Peds Exam 3
T/F The best time for genetic counseling is before a woman becomes pregnant.
True
T/F The small intestine is not fully functional at birth.
True
T/F The spleen is functional at birth.
True
T/F UTI occurs more frequently in males during infancy.
True
A child is seen in the doctor's office after hitting his head while skateboarding. The child suffered no loss of consciousness, and has no external injuries and no significant past medical history. He is acting appropriately at this time. His only complaint is a dull headache. What instructions would you give the parents regarding his care at home? Include when they should seek further medical care.
- Instruct parents or caregiver that a responsible adult must stay with the child for the next 24 hours and be ready to take the child to the hospital if necessary. - The child may require close observation for a few days. Wake the child every 2 hours to ensure that he moves normally, wakes enough to recognize the caregiver, and responds to the caregiver appropriately. - Instruct parents to call their medical provider or bring the child to the emergency room if: the child complains of a constant headache that gets worse; presents with slurred speech, dizziness that does not go away or happens repeatedly, or extreme irritability or other abnormal behavior; vomits more than twice; is clumsy or has difficulty walking; is oozing blood or watery fluid from the ears or nose; has difficulty waking up, unequal-sized pupils, or unusual paleness that lasts longer than 1 hour; or experiences any seizure activity.
A 10-year-old child is admitted to the pediatric unit after experiencing a seizure. A complete, accurate, and detailed history from a reliable source is essential. What information would you ask for while obtaining the history?
- When did the event occur---while sleeping, eating, playing, just after waking? - Provide a description of the child's behavior during the event---what types of movements; progression and length of seizure; respiratory status; any apnea? - How did the child behave after the event? - Have the episodes been recurrent, and if so how frequent? - Have there been any precipitating factors, such as a fever, fall, activity, anxiety, infection, or exposure to strong stimuli such as flashing lights or loud noises?"
The nurse is caring for a child who is in status epilepticus. The child weighs 14.97 kg (33 lb). The medication order reads: Diazepam 3 mg IV push now. Per the Pediatric Dosage Handbook, the recommended dose is 0.1 to 0.3 mg/kg/dose. Diazepam is supplied as 5 mg/mL. How many milliliters will the nurse administer? Round to the nearest tenth.
0.6 milliliters (ml)
The nurse is caring for a child who has had a renal transplant. The child weighs 47 lb. The medication order reads: cyclosporine 96 mg PO every 12 hours. Cyclosporine is supplied as 100 mg/mL. How many milliliters will the nurse administer? Round to the nearest whole number.
0.96 milliliters (ml)
The nurse is caring for a 4-year-old with acute lymphoblastic leukemia. The child weighs 38 lb. The medication order reads: ondansetron 2.6 mg IV every 8 hours for chemotherapy-related nausea/vomiting. Ondansetron is supplied as 4 mg/2 mL. How many milliliters will the nurse administer? Round to the nearest tenth.
1.3 milliliters (ml)
You are to administer 1,000 mL of solution over 10 hours. You should give _____ mL per hour.
100 mL/h
You are to give 500 mL of NS over 4 hours. You should give _____ mL per hour.
125 mL/h
A provider prescribed Keflex 150 mg PO q 6 hours. The child weights 33 lb. Keflex is labeled 125 mg per 5 mL. The safe dose range is 25 to 50 mg/kg/day. How many kg dose the child weigh? How many mL of medication should the child receive with each dose? Is this dose within the safe range?
15 kg 375 to 750 mg/day Yes, the ordered dose is safe to administer.
The nurse is caring for a term newborn born to a mother with HIV infection. The infant weighs 6 lb 5 oz. The medication order reads: zidovudine 25 mg PO twice daily. Zidovudine is supplied as 50 mg/5 mL. How many milliliters will the nurse administer with each dose? Round to the nearest tenth.
2.5 milliliters (ml)
A provider prescribed Phenergan for preoperative medication for a 44 lb child. Phenergan is to be given as 1 mg per kg of body weight. How many mg of medication should the nurse administer, per dose, preoperatively?
20 mg
The provider prescribed an antibiotic 25 mg per kg for a 22 lb, 12 month old child. The medicine is to be given q 12 hours. How many mg per dose should the child receive q 12 hours?
