NUR 410 PEDS VSIM

The nurse is performing a physical assessment on a toddler and suspects hearing loss. What symptoms might indicate a problem? (Select all that apply.)

1. Incomplete formed pinna 2. Child leaning forward 3. Unclear speech White forelock on hair

The nurse is caring for a hospitalized infant at risk for developing increased intracranial pressure. Which assessment finding(s) would the nurse communicate to the health care provider for further intervention? Select all that apply.

1. Increased head circumference 2. Pulse rate of 60 beats/min and regular 3. Vomiting 4. Parent states, "My infant does not act right."

A nurse is caring for a 1-year-old child with a head injury. The child was previously unconscious but is now alert and oriented. Oral feedings are prescribed. The nurse determines that the child's risk for aspiration is low based on the presence of which reflex(es)? Select all that apply.

Gag Cough Swallow

The nurse is preparing a room for a child being admitted with meningitis. What is the appropriate action by the nurse?

Gather appropriate equipment and signage for respiratory isolation precautions.

A nursing instructor is teaching about eye disorders in childhood. Which statement made by a student indicates a need for further instruction?

"Cataracts are only present in adults."

The nurse is educating the parents of a 4-year-old boy who has been diagnosed with amblyopia. Which statement by the nurse would be most helpful for the parents?

"Give him a prize when he wears the patch."

The parents of a toddler have just learned that their child has profound hearing loss. The parents are very upset and state to the nurse, "It just isn't fair. We did everything right during our pregnancy all the way to this point." How should the nurse respond?

"I can't imagine how difficult this must be. When you're ready I would be happy to arrange a meeting with a support group of other parents with children who have hearing loss."

The nurse has just admitted a 17-year-old diagnosed with bacterial meningitis. The parents of the adolescent tell the nurse, "We just don't understand how this could have happened. Our child has always been healthy and also just received a booster vaccine last year?" How should the nurse respond?

"I understand your frustration. Unfortunately immunizations are not 100% effective in preventing the infection."

The nurse is teaching a parent how to medicate her 1-year-old child with corticosteroid eye drops. Which of the following instructions would the nurse include in the teaching plan?

"Remember to keep your ophthalmologist's appointments as scheduled."

The nurse is educating an 11-year-old child and her family about caring for her migraine headaches. Which of the following would the nurse most likely include in the child's teaching plan?

"Use the triptan at the first sign of the headache."

The parents of a child with infantile glaucoma are talking with the nurse about the disorder and the treatment options. Which statements by the parents require clarification by the nurse? Select all that apply..

1. "I am thankful that we will be able to manage this disorder with medications." 2. "Thankfully this isn't a serious disorder. We were afraid vision loss would be a possibility."

The nurse is caring for a toddler who was just diagnosed with a hearing impairment. What would the nurse expect to assess in the child?

A delay or lack of clear, understandable speech pattern

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis?

Avoid making noise when in the child's room.

To detect complications as early as possible in a child with meningitis who's receiving IV fluids, monitoring for which condition should be the nurse's priority?

Cerebral edema

The nurse is assessing a 9-year-old child who is suspected of having meningitis. The nurse assesses the child for meningeal irritation using the Kernig sign. Which result would the nurse interpret as positive?

Child reports pain behind the knee when leg is extended.

The nurse is caring for a 10-year-old child with bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick, yellow discharge. What should the nurse teach the patient about the care of the eye?

Clean the discharge away from the inner to outer canthus.

The nurse is caring for a child with hearing loss due to damage from chronic inner ear infections. The nurse knows that the child most likely has which type of hearing loss?

Conductive

The nurse is providing care to an infant with microcephaly. When reviewing the prenatal and birth history, the nurse would identify the mother's exposure to which infection as a potental contributing factor?

Cytomegalovirus

A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?

Decrease environmental stimulation

Which measures should receive priority when planning care for the child who is having surgery to remove a cataract?

Evaluation of intraocular pressure (IOP) and adherence to the occlusive patch regimen

A 9-year-old child with a history of epilepsy is brought to the emergency department. The child has been having a series of tonic-clonic seizures over the past 5 minutes and has not recovered from them between episodes. Which medication would the nurse anticipate being used to control the child's seizures?

Lorazepam

A child is brought to the emergency department and is experiencing status epilepticus. The nurse would expect to administer which treatment as first-line therapy?

Lorazepam

A 17-year-old is brought to the emergency department with a fever, headache, and stiff neck. Bacterial meningitis is suspected. The nurse would anticipate preparing the adolescent for which test to confirm the diagnosis?

Lumbar puncture

A nurse suspects that a child has developed pneumococcal meningitis based on assessment of which of the following?

Nuchal rigidity

A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges?

Positive Kernig sign

A nurse is administering ear drops to a 7-year-old girl. What should the nurse do?

Pull the pinna of the ear up and back to straighten the external ear canal.

To give eardrops to a 4-year-old child, what would be the best technique to use?

Pull the pinna of the ear up and back.

The nurse is planning care for a preschool-age child diagnosed with meningitis. What should the nurse identify as a priority goal for this patient's care?

Reduce the pain related to nuchal rigidity.

The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highestpriority?

Risk for injury

A child has recently been diagnosed with cataracts. The treatment for cataracts is:

Surgery

During the trial period to determine the efficacy of an anticonvulsant drug, which caution should be explained to the parents?

The child shouldn't participate in activities that could be hazardous if a seizure occurs

A child has been diagnosed with strabismus. After further examination, the patient is told that the resting position of the right eye is convergent. The nurse further explains that this means which of the following?

The resting position of the eye is turned in.

After administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason?

To ensure the medication stays in the eye

If a medication is being administered by the otic route, it will be administered in which way?

Warmed to room temperature and dropped into the ear

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply.

1. Oxygen gauge and tubing 2. Suction at bedside 3. Padding for side rails

A child is brought to the emergency department after experiencing a series of continuous seizures. The nurse is reviewing the orders for care and treatment. Which order would be of the highest priority?

Serum glucose level

A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client?

Conjunctivitis

A toddler is ordered amoxicillin for bilateral otitis media. The mother complains that the child refuses to take the oral medication. The nurse knows that more education is needed when the mother states:

I will shake the medication well, and draw up the medication to the top of the syringe. My husband and I will hold the child down and force the medication down his throat.

During the physical examination, the nurse notes a positive Kernig and Brudzinski sign. The nurse interprets these findings to suggest which condition?

Meningeal irritation

The nurse has finished teaching the mother of a 5-year-old male diagnosed with bacterial conjunctivitis how to manage her son's infection at home. Which statement by the mother would indicate a need for further education?

"I will use Visine drops in his infected eye to help reduce redness."