Lets Get This Bread
Kawasaki Syndrome Phase 3:
Convalescent phase - Resolution of signs (3 months after onset) but risk of MI remains high
What primary nursing intervention should be implemented to prevent bacterial endocarditis?
Counsel parents of high-risk children.
Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infants status, which finding is indicative of achieving this goal?
Appropriate weight gain for age
What statement best identifies the cause of heart failure (HF)?
Consequence of an underlying cardiac defect
Kawasaki Syndrome Parent Teaching:
Daily temperature check Postpone immunizations with live vaccines (measles, varicella) for 11 months after IVIG administration
(IPF) Patent Ductus Arteriosus (PDA) S/S:
Intercostal retractions Widening pulse pressures Left ventricle hypertrophy
HTN Teaching:
Low sodium, Low fat diet
HTN Stages:
Norm - < 120/80 Stage 1 - 130-139 / 80-89 Stage 2 - > 140/ 90
(OD) Hypoplastic Left Heart Syndrome (HLHS) Interventions:
Prostaglandins keep PDA open until surgery can be done Norwood procedure: Step 1: Converts R ventricle from pulmonic to systemic function Step 2: Pulmonary and systemic circulatory systems separated
The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?
Pulmonary vascular congestion
After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond?
Record data on the assessment flow record.
A 10-year-old boy has just arrived by ambulance at the emergency room following a motor vehicle accident, and a nurse is assessing him. Which three body systems should the nurse evaluate fist?
Respiratory, cardiovascular, and neurologic
(OD) Hypoplastic Left Heart Syndrome (HLHS) S/S:
Right to Left flow Small left ventricle Diagnosed via ultrasound
(DPF) Pulmonic Stenosis Inverventions:
Subvalvular: Fixed by removing extra tissue Valvular: Balloon valvuloplasty Supravalvular: Fixed by augmenting artery w/ patch angioplasty
A chest radiography examination is ordered for a child with suspected cardiac problems. The childs parent asks the nurse, What will the x-ray show about the heart? The nurses response should be based on knowledge that the radiograph provides which information?
Supplies information on heart size and pulmonary blood flow patterns
Kawasaki Syndrome S/S:
Vomiting Diarrhea Joint pain Cough
An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond?
"Tell me what makes you think the medication is not working"
(DPF) Tetralogy of Fallot (TOF) Patho:
4 defects present: Pulmonic stenosis Right ventricle hypertrophy Ventricular septal defect (VSD) Overriding aorta RV outflow undeveloped (hypoplasia)
(MF) Transposition S/S:
50% die w/in first month if untreated Cyanosis that does not improve w/ oxygenation X-ray shows egg-shaped appearance
The nurse is called into a toddler's room. The child's mother says "he's having trouble breathing." What should the nurse do first?
Assess patency of the child's airway
A child presents to the emergency department via ambulance in critical condition following a traumatic motor vehicle crash. What would the first action of the nurse be?
Assess the child's airway and manage airway patency
The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed?
"Antibiotics are needed to help our child recover from rubella."
The client has been prescribed antihistamines and a round of corticosteroids to treat an allergic reaction to an unknown food source. Which statement by the client indicates he understands the allergic condition and medication regimen?
"Corticosteroids help the inflammation that goes along with an allergy." "I may have to undergo intradermal testing to determine what I am allergic to." "Once we figure out what I am allergic to, it is important for me to avoid that allergen."
A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl?
"Have you noticed any hair loss or redness on your face?"
The nurse is caring for the family of a pediatric client during resuscitative efforts of their child following an accident. Which response by the nurse would be best?
"I am here to answer your questions and be with you during this difficult time."
The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching?
"I can use the egg white when baking, but not the yolk."
The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder?
"My child does not say more than one or two words and grunts to indicate needs."
The school nurse has just completed a presentation about normal adolescent physical growth to a group of adolescent students. Which comments by the adolescents indicate understanding of the nurse's presentation? Select all that apply.
"Our hormones are sure going to cause us to change a lot over our teenage years." "Since I'm a 15-year-old guy, I still have a chance to get taller over the next couple of years." "It doesn't seem fair that girls typically have more fat than boys." "Since I just had my first period and I am 14 years old, I probably haven't reached by peak height yet." "It's strange how girls start getting taller before boys start getting taller."
An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client education about the disease, which statement by the client demonstrates understanding of SLE?
"SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms."
The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?
"We need to make sure that he washes his hands frequently."