250 mg
The nurse is caring for a child who has tinea corporis. The child weighs 18 lb 11 oz. The medication order reads: Griseofulvin 85 mg PO every day. Griseofulvin is supplied as 125 mg/5 mL. How many milliliters will the nurse administer? Round to the nearest tenth.
3.4 milliliters (ml)
Absence of bowel sounds can be determined after a _____ minute period of auscultation.
5
The provider prescribed 10 mg of an antibiotic PO q 12 hours for a 22 lb child. The safe dosage range is 0.5 to 2 mg/kg/day. What is the appropriate dosage range for this child? Is the ordered dose within the safe range?
5 to 20 mg/day Yes, the ordered dose is safe.
A child is NPO during the preoperative period and requires IV fluid maintenance. The child weighs 31 lb 4 oz. What is the child's recommended hourly IV fluid rate?
50 mL/h
To infuse 500 mL of solution over 8 hours, you should give _____ mL per hour.
63 mL/h
A 14-kg child with moderate dehydration has received two boluses of normal saline in the emergency room prior to being admitted to the pediatric nursing unit. The physician orders D5 ½ NS @ 1½ maintenance. What would the intravenous fluid rate be?
75 mL/h
The physician prescribed 1,000 mL of LR to infuse over 12 hours. You should give _____ mL per hr.
83 mL/h
To deliver 500 mL of D5W over a 6 hour period, the nurse should set the flow rate to deliver _____ mL per hour.
83 mL/h
A child's newborn screen came back positive for phenylketonuria. After further testing, the diagnosis is confirmed. What instructions would you give the parents regarding care of their child?
A diet low in phenylalanine is essential to prevent serious complications such as brain damage. Phenylalanine is found mostly in protein-containing foods such as meat and milk (including breast milk and formula). The child will need some protein for growth, and a registered dietitian will help develop an individualized diet for the child. Referral to a registered dietitian and appropriate resources, including support groups, will be important. Encourage the parents to monitor the developmental progress of their child and discuss any concerns with their health care provider as soon as they arise.
The nurse is caring for a child who has just been admitted to the pediatric unit with sickle cell crisis. He is complaining that his right arm and leg hurt. What is the priority nursing intervention? A. Administer pain medication every 3 hours intravenously until pain is controlled B. Perform passive range of motion of the arm and leg to maintain function C. Try acetaminophen for pain first, moving up to opioids only if needed D. Use narcotic analgesics and warm compresses as needed to control the pain
A. Administer pain medication every 3 hours intravenously until pain is controlled
A 5-year old who had a renal transplant 9 months ago and has no history of chickenpox presents to the pediatric clinic for his vaccinations. Which is the most appropriate set to give? A. DTaP, IPV B. DTaP, IPV, MMR, varicella C. DTaP, IPV, varicella D. IPV only
A. DTaP, IPV
The nurse is caring for a child who has received significant partial-thickness burns to the lower body. What is the priority assessment in the first 24 hours after injury? A. Fluid balance B. Wound infection C. Respiratory arrest D. Separation anxiety
A. Fluid balance
A 3-month-old infant presents with a history of vomiting after feeding. The plan for the infant is to rule out GER. What information from the history would lead the nurse to believe that this infant may need further intervention? A. Poor weight gain B. Small "spits" after feeding C. Sleeps through the night D. Difficult to burp
A. Poor weight gain
When compared with adults, why are infants and children at an increased risk of head trauma? A. The head of the infant and young child is large in proportion to the body and the neck muscles are not well developed. B. The development of the nervous system is complete at birth but remains immature. C. The spine is very immobile in infants and young children. D. The skull is more flexible due to the presence of sutures and fontanels.
A. The head of the infant and young child is large in proportion to the body and the neck muscles are not well developed.
A child born with a single transverse palmar crease, a short neck with excessive skin at the nape, a depressed nasal bridge, and cardiac defects is most likely to have which autosomal abnormality? A. Trisomy 21 B. Trisomy 18 C. Trisomy 14 D. Trisomy 13
A. Trisomy 21
______________ is the most prevalent skin condition occurring in childhood.
ACNE
ITP is thought to be an immune response following a viral infection that produces ___________ antibodies.
