OB/PEDS (Workbook) 38 & 39
Abrupt eruption of a _______ warrants immediate medical attention.
petechial or purplish rash
A pregnant client asks if there is any danger to the development of her fetus in the first few weeks of her pregnancy. How should the nurse respond?
"During the first 3 to 4 weeks of pregnancy brain and spinal cord development occur and are affected by nutrition, drugs, infection, or trauma"
A child has been diagnosed with bacterial conjunctivitis. Which statements by the child's parent indicate the need for further education
"I'll continue to use the eye drops to help with redness" "He can go back to school in 4 hours after that thick yellow drainage is gone"
The nurse is providing education to the parents of a 3-year-old girl with hydrocephalus who has just had an external ventricular drainage system placed. Which question is best to begin the teaching session
"What questions or concerns do you have about this device"
The meningococcal vaccine should be offered to high-risk populations. If never vaccinated, who has an increased risk of becoming infected with meningococcal meningitis?
18-year-old student who is preparing for college in the fall and has signed up to live in a dormitory with two other suite mates 12-year-old child with asthma 5-year-old child who routinely travels in the summer with her parents on mission trips to Haiti 9-year-old child who was diagnosed with diabetes mellitus when he was 7 years olf
According to Healthy People 2020 recommendations, visual acuity testing should begin at ______ years of age
3
The nurse works in a pediatrician office. Which children, who have been diagnosed with acute otitis media, does the nurse expect the physician to treat with antibiotics?
8-year-old child who is crying due to ear pain and has a temperature of 103 F 2-month-old child who is having difficulty sleeping and has a fever of 102.6 F 5-month-old child who is fussy and pulling at her ears
The nurse is caring for a near-term pregnant woman who has not taken prenatal vitamins or folic acid supplements. Which congenital defect is most likely to occur based on the mother's prenatal history?
A neural tube defect
The nurse is caring for a 10-year-old girl with acute periorbital cellulitis. Which nursing intervention (therapy) is primary for this disorder?
Administering antibiotics IV as ordered
The nurse is caring for a 24-month-old boy with regressed retinopathy of prematurity. Which intervention is priority for this child?
Assessing the child for asymmetric corneal light reflex
The nurse is explaining information to the parents of a 3-year-old boy who may have strabismus. The nurse should explain that which examinations will be performed first to find out if he has strabismus?
Corneal light reflex test
The young boy was involved in a motor vehicle accident and was admitted to the pediatric intensive care unit with changes in level of consciousness and a high-pitched cry. Which are late signs of increased intracranial pressure?
The child's toes are pointed downward, his head and neck are arched backward, and his arms and legs are extended The child's heart rate is 56 bpm The child's pupils are fixed and dilated
The nurse is caring for a 7-year-old girl in an outpatient clinic diagnosed with amblyopia that is unrelated to any other disorder. Which intervention should be most helpful at this time?
Educating parents on how to use prescribed atropine drops
The nurse is teaching parents of a 9-year-old girl about the importance of wearing the prescribed glasses. Which subject is least important to promoting compliance?
Encouraging the use of eye protection for sports
The nurse is caring for an 8-year-old boy with otitis media with effusion. Which situation may have caused this disorder?
He is experiencing recurrent nasal congestion
During physical assessment of a 2-month-old infant, the nurse suspects the child may have a lesion on the brain stem. Which symptom was observed?
Horizontal nystagmus
The nurse is educating the parents of a 4-year-old boy with strabismus. Teaching for the parents would include the:
Importance of patching as prescribed
The young child has been diagnosed with bacterial meningitis. Which nursing interventions are appropriate?
Initiate droplet isolation Identify close contacts of the child who will require postexposure prophylactic medication Administer antibiotics as ordered Initiate seizure precautions
An 11-year-old child was recently diagnosed with chickenpox. His parents gave him aspirin for a fever and the child is now hospitalized. Which nursing interventions are appropriate for this child?
Request order for an antiemetic Assess intake and output every shift Request order for anticonvulsant
The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity?
Moving the infant's head every 2 hours
The pediatric office nurse notes that several of the young children that are waiting to see the physician may have conjunctivitis. Which findings are consistent with bacterial conjunctivitis?
Only the right eye is involved The drainage is yellow and thick
The nurse is caring for a 2-year-old girl with persistent otitis media with effusion. Which intervention is most important to the developmental health of the child?
