3. Immunity
C
The nurse is caring for a child with cerebral palsy who requires a wheelchair to attain mobility. Which intervention would help the child achieve a sense of normality?A. Encourage follow-through with physical therapy exercises.B. Restrict the child to a special needs classroom.C. Encourage after-school activities within the limits of the child's abilities.D. Ensure the school is aware of the child's capabilities.
D
The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? a. Administer griseofulvin with a fatty meal b. Institute contact isolation precautions c. Apply topical antibiotic cream d. Apply topical antifungal cream.
B
The nurse is teaching about skin care for atopic dermatitis. Which statement by the parent indicates that further teaching may be necessary? a. "I will use Vaseline or Crisco to moisturize my child's skin." b. "A hot bath will soothe my child's itching when it is severe." c. "I will buy cotton rather than wool or synthetic clothing for my child." d. "I will apply a small amount of the prescribed cream after the bath."
give EPI
A 9-year-old client presents to the emergency department after a bee sting and experiencing bouts of nausea and vomiting. The nurse notes the client's blood pressure is 68/40 mm Hg, pulse is 48 beats/minute, O2 saturation is 86%, and the child is dyspneic. Which action will the nurse take? Administer benadryl. Give epinephrine. Determine if the stinger is still intact. Apply ice to the site.
D
A boy with Duchenne muscular dystrophy is admitted to the pediatric unit. He has an ineffective cough. Lung auscultation reveals diminished breath sounds. What is the priority nursing intervention?A. Apply supplemental oxygen.B. Notify the respiratory therapist.C. Monitor pulse oximetry.D. Position for adequate airway clearance.
Helping the kid use corrective devices is important
The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers? The nurse should provide information when the child or caregiver requests it. The nurse should be a contact person when the child is hospitalized. The nurse should support the caregivers in restricting activity during the treatment. The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.
admin pain meds every 3 hours
The nurse is caring for a child who has just been admitted to the pediatric unit with sickle cell crisis. He is complaining that his right arm and leg hurt. What is the priority nursing intervention?a. Administer pain medication every 3 hours intravenously until pain is controlled.b. Perform passive range of motion of the arm and leg to maintain function.c. Try acetaminophen for pain first, moving up to opioids only if needed.Use narcotic analgesics and warm compresses as needed to control the pain
baby powder should not be given to newborns because of the risk of aspiration
The nurse is caring for a mother and newborn on a postpartum unit. The mother asks if it OK to use baby powder on newborns. Which response by the nurse would be most appropriate? "Baby powder should not be used on newborns because of the risk of aspiration upon application." "Baby powder may be used if sprinkled on your hand away from the baby to prevent aspiration." "Baby powder should not be used because so many people are allergic to the ingredients in it." "Baby powder can be used anytime with no concerns."
Contact the helthcare provider to request treatment
The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate? Advise the parents to change the infant's formula. Instruct the parents to soak the lesions in mineral oil. Contact the health care provider to request treatment. Encourage parents to avoid feeding the infant peanuts.
administer a warm bath every morning before school
The nurse is caring for a 6 y/o with juvenile idiopathic arthritis. The mother states that she has touble getting her daughter out of bed in the morning and believes the girl's behavior is d/t a desire to avoid going to school. What is the best advice by the nurese?1. Refere the girl to a psychologist for evaluation of school phobia related to chronic illness2. Administer a warm bath every morning before school3. Give the child her prescribed NSAIDs 30 mins before getting out of bed4. Allow her to stay in bed some mornings if she wants
admin diphenhydramine
A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform? Administer diphenhydramine. Turn the child every 2 hours. Soak the child in a colloidal bath. Provide diversional activities.
iliac crest
A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare? Iliac crest Sternum Anterior tibia Femur
B
The nurse is caring for a 2-year-old with myelomeningocele. When teaching about care related to neurogenic bladder, what response by the parent would indicate that additional teaching is required?A. Routine catheterization will decrease the risk of infection from urine staying in the bladder.B. I know it will be important for me to catheterize my child for the rest of her life.C. I will make sure that I always use latex-free catheters.D. I will wash the catheter with warm soapy water after each use.
applying heat
A nurse is preparing a teaching plan for a child with hemophilia and his parents. Which information would the nurse be least likely to include to manage a bleeding episode? Apply heat to the site of bleeding. Apply direct pressure to the area. Elevate the injured area such as a leg or arm. Administer factor VIII replacement.