ANTIPLATELET
__________ agents are used in the treatment of a confirmed case of aseptic meningitis.
ANTIVIRAL
Juvenile idiopathic arthritis is an autoimmune disorder in which the _________ mainly target the joints.
AUTOANTIBODIES
The nurse is teaching about skin care for atopic dermatitis. Which statement by the parent indicates that further teaching may be necessary? A. "I will use Vaseline or Crisco to moisturize my child's skin." B. "A hot bath will soothe my child's itching when it is severe." C. "I will buy cotton rather than wool or synthetic clothing for my child." D. "I will apply a small amount of the prescribed cream after the bath."
B. "A hot bath will soothe my child's itching when it is severe."
The nurse is caring for a 6-year-old with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl's behavior is due to a desire to avoid going to school. What is the best advice by the nurse? A. Refer the girl to a psychologist for evaluation of school phobia related to chronic illness. B. Administer a warm bath every morning before school. C. Give the child her prescribed NSAIDs 30 minutes before getting out of bed. D. Allow her to stay in bed some mornings if she wants.
B. Administer a warm bath every morning before school.
A mother brings her 4-day-old infant to the clinic with vomiting and poor feeding. The newborn was healthy at birth. The nurse should suspect: A. Sturge-Weber syndrome B. An inborn error of metabolism C. Trisomy 18 D. Turner syndrome
B. An inborn error of metabolism
A 6-month-old infant is admitted to the hospital with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. The priority nursing intervention would be: A. Educate the family on ways to prevent bacterial meningitis. B. Initiate appropriate isolation precautions and begin intravenous antibiotics. C. Assess the infant's fontanels. D. Encourage the mother to hold the infant and feed her.
B. Initiate appropriate isolation precautions and begin intravenous antibiotics.
A child presents with a 2-day history of fever, abdominal pain, occasional vomiting, and decreased oral intake. Which finding would the nurse prioritize for immediate reporting to the provider? A. Temperature 101.9° F B. Rebound tenderness and abdominal guarding C. Parents will be leaving the child alone in the hospital D. Child can tolerate only sips of fluid without nausea
B. Rebound tenderness and abdominal guarding
The nurse is caring for a child with Down syndrome. What should the nurse's focus be? A. Teaching hygiene skills to the child in order to increase self-esteem B. Screening for anomalies and teaching about prevention of respiratory infection C. Finding opportunities to increase socialization for the child and family D. Expecting walking at age 1 year and toilet training completion at age 2 years
B. Screening for anomalies and teaching about prevention of respiratory infection
A 4-year-old girl presents with recurrent urinary tract infection. A prior workup did not reveal any urinary tract abnormalities. What is the priority nursing action? A. Obtain a sterile urine sample after completion of antibiotics. B. Teach appropriate toileting hygiene. C. Prepare the child for surgery to reimplant the ureters. D. Administer antibiotics intramuscularly.
B. Teach appropriate toileting hygiene.
When the nurse is caring for a child with hemolytic-uremic syndrome or acute glomerulonephritis and the child is not yet toilet trained, which action by the nurse would best determine fluid retention? A. Test urine for specific gravity. B. Weigh child daily. C. Weigh the wet diapers. D. Measure abdominal girth daily.
B. Weigh child daily.
A care plan for a child with neonatal seizures will include ensuring adequate __________, correcting any underlying metabolic disturbances, and administering anticonvulsant therapy.
