Exam 2 - Caroline's

Minimize pulmonary complications using a vest airway clearance device Promote growth and developing by administering pancreatic enzymes and providing a well balanced high calorie, high protein diet Facilitate coping adjustments by developing a schedule for pulmonary maintenance.

A child with cystic fibrosis is being discharged to home; what education would you provide to the family?

a. Cause vasodilation

A child with heart failure is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also has what effect?

16.2 Kg

A child's weight is 35 lbs, 7 ounces. Convert the weight to kilograms.

b. Children develop hypoxemia more rapidly than adults do

A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which finding?

b. Albuterol

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm?

b. Albuterol

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent is appropriate for an acute episode of bronchospasm?

b. Maintaining skin integrity

A group of nursing students are reviewing the six links in the chain of infection and the nursing implications for each. The students demonstrate understanding of the information when they identify which precaution as helping to break the chain of infection?

c. EMLA 1 hour before

A lumbar puncture is needed on a school-age child. The most approp. action to provide analgesia during this procedure is to apply _______________ before the procedure.

b. Decrease the temperature set point

A nurse instructor is teaching a group of students about the action of antipyretic agents in children. The instructor determines that the teaching has been successful when the students identify which action as the primary action?

c. Hasten air reabsorption

A nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason?

a. Speak at an even rate

A nurse is caring for a hearing-impaired child who lip-reads. The nurse should plan which intervention to facilitate lip reading?

d. chronic otitis media

A nurse is preparing a teaching session for parents on the prevention of childhood hearing loss. The nurse should include that the most common cause of hearing impairment in children is:

d. Pancreatic Enzymes

A nurse is teaching the parents of a child diagnosed with CF about medication therapy. Which would the nurse instruct the parents to administer orally?

a. The nurse violated one of the "rights" of medication administration.

A physician orders a medication dosage that is above the normal dosage. The nurse administers the medication without questioning the dosage. What error did the nurse make?

d. Gonorrhea

A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse initiates erythromycin ophthalmic ointment as a preventative measure for which STI?

Right Drug Right Dose Right Route Right Time Right Patient Right Documentation Right to be Educated Right to Refuse Right Form Right Approach

According to the book, there are 10 pediatric rights to medication administration, what are they?

b. Atrial Septal Defect

After teaching a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow?

a. Neutrophils

After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections?

b. Jerky movements of the face and upper extremities

After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding?

b. I'll grasp the tick and pull it quickly!

After teaching a mother how to remove a tick from her 6-year-old boy's arm, the nurse determines that additional teaching is needed when the mother makes what statement?

a. Avoid tobacco smoke.

An infants parents ask the nurse about preventing OM. Which should be recommended?

-Recent rapid weight gain or lack of weight gain -*Tachycardia or Tachypnea* -Pallor or Cyanosis -Diaphoresis -Edema, nasal flaring or retractions -Cough w/ productive bloody sputum may be present -Murmur, Skin may be cool, clammy, and pale -Lungs may have crackles or wheezes suggestive of pulmonary congestion -Peripheral pulses may be weak and thready -Look for abdominal distention as an indication for ascites -Palpate abdomen and assess for hepatomegaly and splenomegaly

What symptoms would you see for an infant w/ heart failure?

bulls-eye rash; fever, fatigue, headache

What would you expect to find in a child who has Lyme disease?

b. Strawberry tongue

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?

Age and Weight Organ maturation, specifically renal The thinness of their skin and absorption rate Metabolism

When you are considering the impact of certain drugs on children, what factors matter?

-VSD -ASD -Patent Ductus Arteriosus

Which congenital defects are linked to increased pulmonary blood flow?

c. Atrial septal defect

Which defect results in increased pulmonary blood flow?

a. Underdeveloped cricoid cartilage and narrow nasal passages.

Which of these factors contributes to infants' and children's increased risk for upper airway obstruction as compared with adults?

b. Epiglottitis

Which type of croup is always considered a medical emergency?

d. They help decrease fluid requirements.

While reviewing various studies about the use of antipyretics possibly prolonging illness, the nurse notes that there are benefits to their use or the child with fever. What would the nurse identify as the best explanation related to the benefit of antipyretics?

Result of increased capillary growth as the body attempts to supply more oxygen to distal body cells.

Why does clubbing occur in children who have chronic respiratory illnesses?

-Use fine tip tweezers -Protect with a tissue, paper towel or latex glove -Grasp tick as close to the skin as possible and pull upward steadily with even pressure -Do not twist or jerk -Once tick is removed, clean site w/ soap and water and wash your hands. -Save the tick for identification in case the child becomes sick. Note the date of the tick bite.

What are the instructions you give a parent to remove a tick from a child?

fever, tachycardia epistaxis, anemia, joint pain nodule on joint or subcutaneous tissue carditis-> chest pain affected valves murmurs (from stenosis or insufficiency) abdominal pain, chorea

What are the s/s of rheumatic fever?

Tachycardia, dry mouth, palpitations, tremors

What are the side effects of albuterol?

Breathlessness, dizziness fatigue, and syncope

What are the symptoms of Acyanotic defect?

barking cough, persistent stridor, hoarseness

What are the symptoms of CROUP?

bluish tint to the skin, lips, and nail beds

What are the symptoms of a Cyanotic defect?

Long-acting beta2agonist's (formoterol and salmeterol)

What asthma meds are considered controller medications?

