomiting. What instruction should the nurse give to the mother? 1.To continue to monitor the child 2.That lethargy and vomiting are normal with mumps 3.To bring the child to the clinic to be seen by the pediatrician 4.That, as long as there is no fever, there is nothing to be concerned about
1.Provide a soft diet. 5.Administer ibuprofen for fever every 4 hours as prescribed and as needed. 6.Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.
A child has been diagnosed with acute otitis media of the right ear. Which interventions should the nurse include in the plan of care? Select all that apply. 1.Provide a soft diet. 2.Position the child on the left side. 3.Administer an antihistamine twice daily. 4.Irrigate the right ear with normal saline every 8 hours. 5.Administer ibuprofen for fever every 4 hours as prescribed and as needed. 6.Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.
1.Red throat 3.Conjunctival hyperemia 5.Enlargement of the cervical lymph nodes Assessment findings in the acute stage include fever, conjunctival hyperemia, red throat, swollen hands, rash, and enlargement of the cervical lymph nodes.
A child is admitted to the pediatric unit with a diagnosis of acute stage Kawasaki disease. Which assessment findings by the nurse are characteristic of this disorder? Select all that apply. 1.Red throat 2.Cracking lips 3.Conjunctival hyperemia 4.Desquamation of the skin 5.Enlargement of the cervical lymph nodes
A previous dose of hepatitis B vaccine or component A contraindication to receiving the hepatitis B vaccine is a previous anaphylactic reaction to a previous dose of hepatitis B vaccine or to a component (aluminum hydroxide or yeast protein) of the vaccine
A child is receiving a series of the hepatitis B vaccine and arrives at the clinic with his parent for the second dose. Before administering the vaccine, the nurse should ask the child and parent about a history of a severe allergy to which substance? 1.Eggs 2.Penicillin 3.Sulfonamides 4.A previous dose of hepatitis B vaccine or component
2.Erythema on the face, giving a "slapped cheeks" appearance
A child is sent to the school nurse by the teacher. On assessment of the child, the nurse notes the presence of a rash. The nurse suspects that the child has erythema infectiosum (fifth disease) based on which assessment finding? 1.A discrete rose-pink maculopapular rash on the trunk 2.Erythema on the face, giving a "slapped cheeks" appearance 3.A highly pruritic, profuse macule-to-papule rash on the trunk 4.A discrete pinkish-red maculopapular rash on the arms and trunk
1.Keep the child in a room with dim lights. A nursing consideration in rubeola is eye care. The child usually has photophobia, so the nurse should suggest that the parent keep the child out of brightly lit area
A child seen in the clinic is found to have rubeola (measles), and the mother asks the nurse how to care for the child. The nurse should tell the mother to implement which action? 1.Keep the child in a room with dim lights. 2.Give the child warm baths to help prevent itching. 3.Allow the child to play outdoors because sunlight will help the rash. 4.Take the child's temperature every 4 hours and administer 1 baby aspirin for fever.
4.Apply cold compresses for 24 hours for 20 minutes at a time.
A child was seen in the health care clinic and received an immunization of DPT (diphtheria, pertussis, tetanus) vaccine. One hour later, the mother calls the clinic and tells the nurse that the injection site is painful and red. Which instruction should the nurse provide to the mother? 1.Monitor the child for a fever. 2.Call the primary health care provider. 3.Return to the health care clinic immediately. 4.Apply cold compresses for 24 hours for 20 minutes at a time.
1. Varicella vaccine 3. Inactivated polio vaccine (IPV) 6. Measles, mumps, rubella (MMR) Vaccine At age 4, the child will receive the diphtheria, tetanus, and acellular pertussis vaccine, inactivated polio vaccine, MMR, and varicella vaccine.
A child who is 4 years old is seen for a well-child checkup. He has been regularly receiving immunizations. Which immunizations should the child receive at this visit? Select all that apply. 1.Varicella vaccine 2.Rotavirus vaccine 3.Inactivated polio vaccine 4.Meningococcal conjugate vaccine 5.Haemophilus influenzae type B vaccine 6.Measles, mumps, and rubella (MMR) vaccine
3.A hypercyanotic episode
A child with a diagnosis of tetralogy of Fallot exhibits an increased depth and rate of respirations. On further assessment, the nurse notes increased hypoxemia. The nurse interprets these findings as indicating which situation? 1.Anxiety 2.A temper tantrum 3.A hypercyanotic episode 4.The need for immediate primary health care provider notification
3.The child develops stridor. The mother should be instructed to bring the child to the emergency department if the child develops stridor at rest, cyanosis, severe agitation or fatigue, or moderate to severe retractions or is unable to take oral fluids.
