Peds- Chapter 37

The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A) "I can't believe it. We're not unclean, poor people." B) "We'll have to get that special shampoo." C) "Everybody in the house will need to be checked." D) "That explains his complaints of itching on his neck."

A) "I can't believe it. We're not unclean, poor people." Head lice is not an indication of poor hygiene or poverty. It occurs in all socioeconomic groups. Thus, the parents' statement about being unclean and poor reflects a lack of knowledge about the infection. A pediculicide is used to wash the hair to treat the infestation. Household contacts need to be examined and treated if affected. Extreme pruritus is the most common symptom, with nits or lice especially behind the ears or at the nape of the neck.

The parents of a 7-month-old child with an infection ask the nurse about how to treat their child's fever. After providing teaching, the parents voice understanding with which statements? Select all that apply. A) "Unless my child develops a fever over 102.2°F , I don't need to make an appointment with the physician." B) "Having a temperature over 38°C puts my child at risk for the infection spreading to the bloodstream." C) "I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection." D) "Even though people get frightened, fevers are not a bad thing during an infection unless it gets too high." E) "Any fever is dangerous and can cause serious damage to brain cells if it goes on too long."

A) "Unless my child develops a fever over 102.2°F , I don't need to make an appointment with the physician." C) "I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection." D) "Even though people get frightened, fevers are not a bad thing during an infection unless it gets too high." In infants older than 3 months of age, fever less than 39°C (102.2°F) usually does not require treatment by a physician. Antipyretics, such as acetaminophen, provide symptomatic relief but do not change the course of the infection. A fever can actually enhance various components of the immune response. Infants younger than 3 months of age with a rectal temperature greater than 38°C should be seen by a physician or nurse practitioner because of increased risk of sepsis.

An adolescent is diagnosed with gonorrhea. When developing the plan of care for this adolescent, the nurse would expect that she would also receive treatment for what? A) Chlamydia B) Syphilis C) Genital herpes D) Trichomoniasis

A) Chlamydia Patients with gonorrhea usually receive treatment for chlamydia as well because patients often are coinfected. Coinfection with syphilis, genital herpes, or trichomoniasis is uncommon.

Therapeutic management of Pertussis includes: SATA A) Eradicating bacterial infection B) Providing respiratory support C) Infants older than 1 month- macrolide drugs including erythromycin, clarithromycin, and azithromycin are drugs of choice D) Younger infants- azithromycin should be used and erythromycin and clarithromycin should be avoided E) All close contacts who are younger than 7, and who are unimmunized should have pertussis immunization initiated/series completed. F) For all children azithromycin should be given

A) Eradicating bacterial infection B) Providing respiratory support C) Infants older than 1 month- macrolide drugs including erythromycin, clarithromycin, and azithromycin are drugs of choice D) Younger infants- azithromycin should be used and erythromycin and clarithromycin should be avoided E) All close contacts who are younger than 7, and who are unimmunized should have pertussis immunization initiated/series completed.

The nurse determines that it is necessary to implement airborne precautions for children with which infection? A) Measles B) Streptococcus group A C) Rubella D) Scarlet fever

A) Measles Airborne precautions are designed to reduce the risk of infectious agents transmitted by airborne droplet nuclei or dust particles such as for children with measles, varicella, or tuberculosis. Droplet precautions would be used for children with streptococcal group A infections, rubella, and scarlet fever.

After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections? A) Neutrophils B) Eosinophils C) Basophils D) Lymphocytes

A) Neutrophils Elevations in certain portions of the white blood cell count reflect different processes occurring in the body. Neutrophils function to combat bacterial infection. Eosinophils function in allergic disorders and parasitic infections. Basophils combat parasitic infections and some allergic disorders. Lymphocytes function in viral infections.

