PDQ CH 20

17. A mother calls the outpatient clinic requesting information on appropriate dosing for over-the-counter medications for her 13-month-old who has symptoms of an upper respiratory tract infection and fever. The box of acetaminophen says to give 120 mg q4h when needed. At his 12-month visit, the nurse practitioner prescribed 150 mg. What is the nurse's best response?

"The nurse practitioner ordered the drug based on weight, which is a more accurate way of determining a therapeutic dose."

40. A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 ml/8 hr is being infused rather than the ordered amount 300 ml/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours?

300 ml

2. A physician's prescription reads, "ampicillin sodium 125 mg IV every 6 hours." Themedication label reads, "1 g = 7.4 ml." A nurse prepares to draw up _____ milliliters toadminister one dose. (Round your answer to two decimal places.)

ANS: 0.93

1. A 6-month-old infant is admitted to the pediatric unit with respiratory syncytial virus (RSV). The nurse places the infant on strict intake and output. The infant is in a size #2 diaper and the dry weight is 24 g. At the end of the shift, the infant has had two diapers with urine. One diaper weighed 56 g and one weighed 65 g. What is the total milliliter output for the shift?(Record your answer as a whole number below.)

ANS: 73

1. A child with congestive heart failure is placed on a maintenance dosage of digoxin (Lanoxin).The dosage is 0.07 mg/kg/day, and the child's weight is 7.2 kg. The physician prescribes thedigoxin to be given once a day by mouth. Each dose will be _____ milligrams. (Record youranswer below using one decimal place.)

ANS:0.5

28. When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration?

Administer the medication with a syringe (without needle) placed along the side of the infant's tongue.

3. Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. What is the most appropriate nursing action?

Allow her to wear her underpants

23. The Allen test is performed as a precautionary measure before which procedure?

Arterial puncture

21. Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. Which is the most appropriate way to collect small amounts of urine for these tests?

Aspirate urine from cotton balls inside the diaper with a syringe.

36. It is important to make certain that sensory connectors and oximeters are compatible. What can ncompatible wiring cause?

Burns under sensors

14. The nurse approaches a group of school-age patients to administer medication to Sam Hart. What should the nurse do to identify the correct child?

Check the patient's identification name band

37. The nurse is teaching a mother how to perform chest physical therapy and postural drainage on her -year-old child, who has cystic fibrosis. How should the nurse instruct the mother?

Cover the skin with a shirt or gown before percussing.

4. Using knowledge of child development, which is the best approach when preparing a toddler for a procedure?

Demonstrate the procedure on a doll.

16. The nurse gives an injection in a patient's room. The nurse should perform which intervention with the needle for disposal?

Dispose of syringe and needle in a rigid, puncture-resistant container in the patient's room.

31. Several types of long-term central venous access devices are used. Which is considered an advantage of a Hickman-Broviac catheter?

Easy to use for self-administered infusions

38. The nurse must suction a child with a tracheostomy. What is the appropriate technique?

Ensure each pass of the suction catheter should take no longer than 5 seconds.

11. A 3-year-old child has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102° F even though she had acetaminophen 2 hours ago. The nurse's action should be based on which statement?

Fevers such as this are common with viral illnesses.

9. What is an appropriate intervention to encourage food and fluid intake in a hospitalized child?

Give high-quality foods and snacks whenever the child expresses hunger.

5. The nurse is preparing a 12-year-old girl for a bone marrow aspiration. The girl tells the nurse she wants her mother with her "like before." What is the most appropriate nursing action?

Grant her request

32. When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

In the conjunctival sac that is formed when the lower lid is pulled down

19. A venipuncture will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. What information should the nurse include in her response to the child?

It is helpful to relax the child.

25. The nurse has just collected blood by venipuncture in the antecubital fossa. Which should the nurse do next?

Keep the arm extended, and apply pressure to the site for a few minutes.

