Peds Exam 4
RSV Patient/Parent Education
-Between 2 and 8 days from the time of exposure to the time the person gets sick. Then the illness lasts about 3 to 7 days -Recovery time varies, depends on the severity of illness and overall health of patient. -Contagious for about 3 to 8 days. -Some people may be contagious for several weeks (such as those with a weakened immune systems) -Highly contagious -Seek immediate treatment if patient develops: Dehydration, Difficulty breathing, rapid breathing, Bluish tint to lips or nail beds, High fever, Lethargy, thick nasal discharge, worsening cough, productive cough
Bronchitis
-Bronchitis (sometimes referred to as tracheobronchitis) is inflammation of the large airways (trachea and bronchi), which is frequently associated with URIs. -Viral agents are the primary cause of the disease, including influenza A and B, parainfluenza, coronavirus (types 1 to 3), rhinovirus, respiratory syncytial virus, and human metapneumovirus. -The condition is characterized by a dry, hacking, and nonproductive cough that is worse at night, lasting more than 5 days but that can persist for 1 to 3 weeks.
Signs & Symptoms of RSV
-Coughing -Nasal discharge -Sneezing -Wheezing -Fever -Respiratory Distress -Retractions -Tachypnea -Apneic Episodes -Lethargy -Decreased LOC -Dehydration(poor Feeding) -Tachycardia -Cyanosis (not relieved by oxygen in severe cases) -Hypoxemia and Hypercapnia
Influenza
-Influenza (the "flu") is caused by the orthomyxoviruses and classified into three antigenically distinct groups: types A and B, which cause epidemic disease (included in the vaccine), and type C, which causes milder disease and is not included in the vaccine. -The disease is more common during the winter months and has a 1- to 4-day incubation period (average of 2 days), and affected persons are most infectious for 24 hours before and 5 to 7 days after the onset of symptoms.
Respiratory syncytial virus (RSV)
-RSV is caused by a virus and spread when an infected person coughs or sneezes. -The virus enters the body through the nose, mouth, or through the eyes. -Begins as a mild upper respiratory tract infection & eventually affects the bronchioles or lower airways-Most common in children 2-6 months of age-after a few days, they may develop a fever and bronchial inflammation. -Increased mucous secretions and bronchial inflammation block the mall bronchioles of the lungs -Because of this blockage, the air enters and can not leave, causing alveolar hyperinflation. -After hyperinflation of the alveoli, atelectasis occurs (collapse of the alveoli) as trapped air is absorbed rather than expired. -Hypoxia and death can occur without treatment.
Signs & Symptoms of Influenza
-The manifestations of influenza may be subclinical, mild, moderate, or severe. In most cases, there is a dry cough and a tendency toward hoarseness. A sudden onset of fever and chills may be accompanied by flushed face, photophobia, myalgia, sore throat, headache, hyperesthesia, fatigue and sometimes prostration, vomiting, and diarrhea. Subglottal croup is common, especially in infants. The symptoms of influenza last for 4 or 5 days. -Complications include severe viral pneumonia (often hemorrhagic), febrile seizures, encephalitis, encephalopathy, dehydration, and secondary bacterial infections, such as myocarditis, OM, sinusitis, or pneumonia.
Medications for Influenza
-Uncomplicated influenza in children usually requires only symptomatic treatment, including acetaminophen or ibuprofen for fever and sufficient fluids to maintain hydration. -Only oral oseltamivir (Tamiflu), inhaled zanamivir (Relenza), and IV peramivir (Rapivab) are recommended because of widespread resistance to amantadine (Symmetrel) and rimantadine (Flumadine). -Oseltamivir is the antiviral drug of choice that may be administered orally for 5 days to decrease flu symptoms. The medication can be used for infants and children of any age and is effective for types A and B influenza. As with other antiviral drugs, for best results the medication should be started within 2 days of the onset of symptoms. -Zanamivir can be used for treatment of influenza in patients 7 years of age and older or as a prophylaxis for patients 5 years of age and older. Zanamivir is an inhaled medication effective for types A and B influenza. The drug is taken twice daily for 5 days and is administered by a specially designed oral inhaler (Diskhaler). Bronchospasm and a decline in lung function can occur when zanamivir is used in patients with underlying airway disease, such as asthma or chronic obstructive pulmonary disease (COPD).
