Pediatrics Ch. 33
A nurse caring for a neonate immediately after birth notices an excessive amount of frothy mucus coming from the child's nose and mouth. What condition does the nurse suspect?
Tracheoesophageal fistula
Which inflammatory bowel disease is characterized by inflammation limited to the colon and rectum?
Ulcerative colitis
What should dietary management of a child with inflammatory bowel disease include?
Vitamin supplements
What should the nurse teach the parents about reducing the risk for transmitting bacteria via food?
Wash hands with hot, soapy water after contact with raw meat.
What complication can result when a child ingests an excessive volume of electrolyte-free water?
Water intoxication
Which factor does the nurse associate with chronic diarrhea in a child?
Lactose intolerance
Which diet is most appropriate for the child with celiac disease?
Low-gluten
What type of diet is recommended for a child with inflammatory bowel disease?
well-balanced high-protein, high-calorie diet
The nurse is providing nutritional counseling to a patient who presented with severe diarrhea, fistulas, weight loss, and severe growth retardation. Which statement by the patient indicates effective learning?
"I should consume a high-protein diet."
The nurse is teaching a 2-year-old's parent about necessary dietary restrictions needed to manage celiac disease. Which statement made by the parent indicates effective learning?
"I should provide a bowl of rice in my child's lunch and dinner."
A stool specimen from a child with diarrhea shows the presence of eosinophils. With what condition is this finding associated?
Parasitic infection
The nurse is reviewing the medical records of four different patients. Which patient requires a change in the treatment plan?
Patient D
A child has a nasogastric (NG) tube after for acute surgery appendicitis. What is the purpose of the NG tube?
Prevent abdominal distention
Which type of diarrhea is associated with antibiotic therapy?
Acute diarrhea
What manifestation in the infant does the nurse associate with hypertrophic pyloric stenosis?
Projectile vomiting
What does management of the child with a peptic ulcer often include?
Proton dund inhibitors
What should the nurse teach the parents about caring for the infant with gastroesophageal reflux (GER)?
Avoid vigorous play after feedings.
What should the nurse teach the parents of an infant with cleft lip (CL) about feeding?
Provide cheek support when feeding.
What is the best method of assessing dehydration in a toddler?
Accurate measurements of fluid intake and output
What is an appropriate breakfast for the hospitalized child who has celiac disease?
Eggs, turkey bacon, fruit
What does the care of a newborn with a cleft lip and palate before surgical repair include?
Alternative feeding systems
The nurse assesses a neonate immediately after birth. What is one clinical sign/symptom of tracheoesophageal fistula?
An excessive amount of frothy saliva in the mouth
What is an essential medical intervention for an infant born with symptomatic congenital diaphragmatic hernia?
Immediate endotracheal intubation
What does the nurse recognize as a nursing intervention that is contraindicated for children, especially infants with acute diarrhea?
BRAT diet
An 8-week-old infant is brought to the clinic. The infant's parents tell the nurse that the baby was thriving and doing well with only a mild amount of jaundice at birth but report that over the past several days the baby has become increasingly irritable and has started passing dark yellow urine and is having difficulty gaining weight. The nurse notices jaundice in the baby's sclerae. With what condition are these clinical manifestations associated?
Biliary atresia
What progressive inflammatory process causes both intrahepatic and extrahepatic bile duct fibrosis?
Biliary atresia
What conditions place an infant at risk for increased fluid requirements? Select all that apply.
Burns Tachypnea Diabetic ketoacidosis
A patient underwent surgical treatment in which a segment of intestine was anastomosed to the resected porta hepatis. Which medication present in the patient's prescription will help to stimulate bile flow?
Phenobarbital
A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solution (ORS). The child's mother calls the clinic nurse because the child is also occasionally vomiting. What should the nurse recommend?
Continuing to give ORS frequently in small amounts.
Constipation has recently become a problem for a school-age boy who just started attending a new school. What is the most likely cause of his constipation?
Fear of using bathrooms at school
The nurse is caring for a child with hepatitis A. What is the main mode of transmission of this disease?
Fecal-oral route
The nurse is caring for a child weighing 8 kg with minimal dehydration following acute diarrhea. What intervention should the nurse execute to replace the fluid lost due to diarrhea?
Give 90 mL oral rehydration solution (ORS)
Which factors would the nurse attribute to insensible fluid loss in an infant? Select all that apply.
Heat and humidity Body temperature Respiratory rate
An 8-year-old child comes to the clinic with a history of constipation and malnourishment. Her parents say that her stools look like ribbons and smell strong. The nurse notes visible peristalsis and abdominal distension. With what condition are these clinical manifestations associated?
Hirschsprung disease
The nurse is caring for a 6-year-old child who has been brought to the clinic with constipation. The nurse recognizes that constipation may arise as a result of a variety of conditions. Which condition is most commonly associated with constipation?
Hirschsprung disease (HD)
What information should the nurse include when teaching an adolescent with Crohn's disease?
How cope with stress and adjust to chronic illness
In what form of dehydration is rapid fluid replacement contraindicated?
Hypertonic
The parents of a l-month-old infant bring the child to the clinic because the infant has been projectile vomiting 30 minutes after feeding. The parent describes the vomit as stale milk. On assessment the nurse palpates an olivelike mass. What condition do these clinical manifestations characterize?
Hypertrophic pyloric stenosis
An adolescent who has been consuming a low-sodium diet for a long period is at risk for:
Hyponatremia
What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?