VENTILATION
At a well-child visit, hydrocephalus may be suspected in an infant if upon assessment the nurse finds: A. Narrow sutures B. Sunken fontanels C. A rapid increase in head circumference D. Increase in weight since last visit
C. A rapid increase in head circumference
A 14-year-old with thalassemia asks for your assistance in choosing her afternoon snack. Which choice is the most appropriate? A. Peanut butter with rice cake B. Small spinach salad C. Apple slices with cheddar cheese D. Small burger on wheat bun
C. Apple slices with cheddar cheese
The nurse is caring for a child who has had diarrhea and vomiting for the past several days. What is the priority nursing assessment? A. Determine the child's weight B. Ask if the family has traveled outside of the country C. Assess circulation and perfusion D. Send a stool specimen to the lab
C. Assess circulation and perfusion
A child on the pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WBC 24,000, and platelets 20,000. What is the priority nursing assessment? A. Assess for pallor, fatigue, and tachycardia B. Monitor for fever C. Assess for bruising or bleeding D. Determine intake and output
C. Assess for bruising or bleeding
The nurse is caring for a child in the emergency department who was bitten by the family dog, who is fully immunized. What is the priority nursing action? A. Administer rabies immunoglobulin. B. Refer the child to a counselor. C. Assess the depth and extent of the wound. D. Administer a tetanus booster.
C. Assess the depth and extent of the wound.
A 5-year-old has been diagnosed with Wilms tumor. What is the priority nursing intervention for this child? A. Educate the parents about dialysis, as the kidney will be removed B. Measure abdominal girth every shift C. Avoid palpating the child's abdomen D. Monitor BUN and creatinine every 4 hours
C. Avoid palpating the child's abdomen
A child with hemophilia fell while riding his bicycle. He was wearing a helmet and did not lose consciousness. He has a mild abrasion on his knee that is not oozing. He is complaining of abdominal pain. What is the priority nursing assessment? A. Perform neurologic checks B. Assess ability to void frequently C. Carefully assess his abdomen D. Examine his knee frequently
C. Carefully assess his abdomen
A mother brings her 6 month old infant to the clinic. The child has been vomiting since early morning and has had diarrhea since the day before. His temperature is 38 C, pulse 140, and respiratory rate 38. He has lost 6 oz since his well-child visit 4 days ago. He cries before passing a bowel movement. He will not breastfeed today. What is the priority nursing diagnosis? A. Thermoregulation alteration B. Pain (abdominal) related to diarrhea C. Fluid volume deficit related to excessive losses and inadequate intake D. Alteration in nutrition, less than body requirements, related to decreased oral intake
C. Fluid volume deficit related to excessive losses and inadequate intake
What is the priority nursing intervention for the child recently admitted with Guillain-Barré syndrome? A. Perform range-of-motion exercises. B. Take temperature every 4 hours. C. Monitor respiratory status closely. D. Assess skin frequently.
C. Monitor respiratory status closely.
The nurse is caring for a child with Turner syndrome admitted to the unit for treatment of a kidney infection. What characteristics associated with this syndrome may the nurse expect to find upon assessment? A. Microcephaly, polydactyly B. Low-set ears, cleft lip C. Short stature, webbed neck D. Gynecomastia, taller than average
C. Short stature, webbed neck
A child with cancer is receiving chemotherapy, and his mother is concerned that the nausea and vomiting associated with chemotherapy are reducing his ability to eat and gain weight appropriately. What is the most appropriate nursing action? A. Administer an antiemetic at the first hint of nausea B. Offer the child's favorite foods to encourage him to eat C. Start antiemetic drugs prior to the chemotherapy infusion D. Maintain IV fluid infusion to avoid dehydration
C. Start antiemetic drugs prior to the chemotherapy infusion
A 14-year-old with systemic lupus erythematosus wants to know how to care for her skin. What should the nurse teach this adolescent? A. Careful sun tanning will give her skin an attractive color. B. No special skin care is needed. C. Use sunscreen daily to avoid rashes. D. Use makeup to camouflage the butterfly rash on her face.
C. Use sunscreen daily to avoid rashes.
The nurse working in a women's health clinic determines that genetic counseling may be appropriate for a woman: A. Who just had her first miscarriage at 10 weeks B. Who is 30 years old and planning to conceive C. Whose history reveals a close relative with fragile X syndrome D. Who is 18 weeks pregnant and whose triple screen came back normal
C. Whose history reveals a close relative with fragile X syndrome
Aplastic anemia refers to failure of the bone marrow to produce _______.
CELLS
Neurologic disorders result from __________ problems, infections, or traumas.
CONGENITAL
Decorticate posturing occurs with damage of the cerebral __________.