Injury prevention
A nursery nurse is providing care to a newborn diagnosed with an open neural tube disorder. What is the nurse's initial priority in providing care to the newborn? nutritional support infection control injury prevention fluid maintenance
keeping the lips with jelly to prevent cracking
A school-aged child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy? Having the child solely eat or drink cold foods to reduce mucosal pain Encouraging the use of acidic fruit juices to decrease mouth organisms Keeping the child's lips moist with petroleum jelly to prohibit cracking Vigorously brushing the teeth and gums to remove secretions
B
A varsity high-school wrestler presents with a "rug burn" type of rash on his shoulder that is not healing as expected, despite use of triple antibiotic cream. Two other wrestlers on his team have a similar abrasion. What infection should the nurse be most concerned about, based on the history? a. Tinea cruris b. MRSA c. Impetigo d. Tinea versicolor.
anticholinisterase meds corticosteroids immunosupressants
what three meds used for MG
Obtain the ID bracelet
A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent? "Your child should join a peer support group to help relieve anxiety about this problem." "I recommend you consult a genetic counselor to reveal other susceptible family members." "Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily." "Arrange for your child to receive allergy testing for foods with ingredients similar to those in insect venom."
cellular
Antibodies produced by native T-cell lymphocytes cellular or humoral
read
Food allergy symptoms include hives, flushing, facial swelling, mouth and throat itching, and runny nose
keep the benadryl and the epi pen on hand
Patient teaching for the kid with allergies
diphenhydramine or acetaminophen
Premedication with _____________ or ____________ may be indicated in children who have never received IVIG
eczema and thrombocytopenia
Wiskott aldric syndrome is an x linked genetic disorder that results in immunodeficiency ______ and ________
read
10 warning signs for primary immunodeficiency uFour or more new episodes of acute otitis media in 1 year uTwo or more episodes of severe sinusitis uTreatment with antibiotics for 2 months or longer with little effect uTwo or more episodes of pneumonia in 1 year uFailure to thrive in the infant uRecurrent deep skin or organ abscesses uPersistent oral thrush or skin candidiasis after 1 year of age uHistory of infections requiring IV antibiotics to clear uTwo or more serious infections such as sepsis uFamily history of primary immunodeficiency
chronic diarrhea failure to thrive persistent thrush adventitious sounds related to pneumonia
4 nursing assesment signs of severe combined immunodefiency
hemolytic anemia neutropenia IBD arhtirits renal disease
5 complications of wiskot aldrich syndrome
milk eggs peanuts tree nuts fish and shellfish wheat and soy
6 most common allergens first years of life
use sunscreen to avoid rashes
A 14 y/o with systemic lupus erythematosus wants to know how to care for her skin. What should the nurse teach this adolescent?1. Careful sun tanning will give her skin an attractive color2. No special skin care is needed3. Use sunscreen daily to avoid rashes4. Use makeup to camouglage the butterfly rash on her face
apple slices with cheese
A 14-year-old with thalassemia asks for your assistance in choosing her afternoon snack. Which choice is the most appropriate?a. peanut butter with rice cakeb. small spinach saladc. apple slices with cheddar cheesesmall burger on wheat bun
avoid palpating the childs abdomen
A 5-year-old has been diagnosed with Wilms tumor. What is the priority nursing intervention for this child?a. Educate the parents about dialysis, as the kidney will be removed.b. Measure abdominal girth every shift.c. Avoid palpating the child's abdomen.Monitor BUN and creatinine every 4 hours
assess for brusing and bleeding
A child on the pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WBC 24,000, and platelets 20,000. What is the priority nursing assessment?a. Assess for pallor, fatigue, and tachycardia.b. Monitor for fever.c. Assess for bruising or bleeding.Determine intake and outputa
carefully assess the abdomen
A child with hemophilia fell while riding his bicycle. He was wearing a helmet and did not lose consciousness. He has a mild abrasion on his knee that is not oozing. He is complaining of abdominal pain. What is the priority nursing assessment?a. Perform neurologic checks.b. Assess ability to void frequently.c. Carefully assess his abdomen.Examine his knee frequently
avoid sitting in one position for long periods of time wear c otton t shirt loosen during meals if appropriate
A nurse caring for a child wearing a brace to correct scoliosis provides client and family teaching for home care of the brace. Which of these are accurate interventions for this situation? Select all that apply. Avoid sitting in one position for long periods of time. Tell the client to loosen the brace during meals if necessary. Schedule brace wear for waking hours for best therapeutic results. Wear a 100%-cotton T-shirt under the brace to absorb moisture. Recommend a shower instead of a bath to stimulate the skin. Gradually decrease wearing time so the skin can develop tolerance
premedicate before changing the dressing
An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do? Premedicate the child before changing the dressing. Elevate the area after performing the dressing change. Ensure that the temperature of the solution is 120°F (48.9°C). Use a fragrance-free, dye-free soap to clean the wound.
