Pediatrics Ch. 21

Which statement best represents infectious mononucleosis?

Herpes-like Epstein-Barr virus is the principal cause.

What complication does the nurse expect in a child with cystic fibrosis?

Prolapse of the rectum

What is the most appropriate nursing intervention for a child after tonsillectomy?

Watching for continuous swallowing

What type of diet do children with cystic fibrosis require?

A well-balanced high-protein, high-calorie diet

Because the absorption of fat-soluble vitamins is decreased in cystic fibrosis, which vitamin supplementation is necessary?

A, D, E, K

The nurse is educating a group of parents about the hazards of aspiration of foreign bodies (FBs). What does the nurse teach about immediate measures to relieve an emergency obstruction in a 2-year-old child?

Abdominal thrust

A nurse is caring for a 3-year-old child who has rapidly progressing dysphagia and stridor. The child also has a high fever and rapid pulse and respirations. What syndrome does this child most likely have?

Acute epiglottitis

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent what?

Acute rheumatic fever

What should the nurse teach the parents of a school-age child with nasal blockage about the use of vasoconstrictive nose drops? Select all that apply.

Administer the drops 15 to 20 minutes before feeding. Avoid using the same bottle for more than one illness. Avoid using the same bottle for more than one child.

What therapeutic management would the nurse expect the primary health care provider to prescribe for an infant with nasopharyngitis?

Antipyretic

The nurse is caring for a child admitted to the health care facility following a fire accident. The child is breathing well. Which intervention does the nurse perform first?

Assess for obstruction

What conditions weaken the defenses of the respiratory tract and predispose children to infection?

Asthma, history of respiratory syncytial virus infection, cystic fibrosis

What symptom would the nurse expect to find in a child with acute laryngotracheobronchitis (LTB)?

Barky, brassy cough

What clinical manifestations in the child would the nurse relate to asthma? Select all that apply.

Barrel chest Elevated shoulders Flattened malar bones

What is the most appropriate time to perform bronchial postural drainage?

Before meals and at bedtime

One of the goals for children with asthma is to prevent respiratory tract infection because of which effect?

Can trigger an episode or aggravate an asthmatic state

What age group is most affected by bronchitis?

Children ages 4 and under

What manifestations does the nurse identify in a child that indicate the need for an adenoidectomy? Select all that apply.

Chronic otitis media with effusion Recurrent nasopharyngitis Sleep-disordered breathing

What category of medication is the first-line therapy for inflammation in children with asthma?

Corticosteroids

The nurse is caring for a child with foreign body aspiration. For which manifestation does the nurse first observe to evaluate for an obstruction?

Coughing and gagging

What endocrine disorder is commonly found in children with cystic fibrosis?

Diabetes mellitus

What nursing interventions will help prevent ventilator- associated pneumonia in children? Select all that apply.

Evaluating the patient daily for extubation Draining the ventilator circuit before repositioning the patient Hand hygiene before and after contact with the ventilator circuit

What triggers tend to precipitate or aggravate asthma in children? Select all that apply.

Exercise Tobacco smoke Thyroid disease

What therapeutic management methods would the nurse expect will be applied for a child with bronchiolitis?

Humidified mist

What care must the nurse take when performing the tuberculin skin test for a child?

Inject in such a way that a visible wheal appears on the skin.

What does the nurse recognize as the primary factor responsible for multiple clinical manifestations of cystic fibrosis?

Increased viscosity of mucous gland secretions

What is the most appropriate way to administer penicillin G procaine or penicillin G benzathine suspension?

Intramuscularly

What is the most profound complication of prolonged middle ear disorders?

Loss of hearing

Asthma is classified in four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. What are the clinical features used to determine these categories? Select all that apply.

Lung function Frequency of symptoms Frequency and severity of exacerbations Degree of interference with normal activities

What should the nurse teach the family about reducing the risk of otitis media (OM) in the child than 2 years of younger age? Select all that apply.

Maintain routine childhood immunizations. Breastfeed the child until 6 months of age. Eliminate tobacco smoke and allergens.

What is the earliest postnatal manifestation of cystic fibrosis?

Meconium ileus

What are some triggers that precipitate or aggravate asthma exacerbations? Select all that apply.

Medications Strong emotions Indoor allergens

The nurse is caring for a 3-year-old with asthma. The parents state that the child has symptoms three times a week, once a day. They give the child a short-acting B-agonist for symptom control 1 day a week. What is this child's asthma severity classification?

Mild persistent

What clinical manifestation would the nurse expect to note when a pneumothorax occurs in a neonate who is undergoing mechanical ventilation?

Nasal flaring and retractions

What is the first line of treatment for the child with epiglottitis and severe respiratory distress?

Nasotracheal intubation or tracheostomy

What are some clinical manifestations of acute epiglottitis? Select all that apply.