CORTEX
A 3-day-old infant presenting with physiologic jaundice is hospitalized and placed under phototherapy. Which response indicates to the nurse that the parent needs more teaching? A. "My infant is at risk for dehydration." B. "My infant needs to stay under the lights, except during feeding time." C. "My infant can continue to breastfeed during this time." D. "My infant has a serious liver disease."
D. "My infant has a serious liver disease."
The nurse is performing education for the parents of an infant with bladder exstrophy. Which statement by the parents would indicate an understanding of the child's future care? A. "Care will be no different than that of any other infant." B. "My infant will only need this one surgery." C. "My child will wear diapers all his life." D. "We will need to care for the urinary diversion."
D. "We will need to care for the urinary diversion."
The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? A. Administer Griseofulvin with a fatty meal. B. Institute contact isolation precautions. C. Apply topical antibiotic cream. D. Apply topical antifungal cream.
D. Apply topical antifungal cream.
A child with leukemia has the following am laboratory results: Hgb 8.0, Hct 24.2, WBC 8,000, platelets 150,000. What is the priority nursing assessment? A. Monitor for fever B. Assess for bruising or bleeding C. Determine intake and output D. Assess for pallor, fatigue, and tachycardia
D. Assess for pallor, fatigue, and tachycardia
You are counseling a couple, one of whom is affected by neurofibromatosis, an autosomal dominant disorder. They want to know the risk of transmitting the disorder. The nurse should tell them that each offspring has a: A. One in four (25%) chance of getting the disease B. One in eight (12.5%) chance of getting the disease C. One in one (100%) chance of getting the disease D. One in two (50%) chance of getting the disease
D. One in two (50%) chance of getting the disease
A 10-year-old child is admitted to the hospital due to history of seizure activity. As his nurse, you are called into the room by his mother, who states he is having a seizure. What would be the priority nursing intervention? A. Prevention of injury by removing the child from his bed B. Prevention of injury by placing a tongue blade in the child's mouth C. Prevention of injury by restraining the child D. Prevention of injury by placing the child on his side and opening his airway
D. Prevention of injury by placing the child on his side and opening his airway
When two alleles are heterozygous, the ____________ gene will determine the phenotype of the individual.
DOMINANT
Epispadias refers to a urethral defect resulting in the opening occurring on the ________ surface of the penis.
DORSAL
A 6-month-old baby is brought to the physician's office with a history of diarrhea. She has had six watery stools in the past 18 hours. She is vomiting her formula. Her mother states that she has had no fever. Upon completion of the history and physical examination, what signs and symptoms would you expect to find that would indicate that the baby is experiencing mild dehydration?
Decrease in number of wet diapers, but otherwise normal examination findings (alert, oral mucosa moist and pink, skin pink with elastic turgor, fontanel soft and flat, normal pulse and blood pressure).
A 6-month-old baby is brought to the physician's office with a history of diarrhea. She has had six watery stools in the past 18 hours. She is vomiting her formula. Her mother states that she has had no fever. What is the priority nursing diagnosis for this infant?
Deficient fluid volume
______________ is the inability to swallow or difficulty swallowing.
Dysphagia
Nephrotic syndrome results in significant proteinuria and ______________.
EDEMA
The parents of children with chronic neurologic disorders will require large amounts of __________ and support throughout the child's life time.
EDUCATION
Sixteen-year-old Melody Carson is admitted to the pediatric intensive care unit after being a passenger in a car struck by a train. Two of her friends, also in the car, were killed in the accident. Melody is unconscious at this time. She also has a broken right femur, two broken ribs, and a fractured pelvis. What psychosocial implications could this injury have on Melody and her family as she enters rehabilitation?
Education about Melody's injury and care Involving the family in the interdisciplinary team Involving the family in Melody's care Encouraging verbalization of their feelings and concerns
___________ is reddening of the skin.
Erythema
Hydrocele is characterized by ___________ in the scrotal sac.
FLUID
Tinea is a term used to refer to a ___________ disease of the skin occurring on any part of the body.
FUNGAL
T/F A macule is a small raised bump on the skin.
False
T/F Hemoglobin is the percentage of red blood cells in the blood including serum.
False
T/F Infants and young children display relatively smaller lymph nodes, tonsils, and thymus compared with adults.