Suicide:
3rd leading cause of death Remove firearms and meds and monitor social media accounts
An infant is brought to the emergency department with acetaminophen poisoning. Which medication should the nurse expect to administer to this child?
Acetylcysteine
(DPF) Tetralogy of Fallot (TOF) Interventions:
Blalock-Taussig shunt performed
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule?
Discolored skin spot not elevated at the surface
The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate?
Document the bruises and any statements made by the child relating to them
Adolescent assessment privacy:
Have parents leave Keep body covered Explain everything
What nutritional component should be altered in the infant with heart failure (HF)?
Increase in calories
What blood flow pattern occurs in a ventricular septal defect?
Increased pulmonary blood flow
(IPF) Ventricular Septal Defect (VSD) S/S:
Increased pulmonary infections Pulmonary HTN R and L hypertrophy
The school nurse is preparing an educational session for adolescents to address the 2020 National Health Goals for healthy habits. What should the nurse include in this presentation? Select all that apply.
Maintaining a healthy body weight Avoidance of tobacco products Refusing to participate in substance abuse Abstaining from alcohol
The diagnosis of hypertension depends on accurate assessment of blood pressure (BP). What is the appropriate technique to measure a childs BP?
Measure BP with the child in the sitting position on three separate occasions.
Mixed Flow Disorders Presentation:
Mixing of well-oxygenated w/ poorly oxygenated blood Lower overall oxygen Decreased cardiac output
A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease?
Mumps
A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client?
Severe erosion of teeth
Gross motor:
Speed, coordination, and endurance increase. Tend to narrow focus on desired sport
The nurse is caring for a child who has been hospitalized for maltreatment. When reviewing the child's records which findings may have placed the child at an increased risk for abuse? Select all that apply.
The child's mother has a history of substance use disorder. The child was born prematurely. The child has cerebral palsy.
Parents usually ask when their child can return to school after having chickenpox. The correct answer would be:
as soon as all lesions are crusted.
HTN (secondary):
due to renal, endocrine, renovascular diseases
HTN (primary):
no identifiable cause & most common in pediatrics
The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge?
"I can't believe it. We're not unclean, poor people."
An extremely thin preadolescent is being assessed by the nurse. Which client statement should the nurse identify as being consistent with that of a person with anorexia nervosa?
"I feel chubby no matter what I wear."
The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education?
"If we need to use the EpiPen® we will need to notify her physician's office the next business day."
The mother of a 2-month-old infant questions the nurse about autism. She reports a close family member has a child with this disorder and she is concerned about her child. What information can be provided to the child's mother? Select all that apply.
"In infancy a lack of loving behaviors such as cuddling is concerning." "Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."
A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child?
"Is there anything that you do over and over again and can't resist doing?"
A nurse is teaching parents of a child with a nursing diagnosis of pain related to pruritus from skin lesions. Which of the following would the nurse include in the instructions? Select all that apply
"Keep the child's fingernails short." "Bathe the child in lukewarm water and baking soda." "Have the child press on the itching area instead of scratching it."
The mother of a an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse?
"While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."
A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply.
"We need to set clear limits for our child's behavior." "A reward system would be useful to give our child positive feedback." "We need to limit the number of choices our child has."
The nurse is teaching the parents of a child with varicella about the disorder. The nurse determines that the teaching was successful when the parents state which of the following?
"We will make sure to remind him not to scratch the lesions."
A male adolescent comes to the clinic for a routine health care followup accompanied by the parents. During the visit, the parents tell the nurse, "Our son just doesn't seem to listen to us anymore. It's like he's tuning us out. Is there anything we can do to get him to hear what we're saying to him?" Which suggestions would be appropriate for the nurse to offer? Select all that apply.
"When you talk to him, speak to him face to face and be careful of your body language." "Choose words carefully to make sure that he understands you." "Talk to you son as an equal and don't talk down to him." "Don't be afraid to ask him questions about why he feels a certain way."
A nurse is teaching parents about erythema infectiosum and describing the progression of the disease from earliest to latest. Place the following manifestations in the order in which the nurse would describe them
1. Fever and headache 2. Intense red rash on the face 3. Rash on extremity extensor surfaces 4. Rash on the flexor surfaces of extremities and trunk 5. Lace-like lesion appearance
. The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level?
1300/mm3
Kawasaki Syndrome Acute Phase Manifestations:
5 principle manifestations: (4 of 5 symptoms + fever = diagnosis): Strawberry tongue Polymorphous rash on trunk, extremities, and perineal area Bilateral, non-purulent conjunctivitis Erythema of hands/feet Cervical lymphadenopathy
After returning from cardiac catheterization, the nurse monitors the childs vital signs. The heart rate should be counted for how many seconds?
