Exam 2 Quizlet POTTS
When you are considering the impact of certain drugs on children, what factors matter?
Age and Weight Organ maturation, specifically renal The thinness of their skin and absorption rate Metabolism
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: a. report ear pain b. be at risk for respiratory distress c. have unilateral breath sounds upon auscultation d. experience nuchal rigidity
B
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? a. 8 to 16 mg b. 16 to 32 mg c. 35 to 70 mg d. 70 to 140 mg
B
What are the symptoms of acyanotic defect?
Breathlessness, dizziness fatigue, and syncope
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? a. Keeping linens dry and clean b. Maintaining skin integrity c. Washing hands frequently d. Coughing into a handkerchief
C
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. a. TAC 15 minutes prior b. transdermal Fentanyl patch immediately c. EMLA 1 hour before d. EMLA 30 minutes before
C
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. Improve gas exchange b. Bypass the obstruction c. Hasten air reabsorption d. Prevent hypoxemia
C
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. Swelling in the neck b. Confusion and anxiety c. Ring like rash on lower leg d. Hypersalivation
C
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. 50 to 100 mg per dose b. 100 to 500 mg per dose c. 500 to 1,000 mg per dose d. 1,000 to 5,000 mg per dose
C
Which defect results in increased pulmonary blood flow? a. Pulmonic stenosis b. Tricuspid atresia c. Atrial septal defect d. Transposition of the great arteries
C
What are the instructions you give a parent to remove a tick from a child?
-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.
Which congenital defects are linked to increased pulmonary blood flow?
-VSD -ASD -Patent Ductus Arteriosus
For a child with heart failure; what are the benefits of giving O2?
-increase tissue oxygenation -helps w/ dyspnea -causes vasodilation -provide cool, humidified O2 via an oxygen hood (or tent), mask or NC
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? a. Neutrophils b. Eosinophils c. Basophils d. Lymphocytes
A
An infants parents ask the nurse about preventing OM. Which should be recommended? a. Avoid tobacco smoke. b. Use nasal decongestant c. Avoid children w/ OM d. Bottle-feed or breast-feed in supine position
A
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? a. Suctioning a tracheostomy tube b. Administering drugs w/ a nebulizer c. Providing trach care d. Suctioning w/ a bulb syringe
A
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? a. Listening to the lung sounds b. Playing with the child c. Talking to the child d. Touching
A
The nurse is teaching the caregivers of a child w/ cystic fibrosis. What is most important for the nurse to teach this family? a. Encourage everyone in the family to use good handwashing techniques. b. Be sure the child exercises daily. c. Avoid overprotecting the child. d. Watch out for signs that family members are overly stressed.
A
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? a. FACES b. Numeric c. Oucher d. FLACC
D
What symptoms would you see for an infant w/ heart failure?
-Recent rapid weight gain or lack of weight gain -Tachycardia or Tachypnea - listed in the book as the first indicators of heart failure in an infant -Pallor or Cyanosis -Diaphoresis -Edema -Increased work of breathing such as 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 (enlarged liver and spleen)
A child's weight is 35 lbs, 7 ounces. Convert the weight to kilograms.
16.2 Kg
The nurse is caring for a child who has a rash and is complaining of feeling itchy and is continually scratching. The child weighs 32 lbs. The medication order reads: Diphenhydramine (Benadryl) 6.25 mg po every 4 to 6 hours as needed for itching. Diphenhydramine is supplied as 12.5 mg/5 ml. How many milliliters will the nurse administer? Round to the nearest tenth.
2.5 ml per dose
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? a. 1:30 pm b. 3:00 pm c. 3:30 pm d. 4:00 pm
A
What are the side effects of albuterol?
Tachycardia, dry mouth, palpitations, tremors
What is the most common site for IM injections/vaccinations?
Vastus Lateralis
The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using a tongue depressor might precipitate which symptom or conditon? a. Inspiratory Stridor b. Complete obstruction c. Sore throat d. Respiratory Tract Infection
B
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. You need to wait until you finish the entire prescription of the antibiotic. b. Once the drainage is gone, he can go back to school. c. You can send him to school this afternoon after his first dose of antibiotic. d. He needs to be symptom-free for at least 72 hours.
B
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? a. Children's demand for oxygen is lower than that of adults. b. Children develop hypoxemia more rapidly than adults do. c. An increase in oxygen saturation leads to a much larger decrease in pO2. d. Children's bronchi are wider in diameter than those of an adult.