A child with croup is being discharged from the hospital. The nurse provides instructions to the mother and advises the mother to bring the child to the emergency department if which occurs? 1.The child is irritable. 2.The child appears tired. 3.The child develops stridor. 4.The child takes fluids poorly.
4.Let the mother hold the child and direct the cool mist over the child's face.
A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying, and trying to climb out of the tent. Which is the most appropriate nursing action? 1.Tell the mother that the child must stay in the tent. 2.Place a toy in the tent to make the child feel more comfortable. 3.Call the pediatrician and obtain a prescription for a mild sedative. 4.Let the mother hold the child and direct the cool mist over the child's face.
4. DTaP, Hib, IPV, PCV, RV DTaP is administered at 2, 4, and 6 months of age; at 15 to 18 months of age; and at 4 to 6 years of age. Hib is administered at 2, 4, and 6 months of age and at 12 to 15 months of age. IPV is administered at 2, 4, and 6 months of age and at 4 to 6 years of age. PCV is administered at 2, 4, and 6 months of age and at 12 to 15 months of age.
A parent brings her 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant? 1.Varicella, hepatitis B vaccine (HepB) 2.Diphtheria, tetanus, acellular pertussis (DTaP); measles, mumps, rubella (MMR); inactivated poliovirus vaccine (IPV) 3.MMR, Haemophilus influenzae type b (Hib), DTaP 4.DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus vaccine (RV)
4.When drawing blood for electrolyte level testing Crying exhausts the limited energy supply, increases the workload of the heart, and increases the oxygen demands. Oxygen administration may be prescribed for stressful periods, especially during bouts of crying or invasive procedures.
A pediatrician has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant? 1.During sleep 2.When changing the infant's diapers 3.When the mother is holding the infant 4.When drawing blood for electrolyte level testing
Apply a thin layer of cream and rub it into the area thoroughly.
A topical corticosteroid is prescribed by the primary health care provider for a child with contact dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 1.Apply the cream over the entire body. 2.Apply a thick layer of cream to affected areas only. 3.Avoid cleansing the area before application of the cream. 4.Apply a thin layer of cream and rub it into the area thoroughly.
4."My contact lenses can be worn if they are cleaned as directed."
An adolescent client is diagnosed with conjunctivitis, and the nurse provides information to the client about the use of contact lenses. Which client statement indicates the need for further information? 1."I should obtain new contact lenses." 2."I should not wear my contact lenses." 3."My old contact lenses should be discarded." 4."My contact lenses can be worn if they are cleaned as directed."
Lyme disease
An adolescent patient is admitted to the emergency room with complaints of pain in her right knee. The knee is swollen and warm to the touch. No exudate is noted. Patient is febrile. Which disease process would be included as part of the patient's differential diagnosis? - Juvenile Diabetes - Lyme Disease - Rheumatoid arthritis - Congestive heart failure
2.Administer the vaccination.
An infant is brought to the clinic for his third diphtheria, tetanus toxoid, and acellular pertussis vaccination (DTaP). The mother reports that the infant developed a 99.4º F (37.4º C) temperature after the last DTaP. Which action is most appropriate? 1.Withhold the vaccination. 2.Administer the vaccination. 3.Draw blood for a pertussis titer. 4.Notify the primary health care provider.
Apply a cold pack
An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent? 1.Monitor the infant for a fever. 2.Bring the infant back to the clinic. 3.Apply a hot pack to the injection site. 4.Apply a cold pack to the injection site.
"Administer the antibiotics until they are gone."
Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympanostomy tubes. The nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided? 1."Administer the antibiotics until they are gone." 2."Administer the antibiotics if the child has a fever." 3."Administer the antibiotics until the child feels better." 4."Begin to taper the antibiotics after 3 days of a full course."
