NURS 401 PrepU CH 40 (Pediatrics)

An 8-year-old with cystic fibrosis has had a noted decline on the growth chart. Which nursing intervention is best for maintaining adequate nutrition?

Provide high caloric meals to the client's liking. Delay pancreatic enzymes until food enters the small intestine. Encourage high calorie, high protein snacks. Limit sodium to a 2 gram sodium restricted diet Encourage high calorie, high protein snacks.

The nurse is taking a respiratory history of a newly admitted child. While documenting the symptoms the child has, what other item is important to document when taking a history on an altered respiratory status?

The child's weight The child's diet The child's hospital history The triggers in the environment The triggers in the environment

What is a symptom of bacterial pharyngitis?

fever rhinitis symptoms have gradual onset white blood cell (WBC) count in normal range fever

A 5-year-old girl who was already admitted to the hospital for an unrelated condition suddenly becomes irritable, restless and anxious. These may be early signs of respiratory distress in a child if accompanied by:

tachypnea. retractions. cyanosis. clubbing of fingers tachypnea.

A 9-year-old female child was brought to the emergency department after experiencing wheezing and shortness of breath while playing soccer. The parents administered two puffs of albuterol metered dose inhaler (MDI) with little effect, and 911 was notified. Paramedics applied oxygen 2 liters by nasal cannula for oxygen saturation of 90% on room air, and administered an albuterol nebulizer treatment. Audible wheezing was heard, and a 20-gauge intravenous (IV) catheter was inserted. Vital signs upon arrival at the emergency room: temperature, 98.8°F (37.1°C); heart rate, 125 beats/min; blood pressure, 88/50 mm Hg; respiratory rate, 32 breaths/min; oxygen saturation, 92% on simple face mask. Child appears anxious.

The emergency room nurse should first a) assess airway b) assess circulation c) assess LOC then a) administer IV methylprednisolone b) administer albuterol MDI c) instruct client to use peak flow meter assess airway, admin methylprednisolone

A nurse is caring for an infant admitted with a diagnosis of bronchiolitis. After completing an assessment, the nurse creates a plan of care for the infant. Which client goal would be priority in the plan of care?

The infant will attain oxygen saturation of 90% on room air. The infant's airway will remain clear and free of mucus. The infant's breathing will be less labored. The infant will have decreased nasal stuffiness. The infant's airway will remain clear and free of mucus.

The nurse is caring for a 7-year-old boy who has just had a tonsillectomy. Which intervention is least appropriate for this child?

Providing fluids by straw Applying an ice collar Placing the child on his side Discouraging the child from coughing Providing fluids by straw

A 5-year-old child is brought to the clinic by his father because the child developed a high fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs and symptoms? Select all that apply.

difficulty speaking drooling sitting with neck extended frightened appearance cough difficulty speaking drooling sitting with neck extended frightened appearance

The nurse is collecting data on a child admitted with a respiratory concern. The nurse notes that the child is anxious and sitting forward with the neck extended to breathe. The signs the nurse noted indicate the child likely has:

epiglottitis. asthma. cystic fibrosis. tuberculosis (TB). epiglottitis.

A female nurse of childbearing ages caring for a 2-year-old child diagnosed with bacterial pneumonia. The child has been placed in a mist tent. In caring for the child, it is important for the nurse to:

monitor the child regularly for signs of cyanosis. avoid contact with the mist. use contact transmission precautions. check for hyperthermia related to enclosure in the tent. monitor the child regularly for signs of cyanosis.

What is a complication of cystic fibrosis?

pneumothorax urinary tract infection kidney disease Crohn disease pneumothorax

The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to:

report ear pain. experience nuchal rigidity. have unilateral breath sounds upon auscultation. be at risk for respiratory distress. be at risk for respiratory distress.

The nurse identifies a nursing diagnosis of Ineffective airway clearance related to inflammation and copious thick secretions. What action is the priority?

suctioning secretions from the airway administering oxygen as ordered monitoring oxygen saturation by pulse oximeter administering analgesics as ordered suctioning secretions from the airway

The nurse is preparing to administer albuterol to a 14-year-old client for the first time. Prior to administration, which adverse reaction is priority for the nurse to educate the client?

tachycardia hypoactivity bronchial muscle relaxation increased appetite tachycardia

The caregivers of an 8-year-old bring their child to the pediatrician and report that the child has not had breathing problems before, but since taking up lacrosse the child has been coughing and wheezing at the end of every practice and game. Their friend's child has often been hospitalized for asthma; they are concerned that their child has a similar illness. The nurse knows that because the problems seem to be directly related to exercise, it is likely that the child will be able to be treated with:

decreased activity and increased fluids. corticosteroids and leukotriene inhibitors. removal of allergens in the home and school. a bronchodilator and mast cell stabilizers. a bronchodilator and mast cell stabilizers.