B
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? a. Salmeterol b. Albuterol c. Ipratropium d. Cromolyn
B
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? a. Salmeterol b. Albuterol c. Ipratropium d. Cromolyn
B
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? a. Cause vasodilation to promote heat loss b. Decrease the temperature set point c. Block release of histamine d. Promote prostaglandin production
B
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. Tetralogy of Fallot b. Atrial Septal Defect c. Hypoplastic left heart syndrome d. Transposition of the great vessels
B
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? Select all that apply. A) The nurse identifies the child by checking the name on the child's chart. B) The nurse makes sure the medication is given within the hour of the ordered time. 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. F) The nurse administers the medication even though the child is adamant about not taking it.
C, D, E
What is the FLACC scale?
Face Legs Activity Cry Consolability Used in ranges 0-7 and each category has a rating of 0-2.
What should a normal tympanic membrane look like in a newborn?
Horizontal, more vascular with inconsistent light reflex and a shorter and straighter eustachian tube. Pearly in color.
Why does clubbing occur in children who have chronic respiratory illnesses?
It is the result of increased capillary growth as the body attempts to supply more oxygen to distal body cells.
What asthma meds are considered controller medications?
Long-acting beta2agonist's such as formoterol and salmeterol; these meds will be used in conjunction w/ corticosteroids.
A child with cystic fibrosis is being discharged to home; what education would you provide to the family?
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. .
The nurse is caring for a child with acute asthma. The child weighs 37.5 lbs. The medication order reads: methylprednisolone 20 mg IV twice a day. The Pediatric Dosage Handbook provides a recommended dose for acute asthma of 1 to 2 mg/kg/day in two divided doses. Is the ordered dose safe?
No, the dose is not safe. The dose is asking for a total of 40 mg in one day. The maximum daily dose is 34 mg.
What medication do Cystic Fibrosis kids take, orally?
Pancreatic Enzymes (Pancrealipase is an example)
What is the cardinal sign of Kawasaki disease?
Strawberry tongue
A nurse is teaching the parents of a child diagnosed with CF about medication therapy. Which would the nure instruct the parents to administer orally? a. Recombinant human DNase b. Bronchodilators c. Anti-Inflammatory Agents d. Pancreatic Enzymes
D
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? a. Janeway lesions b. Jerky movements of the face and upper extremities c. Black lines d. Osler nodes
B
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. I'll protect my fingers with a paper towel. b. I'll grasp the tick and pull it quickly! c. I should put the tick in a plastic bag in the freezer. d. I need to grasp the tick close to the child's skin.
B
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? a. Inspiratory Disorder b. Complete Obstruction c. Sore Throat d. Respiratory Tract Infection
B
The nurse is caring for a 10-year-old girl with cystic fibrosis who receives pancreatic enzymes. Which comment by a parent demonstrates understanding of the instructions regarding the medication? a. I should stop the enzymes if my child is taking antibiotics. b. I should give the enzymes before each meal or snack. c. Between meals is the best time to give the enzymes. d. I should reduce the dose if she has large, malodorous stools.
B
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. Incorporate the mother's assistance in care when convenient. b. Recognize the mother as the expert on her child's needs and care. c. Recommend that the mother go home to get some rest. d. Provide family-centered care since the mother is here.
B
What are the s/s of rheumatic fever?
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
The position used for tetralogy of Fallot when a child is experiencing a "Tet's" spell would be?
knee-chest position
A nurse is using the FLACC scale to evaluate pain in a preverbal child. The nurse makes the following assessment: Face: occasional grimace; Leg: relaxed; Activity: squirming, tense; Cry: no cry; Consolability: content, relaxed. The nurse records the FLACC assessment as which number?
2
The nurse is caring for a child who is in status epilepticus. The child weighs 14.97 kg. The medication order reads: Diazepam 3 mg IV push now. Per the Pediatric Dosage Handbook, the recommended dose is 0.1 to 0.3 mg/kg/dose. Diazepam is supplied as 5 mg/ml. How many mL will the nurse administer? Round to the nearest tenth.
0.6 mL
The nurse is caring for an infant with a ventricular septal defect who has heart failure. The infant weighs 11 lbs. The medication order reads: spironolactone 5 mg PO every 12 hours. Spironolactone is provided by the pharmacy in a solution of 2.5 mg/ml. How many mL will the nurse administer? Round to the nearest whole number.
2 ml/dose; the question does not specify this so if it were to say daily it would be 4 ml/day
A dose of oxycodone (OxyContin) 2 mg/kg has been ordered for a child weighing 33 lb. How many milligrams of OxyContin should the nurse administer? (Record your answer as a whole number.)
30 mg
The nurse is caring for a child with acute otitis media. The child weighs 22 lbs. The medication order reads: amoxicillin 160 mg PO every 8 hours. Amoxicillin is supplied as 200 mg/5 ml. How many milliliters will the nurse administer? Round to the nearest whole number.