Diuretic therapy with Aldactone The use of ACE inhibitors in combination with Aldactone, which is a potassium sparing inhibitor can lead to potential hyperkalemia. As such this type of diuretic therapy should not be used. ACE inhibitors typically are not associated with dizziness but continued monitoring for this presentation should be included. Normal urine output is a favorable sign. ACE inhibitors can cause hypotension so continued monitoring would be needed at this point.
If a child is being treated with ACE inhibitors as part of the therapeutic regimen for heart failure, which observation is noted would alert the nurse to a potential interaction? - Diuretic therapy with Aldactone - Child complains of being slightly dizzy at times - Maintaining normal urine output - Blood pressure monitoring at lower end of normal range
organize activities to allow for uninterrupted sleep. The child needs to be well rested before feeding. The child's needs should be met to minimize crying. The nurse must organize care to decrease energy expenditure. The child in congestive heart failure has an excess of fluid, so forcing fluids is contraindicated. Monitoring of vital signs is appropriate, but minimizing energy expenditure is a priority. The child often cannot tolerate larger feedings; small, frequent feedings should be given to the child in congestive heart failure.
Nursing care of the infant and child with congestive heart failure includes - force fluids appropriate to age. - monitor respirations during active periods. - organize activities to allow for uninterrupted sleep. - give larger feedings less often to conserve energy.
3."The disease can be spread to others from 10 days before any sign of the disease appears to 15 days after the rash appears." The communicable period for rubeola ranges from 4 days before to 5 days after the rash appears, mainly during the prodromal stage. All other options are accurate descriptions of rubeola, so they would not indicate a need for further teaching. The small blue-white spots found in this communicable disease are called Koplik's spots. The incorrect option describes the incubation period for rubella, not rubeola.
Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the schoolchildren. Which statement made by a parent indicates a need for further teaching regarding this communicable disease? 1."Small blue-white spots with a red base may appear in the mouth." 2."The rash usually begins on the face and spreads downward toward the feet." 3."The disease can be spread to others from 10 days before any sign of the disease appears to 15 days after the rash appears." 4."Respiratory symptoms such as a profuse runny nose, cough, and fever occur before the development of a rash."
Fine grayish red
The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? 1.Fine grayish red lines 2.Purple-colored lesions 3.Thick, honey-colored crusts 4.Clusters of fluid-filled vesicles
Possible sexual abuse
The mother of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red, and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation? 1.Possible trauma 2.Possible sexual abuse 3.Presence of an allergy 4.Presence of a respiratory infection
"Antibiotics are not indicated unless a bacterial infection is present."
The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the pediatrician did not prescribe antibiotics. Which response should the nurse make? 1."The child may be allergic to antibiotics." 2."The child is too young to receive antibiotics." 3."Antibiotics are not indicated unless a bacterial infection is present." 4."The child still has the maternal antibodies from birth and does not need antibiotics."
4.Encourage the child to lie on the right side. Splinting of the affected side by lying on that side may decrease discomfort.
The mother of an 8-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother? 1.Increase the dose of ibuprofen. 2.Increase the frequency of ibuprofen. 3.Encourage the child to lie on the left side. 4.Encourage the child to lie on the right side.
4.Small, blue-white spots with a red base found on the buccal mucosa
The nurse caring for a child diagnosed with rubeola (measles) notes that the pediatrician has documented the presence of Koplik's spots. On the basis of this documentation, which observation is expected? 1.Pinpoint petechiae noted on both legs 2.Whitish vesicles located across the chest 3.Petechiae spots that are reddish and pinpoint on the soft palate 4.Small, blue-white spots with a red base found on the buccal mucosa
Remove excess clothing and blankets from the child
The nurse has just administered ibuprofen to a child with a temperature of 102° F (38.8° C). The nurse should also take which action? 1.Withhold oral fluids for 8 hours. 2.Sponge the child with cold water. 3.Plan to administer salicylate in 4 hours. 4.Remove excess clothing and blankets from the child.
4.Providing a consistent routine with touching, rocking, and cuddling throughout hospitalization A 10-month-old is in the Trust versus Mistrust stage of psychosocial development according to Erikson.
