PEDS PP 2

The nurse is preparing to administer digoxin to an infant who weighs 13.7 lb (6.2 kg). The practitioner has ordered 25 mcg/kg divided in three doses with one-half of the total dose for the initial dose, then one-quarter of the total dose for each of two subsequent doses given at eight-hour intervals. The medication comes in an oral solution of 0.05 mg/ml. How many milliliters would the nurse give for the second dose? Record your answer using two decimal places.

0.78

When caring for a client who is a primigravida, how long should the nurse expect the second stage of labor to last?

1 hour

he nurse is caring for a 1-month-old infant who fell from the changing table during a diaper change. Which signs and symptoms of increased intracranial pressure (ICP) is the nurse likely to assess in a 1-month-old infant? Select all that apply.

bulging fontanels high-pitched cry irritability

A nurse is caring for a 16-year-old client with aortic stenosis. Which symptoms would this teen experience during physical activity? Select all that apply.

chest pain dizziness lack of endurance

A parent is planning to enroll the 9-month-old infant in a day care. The parent asks the nurse what indicators would ensure that the daycare facility is adhering to good infection control measures. How should the nurse reply? Select all that apply.

Diapers are discarded into covered receptacles. Disposable papers are used on the diaper-changing surfaces. Facilities for hand hygiene are located in every classroom.

A nurse on a labor and birth unit goes to the cafeteria for lunch with colleagues. One colleague begins talking about a newer staff member and says, "I heard that she does not have any labor and birth nursing experience." Which is the nurse's most appropriate action?

Discuss the colleague's behavior in private.

A client at 30 weeks gestation experiences a rupture of membranes with mild contractions 8 minutes apart. Which nursing interventions are included on the plan of care to improve newborn outcomes? Select all that apply.

Maintain the client on the fetal monitor throughout the labor process. Administer a dose of betamethasone per healthcare provider's order. Arrange a neonatologist to be available for the birth

Which child most needs a developmental referral for a language delay?

4-year-old who is difficult to understand

An infant is admitted to the hospital's pediatric unit with gastroenteritis. The nurse will include what nursing actions in the plan of care? Select all that apply.

Begin prescribed rehydration measures. Establish intake and output. Weigh the infant. Review arriving laboratory reports. Protect skin from diarrheal stool. Provide time for the parents to hold infant.

The nurse begins cardiopulmonary resuscitation (CPR) on a 5-year-old unresponsive client. When the emergency response team arrives, the child continues to have no respiratory effort but has a heart rate of 50 bpm with cyanotic legs. What should the team do next?

Begin two-person CPR at a ratio of two breaths to 15 compressions.

A healthy 2-month-old infant is being seen in the local clinic for a well-child checkup and initial immunizations. When analyzing the pediatric record, which immunizations would the nurse anticipate administering at this appointment? Select all that apply.

DTaP (diphtheria, tetanus, and acellular pertussis) IPV (inactivated polio vaccine) Hib (Haemophilus influenzae vaccine) PCV (pneumococcal vaccine)

The nurse is receiving shift report on four clients on an antenatal unit. The four clients are (1) a 35-week-gestation mother with severe pre-eclampsia started on a maintenance dose of magnesium sulfate 1 hour ago; (2) a 30-week-gestation patient with preterm labor on oral nifedipine and having no contractions in 6 hours; (3) a hyperemesis client with emesis four times in the past 12 hours; and (4) a 33-week-gestation client with placenta previa who began to feel pelvic pressure during change of shift report. In what order should the nurse see these clients?

Evaluate the placenta previa client without an exam. Evaluate the client with pre-eclampsia for maternal and fetal tolerance of magnesium sulfate and the labor pattern. Assess the hyperemesis client for nausea for further emesis, or dehydration. Assess the client with preterm labor for tolerance of nifedipine and the labor pattern.

A nurse is caring for a newborn with transient tachypnea of the newborn (TTN). Which responses made by the newborn's mother demonstrates that she understands the newborn's condition? Select all that apply.

Having a cesarean section increased the risk of transient tachypnea of my newborn." "The healthcare provider will need chest X-rays to monitor my baby's respiratory

The nurse is preparing discharge plans for the parents of an infant born at 24 weeks' gestation. What priority information should the nurse tell these parents regarding vaccinations for their child?

Palivizumab should be given to prevent RSV infection in preterm infants.

A neonate was born to a mother diagnosed with hydramnios in utero. When the first feeding was given, the newborn began coughing, became cyanotic, and was having difficulty breathing. The nurse suspects esophageal atresia. Which is the priority nursing action for this neonate?

Placing the infant in an upright, 60° angle

Which recommendation would be most helpful to suggest to a primigravid client at 37 weeks' gestation who has leg cramps?

Straighten the knees and flex the toes toward the chin.

The nurse reviews the vaccine records of a 19-year-old and recommends a pneumococcal vaccine based on which finding?

The client is a smoker.

A client asks the nurse if she is at risk for developing postpartum depression. Which of the following assessment data would further assist the nurse to identify a postpartum depression risk? Select all that apply.

The client states she has a history of postpartum depression. The client states she has a history of depression. The client's partner has stated the couple has financial problems. The client's pregnancy has had multiple complications.

The parents of a child with sickle cell disease ask the nurse why their child's hemoglobin was normal at birth but now the child has S hemoglobin. Which response by the nurse is appropriate?

The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth."

A nurse is caring for a toddler diagnosed with an inoperable brain tumor. The parents are having difficulty deciding on a treatment plan. What is the nurse's primary role during treatment plan meetings?

act as a liaison among the child, the parents, and the healthcare team

Condition: Plugged milk duct

actions to take: Encourage the use of moist heat Teach feeding techniques monitor: Temperature Flu-like symptoms

The nurse is caring for a child with congenital heart disease. What assessment findings does the nurse interpret as indicating possible progression to cardiogenic shock? Select all that apply.

decreased urine output tachypnea

An 18-month-old child with acquired immunodeficiency syndrome is seen in the clinic for health maintenance. Which vaccine(s) should the nurse anticipate administering to this toddler? Select all that apply.

diphtheria-tetanus-acellular pertussis inactivated influenza vaccine inactivated polio vaccine

The nurse is reviewing results for clients who are having antenatal testing. The assessment data from which client warrant prompt notification of the health care provider (HCP) and a further plan of care?

multigravida who had a positive oxytocin challenge test

During the early postpartum period, a nurse is evaluating several clients' attachment to their neonates. Which client is the highest priority for the nurse?

one whose parent died recently

A child presents with a skin rash that resembles an allergic response, similar to atopic dermatitis, and requires differentiation by the nurse. Which communicable diseases should the nurse consider? Select all that apply.

rubella rubeola erythema infectiosum

A nurse is planning a health teaching session for a group of parents with toddlers. When describing a toddler's typical eating pattern, the nurse should mention that many children of this age exhibit:

strong food preferences.

The nurse is caring for a 19-year-old male client with Duchenne muscular dystrophy whose symptoms are getting progressively worse.

symptoms-hypokalemia, irregular heart rhythm, anorexia and will need an order for serum electrolyte levels

A primigravid client with diabetes at 38 weeks' gestation asks the nurse why she had a fetal acoustic stimulation during her last nonstress test. Which should the nurse include as the rationale for this test?

to startle and awaken the fetus

A nurse is conducting an assessment of a neonate born 3 hours ago. Which finding makes the nurse suspect a congenital hip dislocation?

unequal gluteal folds