Pain Fever Drooling Tripod position

A 4-year-old child is brought to the emergency department. The child exhibits a "froglike" croaking sound on inspiration, is agitated, and is drooling. The child insists on sitting upright. What is the priority action by the nurse?

Notify the health care provider immediately and monitor airway patency.

What must the nurse teach the parents of the child with streptococcal pharyngitis?

Orthodontic appliances used by the child must be washed thoroughly.

In the planning of care for a 2-year-old admitted with bacterial tracheitis, what are the priorities of care in the therapeutic management of this respiratory dysfunction?

Oxygen therapy, antipyretics, and antibiotics

A nurse is caring for a child with acute viral nasopharyngitis. What is the priority of care for this patient?

Patent airway

The nurse understands that which guidelines are followed for administering the tuberculin skin test (TST)?

Periodic administration for children who are at high risk

Which predominant characteristic does the nurse recognize as a manifestation of bronchitis?

Persistent dry hacking cough

The parent of a child with cystic fibrosis calls the clinic nurse to report that the child is experiencing tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these symptoms are suggestive of what?

Pneumothorax

Which manifestations in a child with croup syndrome does the nurse distinguish as a sign of acute epiglottitis? Select all that apply.

Presence of drooling Presence of stridor when supine Presence of toxic appearance

What assessment finding does the nurse recognize as a manifestation of acute otitis media (AOM)?

Presence of fever and otalgia, or earache

An infant with a congenital heart defect is being given palivizumab. What is the purpose of this medication?

Prevent respiratory syncytial virus (RSV) infection

What immediate intervention should be taught to parents for when an infant chokes on a piece of food?

Positioning the infant head down and face down, then administering five quick back slaps

What postoperative nursing care must be provided for the child who had a tonsillectomy?

Provide analgesics rectally or intravenously.

nurse finds that the Following a tonsillectomy, the charge patient has difficulty breathing and swallowing. Which action by the new nurse is responsible for this?

Providing some orange juice twice a day for the patient

The nurse is performing discharge teaching for the parents of an infant with an upper respiratory tract infection. Which respiratory complication should prompt the parents to notify the health care practitioner?

Refusal to drink and decreased urination

Why is a humidified atmosphere recommended for a young child with an upper respiratory tract infection?

Soothes inflamed mucous

How does a humidified atmosphere improve an upper respiratory tract infection?

Soothes inflamed mucous membranes

A 4-year-old boy needs to use a metered-dose inhaler for asthma. He cannot coordinate his breathing to use it effectively. What should the nurse suggest that he use?

Spacer

What fluid should be avoided in attempts to rehydrate a child?

Sports drink

What are common signs of a pneumothorax in a child with cystic fibrosis?

Tachypnea, tachycardia, dyspnea, cyanosis

What manifestations in a child with asthma does the nurse recognize as severe respiratory distress requiring immediate intervention? Select all that apply.

The child is sweating profusely The child is severely agitated The child has prolonged expiration.

What interventions must the nurse perform when caring for an infant with respiratory syncytial virus (RSV) infection? Select all that apply.

Teach parents to instill normal saline drops in the nares. Teach parents to suction the mucus with a bulb syringe. Offer small amounts of fluids at frequent intervals.

How does the nurse distinguish nasopharyngitis from pharyngitis in a young child on the basis of clinical manifestations? Select all that apply.

The child breathes through the mouth. The child may have vomiting and diarrhea. The child has vasodilation of the mucosa.

What manifestation helps the nurse to identify severe persistent asthma?

The child has a peak expiratory flow less than 60%. week.

Which statement by the parents does the nurse associate with cystic fibrosis in the child?

The infant tastes "salty."

A child who has a history of being born preterm is prescribed an intramuscular injection of palivizumab. What should the nurse interpret from this finding about the child's current acute condition?

The patient has cystic fibrosis.

history of being born preterm is prescribed A child who has a an intramuscular injection of palivizumab. What should the nurse interpret from this finding about the child's current acute condition?

The patient has cystic fibrosis.

What developmental factor increases the risk of infection in infants and young children?

The relatively short and open eustachian tubes of young children give pathogens easy access to the middle ear.

The mother of a 20-month-old tells the nurse that the child has a barking cough at night. The child's temperature is 37° C (98.6° F). The mother states the child is not having difficulty breathing. The nurse, suspecting croup, should recommend what?

Trying a cool-mist vaporizer at night and watching for signs of difficulty breathing

A child with asthma is undergoing pulmonary function tests. What is the purpose of the peak expiratory flow rate test?

Used to assess the severity of asthma

A 5-year-old child is brought to the emergency department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. Acute epiglottitis is suspected. What are the most appropriate nursing interventions? Select all that apply.

Vital signs Medical history Assessment of breath sounds Ready availability of emergency airway equipment

What must the nurse teach the parents of the child with cystic fibrosis about the use of pancreatic enzymes?

enzymes must be taken with high-fat foods.