The nurse is admitting a 10-month-old infant who is being hospitalized for a respiratory infection. The nurse develops a plan of care for the infant and includes which most appropriate intervention? 1.Keeping the infant as quiet as possible 2.Restraining the infant to prevent dislodging of tubes 3.Placing small toys in the crib to provide stimulation for the infant 4.Providing a consistent routine with touching, rocking, and cuddling throughout hospitalization
4.Withhold the medication and notify the primary health care provider. The apical pulse rate for a newborn is 120 to 160 beats/min. The therapeutic digoxin level ranges from 0.5 to 0.8 ng/dL (0.64 to 1.02 mmol/L). Because the apical rate is low and the digoxin blood level is elevated, indicating toxicity, the nurse would withhold the medication and notify the primary health care provider.
The nurse is assessing a newborn with heart failure before administering the prescribed digoxin. In reviewing the laboratory data, the nurse notes that the newborn has a digoxin blood level of 1.6 ng/mL (2.05 mmol/L) and an apical heart rate of 90 beats/min. The mother also tells the nurse that the newborn just vomited her formula. Which intervention should the nurse take? 1.Retake the apical pulse. 2.Administer the medication. 3.Withhold the medication for 1 hour. 4.Withhold the medication and notify the primary health care provider.
2."I need to stop breast-feeding as soon as possible." Additionally, parents should be told not to smoke in the child's presence because passive smoking increases the incidence of otitis media.
The nurse is assisting in providing an educational session to new mothers regarding the methods that will decrease the risk of recurrent otitis media in infants. Which statement by a mother in the group indicates a need for further teaching? 1."I need to feed my infant in an upright position." 2."I need to stop breast-feeding as soon as possible." 3."Bottle-feeding should be stopped as soon as possible." 4."I should not provide my infant with a bottle during naptime."
1.An intense fiery red edematous rash on the cheeks
The nurse is caring for a child diagnosed with erythemia infectiosum (fifth disease). Which clinical manifestation should the nurse expect to note in the child? 1.An intense fiery red edematous rash on the cheeks 2.Pinkish-rose maculopapular rash on the face, neck, and scalp 3.Reddish and pinpoint petechiae spots found on the soft palate 4.Small bluish-white spots with a red base found on the buccal mucosa
Digoxin
•Normal maintenance dosage is 10-15 mcg/kg/day in two doses •Doses are usually less than 1 mL oral and IV dosages are between 0.62 mg to 1.25 mg in children •Must take apical HR prior to giving a dose •90-100 bpm for Infants •70 bpm for older children
3.Bluish discoloration of the skin The child with a right-to-left shunt will be considerably sicker than a child with a left-to-right shunt. Many of these children will present with symptoms in the first week of life. The most common assessment finding in these children is bluish discoloration of the skin, known as cyanosis. The child may also become dyspneic after feeding, crying, and other exertional activities.
The nurse is caring for a child with a diagnosis of a right-to-left cardiac shunt. On review of the child's record, the nurse should expect to note documentation of which most common assessment finding? 1.Severe bradycardia 2.Asymptomatic after feeding 3.Bluish discoloration of the skin 4.Higher than normal body weight
2,1,4,3,6,5
The nurse is caring for a pediatric client who is going to receive a vaccination. Place the nursing actions for performing this procedure in order of priority. All options must be used. Select the correct sequence number for each item. 1.Assess for allergies. 2.Verify the prescription. 3.Check the lot number and expiration. 4.Obtain parental consent. 5.Provide a vaccination record to the parents. 6.Select appropriate site and administer the vaccine.
2,1,3,5,4
The nurse is caring for an infant client with tetralogy of Fallot who is experiencing a hypercyanotic spell. Place the actions the nurse should take in order of priority. All options must be used. Select the correct sequence number for each item. 1.Administer 100% oxygen. 2.Place the infant in a knee-chest position. 3.Administer morphine sulfate as prescribed. 4.Document the occurrence, actions taken, and the infant's response. 5.Administer fluids intravenously.
4.Clubbing of the fingers
The nurse is caring for an infant with a diagnosis of congenital heart disease. Which finding, on physical assessment, does the nurse attribute to chronic hypoxia? 1.Tachypnea 2.Tachycardia 3.Sucking on the fingers 4.Clubbing of the fingers
2.Knee-chest position This position improves systemic arterial oxygen saturation.
