mother/baby chapter 47
The nurse is speaking with the parent of an infant with severe atopic dermatitis. What information should the nurse reinforce with the parent (Select all that apply)?
"You will need to keep your infant's skin well hydrated by using a mild soap in the bath." "You will need to prevent your baby from scratching the area by using a mild antihistamine." "You should apply an emollient to the skin immediately after a bath."
The nurse is talking to the parents of a child with pediculosis capitis. Which should the nurse include when explaining how to manage pediculosis capitis?
"You will need to remove nits with an extra-fine tooth comb or tweezers."
Which nursing intervention is the highest priority in the initial care of a child with a major burn injury?
Establishing and maintaining the child's airway
Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug include:
Explaining that medication should not be applied until at least 20 to 30 minutes after washing.
Ringworm, frequently found in schoolchildren, is caused by:
Fungus
An effective strategy to reduce the stress of burn dressing procedures is to:
Give the child as many choices as possible.
A toddler sustains a minor burn on the hand from hot coffee. The first action in treating this burn is to:
Hold the burned area under cool running water.
Which physiologic change causes the edema formation that occurs with burns?
Increased capillary permeability
After the acute stage and during the healing process, the primary complication from burn injury is:
Infection
Which statement regarding atopic dermatitis (eczema) in the infant is most accurate?
It is associated with allergy with a hereditary tendency.
The only symptom of pediculosis capitis (head lice) is usually:
Itching
Which should the nurse include when teaching parents about preventing childhood burn injuries (Select all that apply)?
Keep hot liquids out of reach. Baby-proof electrical outlets. Test water temperature before placing your child in the tub bath.
The family of a 4-month-old infant will be vacationing at the beach. The best recommendation to this family is to:
Keep the infant in total shade at all times.
A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend:
Keeping the child quiet and coming to emergency department.
Which primary treatment will the nurse implement for a child with warts?
Local destruction
The nurse is teaching parents of a 3-year-old with impetigo that they can anticipate:
No scarring.
Biologic dressings are applied to a child with partial-thickness burns of both legs. Nursing actions related to this include:
Observing wounds for signs of infection.
The nurse is caring for a 7-year-old with herpes simplex virus. Which prescribed medication should the nurse expect to be included in the treatment plan?
Oral antiviral agent
Herpes zoster is caused by the varicella virus and has an affinity for:
Posterior root ganglia and the posterior horn of the spinal cord.
Nursing care of the infant with atopic dermatitis focuses on:
Preventing infection.
Fentanyl and midazolam (Versed) are given before debridement of a child's burn wounds. These drugs are important to:
Provide pain relief.
The primary clinical manifestation of scabies is:
Pruritus
A child experiences frostbite of the fingers after prolonged exposure to the cold. Which intervention would the nurse implement first?
Rapid rewarming of the fingers by placing in warm water
A child with extensive burns requires debridement. The nurse should anticipate that a priority goal related to this procedure is to:
Reduce pain.
Rocky Mountain spotted fever is caused by the bite of a:
Tick
To best assess the child with severe burns for adequate perfusion, the nurse monitors:
Urine output.
The nurse should expect to assess which causative agent in a child who has warts?
Virus
An important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns is to:
Wash hands and forearms before and after dressing change.
A child falls on the playground and has a small laceration on the forearm. What should the school nurse do to cleanse the wound?
Wash wound gently with mild soap and water for several minutes.
An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. What is important in her immediate care?
Remove her burned clothing and jewelry
Matt's mother tells the nurse that he keeps scratching the areas where he has poison ivy. The nurse's response should be based on knowing that:
Scratching the lesions may cause them to become secondarily infected.
The most immediate threat to life in children with thermal injuries is:
Shock
A child steps on a nail and sustains a puncture wound of the foot. The most appropriate method for cleansing this wound is to:
Soak foot in warm water and soap.
Cellulitis is often caused by:
Streptococcus or Staphylococcus organisms.
A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise the father to:
Take the child to emergency department.
Which prescribed treatment should the nurse plan to implement for a child with psoriasis?
Tar and exposure to sunlight and ultraviolet light
The nurse is teaching parents of toddlers about animal safety. Which information should be included in the teaching session?
Teach your toddler not to disturb an animal that is eating.
The nurse is teaching a class on preventing diaper rash in newborns to a group of new parents. Which statement made by a parent indicates a correct understanding of the teaching?
"I will wash with a mild soap and water and dry thoroughly whenever my infant has a bowel movement."
A nurse is caring for a 5-year-old child with a major burn. The health care provider has written a prescription to notify the health care provider if urine output falls to or below 2 mL/kg/hr. The child weighs 55 lb. The nurse should notify the health care provider if the milliliters of urine output is at or below _____ for an hour. Record your answer as a whole number.
50 To calculate the child's weight in kilograms, the weight in pounds is divided by 2.2. That number is then multiplied by 2 to get the amount expected for a 1-hour period: 55/2.2 = 25 kg; 25 kg 2 mL = 50 mL/hr.
One of the first signs of overwhelming sepsis in a child with burn injuries is:
Disorientation
Isotretinoin (Accutane) is indicated for the treatment of acne during adolescence when:
Acne has not responded to other treatments.
The nurse is caring for a school-age child with a tinea capitis (ringworm) infection. The nurse should expect that therapeutic management for this child includes:
Administering oral griseofulvin.
A child is admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has:
An inhalation injury.
A high-protein diet for the child with major burns is ordered to:
Avoid protein breakdown.
The community health nurse is teaching parents about prevention of the spread and reoccurrence of pediculosis (head lice). Which should the nurse include in the teaching session (Select all that apply)?
Dry-clean nonwashable items. Boil combs and brushes for 10 minutes. Discourage sharing of personal items.
The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. This is most likely caused by:
Candida albicans.
An important nursing consideration when caring for a child with impetigo contagiosa is to:
Carefully wash hands and maintain cleanliness when caring for an infected child.
The nurse should understand that Lyme disease is:
Caused by a spirochete that enters the skin through a tick bite.
Lymphangitis ("streaking") is frequently seen in:
Cellulitis
Where do the lesions of atopic dermatitis most commonly occur in the infant (Select all that apply)?
Cheeks Extensor surfaces of arms and legs Trunk Scalp
The management of a child who has just been stung by a bee or wasp should include the application of:
Cool compresses.
Hydrotherapy is required to treat a child with extensive partial-thickness burn wounds. Which is the primary purpose of hydrotherapy?
Debride the wounds.
Which of the following best describes a full-thickness (third-degree) burn?
Destruction of all layers of skin evident with extension into subcutaneous tissue