FA Davis Ch 30 & 31

The nurse is teaching the parents information related to appropriate heart rate and blood pressure readings for their child. Which of the following measurements are considered normal for a preschool-aged child? (Select all that apply.)

-Blood pressure of 95/60 mm Hg -Blood pressure of 110/60 mm Hg -Heart rate of 100 beats per minute

The nurse is planning an educational session regarding hypoxia in children. Which facts about hypoxia would the nurse include in the session? Select all that apply.

-It is an acute condition. -It is a potentially life-threatening condition. -It is often related to cardiovascular issues.

The LPN/LVN is reinforcing teaching provided by the RN on Kawasaki disease to a family whose child is diagnosed with the condition. Which information would the LPN/LVN correctly emphasize? Select all that apply.

-It is an inflammatory disease. -It is most common in males of Asian descent.

The nurse is being oriented to a pediatric cardiology clinic and the health history information needed. Which specific health history would the nurse include? Select all that apply.

-Medical history of the child focused on cardiac issues -Detailed information regarding medications -Maternal history associated with an increased risk of a cardiovascular defect

The nurse is providing care for a 4-week-old infant diagnosed with cyanotic heart defect. The nurse is aware that the infant has an absence of readily visible cyanosis. Which manifestations would be related to the infant's diagnosis? Select all that apply.

-There is a mixing of oxygenated and deoxygenated blood. -Another defect was present during the neonatal period. -There is a high pulmonary blood flow. -Oxygen saturation rates can range from 50% to 90%. -The pulmonary blood flow can be low.

The nurse in the neonatal clinic is observing a newborn at 1 week of age. Which findings would the nurse immediately report to the health care provider as a possible indication of impending heart failure? Select all that apply.

-Weight gained since birth is16.5 oz (0.47 kg). -Respiratory rate is 63 breaths per minute. -Diaper weight is 1 g heavier after 2 hours.

The nurse is caring for an infant with bronchopulmonary dysplasia. For which reason would the nurse provide the patient with a prescribed diuretic?

Reduce fluid in the lungs

The LPN/LVN is assisting in the care of multiple pediatric patients who are diagnosed with acquired heart issues. The LPN/LVN is aware that which cardiac condition would be avoidable?

Rheumatic fever

The nurse in the neonatal intensive care unit is providing care for a newborn with a cyanotic heart defect. The nurse observes the newborn's oxygen saturation level and discovers it is at 65%. Which action would the nurse take?

Consult with the pediatric cardiology team.

The nurse is collecting data on a preschool-age patient. Which observations would indicate to the nurse that the patient is experiencing air hunger? Select all that apply.

Cyanosis Diaphoresis Nasal flaring Head bobbing

The nurse is providing teaching to a parent of an 8-month old infant with a congenital heart defect. The teaching is focused on how to reduce the cardiac workload for this infant. Which comment by the parent would indicate a need for additional teaching?

"A video with brightly colored shapes will distract the baby."

The nurse is presenting material on acyanotic heart defects to the nursing staff in a pediatric cardiology unit. Which comment by an attending nurse would indicate a need for additional teaching?

"Blood in the left side of the heart cannot get out and enlarges the ventricle."

The nurse is providing an education session for nursing staff in a pediatric cardiology unit in an acute care setting. Which comment by an attending staff member would indicate the need for additional information?

"Children who experience cardiac arrest have a high survival rate."

A pediatric nurse is performing a respiratory assessment on an 18-month-old child. The nurse most likely uses which recommended techniques?

Assess breath sounds by listening to all lung fields and alternating sides for comparison.

The nurse is counting a 9-year-old patient's respiratory rate. Which rate would be considered abnormal and prompt the nurse to notify the charge nurse?

26 breaths per minute

A child with cystic fibrosis is too weak to attend physical therapy. Which action would be taken instead to mobilize the patient's lung secretions?

Chest percussion

A pediatric nurse explains discharge instructions to the parents of a child who is postoperative from a tonsillectomy. Which instruction does the nurse stress?

Avoid highly seasoned and "sharp" foods.

The nurse is helping a toddler with lunch. Which food item would the nurse identify as a potential risk for aspiration?

Grapes

The nurse is caring for a pediatric patient with nasopharyngitis. Which intervention would the nurse perform to help thin this patient's respiratory secretions?

Increase fluid intake.

The nurse is caring for an infant with bronchiolitis. Which action would the nurse perform to help remove secretions from the infant's nares?