A client asks the nurse why a healthy newborn would be at risk for hypoxemia. How should the nurse reply?

"A newborn only has half of the number of alveoli developed, placing the newborn at risk." "A newborn would be at risk because the newborn has smaller lung volumes." "The shape of the chest and the smaller airway structures place the newborn at higher risk." "The newborn does not take in as much oxygen with each breath, placing the newborn more at risk." "A newborn only has half of the number of alveoli developed, placing the newborn at risk."

The nurse is performing a well-child assessment on a 2-week-old male infant. The mother asks why her baby only breathes out of his nose and does not seem to mouth breathe. What information can the nurse provide to the mother?

"Babies breathe from both their nose and mouth around 2 or 3 weeks of age." "Breathing from the nose only will be noted in newborns for about the first 6 weeks of life." "Your baby is breathing normally for his age." "Babies are nose breathers for about the first 4 weeks of life." "Babies are nose breathers for about the first 4 weeks of life."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with asthma. Which statement best indicates an understanding of the management and treatment for this diagnosis?

"We have taken the carpet out of our house and let my mom take our dog." "He knows how and even when he needs to use his peak flow meter." "Even the babysitter helps us keep up the diary with her symptoms." "The medications she takes are all in one place, ready for her to take at any time." "We have taken the carpet out of our house and let my mom take our dog."

At which age do children have a trachea 4 mm in width?

Newborn Toddler School-aged child Teenager Newborn

Which electrolyte does the client with cystic fibrosis need in abundance?

Potassium Sodium Chlorine Magnesium Sodium

Upon providing discharge instructions home after a tonsillectomy and adenoidectomy, which is most important?

Provide acetaminophen for pain. Note any frequent swallowing. Allow the child an age-appropriate, quiet plan. Stress regular fluid consumption. Note any frequent swallowing.

When preparing the room for an infant with bronchiolitis, which equipment is most important?

a tracheostomy set a metered dose inhaler IV antibiotics oxygen tubing and facemask oxygen tubing and facemask

A child has been admitted to the pediatric unit with pneumonia. The nurse is preparing to administer the prescribed medication to the child to help reduce the viscosity of the child's secretions. Which medication would the nurse most likely give?

guaifenesin albuterol dextromethorphan ipratropium guaifenesin

The nurse is providing education to a client newly diagnosed with asthma. Which statement by the parents indicates additional teaching is needed?

"We will keep an albuterol inhaler with our child at all times." "It is okay for our child to do chores such as sweeping the floor." "We will both enroll in smoking cessation classes." "Our family dog will need to go live with a grandparent." "It is okay for our child to do chores such as sweeping the floor."

The nurse is teaching home care to the parents of a 4-year-old client diagnosed with asthma. The nurse knows additional teaching is needed if the parents make which statement?

"We will not enroll our child in preschool this year." "It is important for us to know what triggers an attack." "We feel confident we can administer medication with a nebulizer." "Emergency instructions and phone numbers are posted in our home." "We will not enroll our child in preschool this year."

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2 saturation 95% on room air. Which action will the nurse take first?

Administer the bronchodilator via a nebulizer. Give the antibiotic as prescribed. Apply oxygen at 2 liters via a nasal cannula. Apply a cardiac monitor to the child. Administer the bronchodilator via a nebulizer.

A 4-year-old child has been admitted to the hospital with a diagnosis of pneumococcal pneumonia. The parents are extremely distraught over the child's condition and the fact that the child has not wanted to eat anything for the past 2 days. Which nursing approach would be most important to take to help alleviate the high anxiety level of the parents?

Allow the parents to remain with the child as much as possible. Encourage the parents to return home and get some rest. Tell the parents that their child is receiving the best care possible. Avoid telling the parents unnecessary facts regarding the child's prognosis. Allow the parents to remain with the child as much as possible.

What is the most common debilitating disease of childhood among those of European descent?

Cystic fibrosis Asthma Pneumonia BPD Cystic fibrosis

The caregivers of a child who was diagnosed with cystic fibrosis 5 months ago report that they have been following all of the suggested guidelines for nutrition, fluid intake, and exercise, but the child has been having bouts of constipation and diarrhea. The nurse tells the caregiver to increase the amount of which substance in the child's diet?