60
Kawasaki Syndrome:
Acute, idiopathic systemic vascular inflammatory disorder affecting those <5 yrs old Most common acquired heart disease in developed countries Self-limiting illness that can cause coronary aneurysm
A group of nursing students are reviewing information about alcohol use in adolescents. The students demonstrate understanding of the information when they identify which of the following personality characteristics as associated with drinking at an early age? Select all that apply.
Anxiety Aggressiveness Hyperactivity
What cardiovascular defect results in obstruction to blood flow?
Aortic stenosis
Kawasaki Syndrome Phase 1:
Acute phase - abrupt onset of fever unresponsive to antibiotics/antipyretics and inflammation of small/medium arteries including myocarditis (1-2 weeks)
A 7-year-old child shows symptoms of anaphylactic shock. Which of the following would be most appropriate for the nurse to do immediately? Select all that apply.
Administer epinephrine as ordered. Administer oxygen. Initiate intravenous access
Which nursing intervention is priority when caring for a child with HIV?
Administer prescribed medications.
A 13-year-old boy has had a near-drowning experience. The nurse notices he has labored breathing and a cough. Which of the following would be the priority?
Administering 100% oxygen by mask
The nurse is caring for a 24-month-old child with a fever of 101°F. The child also exhibits a toxic appearance. Which of the following would the nurse expect to implement?
Administering antibiotics as ordered
Substance abuse:
Affect brain development (prefrontal cortex) Use CRAFFT and SBIRT tools to determine risk
The nurse is instructing parents on how atopic disorders affect the child. For which disorder would the nurse provide information and counseling? Select all that apply.
Allergic rhinitis Asthma Eczema Hay fever
For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder?
An 8-year-old who will not stay overnight at a friend's house
A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication?
Anorexia
A child is brought into the emergency department. After assessing a child's airway, breathing, and circulation (ABCs), which of the following would the nurse do next?
Assess level of consciousness.
The nurse is caring for a child and notes periorbital edema on the left eye with urticaria. Which action by the nurse is priority?
Assess lung sounds bilaterally.
A child is exhibiting symptomatic bradycardia that has been unresponsive to ventilation and oxygenation. Which of the following would the nurse expect to be administered?
Atropine
A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning?
Avoid unattended baths for the toddler
The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply.
Orthostatic hypotension Weak pulse Hypothermia
A young client is admitted to the hospital directly from the clinic. The physician suspects a problem with the child's immune system. What test does the nurse anticipate the physician will order for this client?
Blood analysis
(OD) Coarctation of Aorta S/S:
Blood flow in arms significantly higher (10 mm/Hg +) Loud S2 Palpable thrill in suprasternal notch
A 3-month-old infant has a hypercyanotic spell. What should be the nurses first action?
Place the child in the kneechest position.
What drug is an angiotensin-converting enzyme (ACE) inhibitor?
Captopril (Capoten)
What term is defined as the volume of blood ejected by the heart in 1 minute?
Cardiac output
The nurse is evaluating outcomes for teaching provided to the mother of a school-age child with an itchy rash. Which outcome indicates that teaching has been effective?
Child drinks a glass of water every 1 to 2 hours throughout the day
During a routine well-child visit, the mother of a preadolescent patient asks the nurse to explain signs of sexual abuse. The mother is concerned because an older male neighbor has been making comments and overtly admiring the child when playing outdoors. What signs of sexual abuse should the nurse tell the mother to look out for? Select all that apply.
Child reports abdominal pain. Child has a change in school performance. Child demonstrates anxiety or trouble sleeping. Child does not want to be left alone with a certain adult.
Acne Vulgaris
Comedonal acne (involves follicular sacs filled w/ keratinous material & bacteria) most common form First sign of puberty Open and closed comedones (Treated w/ topical retinoid) Papules Pustules Nodular cysts (Treated w/ isotretinoin)
(IPF) Atrioventricular (AV) Canal (endocardial cushion defect) S/S:
Common in Down's syndrome Weak pulses Ashen skin Holosystolic murmur Cardiomegaly
Immunizations:
Complete HPV 2nd Meningococcal at 16 yrs Tdap
(DPF) Tricuspid Atresia:
Complete failure of valve => no flow
(IPF) Patent Ductus Arteriosus (PDA) Patho:
DA fails to close => connection between PA and Aorta
Fine motor:
Dexterity improves for musical instruments, painting, drawing, sewing Improved hand-eye coordination
Female puberty changes
Early (10-13) - Breast buds, pubic hair, axillary hair, growth spurt, menarche Middle (14-17) - Peak growth velocity Late (18-21) - Increased muscle mass
Male puberty changes
Early (10-13) - Testicular enlargement and start of penile growth Middle (14-17) - Growth spurt, nocturnal emissions, body hair, facial hair Late (18-21) - Lean muscle mass
The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?