A 4-year-old child is scheduled for cardiac surgery in a week. The child's parents call the hospital to ask how to prepare the child for the upcoming hospitalization and surgical procedure. The nurse's reply should be based on the knowledge that A) children who are prepared experience less fear and stress during hospitalization. B) children who are prepared experience overwhelming fear by the time hospitalization occurs. C) preparation at this age will only increase the child's stress. D) preparation needs to be at least 2 to 3 weeks before hospitalization to be effective.
A) children who are prepared experience less fear and stress during hospitalization. Preparing the child for the hospitalization will reduce the number of unknown elements. Taking tours, handling some of the equipment, or being told stories about what to expect will increase the familiar items. Timing of the preparation must also be considered. Four- to 7-year-olds can be prepared up to 1 week in advance of the hospitalization. Preparation of a 4-year-old will reduce stress by having the child incorporate and assimilate the information more slowly. Children between the ages of 4 and 7 years should be prepared about 1 week before hospitalization. A reduction in fear is usually observed when children are prepared appropriately for hospitalization.
It is time to give a 3-year-old medication. What approach is most likely to receive a positive response from the child? A. "It's time for your medication now. Would you like water or apple juice afterward?" B. "Wouldn't you like to take your medicine now?" C. "You must take your medicine because the doctor says it will make you better." D. "See how nicely your roommate took medicine? Now take yours."
A. "It's time for your medication now. Would you like water or apple juice afterward?"
Which hospitalized children should have their intake and output (I&O) recorded as part of the plan of care? (Select all that apply.) A. 14-year-old postoperative for laparoscopic appendectomy with IV access but not receiving any fluids at this time B. 3-year-old receiving parenteral therapy along with antibiotics C. 8-year-old admitted with dehydration D. 14-year-old admitted for observation of concussion as a result of motor vehicle accident E. 16-year-old admitted for treatment of diabetes mellitus
A. 14-year-old postoperative for laparoscopic appendectomy with IV access but not receiving any fluids at this time B. 3-year-old receiving parenteral therapy along with antibiotics C. 8-year-old admitted with dehydration D. 14-year-old admitted for observation of concussion as a result of motor vehicle accident E. 16-year-old admitted for treatment of diabetes mellitus
A parent with a toddler who has a respiratory infection wants to use the traditional method of topical vapor rub. Which statement by the parent indicates that additional teaching is needed with regard to administration of this treatment? A. Application of the medication will be given orally to avoid potential sneezing. B. The parent will inform the pediatrician that the medication is being used. C. The parent states that he will wash his hands before applying the medication. D. The parent will read the product label before administering the medication.
A. Application of the medication will be given orally to avoid potential sneezing.
Apnea of infancy has been diagnosed in an infant scheduled for discharge with home monitoring. Part of the infant's discharge teaching plan should include A. Cardiopulmonary resuscitation (CPR) B. Administration of intravenous (IV) fluids C. Foreign airway obstruction removal using the Heimlich maneuver D. Advice that the infant not be left with caretakers other than the parents
A. Cardiopulmonary resuscitation (CPR)
In performing a work up for a school aged child who reports frequent abdominal pain symptoms, what information would be critical to collect in order to make an accurate clinical diagnosis? A. Find out the duration, onset and quality characteristics of the symptoms. B. Ask the child's parents for detailed information. C. Find out if the child has any food allergies or food intolerances. D. Take and document vital signs to establish a clinical baseline.
A. Find out the duration, onset and quality characteristics of the symptoms. School-age children typically relate recurrent abdominal pain. As such it is critical to obtain factors related to the pain characteristics, onset, duration and symptoms. This will help to correlate with potential organic and non-organic causes. Asking the parents' for detailed information may be needed but not at present to determine what type of pain the child is experiencing. Although it is important to denoted food allergies and food intolerance, the primary concern is abdominal pain presentation. Similarly, vital signs should be recorded but it is not the most critical piece of data that must be collected.
