Chapter 35: Key Pediatric Nursing Interventions Prep U

A nurse is educating the parents how to administer daily oral medication to their 5-year-old boy. Which response indicates a need for further teaching?

"He needs to take his medicine or he will lose a privilege."

To give eardrops to a 4-year-old child, what would be the best technique to use? Press the pinna of the ear forward. Pull the pinna of the ear up and back. Pull the pinna of the ear downward. Lift the pinna of the ear down and back.

Pull the pinna of the ear up and back.

The nurse is providing education to the parent of a 9 year old child about the administration of oral medications after discharge. Which statements by the parent indicate an understanding about the process? Select all that apply. "Maintaining a schedule for giving my child the medications will be helpful." "Any time my child refuses to take the prescribed pills I can crush and add them to yogurt." "I can allow my child to pick the type of juice or water to take the medication with." "Dissolving pills in warm water safe." "If my child argues about taking the medication they will be punished."

"I can allow my child to pick the type of juice or water to take the medication with." "Maintaining a schedule for giving my child the medications will be helpful."

A nurse has just given otic medication instructions to the parents of a 12-year-old child. Which statement would indicate that the parents need further education concerning the medication?

"I will pull the outer ear down and back before administering the medication."

A parent asks the nurse to explain what a PET scan is after learning that the child will be having a PET scan of the abdomen. What is the nurse's best response? "It is a very short procedure done in the diagnostic imaging department." "It stands for positron emission tomography, which is different from computed tomography." "It is similar to a CT scan but uses an injection of dye to help visualize the abdominal organs." "It would be best to ask your provider about this procedure."

"It is similar to a CT scan but uses an injection of dye to help visualize the abdominal organs."

The nurse enters the room to give a subcutaneous injection of insulin to a 6-year-old female who is diabetic. What is the best method of medication administration? Tell the child that she is to remain very still and not cry. Ask her where she would like to have the injection. Announce to the child that it is time for her insulin and give the injection matter-of-factly. Ask the child if it is okay to give her the injection now.

Ask her where she would like to have the injection.

A father believes his 2-year-old son is frightened by seeing an intramuscular (IM) medication injected into his thigh and requests that the child's "butt" be used. What will be the nurse's response? "Because he is still in diapers, the thigh is a better choice." "The muscle in his butt is not well enough developed to receive this injection until he has walked for 1 year." "Because he is 2 years old, this will be OK." "The medication will be better absorbed from his thigh."

"The muscle in his butt is not well enough developed to receive this injection until he has walked for 1 year."

The nurse is preparing to administer an intramuscular immunization to a 5-year-old child. What statement to the child is appropriate for inclusion in the preadministration period?

"This will help prevent you from getting sick."

The nurse is educating the parents of a 5-month-old on how to administer an oral antibiotic. Which response indicates a need for further teaching? "We can follow his medicine with some applesauce or yogurt." "We can place the medicine along the inside of his cheek." "We should not forcibly squirt the medication in the back of his throat." "We can mix the antibiotics into his formula or food."

"We can mix the antibiotics into his formula or food."

The nurse is caring for a child who weighs 31 kg. A medication is ordered for this child with a dosage range of 20 to 40 mg per kg of body weight per dose. Which dosage would be appropriate for the nurse to administer to this child in one dose? 62.0 mg per dose 124.0 mg per dose 12.4 mg per dose 1,000 mg per dose

1,000 mg per dose

A 5-year-old child is to receive long-term IV antibiotics. The mother is concerned about what type of administration method will be used. Which medication administration route may be the most easily accepted? A Hickman catheter in the right upper chest A port in the left upper chest A peripherally inserted central catheter (PICC) line in an antecubital space An intraosseous line in the left lower leg

A peripherally inserted central catheter (PICC) line in an antecubital space

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2 saturation 95% on room air. Which action will the nurse take first? Give the antibiotic as prescribed. Apply oxygen at 2 liters via a nasal cannula. Administer the bronchodilator via a nebulizer. Apply a cardiac monitor to the child.

Administer the bronchodilator via a nebulizer.

A neonate is to receive a hepatitis B vaccine within a few hours after birth. What is the bestapproach for the nurse to take when giving this medication?

Administer the medication in the neonate's vastus lateralis with a 25-gauge needle.

A child is prescribed several diagnostic procedures. How can the nurse advocate for this client? Ask that the procedures be scheduled back to back to prevent fatigue. Advocate for procedures to be separated to allow time for food and rest. Attend all procedures with the child when going to another area of the hospital. Ensure that all procedures are performed with the child under general anesthesia.

