Peds Midterm 6-7

Placing him near a cool-mist humidifier

A 3-year-old boy in respiratory distress is treated in the emergency department. A diagnosis of acute spasmodic laryngitis (spasmodic croup) is made. At the time of discharge, the mother asks how to handle another attack at home. What should the nurse recommend?

Maintain standard and contact precautions

A 6-month-old infant is brought to the emergency department in severe respiratory distress. A diagnosis of respiratory syncytial virus (RSV) infection is made, and the infant is admitted to the pediatric unit. What should be included in the nursing plan of care?

crackles

A bubbling or crackling sound originating from the base of the lungs. Usually brief, this may be described as sounding wet or dry. Excess fluid in the airways causes these sounds.

Respiratory acidosis

A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?

exercise

A child is admitted to the hospital with pneumonia. In addition to ensuring a patent airway, all of the following interventions are appropriate except:

Providing a quiet atmosphere with dimmed lighting

A child is diagnosed with Reye's syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan?

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?

tidal volume

A client is scheduled for a pulmonary function test. The nurse explains that during the test one of the instructions the respiratory therapist will give the client is to breathe normally. What should the nurse teach is being measured when the client follows these directions?

wheeze

A high-pitched whistling sound, usually heard on expiration, and common to asthma. This is caused by narrowed airways or inflammation.

Cloudy CSF, elevated protein, and decreased glucose levels

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis?

bradycardia

A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure (ICP). Which is a late sign of increased ICP?

RN to obtain throat culture

A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the health care provider, should the nurse question?

Was born during the 32nd week of gestation

A nurse in the pediatric clinic should be most observant for signs of cerebral palsy in a 6-month-old infant in which instance?

Purpuric skin rash

A nurse is caring for a child with meningococcal meningitis. What clinical finding does the nurse expect to encounter during a physical assessment?

12 months

A nurse notes that a child is exhibiting signs of cerebral palsy. At what age are these signs usually first noticeable?

Meconium ileus

A nurse who is caring for a 2-day-old neonate suspects that the infant has cystic fibrosis. What early sign of this disorder did the nurse identify?

Children with Down syndrome are more likely to develop acute leukemia than the average child.

A school-age child with Down syndrome is brought to the ambulatory care center by the mother. The child has bruising all over the body. To work most effectively with this child, the nurse first addresses which complication associated with Down syndrome?

mobilize secretions

A school-aged child who has cystic fibrosis complains to the nurse about having to undergo chest physiotherapy and wonders why it is necessary. You are the nurse. How do you explain the primary purpose of chest physiotherapy in terms the child can understand?

is not

Cerebral palsy is or is not prgressively degenerative?

rhonchi

Continous, snoring, low-pitched sounds heard throughout inspiration. May clear with coughing.

viral

Croup, also known as acute laryngotracheobronchitis, is a self-limiting upper airway obstructive disease that affects younger children. Is croup caused by a viral infection or a bacterial infection?__________ infection

Hib

During a 2 month well visit with a patient and her mother you educate the parent on the most common cause of epiglottitis. You explain to the mother the most common cause of this condition is the _______________. In addition, you explain the _________ vaccine can help prevent most cases of this condition?

This disease causes dilation of the passageways of many organs

During clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about CF?

stridor

High-pitched, wheezing sound caused by disrupted airflow. Airflow is usually disrupted by a blockage in larynx or trachea.

21

How much oxygen is present in room air? _____ percent

hypothalamus

The body's thermostat, also known as the ____ is an autonomic center that regulates temperature control, appetite, blood pressure, breathing, sleep patterns, and peripheral nerve discharges.

positive

The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as positive or negative?

The child is leaning forward, with the chin thrust out

The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction?

Astride one of her hips

The hypertonicity of the muscles in an infant with cerebral palsy causes scissoring of the legs. The nurse teaches the mother that the preferred way to carry the infant is in a sitting position in what way?

A chronic multisystem disorder affecting the exocrine glands

The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF?

Lateral recumbent position with the knees flexed and chin resting on the chest

The nurse assists a health care provider in performing a lumbar puncture on a 3-year-old child with leukemia in whom central nervous system disease is suspected. In which position will the nurse place the child during this procedure? (See page 223.)

Monitor for signs of increased intracranial pressure.

The nurse creates a plan of care for a child with Reye's syndrome. Which priority intervention should the nurse include in the plan of care?

Suctioning equipment and oxygen

The nurse develops a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside?

check respiratory status, loosen any clothing, turn child on side

The nurse enters a child's room and discovers that the child is having a seizure. Which actions should the nurse take? Select all that apply.

high

The nurse has provided instructions to the mother of a child with cystic fibrosis about appropriate dietary measures. Should the diet be high in calories or low?

Raise the child's leg with the knee flexed and then extend the leg at the knee and assess for pain

The nurse is assessing for Kernig's sign in a child with a suspected diagnosis of meningitis. Which action should the nurse perform for this test?

Positive Brudzinski sign

The nurse is caring for a client who underwent surgery for a brain tumor. On assessment, the nurse suspects meningitis in the client. Which finding would help confirm the nurse's suspicion?

infection

The nurse is caring for a newborn infant with spina bifida (myelomeningocele) who is scheduled for surgical closure of the sac. In the preoperative period, which is the priority problem?

move infant to a room with another child with RSV

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?

stay with child, move furniture out of the way, time the seizure

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply.

Assess anterior fontanel for bulging.

The nurse is creating a plan of care for a newborn infant with spina bifida (myelomeningocele type). The nurse includes assessment measures in the plan to monitor for increased intracranial pressure. Which assessment technique should be performed that will best detect the presence of an increase in intracranial pressure?

15

The nurse is performing a Glasgow Coma Scale on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record?

Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care?

1. Shake MDI and attach to spacer 2. Exhale completely 3. Place lips tightly around the mouth piece 4. deliver one puff of medication into spacer 5. take a slow deep breath and hold for 10 seconds 6. rinse mouth with water

The nurse is teaching a 9-year-old child with asthma how to use a metered-dose-inhaler (MDI). Place the instructions in the appropriate order. All options must be used.

meningitis

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect?

Negative

The nurse reviews the health record of a 2-year-old child. The health care provider has documented that the results of a tuberculin skin test have indicated an area of induration measuring 5 mm. Is this a positive or negative result? It is a __________ result.

"Antibiotics are recommended for infants younger than 6 months with confirmed diagnosis of AOM"

The parents of a 4-month-old infant with a diagnosis of acute otitis media and fever ask the nurse about the use of antibiotics to treat this condition. What is the best response by the nurse?

Young children have short, horizontally positioned eustachian tubes and the child's tympanic membrane slants horizontally rather than vertically

The parents of an 18-month-old toddler are anxious to know why their child has experienced several episodes of acute otitis media. What should the nurse explain to the parents about why infants and toddlers are prone to middle ear infections?

Short-acting β2 agonist

Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

epiglottitis

this X-ray shows which respiratory disease