False
T/F Nursing interventions for a child with hydrocephalus include maintaining cerebral perfusion, administering intravenous antibiotics, and minimizing neurologic complications.
False
T/F Palpation should be the first in the sequence of the abdominal examination.
False
T/F Phenotype is the environmental variation that influences individual characteristics.
False
T/F The gestational history provides little information about genetic disorders.
False
T/F Children with dark skin tend to have more pronounced cutaneous reactions compared to children with lighter skin.
False
The complete set of chromosomes for a cell is called a ______________ and represents the entire genetic information for that cell.
GENOME
Sixteen-year-old Melody Carson is admitted to the pediatric intensive care unit after being a passenger in a car struck by a train. Two of her friends, also in the car, were killed in the accident. Melody is unconscious at this time. She also has a broken right femur, two broken ribs, and a fractured pelvis. What continuing assessments would the nurse focus on in caring for the neurologic injury Melody has sustained?
Glasgow Coma Scale Change in vital signs Indications of increased pain Restlessness Posturing
Urticaria is commonly known as___________.
HIVES
Normal immune function is a complex process involving phagocytosis, ______ immunity, cellular immunity, and the activation of the complement system.
HUMORAL
Sixteen-year-old Melody Carson is admitted to the pediatric intensive care unit after being a passenger in a car struck by a train. Two of her friends, also in the car, were killed in the accident. Melody is unconscious at this time. She also has a broken right femur, two broken ribs, and a fractured pelvis. What complications would it be important for the nurse to assess Melody for?
Hemorrhage Cerebral edema Herniation Infection
Sickle cell disease refers to a group of ________ hemoglobinopathies.
INHERITED
About one third of all children with urologic malformations are at high risk for the development of _____________ allergy.
LATEX
Complications of ________ poisoning include behavioral issues and learning difficulties and, at high levels, encephalopathy, seizures, and brain damage.
LEAD
Morbilliform refers to a rosy, _________ rash.
MACULOPAPULAR
A varsity high-school wrestler presents with a "rug burn" type of rash on his shoulder that is not healing as expected, despite use of triple antibiotic cream. Two other wrestlers on his team have a similar abrasion. What infection should the nurse be most concerned about, based on the history? A. Tinea cruris B. MRSA C. Impetigo D. Tinea versicolor
MRSA
Gwen Carter, 12 years old, is admitted to the pediatric unit of the hospital with a renal infection. Gwen was diagnosed with trisomy 21. What information would be important to include in the health history?
Maternal age at birth Cardiac defects or disease (treatment regimen, surgical repair) Hearing or vision impairment (last hearing and vision evaluation, any corrective measures) Developmental delays (speech, gross and fine motor skills) Sucking or feeding problems Cognitive abilities (degree of intellectual disability) Gastrointestinal disorders such as vomiting or absence of stools (special dietary management, surgical interventions) Thyroid disease Leukemia Atlantoaxial instability Seizures Infections such as recurrent or chronic respiratory infections, otitis media Growth (height and weight changes, feeding problems, unexplained weight gain) Signs and symptoms of sleep apnea, such as snoring, restlessness during sleep, daytime sleepiness Any other changes in physical state or medication regimen
The gastrointestinal tract includes all of the structures from the __________ to the anus.
Mouth
A 14-kg child with moderate dehydration has received two boluses of normal saline in the emergency room prior to being admitted to the pediatric nursing unit. The physician orders D5 ½ NS @ 1½ maintenance. What will the nurse assess for to determine whether the child is becoming overhydrated?
Overhydration would be indicated by: a. Edema b. weight gain c. Tachycardia d. excessive output of dilute urine
The nurse should assess for hypoxia, fatigue, and ______ in the child with anemia
PALLOR
Physical examination of the genitourinary system includes inspection and observation, auscultation, __________, and palpation.
PERCUSSION
Ricky Roberts, 2 years old, is brought to the emergency room by his parents and is actively having seizures. His mother tells the nurse that Ricky was diagnosed with epilepsy 6 months ago and that he has been having one seizure after another for the past 40 minutes. The mother states that Ricky has not regained consciousness in between seizures. What precautions would the nurse take to ensure the safety of an actively seizing child?
