Pediatric Nursing - The School-Age Child
Which statement by the mother of a child who is receiving pancreatic enzymes for the treatment of cystic fibrosis indicates that the mother understands the teaching? "I should give the medicine about 1 hour before meals." "I can sprinkle the enzymes on food." "I will give the enzymes when my child is sick." "I will give the medication when my child has diarrhea."
"I can sprinkle the enzymes on food."
Which statement indicates that the parents understand the need for their child to receive long-term antibiotic therapy after an episode of rheumatic fever? "It will prevent further streptococcal infections." "It will protect against further joint damage." "The inflammation will subside more quickly." "The inflammation will be reduced with future attacks."
"It will prevent further streptococcal infections."
Which intervention would be most appropriate to institute when a school-age child with burns becomes angry and combative when it is time to change the dressings and apply mafenide acetate? Ensure parental support during the dressing changes. Allow the child to assist in removing the dressings and applying the cream. Give the child permission to cry during the procedure. Allow the child to schedule the time for dressing changes.
Allow the child to assist in removing the dressings and applying the cream.
The nurse is educating parents of first graders about child sexual abuse. What is the most critical information the nurse should convey to the parents? Most cases of child sexual abuse are committed by neighbors. An adult who sexually abuses a child is usually known to the child. Parents are usually the first people to see the signs of sexual abuse. Children often keep the contact a secret to avoid getting into trouble.
An adult who sexually abuses a child is usually known to the child.
A school-age child hospitalized with acute poststreptococcal glomerulonephritis during the acute stage has elevated blood pressure and low urine output for 14 hours. What should the nurse do next? Assess the child's neurologic status. Encourage the child to drink more water. Advise the child to eat a low-sodium breakfast. Help the client to ambulate in the hallway.
Assess the child's neurologic status. The nurse should assess the child's neurologic status because hypertensive encephalopathy is a major potential complication of the acute phase of glomerulonephritis. Seizure precautions also should be instituted. Hypertensive encephalopathy can result in transient loss of vision, hemiparesis, disorientation, and grand mal seizures. Encouraging the child to drink more water is inappropriate because the child has had a low urine output for 14 hours. Typically, in this situation, fluids would be restricted. Although a low-sodium diet is encouraged, it is not the priority action at this time. Initially, bed rest, not ambulation, is advocated during the acute phase of glomerulonephritis.
The primary care provider prescribes cefepime 250 mg every 6 hours for a child weighing 25 kg who had infected burns. The normal dosage for this antibiotic and condition is 20 to 50 mg/kg per 24 hours. Which actions would be most appropriate? Carry out the prescription because the prescribed dose is acceptable. Give the dose recommended by the pharmacy reference material. Question the prescription because the dose is too low. Question the prescription because the dose is a toxic amount.
Carry out the prescription because the prescribed dose is acceptable.
Which intervention should the nurse implement to help reduce eyelid edema in a child with nephrotic syndrome? Apply cool compresses to the child's eyes. Elevate the head of the child's bed. Instill eye drops every 8 hours. Limit the child's television watching.
Elevate the head of the child's bed.
An 8-year-old child is admitted with a T3 spinal cord compression following a motor vehicle accident. The child has an abrupt onset of elevated blood pressure, headache, profuse sweating, and flushing of the skin. What is the priority action for the nurse to take? Place the child in a supine position. Administer a fluid bolus. Empty the child's bladder. Obtain a blood glucose level.
Empty the child's bladder. Autonomic dysreflexia is an emergency condition that can occur in children with spinal cord injuries above T6. The response is often triggered by a full bladder. Treatment includes placing the child in an upright position and emptying the bladder. Supine positioning, fluids, and blood glucose will not relieve the autonomic dysreflexia.
A school-age child was recently hospitalized at a child psychiatric unit for inattention and acting out behavior at school and home. His provider prescribed the methylphenidate patch to control his attention deficit hyperactivity disorder symptoms, and inpatient unit staff worked with him on behavioral control measures. During his first office visit after his discharge from the hospital, the office nurse discovers that the boy has been taking off his patch during the day, which is causing problems at school and at home. In which order of priority from first to last should the nurse take the actions? All options must be used. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Explore the child's reasons for removing the patch during the day rather than at the end of the day. 2Explore the parents' attitudes about the medication administration in general and their child's medication in particular. 3Explain to the family, in terms the child can understand, the benefits of his medication in dealing with school and home problems he is experiencing. 4Have the provider discuss with the child and parents a trial of a different medication.
Explore the child's reasons for removing the patch during the day rather than at the end of the day. Explore the parents' attitudes about the medication administration in general and their child's medication in particular. Explain to the family, in terms the child can understand, the benefits of his medication in dealing with school and home problems he is experiencing. Have the provider discuss with the child and parents a trial of a different medication.
The clinic nurse is teaching caregivers of a 6-year-old client how to administer eye drops for bacterial conjunctivitis. Which will the nurse include in the plan of care? Select all that apply. Administer eye drops after the eye drops have been refrigerated overnight. Remove any drainage from the eye prior to administration of the eye drops. Position the client in a prone position with eyes closed. After administration of the eye drops, keep the eye lid closed for several seconds. Encourage the client to rub the eyes after eye drops are administered.