Encourage rest and relaxation.
A young child is brought to the emergency department and requires advanced life support. The nurse is preparing to administer medication to maintain the child blood pressure and systemic perfusion. Which of the following might the nurse administer?
Epinephrine Dopamine Dobutamine
An unconscious client is brought to the emergency department after ingesting too much prescribed medication. What is the highest priority nursing intervention?
Establish a patent airway
An adolescent comes to the clinic reporting a sore throat and chills. The nurse suspects that the adolescent has infectious mononucleosis based on assessment of which? Select all that apply.
Fever Lymphadenopathy Splenomegaly Pharyngitis Extreme fatigue
A child with allergic rhinitis is prescribed a nasal antihistamine spray. When advising the parents about the use of the sprays, what should the nurse explain about the rebound phenomenon?
It causes an increase in nasal secretions after an initial decrease.
Social Emotional:
Frontal lobe (prefrontal cortex) is last to develop => Responsible for impulse control => risky behavior Role confusion leads to risky behaviors Egocentrism leads to feelings of invincibility
The nurse is caring for a child admitted to the pediatric medical unit with chickenpox who has infected vesicles. What personal protective equipment should the nurse use when measuring the child's vital signs?
Gloves Gown N95 respirator
Secondary sex characteristics stimulated by gonadotropin-releasing hormone (GnRH):
GnRH stimulates pituitary gland to release luteinizing hormone (LH) and follicle stimulating hormone (FSH) LH and FSH stimulate the release of androgens and estrogens
A nurse is conducting an assessment of a 16-year-old's cognitive development. The nurse determines that the adolescent's cognitive development is within acceptable parameters for the adolescent's age based on which assessment finding? Select all that apply.
Has a beginning interest and concern with societal and political issues. Uses scientific methods to solve verbal problems. Demonstrates thinking that the adolescent is invincible.
The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation?
Head lice are becoming very resistant to treatment.
A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?
Heart Failure
(IPF) Atrial Septal Defect (ASD) Patho:
Hole in atria allows oxygenated blood to go from left to right atrium
A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38 C (100.4 F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother?
Immediately bring the child to the clinic for evaluation.
Which nursing diagnosis will the nurse select as appropriate for the child with atopic dermatitis? Select all that apply
Impaired skin integrity related to skin barrier function Anxiety related to continuing or uncontrolled allergic response Powerlessness related to difficulty determining cause of allergy
Piaget Stage - Formal operational
Implications: Develops abstract thoughts Feels invulnerable Better impulse control See other's perspectives
Erickson Stage - Identity vs Role confusion
Implications: Self-conscious about changing body Concerned with attractiveness More stable body image Forming identity
When educating parents of preschoolers what is most important to include in your presentation?
Keep chemicals in a locked cabinet.
A nurse is caring for a stable toddler diagnosed with accidental poisoning due to the ingestion of cleaning solution. What must be included in teaching parents about how to protect a toddler from accidental poisoning?
Keep cleaning solutions locked up
What preparation should the nurse consider when educating a school-age child and the family for heart surgery?
Let the child hear the sounds of a cardiac monitor, including alarms.
A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition?
Mumps
Nutrition
Obesity
The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge?
Parents need to learn specific, important guidelines for administration of digoxin.
A nurse is preparing a class for a group of adolescents about sexuality and sexual activity. The nurse understands that which of the following are often the biggest influences on an adolescent's actions related to sexual activity? Select all that apply.
Peer pressure Self esteem
A child comes to the clinic for evaluation of skin lesions and is diagnosed with impetigo. Which medications are potentially ordered with instructions placed on the discharge summary? Select all that apply.
Penicillin Erythromycin Mupirocin
The nurse is reviewing the immunization schedule with the parent of a child who is HIV positive. What information should the nurse provide? Select all that apply.
Pneumococcal vaccination can be given. The varicella vaccine should not be given if the child is symptomatic. If the CD4 count is low, the measles, mumps, and rubella vaccine should not be given.
The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information?
Process that requires the individual to view a situation from a different perspective
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema?
