peds exam 3 quiz/kahoot questions/MIVF calculation
What age group are at an increased risk for dehydration?
-Children under 2 do not have mature kidney function yet
which nursing action should confirm tracheoesophageal atresia? -respiratory distress increases with oral suctioning -catheter tip noted to be in the stomach on x ray -NG tube easily advances to obtain stomach contents -Soft NG advances but unable to obtain stomach contents
-Soft NG advances but unable to obtain stomach contents
Steps of oral rehydration
-Start with clear fluid (pedialyte)and gradually progress to normal diet based on LOC and tolerance -Can give breast milk or half strength formula -Progress the safe no matter what the diagnosis is -Oral vs. IV rehydration depends of severity
MIVF calculation
-Up to 10 kg: 100 ml/kg/24 hrs -11-20 kg: 1000 ml + (50 ml/kg for weight above 10 kg)/24 hours) > 20 kgs: 1500 ml + (20 ml/kg for weight above 20 kg)/24 hours)
What IV fluids do you generally start with when giving maintenance fluids/bolus?
-Usually LR -Wait for labs to come back to determine which electrolytes need to be added
a 3 year old is admitted to the unit with a tentative diagnosis of Wilms tumor. the nurse obtains the child's health history from the parents. what does the child's history reveal that will help establish the diagnosis? -abdominal swelling -periorbital edema -projectile vomiting -low grade temp
-abdominal swelling
H2 blockers
-action: inhibition of gastric acid secretion by blocking h2 receptors -famotidine, ranitidine, cimetidine
Proton Pump Inhibitors (PPIs)
-action: reduce the amount of stomach acid made by the acid glands in the stomach lining -omeprazole, esomeprazole, etc
an 11 year old child is admitted to the hospital in a vaso-occlusive crisis. the nurse plans for which priority treatment in the care of the child? -splenectomy -adequate hydration and pain management -passive range of motion exercises, adequate hydration before exercising -frequent ambulation, oxygen administration
-adequate hydration and pain management
an 8 year old child who is experiencing a sickle cell pain episode is admitted to the unit. what is the most appropriate nursing care during this acute period? -limiting fluids until the crisis ends -applying cold compresses to painful joints -performing ROM exercises on affected joints -administering prescribed analgesics
-administering prescribed analgesics
what is priority when developing the plan of care for an infant with a cleft palate before surgery is performed? -altering feeding methods to work with the defect -maintaining skin integrity in the oral cavity -preventing the infant from putting fingers in mouth -using techniques to minimize crying
-altering feeding methods to work with the defect
what is the cause of pyloric stenosis? -an enlarged muscle below the stomach sphincter -a telescoping of the large bowel into the smaller bowel -a result of giving their baby more formula than necessary -a result of giving the baby formula too quickly
-an enlarged muscle below the stomach sphincter
a 20 month old is admitted to the hospital with a diagnosis of cryptorchidism. surgical correction is performed at this time to decrease risk of: -peritonitis -herniation -sterility -difficulty urinating
-sterility
the nurse determines that a 2 month old child is dehydrated. which assessment finding supports this conclusion? -capillary refill of 2 secs -intense thirst -sunken anterior fontanelle -absence of tears
-sunken anterior fontanelle
a 9 year old child sustains a fractured femur in a motor vehicle collision. two days after surgery for repair of the fractured the nurse identifies a slight decrease in the child's hemoglobin level. what should the nurse do first concerning this clinical finding? -order additional meat on the child's menu -notify the practitioner immediately -assess the child's abdomen for internal bleeding -schedule blood typing and crossmatching
-assess the child's abdomen for internal bleeding
Gluten containing foods
-beer, ale, all types of breads, cakes, pies, cereals, cookies, crackers , wheat, rye, barley, pasta, gravy
a nurse is teaching the family of an 8 year old with ALL about appropriate activities. which recommendation should the nurse take? -being treated as normal as much as possible -home schooling -restriction from participating in athletic activities -avoiding trips to the shopping mall
-being treated as normal as much as possible
a child with sickle cell disease experiences a sequestration crisis. the parents ask how it differs from a painful episode )vaso-occlusive). what is the best response by the nurse? -peripheral ischemia occurs along with the pain -blood volume decreases and signs of shock appear -RBS production diminishes with severe anemia -destruction of RBCs is accelerated and jaundice becomes evident
-blood volume decreases and signs of shock appear
which symptom does the RN expect to see when caring for a child with intussusception? -watery diarrhea ' -bright red blood and mucus in stool -ribbon like stool -profuse projectile vomiting
-bright red blood and mucus in stool
what does the nurse expect to observe in an infant with suspected esophageal atresia with TEF? -incessant crying -coughing at nighttime -severe projectile vomiting -choking with feedings
-choking with feedings
a 4 week old infant is found to have hypertrophic pyloric stenosis and is scheduled for surgery. oral feedings are usually initiated a few hours after the surgery. what does the nurse expect the practitioner to prescribe initially? -electrolyte solution --full strength formula -half strength formula -cereal thickened water
-electrolyte solution
a 15 year old has been admitted to the hospital with the diagnosis of ALL. which s/s require the most immediate nursing intervention? -enlarged liver/spleen -swollen neck lymph glands and lethargy -fever and petechiae -fatigue and anorexia
-fever and petechiae
a 2 year old is diagnosed and admitted for NS. the RN notes which most common characteristic associated with this syndrome? -HTN -generalized edema -bright red blood in urine -increased urinary output
-generalized edema
what should the plan of care for a newborn with hypospadias include? -giving the parents reasons why the circumcision should not be performed -preparing the infant for a cystostomy tube -explaining to the parents the genetic basis for the defect -keeping the infant's penis wrapped with petroleum gauze
