Mom and Baby exam 4
Which of the following would the nurse include in a presentation for nursing students regarding type 2 diabetes in children? Select all that apply
-an increased intake of whole foods has led to a decrease in the diagnosis of type 2 diabetes - fam history of type 2 diabetes is a risk factor for developing type 2 diabetes - increase in childhood obesity is factor contributing to increase in type 2 diabetes
prevalence of concussions
53% of child athletes report experiencing a concussion by the time they start high school
After reviewing the population demographics for an urban community, the community health nurse determines that community members would benefit from teaching on types 1 and 2 diabetes mellitus in children. What information caused the nurse to come to this conclusion?Select all that apply
A) 60% of community families have both parents diagnosed with type 2 diabetes mellitus. C) 50% of children between the ages of 10 and 19 are African-American. D) 25% of children between the ages of 10 and 19 are Hispanic.
The nurse is concerned that a school-age child has undiagnosed type 1 diabetes mellitus and is experiencing diabetic ketoacidosis. What did the nurse assess in the client to come to this conclusion?Select all that apply. A) Blurred vision B) Irregular heartbeat C) Sunken eye sockets D) Sluggish bowel sounds E) Dry mucous membranes
A) Blurred vision B) Irregular heartbeat C) Sunken eye sockets E) Dry mucous membranes
A client with newly diagnosed otitis media tells the nurse that the left ear has been aching for weeks. Since this health problem has been untreated for so long, which additional problem is this client at risk for developing?A) External otitisB) MeningitisC) PneumoniaD) Influenza
A) External otitis
ABC's of safe sleep
Alone on my Back in my Crib
A 2-year-old child with otitis media is prescribed amoxicillin clavulanate 250 mg/5 mL three times daily by mouth for 10 days. What should the nurse teach the mother about this medication?A) "It is ok to stop the antibiotic if the child begins to have side effects."B) "Give the antibiotic for the full 10 days as prescribed."C) "It is important to measure the prescribed dose in a household teaspoon."D) "Be sure to administer a loading dose of the medication when you get home."
B) "Give the antibiotic for the full 10 days as prescribed."
The Intensive Care nurse is preparing to admit a school-age child for treatment of diabetic ketoacidosis. On what should the nurse focus for this client's care? Select all that apply. A) Peripheral perfusion B) Fluid volume overload C) Frequent blood glucose monitoring D) Intravenous fluid infusions E) Insulin infusion
B) Fluid volume overload C) Frequent blood glucose monitoring D) Intravenous fluid infusions E) Insulin infusion
A multidisciplinary conference has concluded that focused on the care needs of a 10-year-old child with type 2 diabetes mellitus. On which areas should the team focus care to improve this client's long-term prognosis? Select all that apply. A) Weaning off oral medications B) Food intake based on age, sex, and physical activity C) Obtaining adequate rest and sleep D) Physical activity to be at least 30-60 minutes per day most days of the week E) Family participation in the lifestyle change
B) Food intake based on age, sex, and physical activity D) Physical activity to be at least 30-60 minutes per day most days of the week E) Family participation in the lifestyle change
The nurse is planning care for a 6-year-old child newly diagnosed with type 1 diabetes mellitus. The child's mother appears unconcerned with the diagnosis and is complaining about the cost of medication, as three additional children in the family have needs. On which nursing diagnoses should the nurse focus when planning this client's care? Select all that apply. A) Chronic Pain B) Knowledge Deficit C) Ineffective Coping (Family) D) Risk for Unstable Blood Glucose E) Risk for Injury
B) Knowledge Deficit C) Ineffective Coping (Family) D) Risk for Unstable Blood Glucose
An adolescent with otitis media is experiencing extreme pain. Which should the nurse emphasize to address the diagnosis of Acute Pain for this client? A) Apply a cold compress to the affected ear. B) Report abrupt relief of pain immediately. C) Continue plans for air travel. D) Report increased pain when moving the outer ear.
B) Report abrupt relief of pain immediately.
The nurse is teaching the parents of an infant with acute otitis media. What would be most important for the nurse to teach the parents? A) Administer a decongestant for nasal congestion. B) Keep the baby in a flat position during sleep. C) Administer acetaminophen to relieve pain and decrease fever. D) Place the baby to sleep with a pacifier.
C) Administer acetaminophen to relieve pain and decrease fever.