Instill saline drops in the nose before suctioning

The LPN/LVN is assigned to provide care for a young toddler with congestive heart failure. In which manner would the LPN/LVN minimize the toddler's fatigue?

Keep crying at a minimum.

The nurse is collecting data on a toddler who is experiencing an acute onset of respiratory symptoms. For which findings would the nurse suspect that the patient is developing worsening epiglottitis? Select all that apply.

No voice Drooling Sitting in the tripod position Breathing with an open mouth

A 12-month-old patient is admitted to the hospital with suspected congenital heart disease. Upon assessment, the nurse detects a murmur with a distinct "click" quality. What congenital heart defect does the nurse suspect?

Pulmonary stenosis

The LPN/LVN is assisting with the care of a child admitted for treatment of a condition that causes hypoxemia. Which conclusion would the LPN/LVN draw regarding the child's diagnosis?

The condition indicates an issue with red blood cells (RBCs) and the ability to carry oxygen.

The nurse provides care to patients on a pediatric care unit. Which patient would the nurse identify as being most at risk for potential aspiration?

Toddler

The LPN/LVN is assisting with newborn care in the nursery. While caring for a newborn who is 18 hours old, the LPN/LVN notices an increase in cyanosis. Which condition would the LPN/LVN suspect from the finding?

Transposition of the great arteries of the heart

The nurse is helping a school-age patient prepare for a physical evaluation. In which way would the nurse describe the position of the patient in the diagram?

Tripod

The nurse is providing care for an infant recently diagnosed with a congenital heart defect. The health care provider prescribes close monitoring of input and output (I&O). Which connection would the nurse make between the infant's diagnosis and the prescribed I&O?

Urine output will decrease or stop as perfusion decreases.

The nurse is preparing to collect data on a child's respiratory system. Which action would the nurse take to auscultate the patient's breath sounds?

Use the diaphragm of a pediatric stethoscope.

The nurse is observing an infant who presented with a delayed, harsh, loud murmur at 6 weeks of age. Diagnostic studies reveal circulation as illustrated below. Which common condition would the nurse recognize?

Ventricular septal defect (VSD)

The nurse is caring for a neonate patient experiencing respiratory distress. Which oxygen delivery systems prescribed by the health care provider would the nurse question? Select all that apply.

Venturi mask Nasal cannula Simple face mask

A parent states a school-age child's breathing rate seems to be "less than from when the child was a baby." Which information would the nurse provide about the development of the respiratory tract?

"An increase in lung alveoli improves the efficiency of gas exchange and slows the respiratory rate."

The nurse is preparing the initial teaching for a family about the congenital cardiac defect in a child 10 years of age. The family members do not use English as their primary language. Which method of communication would best meet the needs of the family and the child?

A professional interpreter

The nurse is caring for a 1-month-old infant who is experiencing periods of apnea. Which therapies would the nurse anticipate being prescribed for this patient? Select all that apply,

Caffeine Theophylline Continuous positive airway pressure (CPAP) breathing machine

While assessing a child who presented with a sore throat, the nurse notices that the child has begun drooling. What is the nurse's priority action?

Call the provider.

The LPN/LVN is assisting in the care of a child who is 10 years of age. The admitting diagnosis is rheumatic fever caused by nontreatment of streptococcal infection. Which long-term effect would the LPN/LVN associate with the diagnosis?

Cardiac changes

The nurse is assessing an infant who is 8 months of age for signs of systemic venous congestion found in heart failure. Which manifestation would the nurse be unlikely to observe?

Distention of neck veins

The nurse is educating the parent of a child diagnosed with croup about return precautions. What symptom should the nurse include?

Increased respiratory rate

The nurse is preparing a plan of care for a child scheduled for a heart transplant because of cardiomyopathy related to congestive heart failure. Which patient/family teaching by the RN would be the highest priority for the nurse to reinforce?

Instructions on maintaining the essential medication regimen

The nurse is concerned about the high number of newborns diagnosed with congenital heart defects in a specific population. Which conditions in a population would likely be identified as contributing factors? Select all that apply.

Obesity is prevalent. Pregnant women have a high incidence of smoking. Prenatal diabetes is commonly found in women.

A preschool-age child who aspirated a green bean is still able to breathe. Which action would the nurse take to support this patient's airway?

Observe while the patient coughs

The nurse is providing care for a 3-week-old neonate being admitted to rule out coarctation of the aorta (CoA). The nurse is aware that which prescribed care would be most indicative of the diagnosis?

Obtain blood pressure (BP) in all four extremities.

he LPN/LVN is assisting with the care of a 5-year-old who is admitted for complications related to dehydration. Which factor would the LPN/LVN relate to a blood pressure of 92/54 mm Hg?

