Peds Test #2
The nurse is performing echocardiography on a newborn who is suspected of having a congenital heart defect. The child's mother is concerned about the safety of using this on a newborn and wants to know how this technology works. The nurse assures her that this technology is very safe and may be repeated frequently without added risk. What should the nurse mention in explaining how this diagnostic test works? High-frequency sound waves are directed toward the heart X-rays are directed toward the heart A radioactive substance is injected intravenously into the bloodstream and is traced and recorded on video A microphone is placed on the child's chest to record heart sounds and translate them into electrical energy
High-frequency sound waves are directed toward the heart Explanation: Echocardiography, or ultrasound cardiography, has become the primary diagnostic test for congenital heart disease. An echocardiogram involves high-frequency sound waves, directed toward the heart, being used to locate and study the movement and dimensions of cardiac structures, such as the size of chambers; thickness of walls; relationship of major vessels to chambers; and the thickness, motion, and pressure gradients of valves. You can remind parents that echocardiography does not use x-rays so it can be repeated at frequent intervals without exposing their child to the possible risk of radiation. The other answers refer to other types of diagnostic tests, including X-ray studies, radioangiocardiography, and phonocardiography.
An 8-month-old infant has a ventricular septal defect. Which nursing diagnosis would best apply? Ineffective airway clearance related to altered pulmonary status Ineffective tissue perfusion related to inefficiency of the heart as a pump Impaired gas exchange related to a right-to-left shunt Impaired skin integrity related to poor peripheral circulation
Ineffective tissue perfusion related to inefficiency of the heart as a pump Explanation: A ventricular septal defect permits blood to flow across an opening between the right and left ventricles. It results in increased pulmonary blood flow, but it does not cause cyanosis. The blood in the left ventricle, which flows back into the right ventricle, is already oxygenated. Anytime there is an opening between the heart's ventricles, the heart is not as effective as a pump because the pressure gradients are changed. A ventricular septal defect will not cause respiratory problems or problems with peripheral circulation.
What would be the most important measure to implement for an infant who develops heart failure? restricting milk intake daily planning ways to reduce salt intake placing the infant in a semi-Fowler position keeping the infant supine and playing quiet games
placing the infant in a semi-Fowler position Explanation: Placing an infant with heart failure in a semi-Fowler position reduces the pressure of the abdominal contents against the chest and allows for better lung expansion. Keeping the infant supine would cause more pressure on the heart and lungs and increase the work of the heart and lungs. Infants with heart disease need calories to grow. They are given formula or breast milk which is fortified with extra nutrients. Thus the infant can have an intake of the same amount of fluid but receive extra nutrients.
The child has returned to the nurse's unit following a cardiac catheterization. The insertion site is located at the right groin. Peripheral pulses were easily palpated in bilateral lower extremities prior to the procedure. Which finding should be reported to the child's physician? Select all that apply. The right groin is soft without edema. The child's right foot is cool with a pulse assessed only with the use of a Doppler. The child has a temperature of 102.4° F (39.1° C). The child is reporting nausea. The child has a runny nose.
The child's right foot is cool with a pulse assessed only with the use of a Doppler. The child has a temperature of 102.4° F (39.1° C). The child is reporting nausea. Explanation: The following information should be reported to the physician following a cardiac catheterization because they are indicative of possible complications: Negative changes to the child's peripheral vascular circulatory status (cool foot with poor pulse), a fever over 100.4° F (37.8° C), and nausea or vomiting.
The nurse is caring for an 11-year-old presenting with tenderness in the shoulder. He is the pitcher for his baseball team and reports shoulder pain with active internal rotation but is able to continue past the pain with full range of motion. Based on these reported symptoms, the nurse is aware that the disorder is most likely to be: epiphysiolysis of the proximal humerus. Osgood-Schlatter disease. Sever disease. epiphysiolysis of the distal radius.
epiphysiolysis of the proximal humerus. Explanation: Epiphysiolysis of the proximal humerus is an overuse disorder that occurs with rigorous upper extremity activity such as pitching and causes tenderness in the shoulder. Osgood-Schlatter disease causes knee pain and painful swelling or prominence of the anterior portion of the tibial tubercle. Sever disease causes pain over the posterior aspect of the calcaneus. Epiphysiolysis of the distal radius is an overuse disorder that causes wrist pain. It is common in gymnasts.