4 ml
The nurse is caring for a child who is experiencing painful spasms. The child is 6 years old and weighs 42 lbs. The medication order reads: Baclofen 25 mg per GT every 8 hours. Baclofen is supplied as 5 mg/ml. How many mL will the nurse administer? Round to the nearest tenth.
5 ml/dose; the question does not specify this so if it were to say daily it would be 15 mg/day.
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? a. Cause vasodilation b. Increase pulmonary vascular resistance c. Promote diuresis d. Mobilize Secretions
A
A nurse is caring for a hearing impaired child who lip reads. The nurse should plan which intervention to facilitate lip reading? a. Speak at an even rate b. Exaggerate pronunciation of words. c. Avoid using facial expressions. d. Repeat in exactly the same way if child does not understand.
A
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? a. The nurse violated one of the "rights" of medication administration. b. The nurse performed an act outside of the scope of practice for nursing. c. The nurse has not made an error, but the physician did by ordering the wrong dosage of medication. d. The nurse has committed an act of maleficence by administering the medication.
A
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? a. Immature emotional behavior b. Self-stimulatory actions c. Inattention and vacant stare d. Head tilt forward or thrust
A
Which of these factors contributes to infants' and children's increased risk for upper airway obstruction as compared with adults? a. Underdeveloped cricoid cartilage and narrow nasal passages. b. Small tonsils and narrow nasal passages. c. Cylinder-shaped larynx and underdeveloped sinuses. d. Underdeveloped cricoid cartilage and smaller tongue.
A
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? a. obesity from overeating b. clubbing of the nail beds .c. squatting during play activities d. exercise intolerance
A Rationale: B, C, D are expected findings due to decreased oxygenation to the periphery and decreased energy related to decreased oxygenation.
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? a. increased appetite b. tachycardia c. hypoactivity d. bronchial muscle relaxation
B
The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? a. Rectus Femoris b. Vastus Lateralis c. Dorsogluteal Muscle d. Deltoid
B
When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? a. Hirsutism or striae b. Strawberry tongue c. Malar rash d. Cafe au lait spots
B
Which type of croup is always considered a medical emergency? a. Laryngitis b. Epiglottitis c. Spasmodic croup d. Laryngotracheobronchitis
B
The nurse is administering immunizations to children in a neighborhood clinic. What is the most frequent route of administration? a. Oral b. Intradermal c. Intramuscular d. Topical
C
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. 82 ml/h b. 41 ml/h c. 34 ml/h d. 22 ml/h
C
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 cholester level would be of significant concern? a. 120 b. 150 c. 180 d. 210
D
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? a. High fever b. Dysphagia c. Toxic appearance d. Inspiratory Stridor
D
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: a. Measles b. Roseola c. Varicella d. Fifth Disease
D
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: a. auditory nerve damage b. congenital ear defects c. congenital rubella d. chronic otitis media
D
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? a. Genital Herpes b. Hep B c. Syphilis d. Gonorrhea
D
Parents have understood teaching about prevention of childhood otitis media if they make which statement? a. "We will only prop the bottle during the daytime feedings." b. "Breastfeeding will be discontinued after 4 months of age." c. "We will place the child flat right after feedings." d. "We will be sure to keep immunizations up to date."
D
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? a. I will stop the enzymes if my child is receiving abx. b. I will decrease the dose by half if my child is having frequent, bulky stools. c. Between meals is the best time for me to give the enzymes. d. The enzymes should be given at the beginning of each meal and snack.
D
The nurse is determining the amount of IV fluids to administer in a 24-hour period to a child who weighs 40 kg. How many milliliters should the nurse administer? a. 1,000 ml b. 1,500 ml c. 1,750 ml d. 1,900 ml
D
The nurse is using the acronym QUESTT to assess the pain of a child. Which is an accurate descriptor of this process? a. Question the child's parents. b. Understand the child's pain level c. Establish a caring relationship with the child. d. Take the cause of pain into account when intervening.
D
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? a. They slow the growth of bacteria. b. They increase neutrophil production. c. They encourage T-cell proliferation. d. They help decrease fluid requirements.
D
What is QUESTT?
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
According to the book, there are 10 pediatric rights to medication administration, what are they?
Right Drug Right Dose Right Route Right Time Right Patient Right Documentation Right to be Educated Right to Refuse Right Form Right Approach
What asthma meds are considered reliever medications?
Short-acting beta2agonist's such as albuterol, levalbuterol and terbutaline
What are the symptoms of CROUP?
barking cough, persistent stridor, hoarseness
What are the symptoms of a cyanotic defect?
bluish tint to the skin, lips, and nail beds
What would you expect to find in a child who has Lyme disease?
bulls-eye rash; also fever, fatigue, headache