The nurse is preparing discharge teaching for the parents of a child who has been diagnosed with asthma. Teaching the mnemonic "dread", helps to remind the parents of what symptoms associated with asthma?
DREAD
DREAD
S&S of asthma diaphoresis reduction of breath sounds expiratory wheezing accessory muscle use dyspnea
Which of the following is a true statement regarding type 1 vs type 2 diabetes?
Type 1 diabetes has a more rapid onset than does type 2 diabetes
which description is most appropriate for the family centers care approach?
a collaborative plan of care is developed to achieve optimal health
What makes keeping diabetes in control in an adolescent difficult? (Select all that apply.)
a. Hormonal changes b. peer pressure for substance use c. erratic eating problems d. Growth spurts
which interventions would be the most beneficial to decrease risk factors for a child who has had repeated admissions for respiratory syncytial virus (RSV) bronchiolitis? SATA
a. do not smoke, and avoid all secondhand smoke around the child c. encourage physical activity and play d. ensure an adequate nutritional intake e. instruct all care-givers of the importance of proper hand hygiene
the nurse is creating a plan of care for the family of a client with a terminal illness. Which aspects of this family's care should the nurse emphasize when creating this plan? SATA
a. instructing on medication administration d. guiding to determine realistic goals e. identifying strategies to enhance family functioning
a client sustains a concussion during a motor vehicle accident and on admission is disoriented and restless. which nursing diagnosis label should receive top priority?
a. risk for injury
a child is brought to the emergency room after he fell and hit his head on the ground. which nursing assessment suggests the child has a concussion?
a. sleepy, but easily arousable
a nurse is caring for two pediatric clients newly diagnosed with diabetes. one client has type 1 diabetes and the other client has type 2 diabetes. When discussing the difference between type 1 and type 2 diabetes, the nurse recognizes what clinical presentation about type 1?
a. the diagnosis is often made following an acute onset of keto acidosis
the nurse is caring for a client who is hospitalized with pneumonia. which will the nurse assess when determining the impact of the illness on the family? SATA
a. the duration of the illness b. the effect of the illness on future family functioning d. the meaning of the illness to the family e. the financial impact of the illness
which clients should the nurse identify as being at risk for perinatal loss? SATA
a. the woman recovering from a gastrointestinal virus b. the woman who lacks access to health and prenatal care d. the unmarried 14-year-old girl living in the city e. woman drinking one cup of coffee per day
a community health nurse is planning a safety session for children and their parents. the focus will be on concussion prevention. which should be included? SATA
a. wear a safety helmet when riding a bike c. have a soft surface like mulch below swing sets d. avoid tripping hazards in the home
a female client is admitted in a disoriented and restless state after sustaining a concussion during a car accident. which assessment data takes highest priority in this client's plan of care?
acute concussion
A new mother is distraught because her infant has a fever of 102ºF and is diagnosed with otitis media. What should the nurse instruct the mother to help the child's fever and pain?A) Swaddle the baby in blankets.B) Feed the baby solid foods.C) Administer acetaminophen.D) Bathe the baby with cool water.
administer acetaminophen
Which of the following known asthma triggers are considered modifiable? Select all that apply.
animal dander, exposure to cigarette smoke, and exposure to indoor and outdoor allergens
a client diagnosed with a mild concussion is being discharged from the ED. which discharge instruction should the nurse teach the clients significant other?
awaken the client every 2 hours
The nurse is finalizing a plan of care for a school-age child newly diagnosed with type 1 diabetes mellitus. On which areas should the plan focus to achieve the maximum outcomes for this client? Select all that apply. A) Ways to minimize the number of school days missed B) Identification and referral to community resources C) Physical activities that limit exposure to injuries D) Self-management of glucose monitoring and medications E) Signs and symptoms of hypoglycemia and actions to take
b d e
the nurse is assigned to care for a child in a spica cast for fractured femur suffered in an automobile accident. The child's father was driving the family, The nurse learns that the father just recently lost his job and the mother has been working through a "temp" agency. Which nursing diagnosis fits the family?
b. compromised family coping related to the effects of multiple simultaneous stressors
the pediatric nurse is providing education to a new mother regarding ways to decrease the risk of SIDS. which statement by the nurse is appropriate?
b. there is no one cause for the syndrome; the best thing is to understand the risks and eliminate them
the nurse is observing a family counseling session that is focusing on the family members' communication patterns. which observation indicates that there are existing or potential problems with family communication?