Iodized salt Saturated fat Pancreatic enzymes Calories from protein Pancreatic enzymes

The nurse is caring for a 6-week-old with symptoms of irritability, nasal stuffiness, difficulty drinking and occasional vomiting. Which assessment finding produces important information regarding the medical and nursing treatment plan?

Obtain testing for respiratory syncytial virus. Screen for the "allergic salute." Obtain vital signs to determine an infection. Draw a blood count to see if the client is septic. Obtain testing for respiratory syncytial virus.

Pancreatic enzymes are part of the treatment in cystic fibrosis. When should the nurse administer the enzymes?

Once a day Three times a day with water Before meals and snacks with milk At night after dinner Before meals and snacks with milk

During an assessment, a child exhibits an audible high-pitched inspiratory noise, a tripod stance and intercostal retractions. Using SBAR communication, the nurse notifies the health care provider and states which breath sounds that are congruent with the clinical presentation of the child?

Respiratory stridor Wheezing in the bases Rales in the middle lobe Rhonchi throughout the lung Respiratory stridor

Which nursing suggestion is the most helpful when discussing frequent allergic rhinitis (hay fever) attacks with a 12-year-old client and parent?

Take an antihistamine before known allergen exposure. Avoid offending allergen if at all possible. Consider identification of allergen and hyposensitization. Offer homeopathic suggestions on decreasing symptoms. Consider identification of allergen and hyposensitization.

The nurse is taking a health history for a 3-year-old girl suspected of having pneumonia who presents with a fever, chest pain, and cough. Which information places the child at risk for pneumonia?

The child is a triplet. The child was a postmaturity date infant. The child has diabetes. The child attends day care. The child attends day care.

The nurse caring for the child with asthma weighs the child daily. What is the most important reason for doing a daily weight on this child?

To determine medication dosages To monitor the child's growth pattern To ensure that the child's food intake is adequate To determine fluid losses To determine fluid losses

The nurse has assessed a 6-year-old child as having respiratory distress due to swelling of the epiglottis and surrounding structures. Which signs and symptoms would support this assessment?

The child is pale and has vomited. The child has pale, elevated patches on the skin. The child is irritable and tachycardiac. The child is in tripod position. The child is in tripod position.

The nurse working at the child community clinic must administer the influenza vaccine to the high-risk children first. Which child would she choose first?

12-month-old client who is very healthy 21-month-old client who has a cold 23-month-old client who had heart surgery as an infant for a defect 22-month-old client who has a wound from touching a hot pan at home 23-month-old client who had heart surgery as an infant for a defect

The nurse is assessing several children. Which child is most at risk for dysphagia?

7-month-old with erythematous rash 8-year-old with fever and fatigue 5-year-old with epiglottitis 2-month-old with toxic appearance 5-year-old with epiglottitis

The nurse is teaching the caregivers of a child with cystic fibrosis. What is most important for the nurse to teach this family?

Be sure the child exercises daily. Watch out for signs that family members are overly stressed. Avoid overprotecting the child. Encourage everyone in the family to use good handwashing techniques. Encourage everyone in the family to use good handwashing techniques.

A group of nurses is reviewing the diagnosis of cystic fibrosis. With regard to the effect of this disease on the body, which parts of the body (besides the lungs) are most affected by this disease?

Brain and spinal cord Pancreas and liver Heart and blood vessels Kidney and bladder Pancreas and liver

A nurse is teaching a group of parents about possible signs and symptoms of respiratory disorders. The nurse emphasizes that early detection is important in preventing more serious problems. The nurse determines that the teaching was successful when the group identifies which sign as often the first sign of a respiratory illness?

increased respirations cough with mucus blue coloring around the lips irregular breathing pattern increased respirations

A child with a suspected airway obstruction is brought to the emergency room. The child produces a harsh, strident sound on inspiration (stridor). Where should the nurse anticipate the obstruction is most likely to be located?

larynx lower trachea bronchioles pharynx larynx

A 2-year-old toddler is seen for acute laryngotracheobronchitis. What observation would lead the nurse to suspect airway occlusion?

The toddler states being tired and wanting to sleep. The respiratory rate is gradually increasing. The cough is becoming harsher. The nasal discharge is increasing. The respiratory rate is gradually increasing.

The nurse at a camp for children with asthma is teaching these children about the medications they are taking and how to properly take them. The nurse recognizes that many medications used on a daily basis for the treatment of asthma are given by which method?