Redness of the skin produced by congestion of the capillaries
. A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug?
That the infant's skin has greater permeability than that of an adult
Kawasaki Syndrome Phase 2:
Subacute phase - Fever subsides with desquamation of fingers/toes, thrombocytosis, joint pain, anorexia (several weeks)
The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? Select all that apply.
Substance abuse History of previous suicide attempt Mental health changes Poor family dynamics
The nurse is caring for a pediatric client who has a compromised immune system. When reviewing laboratory results, which bone marrow component identifies a dysfunction in bone marrow production? Select all that apply.
T lymphocytes B lymphocytes
Increased Pulmonary Flow Presentation:
Tachypnea Frequent respiratory infections Tachycardia Murmur Heart Failure Poor weight gain
The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion?
The child constantly opens and closes the hands.
The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder?
The child constantly stares at a rotating wheel on the crib mobile.
The parent of a child with mumps on one side of the face is concerned that the disease can develop on the other side in the future. How should the nurse respond to the mother about this concern?
The child is immune to further attacks of the disease.
The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern?
The child needs opportunities to play with peers.
The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply.
The child states that his tongue feels "too big" for his mouth. The child has developed hives on his face and trunk. The child states he feels like he might "throw up". The child states that he feels like he might faint.
The nurse is educating the parents of a 6-year-old boy about his learning disorder. Which of the following facts would the nurse integrate into the discussion?
The disorder is caused by a difference in brain architecture.
After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply
The parents recently divorced The father is unemployed and mother is infrequently home The child is expected to care for younger siblings while mother sleeps There is history of multiple injuries obtained from a motor vehicle crash
Which characteristic of the adolescent should the nurse consider abnormal? Select all that apply.
Third molars erupting at age 13 Heart Rate of 114
The nurse is preparing an educational program for members of the office staff. The topic is the warning signs of primary immunodeficiency. What information should be included? Select all apply.
Two or more episodes of severe sinusitis in 1 year. Failure to thrive in an infant. Two or more serious infections such as sepsis. History of infections requiring IV antibiotics to clear.
A 7-year-old child is rushed into the emergency room after being stung by a yellow jacket. The child is nauseated and vomiting and is experiencing itching and swelling on the arm where stung. The is having trouble breathing. Which type of hypersensitivity response is the child experiencing?
Type I: anaphylaxis
Speech:
Use slang => difficult for parents to understand Use text speak
The nurse is caring for a school-age child with varicella. What should the nurse observe about the rash that is associated with this infection?
Various stages of lesions present at the same time
Infectious Mononucleosis
Virus from Epstein-Barr virus Spread through oral secretions (kissing disease) for 6 months Fever, pharyngitis, enlarged tonsils, hepatomegaly & splenomegaly present
To teach an adolescent how to prevent the recurrence of a sexually transmitted disease, the nurse would include which information in the teaching plan?
Wash genitals well with soap and water after sexual activity. Abstinence is the best protection against sexually transmitted infection. Use a condom with every sexual encounter.
The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse?
When providing health information to a child of this age it should be simplistic and at the child's level of understanding
A nursing instructor teaching a class about immunity asks the students to identify the organs of the immune system. Which would the nursing instructor want them to include? (Select all that apply.)
lymph nodes bone marrow thymus spleen tonsils
Nursing students correctly label the group of cells whose job is to ingest, engulf, and neutralize pathogens as:
macrophages.
(DPF) Pulmonic Stenosis:
right ventricle outflow obstruction
What clinical manifestation is a common sign of digoxin toxicity?
Vomiting
The nurse is performing CPR on a child who is a victim of a near-drowning experience. How should the nurse open the child's airway to provide breaths?
Jaw-thrust maneuver
(OD) Hypoplastic Left Heart Syndrome (HLHS) Patho:
Left side of heart underdeveloped w/ mitral valve stenosis or atresia, hypoplastic ventricle (little contraction), & aortic stenosis Systemic circulation depends on PDA remaining open Most common cause of death among neonates
A nurse is conducting a secondary assessment of a child who has experienced multiple trauma. When inspecting the child's back, which of the following would be most appropriate to do?
Logroll the child to the side
(OD) Coarctation of Aorta Patho:
Narrowing of proximal portion of descending aorta, just distal to subclavian artery Once PDA (PA to Aorta) closes impaired perfusion to lower extremities
(MF) Truncus Arteriosus (Common Trunk) Teaching:
No strenuous sports
A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching?
Preoperative teaching should be adapted to his level of development so that he can understand.
