NSG 242 Chapter 35: Key Pediatric Nursing Interventions

A nurse is educating the parents how to administer daily oral medication to their 5-year-old boy. Which response indicates a need for further teaching? "I should never refer to the medicine as candy." "We should never bribe our child to take the medicine." "He needs to take his medicine or he will lose a privilege." "We checked that the medicine can be mixed with yogurt or applesauce."

"He needs to take his medicine or he will lose a privilege."

The nurse knows additional teaching is needed if a parent makes which comment? "I keep the medications in a drawer under papers." "I lock the medication in a drawer in my bedroom." "I always keep medication in the highest locked cabinet." "I keep refrigerated medications on the highest shelf."

"I keep the medications in a drawer under papers."

The nurse is teaching parents of a 12-year-old child how to administer otic medication. Which statement by the parent indicates a need for further education? "I will pull the outer ear down and back before administering the medication." "After removing the medication from the refrigerator, I need to roll it gently in my palms to warm it." "I will hold the dropper 0.5 in (1.25 cm) above the ear canal and be certain not to touch the ear with the dropper." "After administering the drops, I will ask my child to remain side-lying for several minutes."

"I will pull the outer ear down and back before administering the medication."

The nurse has finished completing a client education program for parents on proper medication administration to children. Which statement by a parent would indicate a need for further education? "I will put my daughter's pill in a small amount of applesauce to help her learn now to swallow it." "When I give my toddler medication, I will make sure they are sitting up." "If my toddler won't swallow her medication, I will hold her nose until she has to swallow." "I will let my preschooler squirt his medication in his own mouth after I have measured it out."

"If my toddler won't swallow her medication, I will hold her nose until she has to swallow."

Which statement by the nurse is most likely to gain the cooperation of a young child? "Do you want to take your medicine now?" "It's time for you to drink your medicine now." "If you take this medicine, I can get you a popsicle." "If you don't drink this medicine, you will need to get a shot."

"It's time for you to drink your medicine now."

The nurse has been caring for a 12-year-old boy during his 5-day hospitalization. The child's IV has infiltrated, and the care provider is getting ready to change the intravenous line site. Which statement made by the nurse would be appropriate in supporting the child? "I will be back after your IV is in place." "Would you like me to stay with you or are you OK alone?" "The client is left-handed and likes to draw; an IV site in his right arm would be best." "The nurses on the unit know the client well, so maybe a nurse could start the IV."

"The client is left-handed and likes to draw; an IV site in his right arm would be best."

A child who is receiving TPN has developed the need to have insulin injections. The child's mother questions this and states that her child does not have diabetes. What is the appropriate response by the nurse? "Illness can sometimes result in the need for insulin." "There is no need to worry. This is temporary." "The feedings are high in sugar and insulin is needed to manage this." "There is a chance these feedings your child is receiving are causing her to have diabetes."

"The feedings are high in sugar and insulin is needed to manage this."

The nurse is preparing to administer an antibiotic for a severe respiratory infection to a 5-year-old boy. The child asks the nurse why he is getting this medication. What is the best response by the nurse? "This medicine will kill the bacteria that is in your body making you sick." "The medicine will help you feel better so that you can go home soon." "The medicine will get rid of the bugs that are making you feel bad." "The medicine is what your doctor wants you to have to make you better."

"The medicine will help you feel better so that you can go home soon."

The nurse is showing the student nurse how to flush a pediatric client's peripherally inserted central catheter (PICC) line. The nurse prepares a 3-ml normal saline flush using a 5-ml syringe. The student asks the nurse why the flush was prepared this way. What is the most accurate response by the nurse? "I like how the 5-ml syringe fits in my hand. I feel like I have a better grip on it than a smaller syringe." "The 5-ml syringe is what we have the most stock of so I just always use it." "Using a larger-volume syringe exerts less pressure on the PICC line." "It is standard policy in our facility to use a 5-ml syringe for all PICC line flushes."

"Using a larger-volume syringe exerts less pressure on the PICC line."

A health care provider has prescribed hydroxyurea 20 mg/kg to a child as part of a treatment regimen for sickle cell disease. The child weighs 27 lb (12.2 kg). How many milligrams should the nurse administer?

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A nurse is providing care for a child diagnosed with beta-thalassemia. The child requires a blood transfusion of packed red blood cells (PRBCs). The health care provider has prescribed a transfusion volume of 10 ml/kg. The child weighs 37 lb (16.8 kg). How many milliliters should the nurse infuse?

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A child with HIV, weighing 25 kg (55.1 lbs), is about to receive an infusion of IVIG. The recommended dose is 400 mg/kg/dose. The medication is available in a concentration of 50 mg/mL. What is the proper amount of infusion that the child will receive? 100 mL 200 mL 1000 mL 2000 mL

200 mL

The nurse is calculating the urinary output for the infant. The infant's diaper weighed 40 g prior to placing the diaper on the infant. After removal of the wet diaper, the diaper weighed 75 g. How many milliliters of urine can the nurse document as urinary output? Record your answer using a whole number.