Padding of side rails and other hard objects Side rails raised on the bed at all times when the child is in bed Oxygen and suction at the bedside Supervision, especially during bathing, ambulation, or other potentially hazardous activities Use of a protective helmet during activity may be appropriate The child should wear a medical alert bracelet
Judy Kirk is a 14-month-old active child who has been brought to the clinic by her parents because of repeated ear infections. While weighing and measuring Judy the nurse notes seven café-au-lait spots on her trunk and lower extremities. What other physical assessments would the nurse make on Judy?
Pigmented nevi Axillary freckling Subcutaneous or dermal neurofibromas Head circumference Length/height
An 8-month-old is seen in the clinic. On assessment the nurse finds eight café-au-lait spots on the child's trunk and extremities. What other assessment findings may be pertinent?
Pigmented nevi; axillary freckling; slow-growing cutaneous, subcutaneous, or dermal neurofibromas; growths on the iris of the eye; a larger-than-normal head circumference; a shorter-than-average length; abnormal development of the spine (scoliosis), the temple bone of the skull, or the tibia; and a first-degree relative (parent, sibling, or child) with neurofibromatosis.
Gwen Carter, 12 years old, is admitted to the pediatric unit of the hospital with a renal infection. Gwen was diagnosed with trisomy 21. What nursing interventions would apply generally to Gwen and her family?
Providing supportive measures Promoting nutrition Providing support and education to the child and family Preventing complications
T/F Dehydration occurs more readily in infants and young children than it does in adults.
True
T/F Enuresis refers to continued incontinence of urine past the age of toilet training.
True
T/F Keloid formation occurs more often in dark-skinned children.
True
The ___________ is the lower orifice of the stomach opening into the duodenum.
Pylorus
Cellular immunity is mediated by the ___________.
T-CELLS
T/F Target lesions look like a bull's eye.
True
A 6-year-old child is admitted to the hospital because of a possible seizure. The child's mother calls the nurse to the room because the child is "jerking all over" and won't respond when she calls the child's name. List appropriate nursing interventions for this child. Prioritize the list of interventions.
The first priority will be to assess ABC's in the child then to prevent injury (loosen or remove tight clothing or necklaces if possible, turn child onto his side and open airway if possible, remove hazards). Time the seizure. Administer appropriate medication and treatments to stop seizure if ordered; remain calm and provide education and support to the child and family; provide appropriate documentation, including a description of behavior seen, length of seizure, and response to interventions.
Ricky Roberts, 2 years old, is brought to the emergency room by his parents and is actively having seizures. His mother tells the nurse that Ricky was diagnosed with epilepsy 6 months ago and that he has been having one seizure after another for the past 40 minutes. The mother states that Ricky has not regained consciousness in between seizures. What would be the nurse's priority action for this child?
The nurse knows that status epilepticus is a medical emergency and the priority would be basic life support—maintaining the airway, followed by breathing and circulation. Further treatment would be to administer anticonvulsants to stop seizure activity.
A 6-month-old baby is brought to the physician's office with a history of diarrhea. She has had six watery stools in the past 18 hours. She is vomiting her formula. Her mother states that she has had no fever. Identify a plan for this nursing diagnosis; include a teaching plan for the mother.
The plan should include oral rehydration (intravenous rehydration is not necessary in the case of mild dehydration), with instructions for clear liquids (preferably an oral rehydration solution) for the first 8 to 24 hours (see Teaching Guidelines 41.1). When vomiting resolves, the diet should include complex carbohydrates and fats to increase transit time, provide nutrition, and bulk up the stools.
T/F Prematurity, difficult delivery, and infection during pregnancy are risk factors associated with neurologic disorders.
True
T/F A family teaching plan for a child with epilepsy should include instructions for responding to seizures for parents, family, teachers, and day care workers.
True
T/F All blood cells originate from a single type of cell called a multipotent stem cell.
True
T/F Behavioral therapy and counseling may be necessary for children who have functional constipation and stool withholding.
True
T/F Contact dermatitis is a cell-mediated response to an antigenic substance exposure.
True