A 3-year-old child is brought to the emergency department after swallowing batteries taken from a grandparent's hearing aids. The parents believe that two batteries were swallowed. What should the nurse explain to the parents regarding the care that the child will need at this time?
Preparation for an emergency endoscopy to remove the batteries
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk?
Prevent dehydration.
(DPF) Tricuspid Atresia Teaching:
Prophylaxis needed to prevent infective endocarditis after surgery Long-term anticoagulant therapy may be necessary
(DPF) Tricuspid Atresia Inverventions:
Prostaglandins started to keep ductus arteriosus open Digoxin diuretics to control heart failure Surgery: Stage 1 - involves pulmonary artery banding or Blalock-Taussig shunt Stage 2 - Glenn procedure: main pulmonary artery trunk removed and distal end closed; superior vena cava connected to right pulmonary artery Stage 3 - Fontan completion: inferior vena cava connected to right pulmonary artery w/ tunnel or conduit
(MF) Transposition Interventions:
Prostaglandins to keep DA open Jatene procedure to switch arteries w/in first 2 weeks of life
(OD) Coarctation of Aorta Interventions:
Prostaglandins to keep DA open until surgery done Synthetic patch aortoplasty
A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?
90 meats/min
The nurse is performing a physical examination of a 5-year-old boy. Which documented findings would most strongly indicate maltreatment of the child? Select all that apply.
Cuts and bruises on the hands Burns on the dorsal surface of the hand A curved laceration on the back Linear lesions across the chest and abdomen
(DPF) Tricuspid Atresia Presentation:
Cyanosis Poor weight gain Hypercyanotic Episode- Right to left shunting via atrial septal defect (ASD) Polycythemia - extra red blood cells
The nurse is caring for a child who is critically ill and requiring fluid resuscitation. Which intravenous fluids are appropriate for use? Select all that apply.
Normal saline Lactated Ringer's
The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurses initial intervention?
Notify the practitioner of these findings.
(IPF) Atrioventricular (AV) Canal (endocardial cushion defect) Patho:
Partial: ASD w/ L to R shunting plus mitral valve regur. due to cleft mitral valve (extra leaflet) Complete: ASD & VSD plus mitral & tricuspid valves are merged to form single multi-leaflet valve
(IPF) Atrial Septal Defect (ASD) Interventions:
Patch
(MF) Transposition Patho:
Pulmonary artery & Aorta are swapped => Left recircs lungs and Right recircs system ASD, VSD, or PDA required to have mixed flow
What structural defects constitute tetralogy of Fallot?
Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
(IPF) Patent Ductus Arteriosus (PDA) Interventions:
Indomethacin or Ibuprofen IV will stimulate closure of DA if premature Ligation (closure via ligature (tie) or clip)
(MF) Truncus Arteriosus (Common Trunk) Interventions:
Digoxin and diuretics Surgery to separate aortic and pulmonic arteries, close VSD, and create semilunar valves
(IPF) Ventricular Septal Defect (VSD) Interventions:
Digoxin to control rate and rhythm Lasix for diuresis Ace inhibitors to decrease aortic pressure, systemic vascular resistance and L to R shunting VSD patch placed at 3-12 mo. of age
A 12-year-old boy has broken his arm and is showing signs and symptoms of shock. Which of the following would the nurse do first?
Establish a suitable IV site.
Kawasaki Syndrome Interventions:
Fluids, IV pain relief, and aspirin
(IPF) Ventricular Septal Defect (VSD) Patho:
Hole in ventricles allows oxygenated blood to go from left to right ventricle
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time?
Report data to the practitioner.
Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4 C (101.1 F). What action should the nurse perform?
Report findings to the practitioner.
(MF) Truncus Arteriosus (Common Trunk) Patho:
Aorta and Pulmonary arteries do not separate and Aortic & Pulmonic valves form one large semilunar valve, and large malaligned VSD Associated with DiGeorge syndrome
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially?
Apply direct pressure above the catheterization site.
(DPF) Tetralogy of Fallot (TOF) S/S:
Hypercyanotic episodes Squatting or knee-chest-chest position decreases return of systemic venous blood to heart (toddlers squat) Loud harsh systolic ejection murmur Boot-shaped heart Prominent aorta
A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply.
Hypersensitivity to touch Lack of facial expression
What nursing consideration is important when suctioning a young child who has had heart surgery?
Suction for no longer than 30 seconds at a time. Expect symptoms of respiratory distress when suctioning. Administer supplemental oxygen before and after suctioning.