What should the nurse consider when providing support to a family whose infant has just been diagnosed with biliary atresia? A. Liver transplantation may be needed eventually. B. Death usually occurs by 6 months of age. C. The prognosis for full recovery is excellent. D. Children with surgical correction live normal lives.
A. Liver transplantation may be needed eventually. Approximately 80% to 90% of children with biliary atresia will require liver transplantation. If the condition is untreated, death will usually occur by 2 years of age. Long-term survival is possible with surgical intervention. Liver transplantation is usually required for long-term survival. Even with surgical intervention, most children progress to liver failure and require transplantation.
The nurse is caring for a child with probable intussusception. The child had diarrhea before admission, but while waiting for administration of air pressure to reduce the intussusception, the child passed a normal brown stool. What is the most appropriate nursing action? A. Notify the physician. B. Measure the abdominal girth. C. Auscultate for bowel sounds. D. Take vital signs, including blood pressure.
A. Notify the physician. Passage of a normal stool indicates that the intussusception has resolved. Notification of the physician is essential to determine whether a change in the treatment plan is indicated. Measurement of the abdominal girth may be indicated, but notifying the physician is the priority. Auscultating for bowel sounds may be indicted, but notifying the physician is the priority. Taking the vital signs, including the blood pressure, may be indicated, but notifying the physician is the priority.
A child is standing playing with toys and suddenly collapses. Attempts to engage the child in conversation are met with no response. Skin color indicates cyanosis. A preliminary assessment of the environment presents no specific issues. Based on this information, you would suspect that the child is? A. Potential aspiration of foreign body B. Experiencing seizure activity C. Potential allergic reaction D. Traumatic injury
A. Potential aspiration of foreign body
When considering Crohn's and Ulcerative Colitis (UC) as disease states, which clinical symptoms may appear to be common presentations in both? A. Rashes and joint pain B. Rectal bleeding C. Growth restriction D. Fistulas and strictures
A. Rashes and joint pain Rashes and joint pain are common presentations in both Crohn's and UC. Rectal bleeding is more common in UC. Growth restriction, fistulas and strictures are more common in Crohn's.
Which statement best describes Hirschsprung disease? A. The colon has an aganglionic segment. B. There is a passage of excessive amounts of meconium in the neonate. C. It results in excessive peristaltic movements within the gastrointestinal tract. D. It results in frequent evacuation of solids, liquids, and gas.
A. The colon has an aganglionic segment. Hirschsprung disease is a mechanical obstruction caused by a lack of motility of a segment of the intestine as a result of the lack of ganglionic cells; therefore, it is referred to as aganglionic megacolon. Hirschsprung disease is associated with a neonate's inability to pass meconium or an older child's inability to pass feces. There is a lack of peristalsis in the affected segment of the infant or child with Hirschsprung disease. The infant or child with Hirschsprung disease will be seen with constipation or the passage of ribbon-like stools.
In order to determine if a child's "toy" does not present a choking hazard while in the hospital, which type of process would the nurse utilize? A. Use a toilet paper roll to indicate whether the toy will pass the choke test. B. Drop the toy on the floor to see if any parts break off. C. Have the parents bring a "new" toy that is just bought from the store as that is the best indicator that there will be no loose parts. D. Have the child agree to not place the toy in his/her mouth while in the hospital.
A. Use a toilet paper roll to indicate whether the toy will pass the choke test.
A 5-year-old child is brought 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.) A. Vital signs B. Throat culture C. Medical history D. Assessment of breath sounds E. Emergency airway equipment readily available
A. Vital signs C. Medical history D. Assessment of breath sounds E. Emergency airway equipment readily available
Informed consent is valid when: (Select all that apply.) A. a person is over the age of majority and competent. B. the choice exercised is free of force, fraud, duress, or coercion. C. universal consent is used. D. information is provided to make an intelligent decision. E. it is completed only for major surgery.
A. a person is over the age of majority and competent. D. information is provided to make an intelligent decision.
A ventilator-dependent child is being discharged home from the hospital. Prior to discharge, the home health care nurse discusses the development of an emergency plan with the family. The most essential component(s) of the plan is/are A. acquisition of a backup generator. B. designation of an emergency shelter. C. notifying the power company that the child is on life support. D. provision for alternate heating and cooling source if power is lost. E. notifying emergency medical services that child is on life support.