A nurse suspects that an adolescent may have community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA). What would the nurse expect to assess? Select all that apply. A) Participation in contact sport B) Recent cut on the lower leg C) History of a recent sore throat D) Raised fluctuant lesions E) Erythematous rash over the trunk and face

A) Participation in contact sport B) Recent cut on the lower leg D) Raised fluctuant lesions With CAMRSA, skin and tissue infections are common, often appearing as a bump or skin area that is red, swollen, painful, and warm to the touch. There also may be fluctuance and purulent drainage. Participation in contact sports, openings in the skin such as abrasions and cuts, contact with contaminated items and surfaces, poor hygiene, and crowded living conditions are risk factors for CAMRSA. Recent sore throat and an erythematous rash on the trunk, face, and possibly the extremities are associated with scarlet fever.

A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease? A) Playing in the woods about a week ago B) Rash is papular and vesicular C) High fever occurring about 4 days before the rash D) Complaints of extreme pruritus with visible nits

A) Playing in the woods about a week ago Lyme disease is caused by the bite of an infected tick, with a rash appearing 7 to 14 days after the tick bite. Ticks are commonly found in wooded areas. Therefore, reports of the child playing in the woods about 7 days ago would support the diagnosis of Lyme disease. A papular and vesicular rash is commonly associated with varicella (chickenpox). A high fever for 3 to 5 days before a rash suggests roseola. Extreme pruritus with visible nits would suggest pediculosis.

Clinical manifestations of scarlet fever include: SATA A) Rash of scarlet fever- on face, trunk, and extremities usually absent from palms and soles of feet. Looks like sunburn but feels like sandpaper. B) Strawberry tongue with thick coat- later loses coating and becomes bright red. C) Herpes/blistering outbreak all over body D) Backache

A) Rash of scarlet fever- on face, trunk, and extremities usually absent from palms and soles of feet. Looks like sunburn but feels like sandpaper. B) Strawberry tongue with thick coat- later loses coating and becomes bright red.

Common Viral Exanthems of Childhood: Rash is usually first sign. Maculopapular rash that begins on face and spreads head to foot; disappears in same order it's spread, usually by 3rd day. Mild pruritus. What are these clinical manifestations indicative of? A) Rubella (German measles) B) Rubeola (measles) C) Varicella Zoster (chickenpox) D) Erythema Infectiosum (fifth disease)

A) Rubella (German measles)

Management for a child with pinworm includes: SATA A) Standard precautions are sufficient B) Droplet precautions are indicated C) Reinfection occurs easily D) Infected people should bathe, preferably in a shower, in the morning, which will remove a large portion of the eggs. E) Frequent changing of underclothes/bedding F) Personal hygiene measures such as keeping fingernails short, avoiding scratching of perianal area and nail biting G) Good hand hygiene is the most effective preventative measure, especially after using the bathroom and before eating. All family members should be treated since transmission from person to person is very easy.

A) Standard precautions are sufficient C) Reinfection occurs easily D) Infected people should bathe, preferably in a shower, in the morning, which will remove a large portion of the eggs. E) Frequent changing of underclothes/bedding F) Personal hygiene measures such as keeping fingernails short, avoiding scratching of perianal area and nail biting G) Good hand hygiene is the most effective preventative measure, especially after using the bathroom and before eating. All family members should be treated since transmission from person to person is very easy.

The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease? A) Swollen lymph nodes B) Strawberry tongue C) Infected tonsils D) Swollen neck

A) Swollen lymph nodes Lymph nodes, especially under the arms, can become painful and swollen due to cat-scratch disease. Strawberry tongue is typical of scarlet fever. Infected tonsils and an edematous neck are symptoms of diphtheria.

Therapeutic management for child with tetanus includes: SATA A) Tetanus immunoglobulin may be given along with tetanus vaccine B) Removal of offending organism by debridement of the wound C) IV antibiotics such as metronidazole may be initiated. D) In severe cases, child may require intensive nursing care with mechanical ventilation. E) IV antibiotics such as azthromycin may be initiated.