A child with hemophilia A is scheduled for surgery. Which precautions would the nurse institute with this client? Handle the child gently when transferring to a stretcher. Caution the child not to brush the teeth before surgery. Do not allow a dressing to be applied postoperatively. Mark the client's chart to receive no analgesia.
Handle the child gently when transferring to a stretcher. Explanation: Hemophilia is a group of X-linked recessive disorders that prevent clot formation. The best care for the child is to prevent any bruising or bleeding so gentle handling when moving the child from the stretcher is necessary. Because the child is having surgery, infusion of clotting agents will be necessary. Analgesia will be needed postoperatively as will surgical dressings. IM injections are contraindicated because of potential bleeding. Brushing the teeth is part of normal daily hygiene.
The nurse will select which meal as the best choice for a child with iron-deficiency anemia? cheeseburger, broccoli, and fresh strawberries chicken breast, French fries, and sweetened tea peanut butter sandwich, cheese stick, and applesauce two slices of pepperoni pizza and a glass of skim milk
cheeseburger, broccoli, and fresh strawberries Explanation: Children with iron-deficiency anemia require diets rich in iron and vitamin C (vitamin C enhances iron absorption). Meats are excellent sources of iron. Broccoli is a good source of iron, and strawberries are a good source of vitamin C. To help the body absorb the most iron from the meal, tea and foods rich in calcium (such as milk and cheese) should be avoided.
A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl? "Do you notice any wheezing when you breathe or a runny nose?" "Do you have any shoulder pain or abdominal tenderness?" "Have you noticed any new bruising or different color patterns on your skin?" "Have you noticed any hair loss or redness on your face?"
"Have you noticed any hair loss or redness on your face?" Explanation: Alopecia and the characteristic malar rash (butterfly rash) on the face are common clinical manifestations of SLE. Rhinorrhea, wheezing, and an enlarged spleen are not hallmark manifestations of SLE. Petechiae and purpura are more commonly associated with hematological disorders, not SLE.
The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning? "I brush my child's teeth once every day." "My child's stools are darker than usual." "I mix ferrous sulfate with milk in a bottle." "My child takes ferrous sulfate after meals."
"I mix ferrous sulfate with milk in a bottle." Explanation: Ferrous sulfate may not be absorbed if taken with milk or tea, and if the parent mixes the medicine with milk in a bottle, there is also concern that if the child does not drink the entire amount of medication. Ferrous sulfate may be taken after meals to prevent gastrointestinal irritation. Dark stools are a common side effect of ferrous sulfate. Parents should be encouraged to brush the child's teeth thoroughly to prevent teeth staining.
A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate? "Infants with pyloric stenosis require ferrous sulfate." "Preterm infants are at risk for iron-deficiency anemia." "Your infant may have been having excessive diarrhea." "Ferrous sulfate helps improve red blood cell formation."
"Preterm infants are at risk for iron-deficiency anemia." Explanation: Infants born prematurely are at risk for iron-deficiency anemia because iron stores are built during the last few weeks of gestation. Although some infants with pyloric stenosis may require an iron supplement, such as ferrous sulfate, not all infants will. Infants with excessive diarrhea may develop iron-deficiency anemia, and ferrous sulfate helps improve red blood cell formation, but this does not explain why a preterm infant is being prescribed an iron supplement.
A child is undergoing skin testing for allergies. About 10 minutes after a scratch test with an allergen, the child develops signs and symptoms of anaphylaxis. The nurse prepares to administer epinephrine subcutaneously. The child weighs 88 pounds. The nurse would administer which dosage of epinephrine? 0.2 mg 0.4 mg 0.8 mg 1 mg
0.4 mg Explanation: The child weighs 88 pounds or 40 kg. The dose of epinephrine is 0.01 mg/kg. So for a child weighing 40 kg, the nurse would give 0.4 mg.
The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level? 1900/mm3 1700/mm3 1500/mm3 1300/mm3
1300/mm3 Explanation: The number of CD4 T lymphocytes in the blood helps to determine the effectiveness of antiretroviral therapy. Normal is 1500/mm3 in the infant, so anything below that number may indicate that the therapy is not effective.