It is important to wear the brace now to stabilize your spinal alignment decreasing your symptoms
An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals? "It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms." "It is important to correct spinal curvature before it gets too bad, causing you problems." "It is important to prevent herniation of a spinal disk, which is painful." "It is important to prevent torticollis."
every 15 minutes for the first hour and then every 30 minutes after
Assess vital signs how often for IVIG
severe combined immune deficiency
Characterized by absent T-cell and B-cell function
ACH receptors
For MG The child's antibodies attack the _____________ and other proteins at the neuromuscular junction inhibiting normal neuromuscular transmission the result is progressive weakness and fatigue of the skeletal muscles
weakness paralysis
GB Results in inflammation and demyelinization of the peripheral nerves causing______and _________ in a progressive fashion
attacks peripheral nervous system (PNS)
GB is an immune response that attacks which nervous system
monitoring the site every 4 hours
In caring for a child in traction, which intervention is the highest priority for the nurse? The nurse should monitor for decreased circulation every 4 hours. The nurse should clean the pin sites at least once every 8 hours. The nurse should provide age-appropriate activities for the child. The nurse should record accurate intake and output.
resp distress dysphagia trouble talking double vision
MG crisis symptoms 4 symptoms
Juvenile Idiopathic Arthritis when does stiffness usually occur?
Mainly targeted joints inflammatory changes in the joints causes pain, redness, warmth, stiffness and swelling Stiffness usually occurs after inactivity
primary immunodeficiencies
Mostly hereditary or congenital May be related to humoral deficiencies, cellular immunity deficiencies or combination of the two
It actually affects both
SLE affects cellular or humoral immunity
more common in females
SLE is more common in females or males
wash your hair with gentle shampoo daily
The clinic nurse is assessing a 12-year-old client. The client reports having dandruff and asks the nurse what can be done for it. Which response by the nurse is best? "Wash your hair with a gentle shampoo daily." "I will let your primary health care provider know you need prescription shampoo." "Wash your hair vigorously twice a day for one week." "Apply warm baby oil to your scalp once a day for a few days."
antiemetic
The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure? Analgesic Antiemetic Antipyretic Antineoplastic
autoimmune disorders
The body manufactures T cells and antibodies against its own cells and organs
we should avoid using petroleum jelly
The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching? "We should avoid using petroleum jelly." "We should keep his fingernails short and clean." "We should avoid tight clothing and heat." "We need to develop ways to prevent him from scratching."
my husband gives our daughter orange juice so she also gets vitamin D
The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate? "When I give my son ferrous sulfate I know he also needs potassium supplements." "I always give the ferrous sulfate with meals." "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C." "We watch closely for any diarrhea since that usually happens when he takes ferrous sulfate."
Has your child ever been tested for a peanut allergy
The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant the child gets a rash. It just does not make sense to me." How should the nurse respond? "Has your child ever been tested for a peanut allergy?" "Is your child allergic to milk?" "That is odd. Does anyone else in your family react that way?" "Maybe it is an allergy to something else and you just notice after eating there by coincidence."
most children will make a full recovery
What is the prognosis for GB
antibacterial soap will be helpful in preventing infections i should use the warmest water
When reviewing bathing habits for a child with dermatitis, which statements by the child's mother indicates the need for further instruction? Select all that apply. "When drying the skin I should pat instead of rubbing it." "Antibacterial soap will be helpful in preventing infections at the site of the rash." "It is important to avoid soaps with dyes and perfumes." "I should apply the topical ointments after bathing." "I should use the warmest water my child can tolerate during the bath.