Short-acting beta2agonist's (albuterol, levalbuterol and terbutaline)

What asthma meds are considered reliever medications?

Question the child Use a reliable and valid pain scale Evaluate the child's behavior Secure the parent's involvement Take the cause of pain into account when interviewing Take action

What is QUESTT?

Face Legs Activity Cry Consolability

What is the FLACC scale?

Strawberry Tongue

What is the cardinal sign of Kawasaki disease?

Vastus Lateralis

What is the most common site for IM injections/vaccinations?

Pancreatic Enzymes

What medication do Cystic Fibrosis kids take, orally?

Horizontal, more vascular with inconsistent light reflex and a shorter and straighter eustachian tube. *Pearly in color*

What should a normal tympanic membrane look like in a newborn?

d. FLACC

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?

d. 210

A 7-year-old with a family history of cardiovascular disease is being screened for hyperlipidemia. When reviewing the child's lab test results, which total cholesterol level would be of significant concern?

d. Inspiratory Stridor

A child is brought to the emergency department by the parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect croup. What would the nurse have most likely assessed?

b. Once the drainage is gone, he can go back to school.

A child is diagnosed with bacterial conjunctivitis and is prescribed topical antibiotic therapy. The child's mother asks when he can return to school. Which response by the nurse would be most appropriate?

a. 1:30 pm

A child is scheduled for a bone marrow aspiration at 4 PM. The nurse would plan to apply EMLA cream to the intended site at which time?

d. Fifth Disease

A child was sent to the school nurse because of a rash. The nurse noted the rash was present on the trunk, extremities, and face. The child's cheeks were bright red. With what is the nurse aware this type of rash is consistent with:

-increase tissue oxygenation -helps w/ dyspnea -causes vasodilation -provide cool, humidified O2 via an oxygen hood (or tent), mask or NC

For a child with heart failure; what are the benefits of giving O2?

d. "We will be sure to keep immunizations up to date."

Parents have understood teaching about prevention of childhood otitis media if they make which statement?

C) The nurse checks the documented time of the last dosage administered. D) The nurse calculates the dosage according to the child's weight. E) The nurse explains the therapeutic effects of the medication to the child and parents.

The nurse is administering acetaminophen PRN to a 9-year-old child on the pediatric ward of the hospital. Which answers reflect nursing actions that follow the rules of the 'eight rights' of pediatric medication administration? SATA

c. Intramuscular

The nurse is administering immunizations to children in a neighborhood clinic. What is the most frequent route of administration?

b. Complete Obstruction

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?

b. Complete obstruction

The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using a tongue depressor might precipitate which symptom or conditon?

b. I should give the enzymes before each meal or snack.

The nurse is caring for a 10-year-old girl with cystic fibrosis who receives pancreatic enzymes. Which comment by a parent demonstrates an understanding of the instructions regarding the medication?

a. Suctioning a tracheostomy tube

The nurse is caring for a 3-year-old girl with a respiratory disorder. The nurse anticipates the need for providing supplemental oxygen to the child when performing which action?

b. Recognize the mother as the expert on her child's needs and care.

The nurse is caring for a 3-year-old with a gastrostomy tube and tracheostomy who is on supplemental oxygen and multiple medications. The mother is rooming-in during this hospitalization. What is the priority nursing action?

a. obesity from overeating

The nurse is caring for a 5-year-old child with a congenital heart anomaly causing chronic cyanosis. When performing the history and physical examination, what is the nurse least likely to assess?

b. be at risk for respiratory distress

The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication o this disorder is for the child to:

d. The enzymes should be given at the beginning of each meal and snack.

The nurse is caring for a child with cystic fibrosis who receives pancreatic enzymes. Which statement by the child's mother indicates an understanding of how to administer the supplemental enzymes?

c. 34 ml/h

The nurse is caring for an infant who weights 8.2 kg and is NPO and receiving IV Fluid therapy. What rate does the nurse calculate as meeting the child's daily fluid requirements?

a. Immature emotional behavior

The nurse is developing a plan of care for a 5-year-old child with a severe hearing impairment focusing on psychosocial interventions based on assessment findings. Which behavior would the nurse have most likely assessed?

c. Ring like rash on lower leg

The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find?

a. Listening to the lung sounds

The nurse is performing a respiratory assessment on a child. The nurse includes five steps in her assessing technique: observation, inspection, palpation, and percussion. Which step was left out of her techniques?

b. 16 to 32 mg

The nurse is preparing to administer a medication to a 5-year-old who weighs 35 lbs. The prescribed single dose is 1 to 2 mg/kg/day. Which is the appropriate dose range for this child?

b. tachycardia

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?

b. Vastus Lateralis

The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select?

c. 500 to 1,000 mg per dose

The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The safe dose for children is 50 to 100 mg/kg/day divided in doses administered every 6 hours. What would be the low single safe dose and high single safe dose per day for this child?

a. Encourage everyone in the family to use good handwashing techniques.

The nurse is teaching the caregivers of a child w/ cystic fibrosis. What is most important for the nurse to teach this family?

d. Take the cause of pain into account when intervening.

The nurse is using the acronym QUESTT to assess the pain of a child. Which is an accurate descriptor of this process?

knee-chest position

The position used for tetralogy of Fallot when a child is experiencing a "Tet's" spell would be?