A nurse is palpating the pulse of a child with suspected aortic regurgitation. Which assessment finding should the nurse expect to note? Appropriate mastery of developmental milestones Bounding pulse Preference to resting on the right side Pitting periorbital edema
Bounding pulse Explanation: A bounding pulse is characteristic of patent ductus arteriosus or aortic regurgitation. Narrow or thready pulses may occur in children with heart failure or severe aortic stenosis. A normal pulse would not be expected with aortic regurgitation.
The nurse is caring for an infant exposed to HIV. The polymerase chain reaction (PCR) test was negative at birth. The nurse tells the mother that the child should be tested again at what age? 4 to 7 weeks 8 to 10 weeks 2 to 3 months 12 months
4 to 7 weeks Explanation: Virologic testing for HIV-exposed infants should be done with the polymerase chain reaction test at birth, at 4 to 7 weeks, and again at 8 to 16 weeks. Serologic testing is done at approximately 12 months of age to document disappearance of the HIV-1 antibody.
A child is diagnosed with rheumatic fever. For which medication will the nurse educate the caregivers? Aspirin Antiviral Insulin Dilantin
Aspirin Explanation: Medications used in the treatment of rheumatic fever include penicillin, salicylates (aspirin), and corticosteroids. Insulin would be given for diabetes and dilantin for seizure disorders. Antivirals are not relevant to the treatment of a bacterial infection.
The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of: non-Hodgkin lymphoma. Hodgkin disease. Ewing sarcoma. neuroblastoma.
Ewing sarcoma. Explanation: Radiographs that show lesions on the bone may indicate tumors (e.g., Ewing sarcoma, osteosarcoma) or metastasis of tumors. Osteosarcoma is the most common type of bone malignancy in children. It occurs primarily in the long bones. Ewing sarcoma is a highly malignant bone cancer. It occurs in the pelvis, chest wall, vertebrae, and midshaft of the long bones. Neuroblastomas are seen in children younger than 5 years old and arise from immature nerve cells and the adrenal glands. Hodgkin disease develops from the immune system. Non-Hodgkin lymphoma is a blood cancer.
A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis? Coarctation of aorta Tetralogy of Fallot Pulmonary stenosis Aortic stenosis
Tetralogy of Fallot Explanation: Tetralogy of Fallot is associated with cyanosis. The defects include ventricular septal defect (VSD), right ventricular hypertrophy, right outflow obstruction, and overriding aorta. Coarctation of aorta, pulmonary stenosis, and aortic stenosis are acyanotic heart diseases and are not associated with cyanosis.
The nurse is caring for a child with idiopathic thrombocytopenic purpura (ITP). Which assessment finding requires immediate notification of the health care provider? Select all that apply. purpura headache petechiae vomiting lethargy
headache vomiting lethargy Explanation: The child with idiopathic thrombocytopenic purpura (ITP) is expected to have petechiae and purpura (bruising), which would not require notification of the health care provider. Headache, vomiting, and lethargy indicate possible intracranial hemorrhage and should be reported to the health care provider.
The nurse is reviewing the laboratory test results of a child with thalassemia. Which results would the nurse expect to find with the hemoglobin electrophoresis? Select all that apply. hemoglobin F hemoglobin A2 hemoglobin A hemoglobin S
hemoglobin F hemoglobin A2 Explanation: In thalassemia, the hemoglobin electrophoresis would reveal the presence of hemoglobin F and A2 only. Hemoglobin S would be found with sickle cell disease.
A child will be undergoing a Holter monitor test. Which statement by the parent indicates the need for further instruction? "Wearing a snug shirt the day of the test will be helpful." "My child cannot have any thing to eat or drink after midnight the day of the test." "This test will monitor my child for about 24 hours." "We do not need to alter our activities during the testing period."
"My child cannot have any thing to eat or drink after midnight the day of the test." Explanation: Ambulatory electrocardiographic monitoring (Holter) testing is an exam that spans approximately 24 hours. The test is done to review the activity of the heart. The child is encouraged to follow one's normal activities during the test. There is no need for the child to be NPO prior to or during the test.
The nurse is teaching the parents of a 4-year-old girl with thalassemia about sound nutritional choices. The nurse asks the mother about good snack choices to send to preschool. Which response by the mother would indicate a need for further teaching? "She can bring graham crackers and peanut butter." "Yogurt with granola is a good choice." "She likes string cheese and saltine crackers." "I can send apple slices with yogurt dip."