The nurse is caring for an infant with a diagnosis of tetralogy of Fallot. The infant suddenly becomes cyanotic, and the nurse recognizes that the infant is experiencing a hypercyanotic spell (blue or tet spell). The nurse immediately places the infant in what position? 1.Prone position 2.Knee-chest position 3.High-Fowler's position 4.Reverse Trendelenburg's position
2.Move the infant to a private room. RSV is a highly communicable disorder and is transmitted via droplets and direct contact with respiratory secretions.
The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action? 1.Initiate strict enteric precautions. 2.Move the infant to a private room. 3.Leave the infant in the present room, because RSV is not contagious. 4.Inform the staff that using standard precautions is all that is necessary when caring for the child.
3.Diaphoresis during feeding
The nurse is caring for an infant with congenital heart disease. Which, if noted in the infant, should alert the nurse to the early development of heart failure? 1.Paleness of the skin 2.Strong sucking reflex 3.Diaphoresis during feeding 4.Slow and shallow breathing
1. Weighing the diapers
The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving diuretic therapy. The nurse should use which most appropriate method to assess the urine output? 1.Weighing the diapers 2.Inserting a urinary catheter 3.Comparing intake with output 4.Measuring the amount of water added to formula
2.Heart failure
The nurse is creating a plan of care for a child admitted with a diagnosis of Kawasaki disease. In developing the initial plan of care, the nurse should include monitoring the child for signs of which condition? 1.Bleeding 2.Heart failure 3.Failure to thrive 4.Decreased tolerance to stimulation
Tachycardia
The nurse is monitoring an infant with congenital heart disease closely for signs of heart failure (HF). The nurse should assess the infant for which early sign of HF? 1.Pallor 2.Cough 3.Tachycardia 4.Slow and shallow breathing
4.A weight gain of 1 lb (0.5 kg) in 1 day The nurse should assess urine output, assess for evidence of facial or peripheral edema, auscultate lung sounds, and report the weight gain to the primary health care provider.
The nurse is monitoring an infant with heart failure. Which sign alerts the nurse to suspect fluid accumulation and the need to call the primary health care provider? 1.Bradypnea 2.Diaphoresis 3.Decreased blood pressure 4.A weight gain of 1 lb (0.5 kg) in 1 day
1.Place the infant in a private room. 3.Wear a mask, gown, and gloves when in contact with the infant. 6.Ensure that nurses caring for the infant with RSV do not care for other high-risk children. The infant should be positioned with the head and chest at a 30- to 40-degree angle and the neck slightly extended to maintain an open airway and decrease pressure on the diaphragm. Cool humidified oxygen is delivered to relieve dyspnea, hypoxemia, and insensible water loss from tachypnea.
The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply. 1.Place the infant in a private room. 2.Ensure that the infant's head is in a flexed position. 3.Wear a mask, gown, and gloves when in contact with the infant. 4.Place the infant in a tent that delivers warm humidified air. 5.Position the infant on the side, with the head lower than the chest. 6.Ensure that nurses caring for the infant with RSV do not care for other high-risk children.
3."Is the child allergic to any antibiotics?"
The nurse is preparing to administer an MMR (measles, mumps, and rubella) vaccine to a 15-month-old child. Before administering the vaccine, which question should the nurse ask the mother of the child? 1."Has the child had any sore throats?" 2."Has the child been eating properly?" 3."Is the child allergic to any antibiotics?" 4."Has the child been exposed to any infections?"
1.Withhold the medication.
The nurse is preparing to administer digoxin to an infant with heart failure. Before administering the medication, the nurse double-checks the dose, counts the apical heart rate for 1 full minute, and obtains a rate of 80 beats/minute. Based on this finding, which is the appropriate nursing action? 1.Withhold the medication. 2.Administer the medication. 3.Check the blood pressure and then administer the medication. 4.Check the respiratory rate and then administer the medication.
do not draw-up dose; suspect dosage error. Digoxin is often prescribed in micrograms. Rarely is more than 1 ml administered to an infant. As a potentially dangerous drug, digoxin has precise administration guidelines. Some institutions require that digoxin dosages be checked with another professional before administration. The nurse has drawn up too much medication and should not give it to the child. Administration procedures as described are correct, but too much medication is prepared, so it should not be given to the child.