Oxygen perfusion is decreased.

The nurse is caring for a premature newborn. Which medication would the nurse prepare to administer to prevent the development of bronchiolitis?

Palivizumab

The nurse is caring for a pediatric patient with cystic fibrosis. Which prescribed medication would the nurse provide to support this patient's growth and development?

Pancreatic enzymes

A 3-year-old patient is admitted to the hospital with suspected congenital heart disease. Upon auscultating the heart sounds, which clinical finding confirms the nurse's suspicions?

S3 and S4

The LPN/LVN at a pediatric clinic is assigned to take blood pressure (BP) measurements on patients. Which blood pressure reading would the LPN/LVN report to the RN?

School-age child at 9 years of age with a BP of 98/54 mm Hg.

The nurse is reviewing an instruction sheet provided to a school-age child with asthma and the child's parent. Which information would the nurse emphasize if the peak-flow meter reading is in the yellow zone? Select all that apply.

Slow down. Keep the inhaler on hand all day. Take a dose of the fast-acting inhaler.

A school-age child is experiencing a cough that is worse in the morning and caused by thick mucus. Which laboratory test would the nurse anticipate being ordered to determine whether the patient has cystic fibrosis?

Sweat test

The nurse is reinforcing patient teaching by the RN with the parents of an 11-year-old child recovering from rheumatic fever. Which information would be most important for the nurse to emphasize?

The need for long-term antibiotic therapy

The nurse is caring for a child with bronchiolitis. For which potential signs of inefficient oxygen intake and gas exchange would the nurse observe in this patient? Select all that apply.

-Hypoxia -Cyanosis -Hypoxemia

The nurse is providing teaching to parents of a child with congenital cyanotic heart disease who is diagnosed with subacute bacterial endocarditis (SBE). Which comment by a parent would indicate that the teaching has been effective?

"We will give antibiotics before dental appointments."

The LPN/LVN reinforces teaching by the RN to the parents of a pediatric patient with cystic fibrosis. Which statement would indicate that the parents are prepared to care for the patient at home?

"We will perform chest percussions several times a day."

The parent of a child diagnosed with cystic fibrosis asks how the child caught the disease. Which response would the nurse offer to the parent?

"It is a genetic disorder caused by a defect in the gene that regulates sweat, digestive enzymes, and mucus."

The nurse is caring for a pediatric patient with croup. Which suggestion would the nurse offer upon learning that the parent does not have a cool-mist humidifier in the home?

"Take your child outside in the cold night air."

The nurse is reinforcing teaching by the RN to new parents about how the circulation of their newborn now differs from the circulation before birth. Which comment by a parent would indicate an understanding?

"Three shunts allowed oxygenated and deoxygenated blood to mix before birth."

The nurse is reviewing teaching provided to the parent of a child with asthma. Which patient statements would indicate to the nurse that the parent understands the teaching?

-"I will keep my child indoors if the ozone level is high." -"I will change the filters on the furnace and air conditioner frequently." -"I will vacuum the carpets and floors every week using a HEPA filter system."

The nurse at a pediatric clinic is assisting with a child who exhibits red swollen eyes, a flat rash on the trunk, and swollen hands and feet. The child's temperature is 102.8°F (39.3°C). The health care provider diagnoses and initiates treatment for Kawasaki disease. Which prescriptions would the nurse expect? Select all that apply.

-Administration of medication for pain management -Monitoring for cardiac and cognitive changes -STAT administration of IV gamma globulin -Administration of high doses of aspirin

The nurse in a pediatric cardiac clinic sees multiple patients with congenital heart disease. For which patients would the nurse check blood pressure with every encounter? Select all that apply.

-All children with a history of aortic arch abnormalities -A 6-year-old child with an average BP of 100/85 mm Hg -An adolescent being treated for obesity

The nurse is caring for a pediatric patient recovering from a tonsillectomy. Which action would the nurse perform when the patient is constantly swallowing?

Assess for bleeding.

A parent seeks medical attention for a 2-year-old pediatric patient with an upper respiratory disorder. Which observation would lead the nurse to suspect croup?

Barking cough at night

The nurse is observing a 4-year-old patient's breathing. Which findings would the nurse identify as expected? Select all that apply.

Bilateral movements Symmetrical movements Pronounced abdominal movements

An infant is admitted to the neonatal intensive care unit to be evaluated for bronchopulmonary dysplasia (BPD). Which information in the medical record would the nurse identify as a risk factor for this health problem?