"She can bring graham crackers and peanut butter." Explanation: Children with thalassemia should avoid foods that are high in iron. Peanut butter is high in iron and should be avoided. Yogurt, granola, string cheese, saltine crackers, and apples are appropriate choices.
The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude? Plotting height and weight on a growth chart Assessing dietary intake by addressing "picky eating" and "food jags" Administering the measles, mumps, rubella (MMR) vaccine Teaching the importance of taking water safety measures
Administering the measles, mumps, rubella (MMR) vaccine Explanation: Live vaccines (viral or bacterial) should not be administered to an immunosuppressed child because of the risk of causing disease. The other health maintenance activities are important for the health maintenance of the toddler and should be included during the well-child visit.
A 5-year-old is being prepared for diagnostic cardiac catheterization, in which the catheter will be inserted in the right femoral vein. What intervention should the nurse take to prevent infection? Avoid drawing a blood specimen from the right femoral vein before the procedure Keep the child NPO for 2 to 4 hours before the procedure Record pedal pulses Apply EMLA cream to the catheter insertion site
Avoid drawing a blood specimen from the right femoral vein before the procedure Explanation: Because the vessel site chosen for catheterization must not be infected at the time of catheterization (or obscured by a hematoma), never draw blood specimens from the projected catheterization entry site before the procedure (generally a femoral vein). The other interventions listed are performed for reasons other than prevention of infection. Children scheduled for the procedure are usually kept NPO for 2 to 4 hours beforehand to reduce the danger of vomiting and aspiration during the procedure. Be certain to record pedal pulses for a baseline assessment. The site for catheter insertion is locally anesthetized with EMLA cream or intradermal lidocaine.
What information would be included in the care plan of an infant in heart failure? Encourage larger, less frequent feedings. Begin formulas with increased calories. Maintain child in the supine position. Administer digoxin even if the infant is vomiting.
Begin formulas with increased calories. Explanation: Infants with heart failure need increased calories for growth. The infants are typically given smaller, more frequent feedings to decrease the amount given and to help conserve energy for feeding. They often are given a higher-calorie formula. The infant should be placed in an upright position or in a car seat to increase oxygenation. The infant should not have any pressure on the diaphragm while in this position. Vomiting is a sign of digoxin toxicity and this should be considered before administering.
The nurse examining a child who was diagnosed with acute lymphoblastic leukemia (ALL) 6 months ago. The child exhibits pallor, ecchymoses, and petechiae. The nurse interprets these findings as indicating that the cancer has invaded which part of the body? Lymph nodes Liver Bloodstream Bone marrow
Bone marrow Explanation: A child with cancer often appears pale and thin, with symptoms of lethargy and generalized malaise. The presence of pallor, ecchymoses, and petechiae may indicate that the cancer has invaded the bone marrow and is interrupting the normal production of red blood cells and platelets, as in leukemia.
The nurse is planning to teach the parents of a child with newly diagnosed muscular dystrophy about the disease. Which definition should she use to best describe this condition? A demyelinating disease Lesions of the brain cortex Upper motor neuron lesions Degeneration of muscle fibers
Degeneration of muscle fibers Explanation: Degeneration of muscle fibers with progressive weakness and wasting best describes muscular dystrophy. Demyelination of myelin sheaths is a description of multiple sclerosis. Lesions within the brain cortex and the upper motor neurons suggest a neurologic, not a muscular, disease.
When providing discharge instructions to a child who was admitted to the hospital following stridor, wheezing, and urticaria after taking penicillin, which nursing action is priority? Question the child about the amount of penicillin that was taken. Encourage the child to wear a medical alert bracelet for penicillin. Advise the parents to have their child evaluated for atopic diseases. Educate the parents about possible side effects of penicillin in children.
Encourage the child to wear a medical alert bracelet for penicillin. Explanation: Oral medications most likely to cause an allergic reaction include antibiotics, acetylsalicylic acid (aspirin), and NSAIDs. Children experiencing stridor, wheezing, and urticaria after taking a medication most likely have an allergy to that medication. The priority nursing action for discharge education is to prevent the child from being exposed to penicillin again, which could be accomplished by encouraging the child to wear a medical alert bracelet. Although children with atopic diseases are more likely to have medication allergies, requesting parents have the child evaluated is not a priority. Questioning the child about the amount of penicillin taken and educating parents about the side effects of penicillin is not a priority.