Directly into the vein Through a gastrostomy tube Using a nebulizer Sprinkled onto the food Using a nebulizer

Which nursing diagnosis would best apply to a child with allergic rhinitis?

Pain related to sinus edema and headache Ineffective tissue perfusion related to frequent nosebleeds Disturbed self-esteem related to inherited tendency for illness Risk for infection related to blocked eustachian tubes Pain related to sinus edema and headache

When the nurse is reinforcing teaching with the caregiver of a 3-year-old child being discharged following a tonsillectomy, the caregiver states to the nurse, "I understand why there might be bleeding in the first 24 hours, but I do not understand why there might be bleeding in 1 week or so." What is the most appropriate explanation for the nurse to give this caregiver?

"Bleeding can occur at this time because the clots dissolve and new tissue is not yet present." "We do not usually do this surgery until the child is older, so postoperative bleeding is a possible complication because of the child's age." "By next week the child will be eating regular foods again, and the salt content may cause bleeding." "The child will have forgotten about the surgery by that time and might start coughing, and the pressure of coughing can cause bleeding." "Bleeding can occur at this time because the clots dissolve and new tissue is not yet present."

A 4-week-old infant is diagnosed with acute bronchiolitis. The parent states, "I do not know how the baby got this!" How should the nurse respond?

"Do you have allergies in the family?" "Do any family members have history of asthma?" "Do you have air conditioning in your house?" "Has your infant been around any crowds?" "Has your infant been around any crowds?"

The nurse is caring for a child with a history of cystic fibrosis (CF). Which finding will the nurse report to the primary health care provider?

Clubbing of the fingers Barrel chest Delayed puberty Wheezing Wheezing

The nurse is caring for a child who has been admitted with a possible diagnosis of tuberculosis. Which laboratory/diagnostic tools would most likely be used to help diagnose this child?

Purified protein derivative test Sweat sodium chloride test Blood culture and sensitivity Pulmonary functions test Purified protein derivative test

The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma?

"I'm going to have the respiratory therapist get some of the mucus from your lungs." "I'm going to have this hospital worker take a picture of your lungs." "We're going to go take a look at your lungs to see if there are any sores on them." "I'm going to hold your hand while the phlebotomist gets blood from your arm." "I'm going to have this hospital worker take a picture of your lungs."

A 4-year-old with bronchiolitis has been admitted to the hospital with respiratory compromise. The father asks the nurse why the physician won't prescribe an antibiotic, "My child just keeps getting worse." What is the best response by the nurse?

"Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses." "You have a very good physician who I trust completely. I'm sure everything possible is being done for your child." "Oftentimes it is more beneficial to treat the symptoms of bronchiolitis rather than try to kill the bacteria with an antibiotic." "Your physician probably doesn't want to take a chance of your child building up an immunity to the antibiotic in case the condition worsens and more antibiotics are needed." "Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses."

A child with asthma has been monitoring his peak expiratory flow rate (PEFR) and has been maintaining it within 90% of his personal best. Today, the child is experiencing symptoms and his PEFR is at 40% of his personal best. The child's mother calls the office and asks the nurse what she should do. What would the nurse instruct the mother to do first?

"Have him use his short-acting bronchodilator right away." "You need to take him to the emergency department right away." "Continue to watch his PEFR readings and call back if they go below 40%." "Have him use his low-dose steroid inhaler now and again in 15 minutes." "Have him use his short-acting bronchodilator right away."

The nurse is caring for a 5-year-old client and notes respiratory rate of 45 breaths per minute, blood pressure 100/70 mm Hg, heart rate 115, temperature 101°F (38.3°C), and oxygen saturation 86%. Which diagnostic test is priority for the nurse to complete?

Arterial blood gas (ABG) Complete blood count (CBC) Electroencephalogram (EEG) Pulmonary function test Arterial blood gas (ABG)

The nurse is caring for a child with a history of asthma who presents to the emergency department with wheezing, tachypnea, and dyspnea. What will the nurse do first?

Ask what may have triggered the attack. Place the child in a high-Fowler position. Assess the child's pulse oximetry reading. Apply oxygen via nasal cannula at 2 liters. Place the child in a high-Fowler position.

The nurse is assessing an infant who has been admitted with acute bronchiolitis. Which probable cause should the nurse suspect?

bacterial infection environmental allergy prenatal complication viral infection viral infection

The nurse is collecting data on a child with a diagnosis of tonsillitis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

bark-like cough hoarseness erythema of the pharynx inability to make audible voice sounds erythema of the pharynx