Born at 31 weeks' gestation

The LPN/LVN is assisting the RN in the care of a newborn who is in the neonatal intensive care unit for failure of the lungs to expand. For this newborn, which outcome would the LPN/LVN expect with ductus arteriosus?

It remains open to permit oxygenation.

The nurse observes that a pediatric patient has slow, deep, labored respirations. In which way would the nurse document this information?

Kussmaul breathing

The nurse is collecting data on a preschool-age patient. Which chest configuration would the nurse identify as unexpected in this patient?

Lateral diameter equal to the anteroposterior diameter

Which prescribed medications should the nurse educate the parents of a child with asthma to administer on a daily basis? (Select all that apply.)

Leukotriene modifiers Theophylline

The nurse is caring for a pediatric patient with asthma. Which option would correctly identify the device pictured in the photograph that the nurse is using on the patient?

Medication inhaler with a spacer

The nurse is providing care for a child who is 11 years of age and undergoing treatment for Kawasaki disease. The child asks the nurse how the condition will impact his life in general. Which information by the nurse would be correct?

An electrocardiogram is recommended every 1 to 2 years.

The nurse in a newborn nursery is regularly observing newborns for signs of difficult transition to extrauterine life. Which finding would be the nurse's best indicator of a possible cyanotic heart defect?

An oxygen saturation level of 78%

The nurse is caring for a toddler recovering from a procedure to remove an aspirated object. Which medication would the nurse anticipate being prescribed if the patient develops signs of an infection?

Antibiotics

The nurse is caring for an infant who experienced a brief resolved unexplained event (BRUE). Which intervention would the nurse anticipate for this patient?

Apnea monitor

The nurse is caring for a pediatric patient experiencing symptoms of asthma. For which reason would the nurse use a peak flow meter when caring for this patient?

Determine the severity of the disorder

The LPN/LVN is assisting the RN in preparing a pregnant patient for fetal cardiac testing. The fetus is small for gestational age, and the mother noticed a recent decrease in fetal activity. Which test would be commonly performed first to determine cardiovascular defects in the fetus?

Fetal echocardiogram

The LPN/LVN is assisting with a child who is 10 years of age during a visit at the pediatric cardiac clinic. The parent states, "I don't understand why he doesn't gain weight; he eats constantly." Which information would the LPN/LVN offer to the RN regarding a topic for patient teaching?

Information about the child's calorie needs

The nurse is collecting data from the parent of an infant who repeatedly experiences bronchiolitis. Which information would the nurse identify as a risk factor for this health problem?

Is exposed to secondhand smoke

The nurse is caring for a pediatric patient with epiglottitis. For which reason would the device in the picture be used when caring for this patient?

Monitor oxygen saturation

An infant is suspected of having bronchiolitis. Which would the nurse anticipate collecting from the patient?

Nasopharyngeal wash

The nurse is reinforcing teaching by the RN for the parents of a school-age child who is diagnosed with congestive heart failure. Which specific information would the nurse emphasize regarding digoxin therapy after discharge from acute care? Select all that apply.

Notify the cardiologist immediately if nausea and vomiting occur.

The LPN/LVN is assisting in the care of a child hospitalized with respiratory-related chronic hypoxemia. Which manifestation would the LPN/LVN expect to see in this child?

Obvious clubbing of the fingers

The nurse is collecting data on a preschool-age child with head and lung congestion. Which information would the nurse categorize as part of the patient's health history?

Parent who smokes

The LPN/LVN is reviewing pediatric heart defects after acquiring a position on the pediatric cardiac unit. Which heart defects would the LPN/LVN understand to cause a left-to-right shift in blood flow? Select all that apply.

Patent ductus arteriosus (PDA) Atrial septal defect (ASD) Ventricular septal defect (VSD)

The nurse is planning care for an infant with a congenital cardiac defect. The nurse focuses on interventions that will improve tissue oxygenation. Which intervention would be least likely to improve the infant's tissue oxygenation?

Place the infant in a semi-Fowler position.

The LPN/LVN is assisting in the care of an infant diagnosed with a congenital heart defect. Every morning, the infant is weighed on the same scale without clothing or a diaper. For which reason would the LPN/LVN understand the importance of this infant's weight?

Weight is an important indicator of heart function.

The LPN/LVN is assisting in the newborn nursery. The LPN/LVN is aware the transition from maternal/placental blood flow to respiratory blood flow is dependent on the newborn's ability to close the fetal shunts. Which maximum time frame for this process would be considered normal?

Within the first several months