27. What is an appropriate method for administering oral medications that are bitter to an infant or small child?

Mix with a small amount (1 teaspoon) of a sweet-tasting substance such as jam or

7. In some genetically susceptible children, anesthetic agents can trigger malignant hyperthermia. The nurse should be alert in observing that, in addition to an increased temperature, what is an early sign of this disorder?

Muscle rigidity

41. In preparing to give "enemas until clear" to a young child, the nurse should select whichsolution?

Normal saline

34. What should the nurse do when caring for a child with an intravenous infusion?

Observe the insertion site frequently for signs of infiltration.

39. How should the nurse administer a gavage feeding to a school-age child?

Position the patient on the right side after administering feeding.

20. A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what is the nurse's best action?

Prepare child for conscious sedation during the test.

26. A nurse must do a venipuncture on a 6-year-old child. What is an important consideration in providing atraumatic care?

Restrain the child only as needed to perform venipuncture safely.

13. Tepid water or sponge baths are indicated for hyperthermia in children. What is the priority nursing action?

Stop the bath if the child begins to chill.

6. The emergency department nurse is cleaning multiple facial abrasions on a 9-year-old child whose mother is present. The child is crying and screaming loudly. What is the best nursing action?

Tell the child it is okay to cry and scream

2. The nurse is planning to prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include which action?

Tell the child that procedures are never a form of punishment.

1. Which should the nurse consider when having consent forms signed for surgery and procedures on children?

The risks and benefits of a procedure are part of the consent process.

12. A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen (Tylenol). What should the nurse explain about antipyretics?

They are of no value in treating hyperthermia

8. The nurse is caring for an unconscious child. Skin care should include which action?

Use draw sheet to move child in bed to reduce friction and shearing injuries.

29. Which is the preferred site for intramuscular injections in infants?

Vastus lateralis

15. The nurse wore gloves during a dressing change. What should the nurse do after the gloves are removed?

Wash hands thoroughly

2. A nurse is caring for a child in droplet precautions. Which instructions should the nurse give to the unlicensed assistive personnel caring for this child? (Select all that apply.)

Wear gloves when entering the room. Wear an isolation gown when entering the room. Wash your hands upon exiting the room.

1. The nurse is preparing to insert a nasogastric tube into a 4-year-old child for intermittentsuctioning after abdominal surgery. Place in correct sequence the steps for inserting anasogastric tube. Provide the answer using lowercase letters separated by commas (e.g., a, b,c, d, e, f).

Place the child in the supine position with head slightly hyperflexed. Measure the tube from the tip of the nose to the ear lobe to midpoint between the xiphoid process and the umbilicus. Insert the nasogastric tube through the nares. Check the placement of the tube by aspirating stomach contents. Lubricate the nasogastric tube with water-soluble lubricant. Tape the nasogastric tube securely to the child's face.

33. A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. Which best explains why an intraosseous infusion is started?

Rapid venous access is not possible.

18. An 8-month-old infant is restrained to prevent interference with the IV infusion. How should the nurse appropriately care for this child?

Remove restraints whenever possible.

10. A 6-year-old child is hospitalized for intravenous (IV) antibiotic therapy. He eats little on his "regular diet" trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which is the best nursing action?

Request these favorite foods for him.

35. What is a nursing consideration related to the administration of oxygen in an infant?

Ensure uninterrupted delivery of the appropriate oxygen concentration.

22. Which is an important nursing consideration when performing a bladder catheterization on a young boy?

Insert 2% lidocaine lubricant into the urethra.

30. Guidelines for intramuscular administration of medication in school-age children include which action?

Insert needle quickly, using a dart like motion.

1. The advantages of the ventrogluteal muscle as an injection site in young children include which considerations? (Select all that apply.)

Less painful than vastus lateralis Free of important nerves and vascular structures Easily identified by major landmarks

24. The nurse must do a heel stick on an ill neonate to obtain a blood sample. What action is recommended to facilitate blood flow?

Wrap the foot in a warm washcloth.

42. The nurse is doing a pre-hospitalization orientation for a 7-year-old child who is scheduled foR cardiac surgery. As part of the preparation, the nurse explains that she will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is:

an appropriate part of the child's preparation.