A) Tetanus immunoglobulin may be given along with tetanus vaccine B) Removal of offending organism by debridement of the wound C) IV antibiotics such as metronidazole may be initiated. D) In severe cases, child may require intensive nursing care with mechanical ventilation.

The nurse is assessing a 8-month-old infant who has symptoms of poor feeding, a poor gag reflex, listlessness and a weak cry. What is the most important question the nurse should ask the parent about these symptoms? A. "Have you given your infant any honey?" B. "When did these symptoms begin?" C. "Has your infant had any unpasteurized milk to drink?" D. "What is the source of your family's water supply?"

A. "Have you given your infant any honey?" Rationale: Infant botulism occurs when the infant ingests the spores of Clostridium botulinum. These multiply in the intestinal track and produce toxins. The disease is caused by the ingestion of spores from dust, improperly preserved home-canned foods and feeding an infant under 1 year of age raw honey. The infant has poor feeding, is listless, has a weak cry, and a has poor gag reflex--a distinguishing symptom. The nurse would ask about the water supply and unpasteurized milk if food poisonings or parasites were suspected. Asking about the date of the infant's illness is important, but this information does not take priority over the question about honey. Reference: p. 1304

What antibiotic may cause potentially fatal hearth rhythm in some patients because it can lead to abnormal changes in the electrical activity of the heart?

Azithromycin

Which antibiotic is contraindicated when treating pertussis in children at risk for cardiovascular events, such as children with prolongation of the QT interval. Alternative drugs should be considered.

Azithromycin

A child is being treated for pertussis and is prescribed azithromycin by the health care provider. Which finding is most important for the nurse to report to the health care provider before administering this drug? A. Child has had previous episodes of supraventricular tachycardia (SVT). B. Child has a potassium level of 3.7 mEq/l (3.7 mmol/l). C. Child is also prescribed a proton pump inhibitor (PPI). D. Child experienced a rash on the back taking this drug previously.

A. Child has had previous episodes of supraventricular tachycardia (SVT). Rationale: Azithromycin is recommended for use to treat pertussis in infants older than 1 month of age and children. It should, however, not be used in children at risk for cardiovascular events. It may cause a potentially fatal heart rhythm, because it can lead in changes in the electrical activity of the heart. It is especially important in children with prolonged QT intervals. The finding of SVT should be reported to the health care provider before the administration of the drug. The potassium level is within a normal range and it has no effect on the drug. Azithromycin should not be given with any aluminum or magnesium antacids. The PPI should be safe. A rash may indicate an allergy to the drug and should be reported, but it is not the most important finding. The health care provider would make a determination for the drug administration based on risks versus benefits. Reference: p. 1303

The nurse is caring for a hospitalized, 1-week-old infant who appears very ill. Which assessment finding(s) will the nurse report to the health care provider? Select all that apply. A. Petechiae B. Heart rate100 beats/min C. Respiratory rate 60 breaths/min D. Axillary temperature 97.6°F (36.5°C) E. Characteristic of cry

A. Petechiae B. Heart rate100 beats/min C. Respiratory rate 60 breaths/min D. Axillary temperature 97.6°F (36.5°C) E. Characteristic of cry Rationale: Sepsis is suspected in any infant under 3 months of age until laboratory findings return. In an infant, the most important findings are hypothermia, bradycardia, and apnea. Tachypnea care be present in both infants and children. The nurse would be concerned with the infant's weak cry, lethargy, and an increased work of breathing such as rate, nasal flaring, grunting, and retractions. The child with sepsis generally has an elevated temperature, but hypothermia is seen in infants. The nurse should perform a good skin assessment. If petechiae are present, it is indicative of a very serious infection caused by Neisseria meningitidis. Reference: p. 1294-1296

After teaching a mother how to remove a tick from her 6-year-old boy's arm, the nurse determines that additional teaching is needed when the mother makes what statement? A) "I'll protect my fingers with a paper towel." B) "I'll grasp the tick and pull it away quickly." C) "I should put the tick in a plastic bag in the freezer." D) "I need to grasp the tick close to the child's skin."