The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose; 4 ml of the drug is to be drawn up. Based on the nurse's knowledge of this medication and safe pediatric dosages, the most appropriate action by the nurse is - do not draw-up dose; suspect dosage error. - mix dose with juice to disguise its taste. - check heart rate; administer dose by placing it to the back and side of mouth. - check heart rate; administer dose by letting infant suck it through a nipple.
3.The child's towels and washcloths should not be used by other members of the household.
The nurse is providing home care instructions to the mother of a child who has bacterial conjunctivitis. The nurse should provide the mother with which information? 1.The child may attend school if antibiotics have been started. 2.Any unused eye medication should be saved in case a sibling gets the eye infection. 3.The child's towels and washcloths should not be used by other members of the household. 4.Any crusted material should be wiped from the eye with a cotton ball soaked in warm water, starting at the outer aspect of the eye and moving toward the inner aspect.
"It is okay to share towels and washcloths.
The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis. Which, if stated by the mother, indicates a need for further teaching? 1."I need to wash my hands frequently." 2."I need to clean the eye as prescribed." 3."It is okay to share towels and washcloths." 4."I need to give the eye drops as prescribed."
4."We need to maintain droplet precautions and a quiet environment for at least 2 weeks." Pertussis is transmitted by direct contact or respiratory droplets from coughing. The communicable period occurs primarily during the catarrhal stage. Respiratory precautions are not required during the convalescent phase
The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction? 1."We need to encourage our child to drink fluids." 2."Coughing spells may be triggered by dust or smoke." 3."Vomiting may occur when our child has coughing episodes." 4."We need to maintain droplet precautions and a quiet environment for at least 2 weeks."
4."If my child vomits after medication administration, I will repeat the dose."
The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin. Which statement made by the parent indicates the need for further instruction? 1."I will not mix the medication with food." 2."If more than 1 dose is missed, I will call the pediatrician." 3."I will take my child's pulse before administering the medication." 4."If my child vomits after medication administration, I will repeat the dose."
3."It is all right to share towels and washcloths as long as they are bleached after use."
The nurse teaches the mother of a child diagnosed with bacterial conjunctivitis about measures to prevent transmission of the infection. Which statement by the mother indicates a need for further teaching? 1."Hands need to be washed frequently." 2."A clean washcloth can be used to wipe my child's eyes." 3."It is all right to share towels and washcloths as long as they are bleached after use." 4."The eye drops must be given as prescribed, and hands need to be washed before and after instillation."
"Lesions most often are located on the arms and chest."
The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? 1."It is extremely contagious." 2."It is most common in humid weather." 3."Lesions most often are located on the arms and chest." 4."It might show up in an area of broken skin, such as an insect bite."
White sacs attached to the hair shafts in the occipital area
The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check for lice? 1.Maculopapular lesions behind the ears 2.Lesions in the scalp that extend to the hairline or neck 3.White flaky particles throughout the entire scalp region 4.White sacs attached to the hair shafts in the occipital area
myocardial ischemia
What is a patient with Kawasaki at risk for?
atrial septal defect (ASD)- acyanotic
What is the defect?
patent ductus arteriosus (PDA)- acyanotic
What is the defect?
contact and airborne
What precautions should be taken with a patient having chicken pox?
Chloride levels 40-60 mmol/L
What results indicate suggestive of CF and would indicate repeat testing?
Apprehension
What should the nurse recognize as an early clinical sign of compensated shock in a child? - Confusion - Sleepiness - Hypotension - Apprehension
Signs of heart failure: Increased respiratory rate increased heart rate dyspnea crackles abdominal distention
What to monitor in a child with kawasaki disease?
At age 4, the child will receive the diphtheria, tetanus, and acellular pertussis vaccine (DTaP), inactivated polio vaccine (IPV), MMR, and varicella vaccine.
What vaccines are given at age 4?
Gloves, gown, and mask Droplet and contact precautions
When caring for a patient with RSV what PPE should be worn?
PCV is administered at 2, 4, and 6 months of age and at 12 to 15 months of age.
When is PCV (pneumoccocal vaccine) administered?
Cyanotic and mixed defects
When to give prostaglandins
