Peds exam 2 QUIZ
Which urine output indicates that a 5-month-old weighing 15 lb (6.8 kg) and being treated for dehydration has a normal urine output?
1 to 2 mL/kg per hour
MMR and varicella immunizaions
12-15 months, 4-6 years
The triage nurse in the emergency department must prioritize the care of children waiting to be seen. Which child is in the greatest need of emergency medical treatment?
6-year-old with a fever of 104° F (40° C), a muffled voice, no spontaneous cough, and drooling
An initial bolus of crystalloid fluid replacement for a child in shock is 20 ml/kg. The nurse is preparing to administer how many milliliters of fluid for a child weighing 30 kg?
600mls
When teaching a caregiver of a 17-month-old about toilet training, which instruction would initially be most appropriate?
Be sure the toddler is ready before starting to toilet train.
The mother of a toddler asks the nurse what she should do with her toddler when he has a temper tantrum. Which suggestion would be most appropriate?
Leave the toddler alone during the tantrum as long as he is safe.
What should be a priority for a 6-year-old child admitted with third-degree burns?
Start an IV line.
Erikson's Toddler
autonomy vs shame & doubt
The nurse should assess the child with nephrotic syndrome for which factors? Select all that apply.
blood pressure generalized edema red blood cells in the urine
Dyspnea
difficulty breathing
An emergency department nurse is caring for a child diagnosed with moderately severe croup. The nebulizer treatment of choice for a child with moderate to severe croup is:
epinephrine
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
A child underwent a tonsillectomy 4 hours ago. Which assessment finding should make the nurse suspect postoperative hemorrhage?
frequent swallowing
A nurse is caring for a client who has just been immunized. When teaching the client's caregivers about potential adverse effects, the nurse should instruct the caregivers to immediately report
generalized urticaria.
A parent asks the nurse if the lesions around her child's mouth could be impetigo. What manifestations would verify the parent's suspicion?
honey-colored crusts, vesicles, and reddish maculae on the skin
The charge nurse reviews the laboratory results of a child admitted with nephrotic syndrome with a nurse new to the pediatric unit. The nurse is aware that teaching is required when the new nurse states that which finding is expected with nephrotic syndrome?
hyperalbuminemia
When teaching the mother of a toddler diagnosed with lead poisoning, what should the nurse include as the most serious complication if the condition goes untreated?
neurologic deficits
Toddler play
parallel play; activity in which children play side by side without interacting
When caring for a toddler with epiglottitis, the nurse should first:
place a tracheotomy tray at the bedside.
The nurse is caring for a 3-year-old child with acute kidney injury. Which laboratory finding should the nurse immediately report to the healthcare provider?
potassium level of 6.5 mEq/L
A toddler is brought to the emergency department after ingesting an undetermined amount of drain cleaner. The nurse should expect to assist with which intervention first?
securing the airway
The nurse obtains a health history from the mother of a 7-year-old child diagnosed with acute rheumatic fever. It is most important for the nurse to determine if the child has recently had which illness?
sore throat
A nurse is helping a pregnant caregiver devise a plan to help her 2-year-old child adjust to the birth of her second child. Which statement by the client indicates more instruction is needed?
"I'll tell my child that the new baby can be a playmate when the baby arrives."
A client was treated for a streptococcal throat infection 2 weeks ago. The client now has been diagnosed with acute poststreptococcal glomerulonephritis. The client asks the nurse how he could have prevented this condition. What should the nurse tell the client?
"See your health care provider (HCP) for an early diagnosis and treatment of a sore throat."
The nurse is caring for a 9-month-old with Reye syndrome. Which nursing intervention should be included when assisting with the plan of care?
Monitor the child's intake and output.
A nurse is teaching the parents of a preschooler about the possibility of post-operative hemorrhage after a tonsillectomy and adenoidectomy. When should the nurse explain that the risk of bleeding is the greatest?
7 to 10 days after surgery. The risk of hemorrhage from a tonsillectomy is greatest when the tissue begins sloughing and the scabs fall off. This typically happens 7 to 10 days after a tonsillectomy.
#1 thing to check before vaccines
Allergies
What should the nurse do first when admitting a toddler with croup?
Assess respiratory status.
Erikson's preschooler
Initiative vs guilt
A 6-month-old infant is brought to the clinic. The mother reports the infant has been lethargic and not eating well.The infant's anterior fontanel is sunken. Which additional information is a priority for the nurse to assess?
Number of wet diapers the in the last 24 hours.
A nurse working in the emergency department is caring for a 2-year-old child with a skull fracture. The parent states that the child rolled off the sofa. Which of the following is the most appropriate action by the nurse?
Reporting suspected child abuse to appropriate agencies. The incompatibility between the history and the injury, in this case, the skull fracture and rolling off the sofa, is the most important criterion on which to base the decision to report suspected child abuse. Nurses are mandated to report suspected child abuse so the nurse must report the suspected abuse to the appropriate agencies. Personnel from the reporting agency will then follow up with the child/parent as appropriate.