The nurse is caring for a child who has been prescribed cyclophosphamide. What nursing consideration is indicated? Administer the medication at bedtime. Limit the child's fluid intake while taking this medication. Administer medication prior to food intake. Encourage voiding with medication administration.
Encourage voiding with medication administration. Explanation: Cyclophosphamide is a cytotoxic medication. It suppresses bone marrow activity. The child should be encouraged to void during and after administration to prevent hemorrhagic cystitis. The medication should be administered in the morning. Food intake does not have a bearing on the administration of this medication. Adequate hydration should be encouraged to decrease the risk of hemorrhagic cystitis.
The pediatric nurse reviews the radiographs of a child and observes that there are lesions on the bone. The nurse interprets this finding as suggesting which condition? Ewing sarcoma Hodgkin disease Non-Hodgkin lymphoma Neuroblastoma
Ewing sarcoma Explanation: Radiographs that show lesions on the bone may indicate tumors (e.g. Ewing sarcoma, osteosarcoma) or metastases of tumors warranting further investigation by bone scan, CT or MRI. Positron emission tomography is the most effective test to diagnose neuroblastoma, Hodgkin disease, Non-Hodgkin lymphoma, bone tumors, lung and colon cancers and brain tumors.
The nurse is conducting a physical examination of a 9-month-old infant with a suspected neuromuscular disorder. Which finding would warrant further evaluation? Presence of symmetrical spontaneous movement Absence of Moro reflex Absence of tonic neck reflex Presence of Moro reflex
Presence of Moro reflex Explanation: The persistence of a primitive reflex in a 9-month-old would warrant further evaluation. Symmetrical spontaneous movement and absence of the Moro and tonic neck reflex are expected in a normally developing 9-month-old child.
Which nursing problems could be associated with a child with primary immunodeficiency? Select all that apply. Risk for infection Altered skin integrity Delayed growth and development Altered fluid and electrolytes Altered gastrointestinal function
Risk for infection Altered skin integrity Delayed growth and development Explanation: All of these can be problems associated with immune system dysfunction. Fluid and electrolytes and GI function are not commonly associated with primary immunodeficiency.
When caring for a child with a congenital heart defect, which assessment finding may be a sign the child is experiencing heart failure? Tachycardia Bradycardia Inability to sweat Splenomegaly
Tachycardia Explanation: Heart failure occurs when the heart has the inability to pump effectively to provide adequate blood, oxygen, and nutrients to the body's organs and tissues. Symptoms occur because of three factors. The neurohormonal influences cause symptoms of tachycardia, pallor, decreased urine output, sweating, hypertension, weight gain and edema. The symptoms seen from systolic dysfunction are dyspnea on exertion, increased work of breathing, and feeding difficulties. Diastolic influences produce hepatomegaly, jugular vein distention and periorbital edema.
When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding? The liver size increases due to cardiac medications. The spleen size increases due to frequent infection. The liver size increases in right-sided heart failure. The spleen size increases due to increased destruction of red blood cells.
The liver size increases in right-sided heart failure. Explanation: The liver increases in size due to right-sided heart failure. This is one of the cardinal signs of congestive heart failure. The spleen is in the upper left quadrant of the abdomen and would increase in size under certain circumstances, but this is asking for the upper right quadrant information. There are certain medications that can affect the liver, but this would not be the most likely reason for hepatomegaly.
The nurse is discussing food allergies with parents of a young child, explaining that a very effective way to determine which foods a child may be allergic to is to implement: a food diary. allergy skin testing. an elimination diet. a raw food diet.
an elimination diet. Explanation: The food diary may identify foods the child does not tolerate well, but it lacks the objectivity of the elimination diet. Skin testing usually involves whole proteins and will not test for reactions to food breakdown products. A raw food diet does not apply to allergy identification.
A client with cancer is diagnosed with typhlitis. Which emergency intervention would the nurse perform? Administer broad-spectrum antibiotics intravenously. Maintain fluid restriction to below maintenance levels. Monitor serum sodium levels. Administer diuretics.