B) "I'll grasp the tick and pull it away quickly." Grasping the tick and pulling it away quickly would indicate the need for additional teaching. When removing a tick, the mother should use fine-tipped tweezers while protecting her fingers with a tissue, paper towel, or latex gloves. The mother should grasp the tick as close to the skin as possible and pull upward with steady, even pressure. Once removed, the mother should place the tick in a sealable plastic bag in the freezer in case the child becomes sick and identification of the tick is needed.

A child is diagnosed with a helminthic infection. Which treatments would the nurse expect to be prescribed? Select all that apply. A) Erythromycin B) Albendazole C) Pyrantel pamoate D) Acyclovir E) Metronidazole F) Permethrin

B) Albendazole C) Pyrantel pamoate Drugs used to treat helminthic infections include albendazole and pyrantel pamoate. Erythromycin is used to treat bacterial infections. Acyclovir is used to treat viral infections. Metronidazole is used to treat trichomoniasis. Permethrin is used to treat pediculosis.

A nursing instructor is teaching a group of students about the action of antipyretic agents in children. The instructor determines that the teaching has been successful when the students identify which action as the primary action? A) Cause vasodilation to promote heat loss B) Decrease the temperature set point C) Block release of histamine D) Promote prostaglandin production

B) Decrease the temperature set point Antipyretics act to decrease the temperature set point in children with elevated temperatures by inhibiting the production of prostaglandins, which leads to heat loss through vasodilation and sweating. Antihistamines block the release of histamine.

A group of nursing students are reviewing the six links in the chain of infection and the nursing implications for each. The students demonstrate understanding of the information when they identify which precaution as helping to break the chain of infection to the susceptible host? A) Keeping linens dry and clean B) Maintaining skin integrity C) Washing hands frequently D) Coughing into a handkerchief

B) Maintaining skin integrity Maintaining the integrity of the child's skin and mucous membranes is a precaution that will break the chain of infection at the susceptible host. Keeping linens dry and clean is a precaution to take at the reservoir link. Washing hands frequently breaks the chain at the mode of transmission. Coughing into a handkerchief is a precaution for the portal of exit.

A nurse is conducting a health history for a 1-month-old with an infectious disorder. Which segment of the health history would be most helpful for the nurse when determining if the infant developed the infection from the mother? A) Family history B) Past medical history C) Home treatments D) Present illness history

B) Past medical history Past medical history will provide information about the mother's pregnancy and delivery, giving insight into the possibility of maternal transmission of the infection. Family history would provide information about lack of immunizations or recent infectious or communicable diseases. Home treatments and present illness history would provide no information about the possibility of maternal transmission of infection.

Common Viral Exanthems of Childhood: Prodromal phase: 2-4 days, consisting of fever, cough, coryza, conjunctivitis. Followed by Koplik spots (bright red spots with blue white centers on mucous membranes, mainly buccal mucosa; look like tiny grains of white sand surrounded by red rings) What are these clinical manifestations indicative of? A) Rubella (German measles) B) Rubeola (measles) C) Varicella Zoster (chickenpox) D) Erythema Infectiosum (fifth disease)

B) Rubeola (measles)

While hospitalized, a child develops scarlet fever. Isolation has been prescribed by the health care provider. The nurse would place this child in what type of isolation? A. Airborne B. Droplet C. Contact D. Reverse

B. Droplet Rationale: Scarlet fever is produced by group A streptococcus. It is most seen in children ages 5 years to 15 years. It is spread by droplets from respiratory secretions by talking, coughing, or sneezing. These droplets can travel 3 feet (1 meter). Isolation recommendations require the use of a mask for care of the child. Airborne isolation is required for illness that also produce droplets but these are smaller, can travel further and stay suspended in air. An N95 mask and negative pressure room is required for this type of isolation. Contact isolation requires the use of gowns, masks and gloves for direct contact with an infected person. Reverse isolation occurs if the client is neutropenic. Reference: p. 1289

A nurse is instructing a parent on how to obtain a stool culture for ova and parasites from a child with diarrhea. What would the nurse include in the teaching plan? A) "Give the child bismuth and then collect the next specimen." B) "Obtain the specimen from the toilet after the child has a bowel movement." C) "Keep the specimen from coming into contact with any urine." D) "Bring the specimen to the laboratory on the third day."