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The mother of a 9-year-old girl calls the physician's office complaining that her daughter continues to vomit soon after being given an oral amoxicillin capsule for her strep throat. The nurse recognizes that the child's vomiting will interfere with which pharmacokinetic process? Absorption Distribution Metabolism Excretion

Absorption

A neonate is to receive a hepatitis B vaccine within a few hours after birth. What is the best approach for the nurse to take when giving this medication? Administer the medication in the neonate's vastus lateralis with a 25-gauge needle. Administer the medication in the vastus lateralis with a 20-gauge needle. Administer the medication in the dorsogluteal with a 25-gauge needle. Administer the medication in the deltoid muscle with a 20-gauge needle.

Administer the medication in the neonate's vastus lateralis with a 25-gauge needle.

An infant is scheduled to have a painful procedure performed. Which nursing action provides the best support for the parents and infant? Explain to the parents that infants do not experience pain. Allow the parents to hold the infant during the procedure. Ask the parents to hold the child down during the procedure. Have the parents remain outside the room while the procedure is occurring.

Allow the parents to hold the infant during the procedure.

A child needs a peripheral IV start as well as a venous blood sample for a laboratory test. The nurse will take what action? Coordinate placing the peripheral IV and the lab blood draw. Delay both the IV start and blood draw until the child is well hydrated orally. Make sure the laboratory specimen is drawn prior to placing the IV access device. Place the IV and start intravenous fluids promptly; then request the laboratory obtain the blood specimen.

Coordinate placing the peripheral IV and the lab blood draw.

The nurse is preparing to administer regular insulin to a nonverbal pediatric client. Which action will the nurse perform prior to administering the medication? Check the full name and birth date on the client's wristband with the medication administration record. Check the full name and room number on the client's wristband with the medication administration record. Check the birth date and full name on the client's wristband with the medication administration record and have another nurse verify. Check the full name and age on the client's wristband with the medication administration record and have the parent verbally confirm.

Check the full name and birth date on the client's wristband with the medication administration record.

A child is receiving intravenous fluids for dehydration. The nurse notes coarse breath sounds and increased pulse and blood pressure. What does the nurse do first? Discontinue the IV infusion. Contact the health care provider. Assess intake, output, and weight. Request a chest X-ray for evaluation.

Discontinue the IV infusion.

A toddler requires 1.5 ml of an antibiotic given intramuscularly (IM). How will the nurse administer this medication? Divide the dose. Administer 0.75 ml IM in each vastus lateralis. Seek an order for an oral form of the antibiotic. Administer the antibiotic IM in the rectus femoris. Reduce the volume of the dose using less diluent than recommended to prepare the antibiotic for IM injection.

Divide the dose. Administer 0.75 ml IM in each vastus lateralis.

A nurse is preparing a dose of insulin to give the client. Which action takes priority when preparing and administering this medication? Double-check the dose with another RN before giving. Double-check the math calculations. Have another RN witness the injection given to the client. Ask the client if he or she has had any adverse reactions to insulin in the past.

Double-check the dose with another RN before giving.

When performing a procedure on a child in the health care setting, what should the priority intervention by the nurse be? Ensuring the child's safety Making sure that the child is restrained Making sure that the parents are present during the procedure Ensuring the child trusts what the nurse is saying

Ensuring the child's safety

A school-age child is scheduled for a diagnostic procedure. Which nursing approach is best for this age group? Explain the procedure and the theory and reason behind it. Encourage the parents to discuss the procedure with their child. Provide a brief overview of the procedure to reduce anxiety. Offer to bring the child a favorite snack after the procedure is over.

Explain the procedure and the theory and reason behind it.

The nurse is assessing a child who is receiving TPN. The nurse determines the TPN bag was hung 24 hours ago. What initial action by the nurse is indicated? Hang a new bag of TPN. Document the amount of solution left in the bag and continue the administration. Increase the rate of the TPN to complete the bag. Discontinue the TPN bag and notify the physician.

Hang a new bag of TPN.

As the nurse prepares to administer a medication to a preschooler, the nurse realizes that the child is extremely underweight for age. What action would the nurse take? Give the child one-half the prescribed dose. Give the child the prescribed dose, because dose is determined by nomogram, not weight. Measure the child's height and weight, and check whether the dose is correct for the child. Call the child's health care provider and alert the provider to the dosage error.

Measure the child's height and weight, and check whether the dose is correct for the child.

Parents asks the nurse why their premature infant is receiving a feeding through the mouth rather than the nose. What is the best explanation by the nurse? It is equally acceptable to use either insertion site. Orogastric tube insertion can cause inflammation and obstruction of the nares. Newborns are obligate nose breathers so nasogastric may obstruct their breathing. Nasogastric tubes decrease the possibility of striking the vagal nerve.

Newborns are obligate nose breathers so nasogastric may obstruct their breathing.

To give eardrops to a 4-year-old child, what would be the best technique to use? Pull the pinna of the ear downward. Lift the pinna of the ear down and back. Press the pinna of the ear forward. Pull the pinna of the ear up and back.

Pull the pinna of the ear up and back.