Advocate for procedures to be separated to allow time for food and rest.

The nurse is preparing to remove an IV device from the arm of a 6-year-old girl. Which approach is best for minimizing fear and anxiety? Explain to the child that the procedure will be painful but the discomfort wont last long. Ask the child if they would like to help remove the tape from the IV. Ask the child to help cut the tape needed for the procedure. Explain that the IV removal will not have any discomfort.

Ask the child if they would like to help remove the tape from the IV.

medications and brings them and the medication administration record to the client's room. The nurse observes that the client is not wearing an identification band. Which action will the nurse to take? Locate another RN who can identify the client. Ask the client to recall his or her name and date of birth. Notify the prescribing health care provider. Call the admitting department and have another ID band prepared stat, so the medications can be given on time.

Ask the client to recall his or her name and date of birth.

The pediatric nurse is bringing the prescribed medication for a child but notes that the identification band is missing. The parents are at the bedside holding the child. What is the best method for identifying the child?

Ask the parents to tell you his or her name and date of birth.

The nurse is preparing to administer regular insulin to a nonverbal pediatric client. Which action will the nurse perform prior to administering the medication?

Check the full name and birth date on the client's wristband with the medication administration record.

The nurse is caring for a child with a nasogastric tube that has been in place for several days. It is time to administer the liquid feeding. What is the priority nursing action? Ensure that the tube extending from the child's nose is secured to the forehead. Instill air into the tube and auscultate for sound over the epigastric area. Seek a radiograph to verify tube placement prior to feedings. Check the length of the tube extending from the nose against the measurement recorded when the tube was placed.

Check the length of the tube extending from the nose against the measurement recorded when the tube was placed.

A child's parents refuse to consent to medical care that is necessary to save the child's life. What is the first action the nurse should take?

Determine the rationale behind the parents' decision.

A nurse is preparing a dose of insulin to give the client. Which action takes priority when preparing and administering this medication? .

Double-check the dose with another RN before giving.

information to give the parent concerning oral medication administration?

Give the medication with a syringe and direct the liquid toward the posterior side of the mouth while holding the infant upright.

The nurse is assessing a child who is receiving TPN. The nurse determines the TPN bag was hung 24 hours ago. What initial action by the nurse is indicated? Document the amount of solution left in the bag and continue the administration. Increase the rate of the TPN to complete the bag. Hang a new bag of TPN. Discontinue the TPN bag and notify the physician.

Hang a new bag of TPN.

When assessing a caregiver's knowledge of proper medication administration, which is the bestway for the nurse to determine the caregiver's knowledge?

Have the caregiver give a demonstration of the medication administration to the nurse before discharge.

The nurse is administering an oral liquid medication to a 5-year-old child. What would be the most appropriate for the nurse to do when administering this medication?

Let the child hold the medication cup.

As the nurse prepares to administer a medication to a preschooler, the nurse realizes that the child is extremely underweight for age. What action would the nurse take?

Measure the child's height and weight, and check whether the dose is correct for the child.

Parents asks the nurse why their premature infant is receiving a feeding through the mouth rather than the nose. What is the best explanation by the nurse? It is equally acceptable to use either insertion site.

Newborns are obligate nose breathers so nasogastric may obstruct their breathing.

Included in the nursing care plan for the child receiving total parenteral nutrition (TPN) will be which intervention? Regularly monitoring the child's blood glucose Flushing the peripheral catheter delivering the TPN solution regularly with saline A daily stool softener Keeping the child nothing by mouth (NPO)

Regularly monitoring the child's blood glucose

The nurse is caring for a child prescribed ophthalmic drops. Place the steps in the order the nurse will complete them when administering the ophthalmic medication to the child. Use each option once. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 Place the child in the supine position, slightly hyperextending the neck with the head lower than the body 2 Instruct the child to gently close the eyes 3 Wipe any excess medication from the skin 4 Retract the lower conjunctival sac 5 Place the prescribed number of drops into the lower eyelid

Place the child in the supine position, slightly hyperextending the neck with the head lower than the body Retract the lower conjunctival sac Place the prescribed number of drops into the lower eyelid Instruct the child to gently close the eyes Wipe any excess medication from the skin

A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client? Place the child on NPO status. Give an antiemetic prior to giving oral medications. Hold all medications until the vomiting stops. Request an intravenous form of the medication.

Request an intravenous form of the medication.