C) "Keep the specimen from coming into contact with any urine." A stool specimen for culture must be free of urine, water, and toilet paper. Therefore, the parent needs to understand how to collect the specimen so that it does not come into contact with any these. In addition, the specimen should not be retrieved out of toilet water. Mineral oil, barium, and bismuth interfere with the detection of parasites. In such cases, specimen collection should be delayed for 7 to 10 days. Once the specimen is collected, it should be brought to the laboratory immediately.

What would be most important to include in the teaching plan for parents of a child with pinworm? A) "Seal the child's clothing in a plastic bag for at least 10 days." B) "Be sure your child wears shoes at all times." C) "Make sure the child washes his hands after using the bathroom." D) "After applying this special cream, leave it on for about 8 to 10 hours."

C) "Make sure the child washes his hands after using the bathroom." The most effective measure to prevent pinworms or a recurrence is good hand hygiene, especially after using the bathroom and before eating. Sealing the child's clothing in a plastic bag is appropriate for pediculosis capitis. Having the child wear shoes at all times is helpful in preventing hookworm. Use of a cream that remains on for a specified time is associated with scabies.

While obtaining a health history from a male adolescent during a well check-up, the nurse assesses his sexual behavior and risk for sexually transmitted infections. Based on the information, the nurse plans to teach the adolescent about using a condom. What would the nurse include in the teaching plan? A) "You can reuse a condom if it's within 3 hours." B) "Store your condoms in your wallet so they are ready for use." C) "Put the condom on before engaging in any genital contact." D) "Use petroleum jelly with a latex condom for extra lubrication."

C) "Put the condom on before engaging in any genital contact." When teaching an adolescent about condom use, the nurse should tell the adolescent to put the condom on before any genital contact. A new condom should be used with each act of sexual intercourse; a condom should never be reused. Condoms should be stored in a cool, dry place away from direct sunlight and never stored in wallets, automobiles, or anywhere they could be exposed to extreme temperatures. Only water-soluble lubricants should be used with latex condoms. Oil-based or petroleum-based lubricants such as Vaseline can weaken latex condoms.

The nurse is developing a teaching plan for the mother of a 4-year-old girl with cold and fever. What would the nurse include in this teaching plan? A) Keeping the child covered and warm B) Calling the doctor if the child's fever lasts more than 36 hours C) Ensuring fluid intake to prevent dehydration D) Observing for changes in alertness resulting from brain damage

C) Ensuring fluid intake to prevent dehydration Teaching the mother to ensure fluid intake is important because fever can cause dehydration. The child should be dressed lightly. There is no need to call the doctor unless the child's fever lasts more than 3 to 5 days or the fever is greater than 105°F. A rapid rise to a high fever can cause a febrile convulsion, but it does not lead to brain damage.

The nurse is caring for a neonate who is suspected of having sepsis. Which assessment findings would the nurse interpret as most indicative of sepsis? A) Rash on face B) Edematous neck C) Hypothermia D) Coughing

C) Hypothermia Hypothermia is a sign of sepsis in neonates. A rash on the face is a symptom of scarlet fever. An edematous neck is a sign of diphtheria. Paroxysmal coughing is a symptom of pertussis.