Administer broad-spectrum antibiotics intravenously. Explanation: Typhlitis (neutropenic enterocolitis) is an inflammatory process of the gastrointestinal tract that occurs with the induction phase of leukemia chemotherapy. The recommended interventions for treatment are to administer broad-spectrum antibiotics or antifungals intravenously, provide supportive care to manage symptoms, and provide IV nutrition. The client should be kept NPO. The nurse should assess for any signs of bowel perforation or shock. Administering diuretics would not be needed and may cause harm. Monitoring sodium levels as well as other electrolytes would be necessary to evaluate IV nutrition.
A child has undergone a hematopoietic stem cell transplant. When assessing the child, the nurse notes the development of a maculopapular rash on the child's palms and bottoms of the feet. Which condition would the nurse suspect? Graft-versus-host disease Disseminated intravascular coagulation Graft failure Veno-occlusive disease
Graft-versus-host disease Explanation: Graft-versus-host disease involves the development of a maculopapular rash on the palmar and plantar surfaces of the hand and feet evolving into erythematous rash over most of body (ranging from slight redness of the skin to complete skin desquamation. Disseminated intravascular coagulation would involve signs of bleeding, including bruising, petechiae and ecchymoses. Graft failure would be manifested by fever, infection and a decrease in blood counts. Veno-occlusive disease would be manifested by sudden, unexpected weight gain, thrombocytopenia, jaundice, hepatomegaly, right upper quadrant pain, ascites and encephalopathy.
A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention? Elevate the head of the bed. Notify the doctor immediately. Administer epinephrine. Observe vitals every two hours.
Notify the doctor immediately. Explanation: The nurse would notify the doctor immediately. Cardiac tamponade is a medical emergency and should be addressed. The child can die if intervention is postponed. It would not be appropriate to perform any interventions until confirming that this is the actual diagnosis.
A mother who is HIV positive is distraught when she learns that her 6-month-old baby is also HIV-positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that the most likely means of transmission of the disease to this child was: placental spread during pregnancy. blood transfusion products contaminated with the virus. the mother kissing the baby on the forehead. breastfeeding.
placental spread during pregnancy. Explanation: Although it is decreasing in incidence, transmission of HIV from mother to child by placental spread is still the most common reason for childhood HIV infection in the United States. Children with hemophilia no longer have a high incidence of the disease because blood products are now screened for the virus. HIV is not transmitted by animals or through usual casual contact, such as shaking hands or kissing, or in households, day care centers, or schools. Infection via breast milk is possible but less likely than via placental spread.
The nurse begins administering blood to a pediatric client with hemoglobinopathy. During the transfusion, the nurse notes: a rash on the child's chest, face, and extremities; temperature 101.8°F (38.8°C); respirations 34 breaths/minute; and the child reports nausea. Which actions will the nurse take? Select all that apply. Stop the blood transfusion. Administer only IV normal saline (NS). Assess the child's vital signs. Monitor the child's urine output. Call the child's primary health care provider.
Stop the blood transfusion. Administer only IV normal saline (NS). Assess the child's vital signs. Monitor the child's urine output. Call the child's primary health care provider. Explanation: Based on the findings, the nurse would suspect an adverse reaction to the blood transfusion. The nurse would immediately stop the transfusion, administer NS IV to the client, send the blood and tubing to the laboratory, and notify the health care provider. The nurse would continue to monitor the child by assessing vital signs and monitor urine output as a decrease in kidney function could indicate acute kidney failure.
A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. What does this prescription indicate to the nurse? The child requires a prophylactic dose of iron. The child has mild to moderate iron deficiency. The child has severe iron deficiency. The child is being prepared for packed red blood cell administration.
The child has mild to moderate iron deficiency. Explanation: The recommended dosage for iron supplementation for a child with mild to moderate iron deficiency is 3 mg/kg/day of ferrous fumarate. A prophylactic dose is 1 to 2 mg/kg/day of up to a maximum of 15 mg elemental iron per day. Severe iron deficiency requires 4 to 6 mg/kg/day of elemental iron in three divided doses. Transfusion of packed red blood cells is reserved for the most severe cases. Prior to the transfusion of packed red blood cells, the nurse would follow specific blood bank guidelines.