The nurse is preparing to give a diphtheria, pertussis, and tetanus (DPT) immunization to a child in an acute care setting before discharge. The label on the DPT bottle indicates the immunization expired yesterday. What is the correct nursing action to take?

Return the bottle to the pharmacy and request a replacement.

The nurse is preparing to administer albuterol to a 14-year-old client for the first time. Prior to administration, which adverse reaction is priority for the nurse to educate the client? Tachycardia Hypoactivity Bronchial muscle relaxation Increased appetite

Tachycardia

A client's parent informs the nurse about having a hard time getting the 6-year-old child to take the liquid medication at home. Which would be the best suggestion for the nurse to offer this parent to help correct this concern? Tell the parent to ask nicely, "Will you drink this for me?" Tell the parent to state firmly, "It's time for you to drink your medicine." Tell the parent to say calmly, "Can you drink this for me?" Tell the parent to tell the child, "It tastes just like candy!"

Tell the parent to state firmly, "It's time for you to drink your medicine."

A child has returned to the unit after having a lumbar puncture. Which instructions are important for the nurse to provide the parents and child? The child should be up and ambulating as soon as possible. The child may be fearful of staff after having this procedure. This procedure needs to be repeated again in 24 hours to determine the results. The child will need to remain flat to prevent a headache.

The child will need to remain flat to prevent a headache.

The nurse has been teaching an adolescent about the treatment for hypothyroidism. Which outcome indicates that the teaching has been successful? The client states understanding that this is a lifetime medication. The parents acknowledge the need for a follow-up appointment in a year. The parents recognize that thyroid medication be taken with food. The client verbalizes the requirement to restrict future athletic activities.

The client states understanding that this is a lifetime medication.

A preschool-age child who is receiving gastrostomy feedings occasionally vomits following a feeding. When the parent describes the feeding process, what does the nurse note as the likely cause of the vomiting?

The mother does not check gastric residual prior to feedings.

An infant is to have a scalp-vein intravenous infusion begun. What is an advantage of this insertion site? .

The scalp veins are easily visualized.

While teaching parents how to effectively reduce the child's fever, the nurse should emphasize avoiding which intervention? acetaminophen acetylsalicylic acid dressing the child in lightweight clothing placing a cool cloth on the forehead

acetylsalicylic acid

The nurse is working to gain a preschooler's cooperation to swallow an oral medication. What would be the nurse's best approach?

ask if the child would like to take the medicine in a cup or through an oral syringe

The site most often used when administering a medication using the intradermal route is the: forearm. deltoid. abdomen. thigh.

forearm

The charge nurse is assisting the new graduate nurse in administering eye drops to a child. The charge nurse would stop the new graduate if which action was observed? allows the child to sit up after blinking a few times positions the child supine on the bed administers drops into conjunctival sac holds the eyelids apart for about 30 seconds

holds the eyelids apart for about 30 seconds

The nurse knows that which situation will prevent an adolescent from having an MRI (magnetic resonance imaging)? metal dental braces watch and jewelry hair pins and eye makeup pierced ears and tongue

metal dental braces

A 4-year-old child is admitted to the hospital for surgery. Before the nurse administers medicine, the best way to identify the child would be to: tell the child to state his or her nickname. call the child's name and see if he or she answers. read the child's armband. ask the child to state his or her name.

read the child's armband.

A preschool child has been admitted to the hospital. Which prescription should the nurse question? NPO nasogastric tube to suction tap water enema 500 ml IV normal saline 25 ml/hour

tap water enema 500 ml

The nurse is preparing to give a 4-month-old an oral medication. Which technique demonstrates the nurse's accurate knowledge of the infant's developmental level? Position the infant upright, offer the infant a bottle of formula, remove the bottle and squirt the medication on the side of the tongue toward the cheek, then offer the infant the bottle again. Position the infant supine in bed, and squirt the medication on the tongue toward the cheek. Place the medication in a bottle with a small amount of the infant's formula and feed the bottle to the infant in an upright position. Place the medication in a bottle with a small amount of juice, then feed the infant the bottle in an upright position.

Position the infant upright, offer the infant a bottle of formula, remove the bottle and squirt the medication on the side of the tongue toward the cheek, then offer the infant the bottle again.

When administering medications to an infant, what information would be most important for the nurse to consider? The infant will take oral medications more readily after he or she has been fed. The infant will take medications more readily if he or she is allowed to move the head as desired. The oral medication should be directed toward the posterior side of the mouth when using a syringe or dropper. The infant will take a medication more readily if the flavor is disguised.

The oral medication should be directed toward the posterior side of the mouth when using a syringe or dropper.