Ch 21: Respiratory Disorders

The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child?

Sweat sodium chloride test

The nurse is caring for a child who has been brought to the clinic for the third time in a week for asthma symptoms. If the goal is to have the parents better manage the child's care, which information will the nurse emphasize? Select all that apply.

adhering to the recommended immunization schedule importance of keeping child away from cigarette smokers instruction on peak flow meters and nebulizer treatments role of good handwashing to reduce transmission of disease

A mother brings her 4-year-old son to the emergency department because the child has swallowed a marble. The nurse assesses the child and notes wheezing that is localized to one side of the chest. The nurse determines that the obstruction is at which location?

bronchus

The nurse is reviewing the chart of a client that reads: "2-year-old client with history of sudden-onset barking cough. Heart rate 105 beats per minute, respiratory rate 38 breaths per minute, blood pressure 92/56 mm Hg, oral temperature 98.6°F (37.0°C)." Which intervention should the nurse review with the client's parents?

cool mist

A 6-year-old child is seen in the clinic for a sick visit. The parent states the child has had a cold for 4 days but today the child seems worse. The nurse has completed an initial assessment with the findings in the chart note shown above. Based on this information, the nurse should expect a diagnosis of which disorder?

laryngotracheobronchitis (LTB)

The nurse is reviewing the chart of a client that reads: "3-year-old client with history of an upper respiratory infection that slowly increased in severity over approximately 1 week. Today, the client exhibits a brassy cough, dyspnea, and irritability. Heart rate 110 beats/min, respiratory rate 45 breaths/min, blood pressure 92/56 mm Hg, oral temperature 100.9°F (38.3°C)." To which croup syndrome should the nurse attribute these findings?

laryngotracheobronchitis (LTB)

A hospitalized child suddenly begins reporting "my chest hurts," is tachypneic, and has tachycardia. The nurse auscultates the lung sounds and finds absent breath sounds on one side. After notifying the health care provider, what action would the nurse take first?

prepare for chest tube insertion

The nurse is reviewing the medical records of several children with asthma. The nurse identifies that a child with a history of which of the following is at increased risk for asthma-related death? Select all that apply.

prior admission to the intensive care unit for asthma recent emergency department visit for asthma treatment in the last month two hospitalizations for asthma treatment over the past year

Which of the following antitubercular agents turns the urine or secretions an orangish color?

rifampin

The parents of a 10-year-old boy with cystic fibrosis restrict him from camping, sleepovers with friends, and school field trips. They time his respiratory treatments and log his diet, choosing most foods for him. They have him seen medically between scheduled appointments and call their physician frequently with concerns. The nurse considers these behaviors indicative of

vulnerable child syndrome.

The nurse has assessed a 6-year-old child as having respiratory distress due to swelling of the epiglottis and surrounding structures. Which signs and symptoms would support this assessment?

The child is in tripod position.

The nurse is collecting data on a child admitted with a respiratory concern. The nurse notes that the child is anxious and sitting forward with the neck extended to breathe. The signs the nurse noted indicate the child likely has:

epiglottitis

The 18-month-old client has had recurrent respiratory infections. The mother expresses concern that this child is having more complications from respiratory infections than her older children had. The nurse's best response would be:

"Air passages are small in toddlers, and when inflamed they become smaller because of edema and are occluded with mucus."

The nurse has been caring for an 8-year-old girl with asthma. Her parents are compliant with her treatment regimen, and the girl has experienced no exacerbation of her symptoms in over 12 months. When the nurse inquires about her participation in sports or other extracurricular activities, the girl says that she can't participate because she is sick with asthma. Which response by the nurse would be most appropriate?

"Your activity is not limited; what types of things would you like to do?"

The nurse is caring for a 5-year-old client and notes respiratory rate of 45 breaths per minute, blood pressure 100/70 mm Hg, heart rate 115, temperature 101°F (38.3°C), and oxygen saturation 86%. Which diagnostic test is priority for the nurse to complete?

Arterial blood gas (ABG)

The nurse is preparing to administer an oral medication to a 6-year-old client in the hospital for an exacerbation of asthma. The nurse notes that the client is due for an oral dose of omeprazole in 1 hour. Which action by the nurse would be most appropriate?

Clarify the order because there is no apparent link between the cient's diagnosis and the medication

The nurse is correct to identify which group of symptoms as present with acute laryngotracheobronchitis?

Fever and labored respirations

Which immunizations are suggested at 2 months of age to prevent bacterial pneumonia? Select all that apply.

Hib Pneumococcal

The nurse is administering medications to a child with cystic fibrosis. Which method would the nurse most likely use to give medications to treat the pancreatic involvement seen in this disease?

Open capsule and sprinkle on food.

The caregivers of a child who was diagnosed with cystic fibrosis 5 months ago report that they have been following all of the suggested guidelines for nutrition, fluid intake, and exercise, but the child has been having bouts of constipation and diarrhea. The nurse tells the caregiver to increase the amount of which substance in the child's diet?

Pancreatic enzymes