peanuts treen nuts fish and shellfish
Which 3 food allergies persist into adulthood
practice frequent gentle oral hygiene
Which intervention is best to use with the 6-year-old who has developed stomatitis as a side effect of chemotherapy? Limit foods to cool, clear liquids Practice frequent, gentle oral hygiene Use lidocaine rinses Have the child freely choose desired foods and beverages
risk for infection
Which nursing diagnosis is most relevant in the first 12 hours of life for a neonate born with a myelomeningocele? risk for infection constipation impaired physical mobility delayed growth and development
humoral
Which type of immunity takes longer to develop
emollinets and moisturizer for the skin and dry off the skin after showers
important patient teaching considerations for wiskott aldrich syndrome
renal failure
serious adverse reaction after IVIG infusion
nsaids corticosteroids antimalarials
three meds used for SLE
premedicated
tips for before IVIG infusion
IVIG infusions may help decrease the number of infections until bone marrow or stem cell transplant can be done
treatment for severe combined immune deficiency
IVIG infusion
treatment for wiskott aldric syndrome
IVIG and plasmapharesis
treatments for GB
humoral
uAntibodies produced by native B-cell lymphocytes cellular or humoral
secondary immunodeficiencies
uOccurs a result of chronic illness, malignancy, use of immunosuppressive medication, malnutrition or protein losing state, prematurity or HIV infection
Guillain-barre syndrome (GB)
upper respiratory tract or gastroenteritis would usually cause which condition GB MG idiopathic thrombotytic purpura Thallassemia
the nurse follows contact precautions
The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority? The nurse soaks the skin with warm water. The nurse applies topical antibiotics to the lesions. The nurse follows contact precautions. The nurse applies elbow restraints to the infant.
C
A 7-year-old child with cerebral palsy has been admitted to the hospital. Which information is most important for the nurse to obtain in the history?A. Age that the child learned to walkB. Parents' expectations of the child's developmentC. Functional status related to eating and mobilityD. Birth history to identify cause of cerebral palsy
the stools are black
A 9-month-old infant with iron-deficiency anemia is given ferrous sulfate therapy. Which assessment would best help the nurse determine that the infant is actually taking it daily? The reticulocyte count will have decreased. The infant will develop diarrhea. The stools will appear black. The infant will be more irritable than at the last visit.
encourage active and passive range of motion excersises
The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions? Encourage child to stifle cough and take shallow breaths to prevent ineffective breathing patterns. Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion. Check for a normal capillary refill of 3 to 5 seconds on a daily basis to ensure there in adequate arterial supply. Give the client large, frequent meals with decreased fiber and increased protein and Vitamin C.
D
The nurse is caring for orthopedic children who are in the postoperative period following spinal fusion. What is the most appropriate activity to delegate to unlicensed assistive personnel?A. Ambulate the children twice daily to promote mobility.B. Encourage commode use to promote bowel function.C. Provide diversionary activities, as the children must stay flat on their backs.D. Assist with log-rolling the children every 2 hours.
In the first 15 minutes of transfusing the blood
When are you most likely to have a blood transfusion reaction
Systemic lupus erythmatosus
Which condition would sport a macropapular rash on the face
wiskott aldrich
Which immuno condition is males only
assuming the feedin posiiton may be difficult
Why will it be necessary for the nurse to be very supportive of parents' attempts to feed the infant with recently repaired myelomeningocele? The infant will have a poor sucking reflex. Pain will interfere with the feeding process. Assuming the usual feeding position will be difficult. Nausea and vomiting often follow repair of the cystic mass.
Immunoglobulins
With hypogammaglobulonemia do not form _______ appropriately
C
The nurse is caring for a child in the emergency department who was bitten by the family dog, who is fully immunized. What is the priority nursing action? a. Administer rabies immunoglobulin b. Refer the child to a counselor c. Assess the depth and extent of the wound d. Administer a tetanus booster
A
The nurse is caring for a child who has received significant partial-thickness burns to the lower body. What is the priority assessment in the first 24 hours after injury? a. Fluid balance b. Wound infection c. Respiratory arrest d. Separation anxiety.
observation shows nystagmus and head tilt
The nurse is assessing a 3-year-old boy whose mother reports that he is listless and has been having trouble swallowing. Which finding suggests the child may have a brain tumor? Observation reveals nystagmus and head tilt. Vital signs show blood pressure measures 120/80 mm Hg. Examination shows temperature of 101.4° F (38.6°C) and headache. Observation reveals a cough and labored breathing.
do not insert anything into the rectum
The nurse is caring for a 6-month-old infant with Wiskott-Aldrich syndrome. Which teaching does the nurse provide the parent? "Do not use a tub bath for daily cleansing." "Do not encourage a pacifier due to possible oral malformation." "Do not insert anything in the rectum." "Do not use a sponge bath for light cleaning."
cellulits
The nurse is caring for a child brought to a pediatric clinic for swelling in the lower extremities. The skin is reddened with undefined borders and pits slightly when pressed. Based on the assessment findings, which of the following would the nurse suspect? cellulitis impetigo staphylococcal scalded skin syndrome (SSSS) cat scratch disease