-giving the parents reasons why the circumcision should not be performed
RN reviews record of child suspected to have acute glomerulonephritis. which should she expect from parents? -his pediatrician said he will most likely recover completely -i noticed his urine was the color of cola lately -i'm so glad they did not find any protein in his urine -the nurse at the drs office said his blood pressure was low
-i noticed his urine was the color of cola lately
what does a nurse identify as the priority as the short term goal for a toddler with dehydration caused by diarrhea? -continuation of an antidiarrheal diet -preservation of perineal skin -improvement of fluid balance -retention of weight appropriate for height
-improvement of fluid balance
If an infant who has been tentatively diagnosed with esophageal atresia, what should the priority nursing diagnosis outcome be? -infant will maintain adequate fluid volume -infant will demonstrate effective breathing pattern -nutritional status will be maintained -parents will exhibit emotional health
-infant will demonstrate effective breathing pattern
a child with hemophilia presents with a burning sensation of the knee and reluctance to move the body part. the nurse collaborates with the care team to provide factor replacement and: -administer an aspirin containing compound -initiate skin traction -institut rest, ice, compression, adn elevation (RICE) -begin physical therapy with active ROM
-institut rest, ice, compression, adn elevation (RICE)
what finding would be expected in a 4 month old infant diagnosed with possible intussusception? -constant accompanied by leg extension -intermittent with knees drawn to chest -only while being held in the mother's arms -shrill during the ingestion of solids
-intermittent with knees drawn to chest
an 8 month old infant undergoes surgical correction for hypospadias. what is a priority nursing intervention during the postoperative phase? -minimizing pain with adequate analgesia -ensuring that privacy is maintained -restricting fluid intake until the stent is removed -gradually increasing the time that the urinary catheter is clamped
-minimizing pain with adequate analgesia
a nurse caring for a child with nephrotic syndrome should anticipate administering: -ibuprofen -penicillin -prednisone -ditropan
-prednisone
to assist in reducing episodes of emesis in an infant with GERD, the RN tells the mom to: -provide more frequent smaller feeds -burp the infant less frequently during feeds -thin the feeds by adding water to the formula -cut a hole in the nipplr for feeding
-provide more frequent smaller feeds
which nursing action is appropriate for an 11 month old with a new palate repair? SATA -using a yankauer suction catheter to remove oral secretions -rinsing mouth with water -removing arm restraints for a 2 hour break -administering an analgesic
-rinsing mouth with water -administering an analgesic
a child presents to the ED with periorbital edema and dark colored urine. what is an important finding from the history? -a fall off skateboard the night before -eating fast food for lunch -sore throat about 10 days before onset of symptoms -international travel to europe
-sore throat about 10 days before onset of symptoms
a nurse is obtaining the health history of a 5 year old child who has been admitted to the child's health unit with acute glomerulonephritis. what does the nurse expect the child's mother to report ? -the child just recovered from measles -the child had a sore throat a few weeks ago -the child's father has a family history of a urinary tract infection -the child's immunizations were administered at the start of school
-the child had a sore throat a few weeks ago
which is the best description of tracheoesophageal fistula (TEF)? -the muscle below the stomach is too tight causing the baby to vomit -the lower bowl is lacking certain nerves ti allow normal function -there is a blind pouch and an opening from the esophagus into the airway -a part of the bowel is on the outside with nothing covering it
-there is a blind pouch and an opening from the esophagus into the airway
a nurse is caring for a 9 month old infant with severe dehydration. what does the nurse expect to note while completing a physical assessment of this infant? -frothy stool -weak rapid pulse -pale copious urine -bulging fontanelle
-weak rapid pulse
which question would elicit helpful data in a 10 year old with suspected appendicitis? -what did you do for the pain? -where did the pain start? -is the pain continuous or does ti let up? -how often do you have a bowel movement?
-where did the pain start?
normal creatinine range
0.2-1.1
normal chloride range
102-112
normal sodium range
134-143
normal urine output
1-2 ml/kg/hr
normal specific gravity range (birth-2)
1.001-1.018
normal specific gravity range (over 2)
1.001-1.030
normal carbon dioxide range
22-29
normal potassium range
3.7-5
what should the plan of care include to minimize the potential for a sickling episode in a child with sickle cell anemia? =promoting adequate oxygenation -providing an iron rich diet -ensuring hemoconcentration =enforcing periods of quiet play
=promoting adequate oxygenation
normal BUN range
5-21
normal BUN range
5-31
normal glucose range (fasting)
70-126
normal calcium range
8.7-10.7
When can potassium be added to IV fluids?
Once the child voids
a toddler is admitted to the unit with diarrhea and severe dehydration. after several days of treatment, the child is evaluated. what clinical findings indicate that the child is rehydrated? SATA -decreased hematocrit -negative blood cultures -increased ESR -increase in daily weight -decreased BUN
decreased hematocrit -increase in daily weight -decreased BUN
a nurse is caring for a child with newly diagnosed ALL. which clinical findings does the nurse anticipate when assessing the child? SATA -fatigue -pallor -jaundice -multiple bruises -generalized edema
fatigue pallor multiple bruises
the school nurse is assessing a 10 year old boy with hemophilia who has fallen while playing in the schoolyard. at which site does the nurse expect to find internal bleeding? -joints -abdomen -cerebrum -epiphysis
joints
an 8 year old male client with nephrotic syndrome is in remission following treatment with prednisone. the nurse should teach the child and parents to check his urine for what? -ketones -protein -glucose -WBCs
protein