c. disagreements are ignored by the family leader
a primigravida is hospitalized at 32 weeks' gestation after a second hemorrhage from a complete placenta previa. the client delivers a stillborn infant 1 week later. which intervention should the nurse perform to help this family in the grieving process?
c. facilitate and support the family viewing and holding the infant
the nurse is evaluating care provided to a new mother regarding infant risk for sudden death syndrome. which statement by the mother indicates teaching has been effective?
c. i plan to quit smoking and will not smoke around baby until then
following the diagnosis of concussion, the nurse is preparing to discharge the client from the ED. which is not appropriate for discharge education?
c. severe migraines are normal during recovery
a nurse explains to the mother of a 1-year-old with a history of frequent ear infections that the PRIMARY cause of otitis media in young children is what?
d. an obstructed eustachian tube
a 15-year-old adolescent is found to have type 1 diabetes. what should the nurse include when teaching the adolescent about type 1 diabetes?
d. it has a more rapid onset than type 2 diabetes
symptoms of a concussion
difficulty concentrating, thinking, or remembering new info dizziness, poor balance, headache, fatigue, photophobia, poor coordination anxiety, irritability, depression insomnia, hypersomnia, difficulty falling asleep
When providing parent education for a child with asthma, the nurse needs to include which of the following in the teaching? Select all that apply
early recognition of symptoms, steps to prevent exacerbations, use of medications
The School nurse is concerned that a child has undiagnosed type 1 diabetes mellitus and is experiencing diabetic ketoacidosis (DKA). What assessment findings would be present? Select all that apply
excessive thirst, fruity breath, nausea and vomiting
a nurse is caring for a preschool age client who was admitted for dehydration. the child lives with the parents and maternal grandparents. in which type of family does this child reside?
extended
The provider has ordered a combination of regular and NPH insulin at 8:00 AM. At 8:45 AM for a child on the pediatric unit. At 9am, the breakfast trays have not yet arrived from the kitchen. What is the best action by the nurse?
give the patient a snack of graham crackers and milk
What factors should the nurse take into consideration when planning the care for an adolescent patient who has recently been diagnosed with diabetes? Select all that apply.
hormonal changes peer pressure growth spurts erratic eating patterns
the nurse has completed a family assessment and is planning care for a newly blended family. the children are having trouble adapting to the new situation. what is the primary goal for this family?
improve family situations
Which education should the nurse include in discharge teaching for an adolescent client, who participates in school athletics, regarding the plan of care for diabetes mellitus?
increased food intake
treatment of otitis media
insertion of tympanostomy tubes if recurrent otitis media or serous that persists > 4 months
The nurse walks into an examination room and sees a young child demonstrate a specific behavior (pulling at ear). Which health problem should the nurse suspect the child is experiencing? A) Sore throat B) Hunger C) Otitis media D) Head cold
otitis media
during a home visit, the nurse instructs a young mother to bottle-feed the baby in the upright position. which health problem will this position help to prevent this child from developing?
otitis media
A client has completed the full course of antibiotics prescribed to treat otitis media. Which primary manifestation of the disorder will be relieved as evidence that treatment has been effective? A) Impaired hearing B) Dizziness C) Pain D) Nausea and vomiting
pain
chronic otitis media
permanent perforation of the tympanic membrane -may result in recurrent formation of pus -results from acute otitis media that recurs, or from trauma
a nursing is caring for a 2-year-old child who has had 3 ear infections in the past 5 months. the nurse should know that the child is at risk for developing which of the following as a long-term complication? SATA
speech delays ** if SATA prolonged hearing loss
symptoms of otitis media
tugging or pulling at ears -fussiness and crying -trouble sleeping -fever -fluid draining from ear -clumsiness or problems with balance -trouble hearing or responding to quiet sounds
acute otitis media
typically follows a respiratory infection -edema of the eustachian tube impairs drainage -mucus and serous fluid accumulate -provides excellent enviro for growth of bacteria
RSV (respiratory syncytial virus)
virus invades epithelial cells -infected cells merge creating syncytia -syncytia burst and die, clogging the lower resp tract
serous otitis media
•Prolonged obstruction of the Eustachian tube -air absorbed from middle ear -obstruction prevents air from entering -results in effusion-movement of sterile serous fluid into the middle ear
