Peds Chapter 35: PrepU
During the health history, a mother tells the nurse her toddler received intravenous (IV) gentamycin for infection as a premature infant. How will the nurse respond?
Arrange for an evaluation by an audiologist.
A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform?
Assess the level of consciousness (LOC).
The nurse is caring for a child who is having a seizure. What is the appropriate action by the nurse?
Attempt to turn the child on their side to prevent aspiration.
The nurse in the acute care setting is caring for a child with deafness. Which nursing intervention is appropriate for this child?
Allow the child to see the nurse prior to touching or completing any assessments or procedures.
A 7-month-old is scheduled for surgical correction of strabismus. The child's mother says to the nurse, "I'm glad my child will never have to wear that patch again." Which of these responses would be most appropriate for the nurse to make?
"Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye."
A young preschooler with impaired visual acuity can be treated with glasses. The parents are reluctant to agree. The nurse explains:
With impaired vision, children have difficulty interacting with their environment and meeting developmental milestones.
The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement?
Encouraging the child to keep his hands away from his eyes
The nurse helps position a child for a lumbar puncture. Which statement describes the correct positioning for this procedure?
"For a lumbar puncture, the child will be placed in a side-lying position with knees bent and neck flexed to assist with arching the back."
The nurse is taking a health history for a 9-year-old with conjunctivitis. Which statement by the parents leads the nurse to suspect that the child is experiencing allergic conjunctivitis?
"He recently helped clean the basement.
While caring for a child who will be undergoing a lumbar puncture, the nurse explains the procedure to the infant's mother. Which statement by the mother would indicate a need for further education?
"I will cradle her in my arms after the procedure for at least 30 minutes."
The mother of a 12-year-old with Reye syndrome approaches the nurse wanting to know how this happened to her child, saying, "I never give my kids aspirin!" Which response by the nurse would be most appropriate?
"Sometimes it's hard to tell if a product contains aspirin."
The community health nurse is preparing a presentation on safety measures to prevent injuries in children. Which example of proper safety guidelines should the nurse include? Select all that apply.
A child wearing a helmet while ice skating An infant in a car seat A child wearing a helmet, knee pads, and elbow pads while riding a skateboard
The school nurse is observing a child in the classroom. The child is speaking and then suddenly stops and stares for about 5 seconds and then continues speaking. The nurse charts this as what type of seizure?
Absence
The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39°C (102.2°F). Which intervention would the nurse expect to implement?
Administering antibiotics as soon as they're available
A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition?
Amblyopia
The 12-year-old child has developed a stye. Which may be included in the child's care?
Apply hot, moist compresses to the affected area.
Parents request help from the nurse in managing their young child's "poor behavior." They describe "loud talk and play, not coming when called, seldom following directions, 'blasting' the volume on the TV set, and difficulty understanding spoken words." The appropriate nursing action is:
Arranging for an evaluation of the child's hearing.
The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?
Assess the child's ability to convey information.
The nurse is caring for a child with hearing loss due to damage from chronic inner ear infections. The nurse knows that the child most likely has which type of hearing loss?
Conductive
Parents report that their preschool child's eyes are not always "straight." What test/procedure can the nurse use to validate the parents' observations?
Corneal light reflex
The nurse is caring for a 3-year-old client with injury to the third cranial nerve. Which assessment finding(s) should the nurse anticipate? Select all that apply.
Dilated pupil Inability to rotate eye upward, medially, or downward Difficulty looking at close-up objects
The nurse is caring for a child who has an intellectual disability. Of the following factors, which is a cause of postnatal intellectual disability?
Lead poisoning
Absence seizures are marked by what clinical manifestation?
Loss of motor activity accompanied by a blank stare
The vision impairment in which the child can see objects at close range but not at a distance is known as:
Myopia
A nurse is providing care to a child with strabismus. The nurse understands that the most common treatment for this condition would be which of the following?
Occlusion therapy
A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority?
Relieving the child's pain
A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause?
Staphylococcus aureus
The nurse instructs a hearing-impaired school-age child on to how self-inject a prescribed medication. Which observation indicates to the nurse that additional teaching is required?
The child places the filled syringe and uncapped needle on the bed to open the alcohol wipe.
The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?
"I hate to think that I will need to be worried about my child having seizures for the rest of his life."
The parent of a child having myringotomy tubes placed asks, "Will my child lose hearing while the tubes are in place?" What is the nurse's best answer?
"The tubes are inserted into a section of eardrum in which the hearing is not affected."
A child having myringotomy tubes placed asks, "How and when will the tubes be removed?" How should the nurse respond to this patient?
"The tubes remain in place for 6 to 12 months until they come out by themselves."
The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope?
"Use this information to teach family and friends."
The parents of an 8-year-old child report that the child's teachers noted the child is having problems seeing the board in school but state they do not understand this since the child is able to read from the computer with no difficulty. Which response from the nurse is most appropriate?
"What you are describing may be what is called myopia."
A nursing instructor is working with a student caring for an 18-month-old client. In order to ascertain that the tympanic membrane is optimally visualized, the faculty will assess that the student pulls the pinna of the ear:
Down and back.
The nurse is preparing a room for a child being admitted with meningitis. What is the appropriate action by the nurse?
Gather appropriate equipment and signage for respiratory isolation precautions.
An infant is diagnosed with infantile glaucoma. When developing the plan of care for the infant, for what would the nurse expect to prepare the infant and family?
Goniotomy
A nurse is reviewing the medical record of a child with hearing loss and notes that the child's hearing loss is in the range 40 to 60 decibels (dB). The nurse interprets this as indicating what level of hearing loss?
Moderate loss
The nurse is assessing a 7-year-old with a hearing aid. His mother says he is losing his hearing again. Which finding would the nurse identify as contributing to this current complaint?
Overproduction of cerumen
The school nurse notices that a child has puffy eyes. Further assessment of the child leads the nurse to suspect viral conjunctivitis based on what finding?
Photophobia
A parent of a newborn asks the nurse if there is any way to prevent acute otitis media. What would the nurse state to the parent?
The frequency of otitis media is reduced in breastfed infants.
A child with persistent otitis media with effusion is to undergo insertion of pressure-equalizing tubes via a myringotomy. The child is to be discharged later that day. After teaching the parents about caring for their child after discharge, which statement indicates that the teaching was successful?
"He should wear earplugs when swimming in a pool or a lake."