A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child? A) Ibuprofen B) Acyclovir C) Penicillin V D) Doxycycline

C) Penicillin V Penicillin V is the antibiotic of choice for the treatment of scarlet fever. Ibuprofen is used to treat fever. Acyclovir is used to treat viral infections. Doxycycline, a tetracycline, is the drug of choice for treating Rocky Mountain spotted fever.

The client has a heavily draining wound for which there is an order to change the dressing every 4 hours. The nurse becomes busy and does not change the dressing as ordered. Which link in the chain of infection has the nurse allowed to flourish? A) Susceptible host B) Portal of exit C) Reservoir D) Mode of transmission

C) Reservoir The reservoir is the area where a pathogen grows and reproduces. Leaving the dressing unchanged allows for a dark, warm, nutrient rich, and moist environment where many organisms will thrive. A susceptible host is a person who cannot fight off an infection. The portal of exit is the way a pathogen exits the host. The mode of transmission is the way the pathogen travels.

The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find? A) Swelling in the neck B) Confusion and anxiety C) Ring-like rash on lower leg D) Hypersalivation

C) Ring-like rash on lower leg A ring-like rash at the site of the tick bite is characteristic for Lyme disease. Swelling in the neck is a symptom of mumps. Confusion, anxiety, and hypersalivation are symptoms of rabies.

A group of nursing students are reviewing information about childhood infectious diseases. The students demonstrate understanding of this information when they identify which disease as a common childhood exanthema? A) Mumps B) Rabies C) Rubella D) West Nile virus

C) Rubella Rubella is a common childhood exanthema. Mumps is a viral infection. Rabies is a zoonotic infection. West Nile virus is a vector-borne disease.

A school-aged child with an infectious disease is placed on transmission-based precautions. Which nursing diagnosis would be the priority? A) Impaired skin integrity related to trauma secondary to pruritus and scratching B) Fluid volume deficit related to increased metabolic demands and insensible losses C) Social isolation related to infectivity and inability to go to the playroom D) Deficient knowledge related to how infection is transmitted

C) Social isolation related to infectivity and inability to go to the playroom Children who are placed on transmission-based precautions are not allowed to leave their rooms and are not allowed to go to common areas such as the playroom or schoolroom. Thus, they are at risk for social isolation. Impaired skin integrity, fluid volume deficit, and deficient knowledge may be appropriate but would depend on the infectious disease diagnosed.

The mother of a 4-year-old boy has contacted the physician's office. She reports her son was exposed to someone with chickenpox. She has inquired about when her son may show if he has gotten the disease. What information should be provided? A) The illness should be seen in a week if he has been exposed. B) Symptoms of the disease should show up within 24 to 48 hours of exposure. C) The incubation period for the disease is between 10 and 21 days. D) Younger children will have longer periods of incubation.

C) The incubation period for the disease is between 10 and 21 days. Chickenpox is the common name for varicella. This condition has an incubation period of 10 to 21 days.

Common Viral Exanthems of Childhood: Prodromal symptoms (fever, malaise, anorexia, headache, mild abdominal pain) may be present 24-48 hours after rash. Rash is often first sign in children. Lesions often appear first on scalp, face, trunk, then extremities; initially intensely pruritic erythematous macules that evolve to papules and then form clear, fluid-filled vesicles. Vesicles eventually erupt, and then lesions scab and crust. Variety of lesions are present at one time. What are these clinical manifestations indicative of? A) Rubella (German measles) B) Rubeola (measles) C) Varicella Zoster (chickenpox) D) Erythema Infectiosum (fifth disease)

C) Varicella Zoster (chickenpox)

The nurse is assessing the tympanic temperature of several children. The nurse documents that the child with which temperature reading has a fever? A) 98.2° F (36.8° C) B) 99.2° F (37.3° C) C) 100° F (37.8° C) D) 100.8° F (38.2° C)

D) 100.8° F (38.2° C) A tympanic temperature greater than 100.4° F (greater than 38° C) is defined as fever. An oral temperature of 100° F (greater than 37.8° C) would identify a fever. An axillary temperature of 99° F (greater than 37.2° C) would identify a fever.