Reassessing for language acquisition
After a difficult birth, the nurse observes that a newborn has swelling on part of his head. Which sign suggests cephalohematoma?
Swelling does not cross the suture lines
A 1o-year-old boy has just been treated for otitis externa and now the nurse is teaching the boy and his parents about prevention. Which recommendation should the nurse include?
Using a hair dryer on cool to dry the ears
The nurse is caring for a 3-year-old boy who is experiencing seizure activity. Which diagnostic test will determine the seizure area in the brain
Video electroencephalogram
The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder?
Washing hands frequently
Delay in language _______________ may occur due to hearing impairment.
acquisition
Among the useful tools for identifying ____________ are the corneal light reflex test and the cover test.
amblyopia
Screening for and treating for _______ is critical to appropriate visual acuity development.
amblyopia
Bacterial otitis media usually requires treatment with ________.
antibiotics
Systemic ______ are used to treat periorbital cellulitis
antibiotics
During auscultation, a loud or localized ______ indicates the need for immediate further investigation
bruit
Variation in head _________ percentiles over time may indicate abnormal brain or skull growth
circumference
Vision or hearing impairment impedes _______ progress
developmental
The nurse has developed a nursing plan for the care of a 6-year-old girl with congenital hydrocephalus whose shunt has become infected. The most important discharge teaching point for the family is
ensuring the parents know how to properly give antibiotics
______ are typically benign seizures associated with a fever and viral illness.
febrile seizures
A bulging ______________can be a sign of increased intracranial pressure (ICP).
fontanelle
Changes in ________, muscle tone, or strength may indicate certain neurologic problems
gait
Infantile glaucoma is frequently associated with other __________ disorders.
genetic
________ may indicate the need for a change in eyeglass prescription.
headaches, eye strain, and dizziness
Short length and ______ position of eustachian tubes leads to greater susceptibility of acute otitis media in children less than 2 years of age
horizontal
Sunset eyes are an early sign of
increased intracranial pressure
The major complications associated with shunts are __________ and ___________.
infection and malfunction
______ pressure is inversely related to level of consciousness
intracranial
The _______ sign is an indication of meningitis
kernig
Recurrent otitis media negatively impacts the child's ability to hear, thus may delay ______ development.
language
The optic nerve is not completely ______________ at birth.
myelinated
Prematurity, difficult delivery, and infection during pregnancy are risk factors associated with
neurologic disorders
The infant with bacterial meningitis may rest in the ____________position.
opisthotonic
Lack of response to _______ stimuli can indicate a life-threatening condition
painful
Chronic otitis media may require treatment with ________
pressure-equalizing tube placement
A family teaching plan for a child with epilepsy should include instructions for
responding to seizures for parents, family, teachers, and day care workers
These surgically implanted electronic devices are a treatment for _______ hearing loss.
sensorineural
Young children have __________ placing them at higher risk for ear infections as compared with older children and adults.
shorter, more horizontally situated Eustachian tubes
________ will lead to visual impairment if not treated.
strabismus
Some infectious eye disorders may be treated with ____________ ophthalmic medications.
topical
When assessing sensory function in an infant, limit the examination to ______ or pain
touch
The nurse is caring for an 8-year-old girl who was in a car accident. Which symptoms suggests the child has a cerebral contusion?
trouble focusing when reading
To measure tympanic eardrum movement, utilize ____________.
tympanometry
Neurologic disorders result from ________________ problems, infections, or traumas.
congenital
The young child has been diagnosed with a corneal abrasion. Which findings are most consistent with this diagnosis?
The child's pupils are equal, round, reactive to light and accommodation The child reports that it hurts to look toward the light The child's eye is draining clear fluid and the child says it feels like it is full of tears
Warm compresses are helpful in the treatment of ____________.
conjunctivitis
Decorticate posturing occurs with damage of the cerebral ____________.
cortex
Permanent visual ____________ can be averted with early identification and treatment of amblyopia
deterioration
The spherical shape of the newborn's lens does not allow for ___________ accommodation
distance
The _______ maneuver can be helpful in assessing cranial nerves III, IV, and VI in an infant, uncooperative child, or comatose child
doll's eye
The parents of children with chronic neurologic disorders will require large amounts of __________________ and support throughout the child's lifetime.
education
A care plan for a child with neonatal seizures will include ensuring adequate ____________, correcting any underlying metabolic disturbances, and administering anticonvulsant therapy.
ventilation
