Peds Exam
when discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease?
HDLs
The nurse is assessing a child post cardiac catheterization. Which complication might the nurse anticipate?
cardiac arrhythmia
the nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include:
cleaning of suture line, supine and side-lying positions and arm restraints
careful hand washing before and after contact can prevent the spread of which condition in day care and school settings?
hepatitis A
which postoperative intervention should be questioned for a child after a cardiac catheterization?
keep the affected leg flexed and elevated
A mother calls the clinic nurse about her 4 year old son who has accute diarrhea. She has been giving him the antidiarrheal drug Imodium AD. The nurse's response should be based on the knowledge that this drug is:
not indicated
What food choice by the parent of a 2 year old with celiac disease indicates a need for further teaching?
oatmeal
an 8 month old infant has a hypercyanotic spell while blood is being drawn. The nurses first action should be to
place the child in the knee chest position
a child with pulmonary atresia exhibits cyanosis with feeding. On reviewing this childs laboratory values, the nurse is not surprised to notice which abnormality?
polycythemia
the nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of CVA exists. An important objective to decrease this risk is to:
prevent dehydration
caring for a newborn with a cleft lit and palate before surgical repair includes:
providing satisfaction of sucking needs
Which action by the school nurse is important in the prevention of rheumatic fever?
refer children with sore throats for throat culture
During the first few days after surgery for cleft lip, which intervention should the nurse do?
remove restraints periodically to cuddle infant
Parents of a 3 year old with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurses reply should be based on knowing that
the child needs opportunities to play with peers
for what reason might a newborn infant with a cardiac defect, such as coarctation of the aorta, that results in a right to left shunt receive prostglandin E1?
to improve oxygenation
nursing interventions for the child after a cardiac cath include which of the following?
assess the affected extremity for temperature and color maintain a patent peripheral intravenous catheter until discharge
nursing interventions for the child after a cardiac catheterization include which of the following?
assess the affected extremity for temperature and color maintain a patent peripheral intravenous catheter until discharge
what is the appropriate nursing action for the infant with CHD who has an increased respiratory rate, is sweating and is not feeding well?
alert the physician
when assessing a child for possible CHD, where should the nurse measure blood pressure?
all four extremeties
what is the nurses first action when planning to teach the parents of an infant with a CHD?
assess the parents anxiety level and readiness to learn
A 3 year old with hirschsprungs disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is:
necessary because it will be an adjustment
a clinical manifestation of the systemic venous congestion that can occur with CHF is
peripheral edema
72 ours after cardiac surgery, a young child as a temp of 101. The nurse should
report the findings
What is the most important information to be included in the discharge planning for an infant with gastroesophageal reflux?
teach the parents CPR
a nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if what conditions occur?
temp above 100 new frequent coughing turning blue or bluer than normal
the nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
I may have to stay on strict bed rest for 3 days
Jose is a 4 year old child scheduled for cardiac catheterization. Preoperative teaching should be:
adapted to his level of development so that he can understand
an important nursing consideration when chest tubes will be removed from a child is to
administer analgesics before procedure
an important nursing consideration when suctioning a young child who has had heart surgery is to
administer supplemental oxygen before and after suctioning
the nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?
administering penicillin
The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing?
administration of analgesics IV fluids until tolerating fluids PO clear liquids as the first feeding
The nurse is caring for a school aged girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet". The nurse finds the bandage and bed soaked with blood. The most appropriate initial action is to
apply direct pressure above the catheterization site
What should the nurse stress in a teaching plan for the mother of an 11 year old boy with ulcerative colitis
coping with stress and avoiding triggers
what is an expected assessment finding in a child with coarctation of the aorta?
disparity in blood pressure between upper and lower extremeties
a current recommendation to prevent neural tube defects is the supplementation of
folic acid for all women of childbearing age
the nurse is caring for a child after heart surgery. What should she or he do if evidence is found of cardiac tamponade?
immediately report to physician
which clinical changes occurs as a result of septic shock?
increased cardiac output
the nurse is caring for an infant with CHD. the nurse should plan which intervention to decrease cardiac demands?
organize nursing activities to allow for uninterrupted sleep
The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?
you may need to increase the caloric density of your infants formula
a preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response?
your child must lie quietly; sometimes a mild sedative is administered before the procedure
Which information should the nurse teach families about reducing exposure to pollens and dust?
replace wall to wall carpeting use an air conditioner put dust proof covers on pillows and mattresses
an adolescent being seen by the nurse practitioner for a sports physical is identified as having hypertension. On further testing, it is discovered the child has a cardiac abnormality. The initial treatment of secondary HTN initially involves:
treating the underlying disease
In which situation is there the greatest risk that a newborn infant will have a congenital heart defect?
trisomy 21 detected on amniocentesis
The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?
visible peristalsis and weight loss
Which intervention should be included in the plan of care for an infant with the nursing diagnosis of excess fluid volume related to congestive heart failure?
weigh the infant every day at the same time on the same scale
which clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock?
cool extremities and decreased skin turgor confusion and somnolence tachypnea and poor capillary refill time
the nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of fallow. Which signs and symptoms should the nurse include?
decreased urinary output sweating (inappropriate) fatigue
The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:
elevating the head but giving nothing by mouth
A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach should be to:
encourage her to express her feelings
The nurse is caring for a 10 month old infant with RSV bronchiolitis. Which interventions should be included in the child's care?
encourage infant to drink 8 ounces of formula every 4 hours institute cluster care to encourage rest place on noninvasive oxygen monitor
A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include:
encouraging and helping mother to breastfeed recommending use of a breast pump to maintain lactation until infant can suck
Which intervention should be included in the nurse's plan of care for a 7 year old with encopresis who has cleared the initial impaction?
give the child a choice of beverage with a laxative
which statements regarding hepatitis B are correct?
hepatitis B can be prevented by vaccine Can be transferred to an infant of breastfeeding mother onset is insidious immunity occurs after one attack
When preparing a school age child and the family for heart surgery, the nurse should consider:
letting the child hear the sounds of an electrocardiograph monitor
The nurse is caring fora boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to:
notify the practitioner
Therapeutic management of the child with acute diarrhea and dehydration usually begins with:
oral rehydration solution
The parents of a young child with CHF tell the nurse that they are "nervous" about giving digoxin. The nurses response should be based on knowing that:
parents must learn specific, important guidelines for administration of digoxin
the nurse assessing a premature newborn infant auscultates a continuous machinery like murmur. This finding is associated with which congenital heart defect?
patent ductus arteriosus
a major clinical manifestation of rheumatic fever is:
polyarthritis
surgical closure of the ductus arteriosus would
prevent the return of oxygenated blood to the lungs
Which interventions should a nurse implement when caring for a child with hepatitis?
provide a well balanced-low fat diet teach parents not to administer any over the counter medications instruct parents on the importance of good hand washing