How can you minimize trauma of being hiospitalized for a toddler?
Toddlers should be examined in the presence of their parents because they fear separation. Allow choices between 2 things when possible.
The nurse teaches appropriate care measures to the parents of child who has been given trimethoprim/sulfamethoxazole for a UTI. What directives should be included in the teaching plan?
Use a sunscreen. Report any rash. Keep medication out of the sunlight. Keep the child well hydrated.
Reye Syndrome (RS)
a disorder defined as a metabolic encephalopathy associated with other characteristic organ involvement. It is characterized by fever, profoundly impaired consciousness, and disordered hepatic function
Which finding would most likely alert the nurse to the possibility that a preschooler is experiencing moderate dehydration?
absence of tear formation. Other findings of moderate dehydration include a dry mouth, sunken eyes, poor skin turgor, and an increased pulse rate. Deep, rapid respirations are associated with severe dehydration.
A nurse discussing injury prevention with a group of workers at a daycare center is focusing on toddlers. When discussing this age-group, the nurse should stress that
accidents are the leading cause of death among toddlers.
Preschool play
associative play with other children;separate activities but exchange toys and comment on one another's behavior. Imaginative/creative. Fantasy play & participation in their care to minimize trauma from hospitalization.
When assessing a family suspected of abusing its 4-year-old child, which behavior is the most important criterion that would suggest abuse?
incompatibility between the history (mechanism) and the injury
A client is brought to the emergency department with suspected croup. Which assessment finding reflects increasing respiratory distress?
intercostal retractions. Clinical manifestations of respiratory distress include tachypnea, tachycardia, restlessness, dyspnea, intercostal retractions, and cyanosis.
A 2 1/2-year-old child and his 2-month-old sibling are brought to the clinic by their father, who explains that the older child says "no" whenever asked to do something. The nurse should explain that the negativism demonstrated by toddlers is frequently an expression of which characteristic?
pursuit of autonomy
Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, the nurse detects dry mucous membranes and lethargy. What other finding suggests a fluid volume deficit?
sunken fontanel. In an infant, signs of fluid volume deficit (dehydration) include sunken fontanels, increased pulse rate, and decreased blood pressure.
A nurse is teaching parents how to reduce the spread of impetigo. The nurse should encourage parents to:
teach children the importance of proper hand washing.
An infant weighing 10 kg is receiving IV fluid replacement. The nurse should suspect that the infant is receiving too little IV fluid replacement when the child exhibits which clinical manifestation?
urine specific gravity of 1.033
postural drainage
use of body positioning to assist in removal of secretions from specific lobes of the lung, bronchi, or lung cavities
A school health nurse is teaching a group of 7-year-old girls about preventing urinary tract infections. What is the most appropriate education for the nurse to inlcude in the teaching?
Tell the girls to use the bathroom when the feeling to urinate happens.
A parent brings her 6-year-old daughter to the pediatrician's office for evaluation. The child recently started wetting the bed and running a low-grade fever. A urinalysis is positive for bacteria and protein. A urinary tract infection (UTI) is diagnosed, and the child is prescribed antibiotics. Which nursing interventions are appropriate? Select all that apply.
Assess the parent's understanding of UTI and its causes. Instruct the parent to administer the antibiotic as prescribed, even if the symptoms diminish.
A nurse is developing a teaching plan for a child with acute poststreptococcal glomerulonephritis. What is the most important point to address in this plan?
Blood pressure monitoring
The nurse advises a mother with a 2-year-old child to avoid encouraging excessive milk consumption by the toddler because excess milk consumption can lead to which problem?
Iron deficiency. Excessive milk consumption can lead to the displacement of iron-rich foods in the diet. This can result in iron deficiency anemia.
An adolescent presents with a large round ring with a swollen border on the left arm. The adolescent often plays ball games in a field behind the school. What condition does the nurse suspect?
Lyme disease. Lyme disease, which results from a tick bite, is characterized by a large round ring with a raised swollen border at the site of the bite.
A client in the emergency department is diagnosed with a communicable disease. When complications of the disease are discovered, the client is admitted to the hospital and placed in respiratory isolation. Which infection warrants airborne isolation?
Measles.
A toddler is admitted to the facility for treatment of a severe respiratory infection. The child's recent history includes fatty stools and failure to gain weight steadily. The physician diagnoses cystic fibrosis. By the time of the child's discharge, the child's parents must be able to perform which task independently?
Performing postural drainage
Encouraging fantasy play and participation by children in their own care is a useful developmental approach for which pediatric age-group?
Preschool age (3 to 5 years)
The nurse is caring for a young child who has been admitted to the hospital with pertussis. To prevent the spread of the infection, which of the following is the most important action of the nurse?
Provide masks for everyone entering the room.
The mother calls the nurse to report that her toddler has just been burned on the arm. What should the nurse should advise the mother to first?
Run cool water over the burned area, and then wrap it in a clean cloth.