Peds Chapter 27

To prevent ____________ the nurse warms the blood that is to be given as a transfusion through a central line

cardiac arrhythmias

What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkin's disease? (Select all that apply)

Application of sunblock Appetite stimulation Conservation of energy Provision for expressions of anger

What is the result of a deficiency of factor IX?

Christmas disease

A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated?

Heart failure

Which statement by a mother may indicate a cause for her 9-month- old's iron deficiency anemia?

"Formula is so expensive. We switched to regular milk right away.

Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?

"It is important for my child to drink plenty of fluids."

A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?

If bleeding occurs, apply pressure, ice, elevate, and rest the extremit

A school-aged child is living with a chronic disease process. Hovw would the nurse anticipate chronic illness will effect growth and development? Select all that apply

Impaired sense of belonging Decreased feelings of independence

The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child?

Risk for infection

A6-year-old with leukemia asks, "Who will take care of me in heaven?" What is the best response by the nurse?

"Who do you think will take care of you ?"

What will the nurse teach the parents of a child with a low platelet count to avoid?

Asprin

On admission, a child with leukemia has widespread purpura and platelet count of 19,000/mm. What is the priority nursing intervention?

Assessing neurological status

Place the stages of dying in the usual order as detailed by Kübler- Ross (1975). Put a comma and space between each answer choice (a, b, c, d, etc.)

C, D, A, F, B, E

The child receiving a transfusion complains of back pain and itching, What is the best initial action by the nurse?

Clamp off blood and keep line open with normal saline

What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?

Clean teeth with a soft toothbrush

The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron?

Cream of Wheat

A newly married couple is seeking genetic counseling are both carriers of the sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease?

Each child has a one in four chance of having the disease and a two in four chance of being a carrier

How has synthetic recombinant antihemophilic factor improved the management of hemophilia? (Select all that apply)

Eliminates the need for frequent transfusions Can be administered by family at home Reduces cost of care of the hemophiliac Reduces risk of HIV and hepatitis A and B transmission

What important focus of nursing care for the dying child and the family should the nurse implement?

Families should be made aware that hearing is the last sense to stop functioning before death

An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this?

III

A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?

Hemosiderosis

What are the classic symptoms of thalassemia major (Cooley's anemia)? (Select all that apply.)

Hepatomegaly Jaundice Protruding teeth Pathological fractures

A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow?

Increased susceptibility to infection

The nurse is presenting information on the congentital disorder of hemophilia A. What fact will the nurse include?

It is transmitted by symptom-free females

The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?

Peripheral neuropathy

The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding? (Select all that apply)

Petichiae Purpura Ecchymosis Hematoma

The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?

Platelet count of 25,000/mm

Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply)

She will feel less neglected by the parents She can make amends for past hostilities to her brother She can express her feelings through care She can experience being supportive of her parents and brother

The nurse finds an adolescent with Hodgkin's disease crying. The adolescent says, "I am so scared." What is the most appropriate nursing response to this comment?

Tell me what's got you scared."

The nurse is dealing with a preschool-age child with a life- threatening illness. What should the nurse remember the child's concept of death is at this age?

That a person becomes alive again soon after death

The family of a child receiving chemotherapy for leukemia should be taught to focus on which aspect(s) of the child's care? (Select all that apply.)

Using a support group Stimulating appetite Maintaining adequate hydration Reporting exposure to infectious diseases

A3-year-old child with sickle cell disease is admitted to the hospital sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing?

Vaso-occlusive

The nurse explains that the COPP medical regimen for the treatment of Hodgkin's disease uses a combination of which drugs? (Select all that apply)

Vincristine Cyclophosphamide Prednisone Procarbazine hydrochloride

What will the nurse administer with ferrous sulfate drops when providing them to a child on the pediatric unit?

With orange juice

The nurse confirms that sickle cell trait can be distinguished fronm sickle cell disease by a lab test called _______

electrophoresis

The rate of RBC production is regulated by_________

erythropoietin

What should the nurse closely assess in a child receiving a transfusion?

fever

The nurse shows slides of red blood cells from a child with sickle cell disease, noting that in addition to their sickle shape, the cells contain the abnormal element of _________

hemoglobin S