Remove any drainage from the eye prior to administration of the eye drops. After administration of the eye drops, keep the eye lid closed for several seconds.
The school nurse learns that at least one of the children in the school has a new diagnosis of erythema infectiosum (human parvovirus) after developing a bright red facial rash. What interventions should be implemented to prevent a possible spread of the infection to other students in the school? Require the client to remain at home until the rash fades. Remove the pets from the classroom. Teach everyone to implement hand hygiene. Administer acetaminophen to the client.
Teach everyone to implement hand hygiene.
When talking with 10-year-old children about death, the nurse should incorporate which guidelines? Select all that apply. Logical explanations are not appropriate. The children will be curious about the physical aspects of death. The children will know that death is inevitable and irreversible. Attitudes of the adults in their lives will influence the children. Teaching about death and dying should not start before age 11 years. Teach children that death is the same as going to sleep as a way of relieving fear.
The children will be curious about the physical aspects of death. The children will know that death is inevitable and irreversible. Attitudes of the adults in their lives will influence the children.
An adolescent client is having surgery to repair a fractured left femur. As a part of the preoperative safety checklist, what should the nurse do? Ask the teen to point to the surgery site. Verify that the site, side, and level are marked. Ask the parents if they have signed the operative permit. Restate the surgery risks to the parents.
Verify that the site, side, and level are marked.
Which beverage should the nurse plan to give a child with leukemia to relieve nausea? orange juice weak tea plain water a carbonated beverage
a carbonated beverage
When developing the plan of care for a child with cystic fibrosis (CF) who is scheduled to receive postural drainage, the nurse should anticipate performing postural drainage at which times? after meals before meals after rest periods before inhalation treatments
before meals
A mother is concerned about her 9-year-old child's compulsion for collecting things. The nurse's explanation is based on the understanding that this behavior is related to the cognitive ability to perform which functions? concrete operations formal operations coordination of secondary schemata tertiary circular reactions
concrete operations
When taking a diet history from the mother of a 7-year-old child with phenylketonuria, a report of an intake of which food should cause the nurse to gather additional information? diet cola carrots orange juice bananas
diet cola Foods with low phenylalanine levels include vegetables, fruits, and juices. Foods high in phenylalanine include meats and dairy products, which must be restricted or eliminated. Diet colas contain more phenylalanine than the fruits listed.
The nurse discusses the eating habits of school-age children with their parents, explaining that these habits are most influenced by which factor? food preferences of their peers smell and appearance of foods offered examples provided by parents at mealtimes parental encouragement to eat nutritious foods
examples provided by parents at mealtimes
A child has a urinary tract infection and is being treated with antibiotics. The nurse should instruct the parents to report which symptom? increased urine output loss of appetite jaundice fever
fever
A 6-year-old child with a history of varicella and aspirin intake is brought to the emergency department. The nurse suspects Reye's syndrome. Which assessment findings are consistent with this syndrome? fever, decreased level of consciousness (LOC), and impaired liver function joint inflammation, red macular rash with a clear center, and low-grade fever peripheral edema, fever for 5 or more days, and "strawberry tongue" red, raised "bull's eye" rash, malaise, and joint pain
fever, decreased level of consciousness (LOC), and impaired liver function
According to Erikson's psychosocial theory of development, an 8-year-old child would be in which stage? trust versus mistrust initiative versus guilt industry versus inferiority identity versus role confusion
industry versus inferiority
After a car accident, a 10-year-old child is treated in the emergency department for a fractured clavicle and evaluated for a possible head injury. What is the priority nursing measure? orientation assessment breath sound auscultation initiation of intravenous therapy ambulation assessment
orientation assessment
A client is admitted to the emergency department with abdominal pain. The client's caregiver states the pain began about 12 hours ago. The nurse notes the client has a temperature of 100.8° F (38.2° C) and nausea. The client vomited once. Which abdominal area would be most appropriate for the nurse to assess? left lower abdominal quadrant right upper abdominal quadrant left upper abdominal quadrant right lower abdominal quadrant
right lower abdominal quadrant
When teaching the child with scoliosis being treated with a Boston brace about exercises, the nurse explains that the exercises are performed primarily for what reason? to decrease back muscle spasms to improve the brace's traction effect to prevent spinal contractures to strengthen the back and abdominal muscles
to strengthen the back and abdominal muscles
A 12-year-old child has been receiving aggressive treatment for leukemia for the past year. The child's prognosis is poor and the parents would like to implement a do-not-resuscitate order. They ask the nurse to discuss their decision with their child because they can't bring themselves to talk with the child about it. When approaching this subject with the child, the nurse must first assess: what the child knows about the disease. how the child would like to handle the care plan. what interventions the child would like implemented in the event of cardiac or respiratory arrest. the child's experiences with death.
what the child knows about the disease. When discussing a child's wishes for future care, a nurse must first identify what the child knows about the disease. How severe the child perceives the illness to be will significantly affect the child's thoughts about realistic outcomes. A care plan proposed by a child who doesn't understand the disease process or prognosis won't effectively or realistically reflect the child's actual health status. A child who doesn't understand the disease process or prognosis might feel frightened or threatened by questions about what interventions the child would like to have implemented in the event of cardiac or respiratory arrest. Although exploring the child's experiences with death would be important, it shouldn't be the initial area of discussion.