peds quiz #2

A nurse is reinforcing teaching about controlling a bleeding episode with a parent of a child who has hemophilia. Which of the following statements by the parent indicates a need for further teaching?

"I will apply warm compress over the site."

A nurse is caring for a toddler who has laryngotracheobronchitis. For which of the following findings should the nurse monitor to detect airway obstruction? -Decreased stridor -Decreased restlessness -Increased heart rate -Decreased temperature

-Increased heart rate monitor for increased heart rate

infant with bronchiolitis w/RSV , appropriate nursing action?

1. Place the infant in a private room. 2. Place the infant in a room near the nurses' station. 3. Ensure that the infant's head is in a flexed position. 4. Wear a mask at all times when in contact with the infant. 5. Place the child in a tent that delivers warm, humidified air. 6. Position the infant side-lying, with the head lower than the chest. Rationale: The infant with RSV should be isolated in a private room or in a room with another child with RSV. The infant should be placed in a room near the nurses' station for close observation. The infant should be positioned with the head and chest at a 30- to 40-degree angle and the neck slightly extended to maintain an open airway and to decrease pressure on the diaphragm. Cool, humidified oxygen is delivered to relieve dyspnea, hypoxemia, and insensible water loss from tachypnea. Contact precautions (wearing gloves and a gown) reduce the nosocomial transmission of RSV.

which would the nurse expect to assess on a infant with developmental dysplasia of the hip 1. excessive hip abduction 2. femoral lengthening of an affected leg 3. asymmetry of gluteal and thigh folds 4. pain when lying prone

3. asymmetry of gluteal and thigh folds

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply.) A. Weak femoral pulses B. Cool skin of lower extremities C. Severe cyanosis D. Clubbing of the fingers E. Heart failure

A. Weak femoral pulses B. Cool skin of lower extremities E. Heart failure

A nurse caring for a preschooler who has epiglottis from a streptococcal infection. Which of the following actions should the nurse take?

Apply humidified oxygen via a mask

When caring for a 3 year old with tetralogy of Fallot, he nurse expects to see fatigue and poor activity tolerance. This is caused by: A. poor muscle tone B. inadequate oxygenation of tissues. C. restricted blood flow leaving the heart D. inadequate intake of food.

B. inadequate oxygenation of tissues. The child's fatigue results from left to right shunting that occurs with tetralogy of Fallot. This shunting causes poorly oxygenated blood to circulate through the body. Poor muscle tone and inadequate food intake can result from this condition, but these are effects, not causes. Restricted blood flow leaving the heart is associated with aortic stenosis.

A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client's parent is the nurse's priority? A) He takes a two hour nap every day after school B) He says he feels sick to his stomach after taking the med C) He has so many new bruises on his body D) He says his mouth is always dry

C) He has so many new bruises on his body Bruising is a priority concern because this is a manifestation of carbamazepine toxicity. Bone marrow depression including leuopenia, anemia, and thrombocytopenia. Monitor for bleeding, bruising, sore throat

Nurse taking care of child with Kawasaki, what other system affected?

Cardiovascular - Monitor vital signs and cardiac status. Maintain cardiac monitoring. - Assess client for heart failure (decreased urine output, gallop heart rhythm, tachycardia, respiratory distress). - Monitor I&O. Obtain daily weight.

You are taking care of child with nosebleed, what is emergency intervention?

Child sit with head tilt forward with pressure on nose for 10 minutes

child with spinal bifida , what are precautions?

Latex precaution d/t allergy

You are taking care of child who is admitted to hospital, what kind of toys can be given?

Modeling clay

You are taking care of child with congenital heart defect, what is associated increase pulmonary blood flow? The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect?a. Pulmonary stenosis b. Patent ductus arteriosus c. Ventricular septal defect d. Coarctation of the aorta

Patent ductus arteriosus

how to position for seizure

The side lying position is the best natural opening for thetrachea and the bronchi. Keep the airway open byturning the head to the left during the seizure.

After a tonsillectomy, child begins to vomit bright red blood. Initial nursing action w/be to:

Turn the child to the side. R: After a tonsillectomy, if bleeding occurs, the child is turned to the side, and RN then notified; RN will contact physician. An NPO status w/be maintained, and an antiemetic may be prescribed; however, the initial nursing action w/be to turn the child to the side.