Hypotonic
The nurse is providing discharge instructions to the parents of a 5-year-old child with gastroesophageal reflux. What information should the nurse give the parents about the administration of a protein pump inhibitor?
If the medication is given twice a day, the second best time for administration is 30 minutes before the evening meal.
Which factor predisposes an infant to fluid imbalances?
Immature kidney function
What factors contribute to infants' having a greater and more rapid water loss than adults? Select all that apply.
Infants lose a large amount of fluid at birth. Infants maintain more extracellular fluid than do adults.
The nurse is caring for a child with a peptic ulcer, who has been prescribed omeprazole. What is the effect of this drug on the child?
Inhibits hydrogen ion pump in parietal cells
A 3-month-old child presents with sudden acute abdominal pain. The child is having episodes of screaming and drawing knees to her chest followed by periods of comfort. The parent tells the nurse the child's stool looked like red jelly. What do these clinical manifestations suggest?
Intussusception
What interventions must the nurse perform for the child after an uncomplicated appendectomy? Select all that apply.
Irrigate the wound with saline. Listen for bowel sounds. Encourage intake of ice chips.
What is the primary form of dehydration in children?
Isotonic dehydration
What should the nurse consider when providing support to a family whose infant has just been found to have biliary atresia?
Liver transplantation may be needed eventually.
What care must the nurse take when obtaining abdominal measurements for a child with Hirschsprung disease?
Mark the point of measurement on the abdomen with a pen.
How long is the period of communicability for hepatitis B?
May persist for years or a lifetime
The nurse is caring for a child who had an appendectomy following a ruptured appendix and peritonitis. Which intervention does the nurse perform first for the child with risk for infection?
Monitor wound status, integrity, and type of dressing.
While waiting for the administration of air pressure to reduce an intussusception, the child passes a normal brown stool. What is the most appropriate nursing action?
Notifying the health care provider immediately
What is a common characteristic of acute peptic ulcer disease in neonates?
O Usually gastric ulcers
An infant with neurologic impairment and delay is receiving several medications, including a proton pump inhibitor. Which of these medications are proton pump inhibitors? Select all that apply.
Omeprazole Pantoprazole
The nurse is caring for a 5-year-old child who has acute diarrhea. What is the first line of treatment for this condition?
Orally administered rehydration solutions
A patient with gastrointestinal Helicobacter pylori is prescribed triple-drug therapy of bismuth, clarithromycin, and metronidazole as first-line treatment. Which condition does the nurse expect to be present in the patient?
Peptic ulcer disease
What action must the nurse take when feeding the child with inflammatory bowel disease?
Provide mouth care before eating.
The nurse is monitoring an infant for water intoxication. Which actions may lead to water intoxication? Select all that apply.
Providing intravenous (IV) fluid replacement Administering tap water enema Administering 0.45% sodium chloride
When discharging an infant with short-bowel syndrome home on parenteral nutrition (PN) and gastrostomy feedings the nursing care should include:
Recognition of signs of central venous catheter infections
A nurse is caring for a 6-month-old infant who has been brought to the clinic with a moderate fever and foul-smelling watery stools for the past 2 days. What is the most common cause of diarrhea in children of this age group?
Rotavirus
Infection with which bacterial pathogen that results in acute diarrhea has the highest incidence in infants?
Salmonella
The nurse understands that the long-term management of a child with a cleft lip often involves several types of treatment. What are those treatments? Select all that apply.
Speech therapy Orthodontics and prosthodontics Placement of pressure-equalization tubes
What are some clinical manifestations of gastroesophageal reflux in infants? Select all that apply.
Spitting up Failure to thrive Excessive crying and arching of the back
The nurse is aware of the need to maintain water balance in infants. Which infants would the nurse expect to have an increased need for water replacement? Select all that apply.
The infant in the radiant warmer An infant receiving phototherapy The febrile infant who is vomiting
An infant is found to have malrotation of the intestine. What is the therapeutic management to reverse this condition?
Surgery remove the affected area
When evaluating the extent of an infant's dehydration, the nurse should recognize which symptoms of severe dehydration?
Tachycardia, parched mucous membranes, sunken eyes and fontanels
The nurse is discussing home care with the mother of a 6-year-old child with hepatitis A. What should the discharge teaching plan include?
Teaching infection-control measures to family members
The nurse is reviewing assessment findings for a child with severe dehydration. Which assessment finding does the nurse associate with severe dehydration?
The capillary refill is 5 seconds
The nurse reviews the medical record of a child with a cleft palate scheduled for surgery. Which finding suggests possible complications?
The child's hemoglobin content is 8 mg/dL.
Which statement best describes Hirschsprung disease?
The colon has an aganglionic segment.
The nurse is caring for a newborn admitted to the nursery with a cleft lip and palate. What preoperative nursing care goals should the nurse set with this patient and family? Select all that apply.
The infant will be prepared for surgery. The infant will receive optimal hydration and nutrition. The family will cope with the impact of an infant with a defect.
A nurse assesses that the newborn has frothy saliva, cyanosis, oxygen desaturation, and unexplained episodes of apnea. Which surgical treatment will be beneficial for the child?
Thoracotomy
A 2-month-old breastfed infant is receiving oral rehydration solution for acute diarrhea. What instructions should the nurse give the mother about breastfeeding?
To continue breastfeeding
The nurse is caring for an infant with celiac disease. Why does the nurse expect the child to be prescribed a wheat-free diet at all times?
To prevent villous atrophy