After teaching the parents of a child with chickenpox- varicella zoster, the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? A) After day 5 of the rash B) When the rash is completely healed C) Once the rash appears D) After the lesions have crusted

D) After the lesions have crusted Children with chickenpox (varicella zoster) can return to school once the lesions have crusted.

Common Viral Exanthems of Childhood: Prodromal phase: mild symptoms, low-grade fever, headache, mild upper respiratory infection. Rash occurs in 3 stages- 1) Begins with erythematous flushing often described as "slapped-cheek" appearance, often with circumoral pallor. 2) Spreads to trunk 3) Moves peripherally, appearing as a maculopapular, lace-like appearance, often pruritic. What are these clinical manifestations indicative of? A) Rubella (German measles) B) Rubeola (measles) C) Varicella Zoster (chickenpox) D) Erythema Infectiosum (fifth disease)

D) Erythema Infectiosum (fifth disease)

A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure for which sexually transmitted infection (STI)? A) Genital herpes B) Hepatitis B C) Syphilis D) Gonorrhea

D) Gonorrhea To prevent gonococcal ophthalmia neonatorum, erythromycin or tetracycline ophthalmic ointment is instilled into the eyes of all newborns. This action is required by law in most states. The ointment is not used to prevent conditions related to genital herpes, hepatitis B, or syphilis.

The nurse is preparing a plan of care for a 5-year-old boy with chickenpox. Which nursing intervention should be questioned? A) Administer antipyretics as ordered. B) Keep the child's fingernails short. C) Monitor fluid intake and output. D) Provide alcohol baths as needed.

D) Provide alcohol baths as needed Treatments such as sponging the child with alcohol or cold water are not appropriate interventions for fever management. Rather, the nurse would use tepid sponge baths and cool compresses. Administering antipyretics, keeping the child's fingernails short, and monitoring intake and output are appropriate.

While reviewing various studies about the use of antipyretics possibly prolonging illness, the nurse notes that there are benefits to their use for the child with fever. What would the nurse identify as the best explanation related to the benefit of antipyretics? A) They slow the growth of bacteria. B) They increase neutrophil production. C) They encourage T-cell proliferation. D) They help decrease fluid requirements.

D) They help decrease fluid requirements. Antipyretics provide symptomatic relief by increasing comfort in the child and decreasing fluid requirements, which helps to prevent dehydration. Fever has been shown to slow the growth of bacteria, increase neutrophil production, and encourage T-cell proliferation.

The nurse is preparing to obtain a blood specimen via capillary heel puncture. Which action would be most appropriate for the nurse to do? A) Apply a cool compress for several minutes before collection. B) Elevate the extremity used after puncturing it. C) Squeeze the area to facilitate specimen collection. D) Wipe away the first drop of blood with dry gauze.

D) Wipe away the first drop of blood with dry gauze. When obtaining a blood specimen by capillary puncture, the nurse should wipe away the first drop of blood with a cotton ball or dry gauze pad and then collect the sample without squeezing the foot to prevent possible hemolysis. Prior to the puncture, the nurse can apply a commercial heel warmer or warm compress for several minutes to promote vasodilation. The extremity being used should be placed in the dependent position after puncturing the heel.

An acute respiratory disorder characterized by paroxysmal cough (whooping cough) and copious secretions. Highest incidence and greatest risk for severe disease and death are seen in children younger than 1 year of age. Complications of this include: hypoxia, apnea, pneumonia, seizures, encephalopathy, and death.

Pertussis

An infection resulting from group A streptococci - usually occurs with a strep throat infection or rarely a streptococcal skin infection. In this case bacteria produce a toxin that causes a rash. Complications such as rheumatic fever, glomerulonephritis, skin infections, abscesses of the throat, pneumonia, and arthritis can occur if prompt diagnosis and treatment are not provided.

Scarlet Fever