ATI - Peds Excretion
do not palpate abdomen
child is admitted with suspected diagnosis of Wilm's tumor, which warning should the nurse place over the child's bed? -do not palpate abdomen -no venipuncture or BP in left arm -contact precautions -collect all urine
Wilm's tumor (peds ATI, p. 445)
nurse is caring for child on oncology unit. Child's parents are asking nurse about cancer diagnosis. Which of following information should nurse provide to parents about most common RENAL and INTRA-ABDOMINAL tumor in children? -Ewing sarcoma -osteosarcoma -neuroblastoma -Wilm's tumor
continue to monitor patient (UO is normal, UO should be > 1 mL/kg/hr)
nurse is caring for child with UO of 160 mL over past 8 hr. Child weighs 33 lb. Which of following actions should nurse take? -notify provider -continue to monitor patient -provide oral re-hydration fluids -perform bladder scan at bedside
check child's daily weight (ADPIE, peds ATI, p. 288)
nurse is caring for child with acute glomerulonephritis, which action is nurse's priority? -place child on no salt-added diet -check child's daily weight -educate parent's about potential complications -maintain saline lock
low-sodium, fluids restricted (peds ATI, p. 285)
nurse is caring for school-age child who has acute glomerulonephritis with peripheral edema and UO of 35 mL/hr. The nurse should place the patient on which diet? -low-sodium, fluids restricted -regular diet, no salt added -low-carb, low-protein -low-protein, low-potassium
BUN 50 mg/dL, BUN is elevated in GN (normal BUN = 30-40) (peds ATI, p. 285)
nurse is reviewing lab results of adolescent with chronic glomerulonephritis, which of following is expected? -BUN 50 mg/dL -potassium 3.8 mEq/L -absence of proteinuria -phospherus 4 mEq/dL
I only need to cath myself twice a day (should cath q 4 hr)
nurse is caring for adolescent who has spina bifida and is paralyzed from waist down, which statement by patient indicates need for further teaching? -I only need to cath myself twice a day -I carry a water bottle with me because I drink a lot of water -I use a suppository every night to have a bowel movement -I do wheeelchair exercises while watching TV
projectile vomiting (peds ATI, p. 250)
nurse is caring for a 6 week old infant with pyloric stenosis, which of the following S/S should the nurse expect? -recurrent jelly stools -distended neck veins -projectile vomitting -rigid abdomen
Wilm's tumor (peds ATI, p. 445)
nurse assessing a 1 year-old toddler notices a large abdominal mass and blood-tinged urine on the diaper, which of the following disorders should the nurse expect? -pyloric stenosis -nephritic syndrome -Wilm's tumor -intussesception
irritability
nurse in ED is assessing an infant who's dehydrated, which finding should the nurse expect? -irritability -slow bounding pulse -decreased temp -tetany
body weight
nurse in ED is caring for infant with 2 day history of vomitting and elevated temp, whic of following should nurse recognize as most reliable indicator of fluid loss? -body weight -skin integrity -BP -RR
2 mL/kg/hr (1 y/o who's not dehydrated should produce this much)
nurse is admitting 6 month-old infant with dehydration, which urinary output (UO) indicates that treatment has corrected fluid imbalance? -0.5 mL/kg/hr -2 mL/kg/hr -7.5 mL/kg/hr -15 mL/kg/hr
3% weight loos (peds ATI, p. 240)
nurse is admitting an INFANT with severe dehydration from acute gastroenteritis, which of the following finding should the nurse expect? -bulging anterior fontanel -bradypnea -3% weight loss -cap refill 3 seconds
yellow nasal discharge indicates URI (ped ATI, p. 290 - infx is biggest comp, the other S/S are expected)
nurse is assessing child with acute nephrotic syndrome, which of the following findings should be reported to provider? -yellow nasal discharge -facial edema -poor appetite -irritability
facial edema worse in AM (-increase in pr- permeability = less pr- in bld and fl shift to ECF = decreases UO) (-frothy urine, not smokey brown) (-loss of pr- causes fl shift & hypovolemia = hypotension)
nurse is assessing child with nephrotic syndrome, which of the following findings is expected? -polyuria -facial edema -smoky brown urine -HTN
muscle tremors
nurse is assessing preschooler with calcium level 8 mg/dL, which finding should nurse expect? -dry sticky mucous membranes -polyuria -negative Chevock's sign -muscle tremors
urine specific gravity 1.015
nurse is caring for 3 year-old child admitted with acute diarrhea and dehydration, which finding indicated oral dehydration therapy has been effective? -HR 130 bpm -RR 24/min -urine specific gravity 1.015 -cap refill > 3 seconds
it is expected for hospitalized children to regress, toileting skills will return when child feels better.
nurse is caring for 4 y/o patient with croup who wet the bed overnight. When parents visit, nurse explains situation and one of parents say "I'm so embarassed. She never wets the bed at home." Which response should nurse make? -it is expected for hospitalized children to regress, toileting skills will return when child feels better. -I know this can really be embarassing. I have kids myself so I understand and it doesn't bother me. -child did not seem upset, so I wouldn't worry about it if I were you. -why does it bother you that your child has wet the bed?