A nurse is assisting with the care of a school-age child who has respiratory failure due to pneumonia. Which of the following positions should the nurse encourage to allow maximal lung expansion? a. Prone b. Supine c. Side-lying d. Upright

Upright

You are taking care of pt with bacterial meningitis's (infection), what is action?

antibiotics Antibiotics given until culture and sensitivity results are available. Effective for bacterial infections.

A nurse at a pediatric hotline receives a call from a mother who plans to administer aspirin to a toddler for a fever and wants to know the dosage. Which of the following statements by the nurse is not an appropriate response? a. You'll have to call your physician. b. Give her no more than three baby aspirin every 4 hours. c. Give her acetaminophen, not aspirin d. Follow the directions on the aspirin bottle for her age and weight."

b. Give her no more than three baby aspirin every 4 hours. +"Give her acetaminophen, not aspirin."(The nurse should instruct the mother to administer acetaminophen. Administering aspirin to the toddler can cause Reye Syndrome, an acute encephalopathy condition.)

a nurse is preparing a 4 year old child for discharge following a bilateral myringotomy with tympanostomy tube placement. the mother asks what to do if the tube fall out. the nurse should give the parent which of the following instructions?

call the health care clinic to report that the tubes have fallen out

instructing a mother of a child with cystic fibrosis about appropriate dietary measure, what to feed? A nurse is teaching the parents of a child with cystic fibrosis about proper nutrition. Which instruction should the nurse include?

chicken tenders and baked potato with butter Encourage a high-calorie, high-protein diet; The child should be encouraged to eat a high-calorie, high-protein diet. In cystic fibrosis, the pancreatic enzymes (lipase, trypsin, and amylase) become so thick that they plug the ducts. In the absence of these enzymes, the duodenum can't digest fat, protein, and some sugars; therefore, the child can become malnourished. A child with cystic fibrosis needs to drink plenty of fluid and take salt supplements, especially on warm days or when exercising, to help maintain hydration and adequate sodium levels. Water-soluble forms of the fat-soluble vitamins (A, D, E, and K) are essential.

3 yr old has preistent otitis media, the nurse should ask the parent? A nurse is reinforcing teaching with the parents of a 3-year-old child who has persistent otitis media about prevention. Which of the following statements by the parents indicates an understanding of the teaching?

does anyone smoke in the same house as your daughter? "We should not smoke around our child."

child with hearing impairment , what is the nursing action? The nurse should plan which actions to facilitate lipreading for a child with a hearing impairment? (Select all that apply.)

face to face , speak slowly and clearly Ans: Face the child directly Ans: Speak at eye level Ans: Keep sentences short Ans: Establish eye contact and show interest

A nurse is monitoring a child who is postoperative following a tonsillectomy for signs of hemorrhage. Which of the following findings is a sign of this postoperative complication

frequent swallowing

Child with croup, what is instruction given

give child cough syrup if developed

Child with sickle cell crisis, what is plan of action?

hydration

The nurse is giving discharge teaching to child with sickle cell anemia is recovering from acute sickle cell crisis, what instruction do you need to reenforce with child's parent?

increase fluids intake

A nurse is collecting data from an infant who hit her head when she fell off of a dressing table. The nurse should identify which of the following findings as indicating increased intracranial pressure? A. Brisk pupillary reaction to light B. Irritability C. Tachycardia D. Increased sensory response to painful stimuli

irritability, agitation and restless

what food to give patient with laryngotomty?

jello

4yr old child 2 days post op, with ventriculoperitoneal shunt , what is priority finding?

lethargy

adolscencent with plastic cast for fracture of right tibia w/ ff action should the nurse take? The nurse is caring for a client with a fractured tibia and fibula. Eight hours after a long leg cast was applied, the client began to report an increase in pain level even after administration of the prescribed dose of opioid analgesic. Which is the initial nursing action?

neuromuscular by checking the pulses in the lower extremities Check the neurovascular status of the toes on the casted leg.

You are allowed to give aspirin to babies?

no cause reyes syndrome

A nurse is caring for a client who is postoperative immediately following a tonsillectomy. Which of the following snacks should the nurse offer the client?

orange popsicle or jello

2 yr old child - instill medication , how do you instruct?

pull pinna back and down

What is abnormal lateral curvature of the spine?

scoliosis

Collecting data of child with sickle cell, child is experiencing vaso-oclusive crisis, what should the nurse monitor?

severe pain

what instruction to give to parents who child taking iron deficiency taking ferrous sulfate?

use a straw

discharge instruction for cystic fibrosis

wash hands before eating