The nurse is caring for a comatose school-age child receiving gastrostomy tube feedings. The nurse aspirates 15 ml of stomach contents prior to administering a feeding. What is the appropriate action by the nurse? Discard the stomach contents and continue with the feedings as prescribed. Replace the stomach contents and hold the feeding. Replace the stomach contents and continue with the feedings as prescribed. Discard the stomach contents and notify the health care provider of the aspiration amount.

Replace the stomach contents and continue with the feedings as prescribed.

A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client? Place the child on NPO status. Hold all medications until the vomiting stops. Request an intravenous form of the medication. Give an antiemetic prior to giving oral medications.

Request an intravenous form of the medication.

A parent informs the nurse about having a hard time getting her 6-year-old child to take the liquid medication at home. Which would be the best suggestion for the nurse to offer the parent to help correct this concern? Tell the parent to say calmly, "Can you drink this for me?" Tell the parent to ask the child nicely, "Will you drink this for me?" Tell the parent to state firmly, "It's time for you to drink your medicine." Tell the parent to tell the child, "It tastes just like candy!"

Tell the parent to state firmly, "It's time for you to drink your medicine."

A preschool-age child who is receiving gastrostomy feedings occasionally vomits following a feeding. When the parent describes the feeding process, what does the nurse note as the likely cause of the vomiting? The mother does not check gastric residual prior to feedings. Caretakers omit flushing the tube at the conclusion of bolus feedings. Bolus feedings are administered over a period of about 25 minutes. A feeding pump is used to administer the feedings.

The mother does not check gastric residual prior to feedings.

When administering medications to an infant, what information will the nurse consider? The infant will take oral medications more readily after he or she has been fed. The infant will take medications more readily if he or she is allowed to move the head as desired. The oral medication should be directed toward the side of the mouth when using a syringe or dropper. The infant will take a medication more readily if the flavor is disguised.

The oral medication should be directed toward the side of the mouth when using a syringe or dropper.

An infant is to have a scalp-vein intravenous infusion begun. What is an advantage of this insertion site? The scalp veins are easily visualized. Glucose is absorbed best from scalp veins. Infiltration cannot occur with this insertion site. The child will not feel pain from the needle insertion.

The scalp veins are easily visualized.

The nursing student identifies which technique as the correct one to use when giving oral medications to an infant? Use a dropper and squirt the liquid quickly into the back of the infant's mouth. Use a dropper and slowly inject the liquid into the side of the infant's mouth. Use a dropper and let it rest on the infant's tongue when squirting the medicine. Allow the child to lay flat while giving the liquid medication to relax the child.

Use a dropper and slowly inject the liquid into the side of the infant's mouth.

The nurse is preparing to administer an IV antibiotic to a child. After calculating the recommended dose with the child's weight, the nurse discovers the prescribed dose exceeds the safe dose range in a pediatric drug book. The medication has been given to the child at this dose for 3 days. What action should the nurse take next? Verify the dose with the prescribing health care provider. Give the prescribed dose since the child has been receiving that dose for 3 days. Ask the child's parents if this dose has been given all week. Call the pharmacy.

Verify the dose with the prescribing health care provider.

The nurse is working with parents who administer cycled total parenteral nutrition (TPN) over a 12-hour period at night to free their teenage son for activities during the day. In teaching this family, what areas would the nurse stress? Select all that apply. administering the solution at half-rate during the first and last hour of the infusion inspecting the insertion site of the catheter regularly storing the solution at room temperature until administered checking the teen's weight twice daily carefully calculating and counting the gravity drip rate

administering the solution at half-rate during the first and last hour of the infusion inspecting the insertion site of the catheter regularly

The nurse is caring for a 7-year-old with a low-profile gastrostomy tube placed 6 months ago. Which is the priority intervention to prevent irritation of the skin at the insertion site? cleaning the surrounding skin with soap and water daily plus keeping the area dry cleaning under the external disc or bumper with diluted hydrogen peroxide rotating the gastrostomy tube or button daily cleansing the skin around the site with an alcohol wipe after each feeding

cleaning the surrounding skin with soap and water daily plus keeping the area dry

The new graduate nurse is preparing to administer medication to a 4-year-old client. When would it be appropriate for the supervising nurse to intervene? The new graduate: explained why the medication was being administered. had two whole tablets to administer to the child. used the child's weight to calculate the dosage. is going to give an IM injection in the vastus lateralis.

had two whole tablets to administer to the child.

A child will be receiving a gastrostomy tube for long-term gastrostomy feedings. The surgeon is inserting a gastrostomy button. What are the advantages of the button placement? Select all that apply. more desirable cosmetically simple to care for less skin irritation than a tube shorter duration of tube insertion higher flow of enteral feeding

more desirable cosmetically simple to care for less skin irritation than a tube

When preparing to administer medication to an infant, the nurse should utilize which device? measured medication spoon infant formula and bottle oral syringe without a needle medicine cup

oral syringe without a needle

The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. The nurse expects the injection to be administered at which preferred site? butt deltoid thigh

thigh

The nurse is preparing to administer a vaccine to a 6-month-old child. The medication is to be given intramuscularly. The nurse is correct in choosing which administration site? deltoid muscle dorsogluteal site vastus lateralis site ventrogluteal site

vastus lateralis site