A. acquisition of a backup generator.
A 2-month-old breastfed infant is successfully rehydrated with oral rehydration solutions (ORSs) for acute diarrhea. Instructions to the mother about breastfeeding should include to A. continue breastfeeding. B. stop breastfeeding until breast milk is cultured. C. stop breastfeeding until diarrhea is absent for 24 hours. D. express breast milk and dilute with sterile water before feeding.
A. continue breastfeeding. Breastfeeding should continue even if the infant has acute diarrhea. Culturing the breast milk is not necessary. Breastfeeding can continue with ORS to replace the ongoing fluid loss due to the diarrhea. Breast milk should not be diluted.
A 10-year-old child requires daily medications for a chronic illness. The mother tells the nurse that she is always nagging the child to take the medicine before school. The most appropriate nursing intervention to promote the child's compliance is to A. establish a contract with the child, including rewards. B. suggest time-outs when the child forgets her medicine. C. discuss with the child's mother the damaging effects of nagging. D. ask the child to bring her medicine containers to each appointment so that the pills can be counted.
A. establish a contract with the child, including rewards.
A physiologic benefit of fever in a child is that it A. increases interferon production. B. prevents spread of infection due to decrease in release of chemical mediators. C. indicative of the infectious process being viral in origin. D. correlates with overall prognosis of medical event.
A. increases interferon production.
The best explanation for using pulse oximetry on young children is that it A. is noninvasive. B. is better than capnography. C. is more accurate than arterial blood gas measurements. D. provides intermittent measurements of oxyge
A. is noninvasive.
A home health nurse is assigned to an adolescent with recently acquired quadriplegia. The adolescent's mother tells the nurse, "I'm sick of providing all the care while my husband does whatever he wants and whenever he wants." Based on the nurse's knowledge of family-centered care, the most appropriate nursing intervention is to A. listen and reflect the mother's feelings. B. refer the mother for psychological counseling. C. suggest ways the mother can get the husband to help with care. D. meet with the adolescent's father in private and ask why he does not help.
A. listen and reflect the mother's feelings. It is appropriate for the nurse to reflect with the mother about her feelings and explore avenues for additional home health assistance and provide respite care for the mother. A support group for caregivers is more appropriate at this time, not counseling. It is inappropriate for the nurse to agree with the mother that the husband is not helping enough. The nurse is making a judgment that is beyond the role of the nurse in addition to undermining the family relationship. It is inappropriate to meet with the father privately because the meeting is based on the mother's assumption of the father's minimal involvement with the adolescent's care. The father may be working two jobs to support the family's additional expenses.
Asthma is classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include (Select all that apply) A. lung function. B. associated allergies. C. frequency of symptoms. D. frequency and severity of exacerbations.
A. lung function. D. frequency and severity of exacerbations.
The parent of a child with cystic fibrosis calls the clinic nurse to report that the child has developed 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 A. pneumothorax. B. bronchodilation. C. carbon dioxide retention. D. increased viscosity of sputum.
A. pneumothorax.
An infant with a congenital heart defect is receiving palivizumab (Synagis). Based on the nurse's knowledge of medication, the purpose of this medication is to A. prevent respiratory syncytial virus (RSV) infection. B. make isolation of the infant with RSV unnecessary. C. prevent secondary bacterial infection. D .decrease toxicity of antiviral agents.
A. prevent respiratory syncytial virus (RSV) infection.
A child, age 7 years, is being treated at home and has a fever associated with a viral illness. The principal reason for treating the child's fever is A. relief of discomfort. B. reassurance that illness is temporary. C. prevention of secondary bacterial infection. D. prevention of life-threatening complications.
A. relief of discomfort.
A 4-year-old boy needs to use a metered-dose inhaler to treat asthma. He cannot coordinate the breathing to use it effectively. The nurse should suggest that he use a A. spacer. B. nebulizer. C. peak expiratory flow meter. D. trial of chest physiotherapy.
A. spacer.
Prior to accepting an assignment as a home health nurse, the nurse must realize that A. the family is in charge. B. all decisions are made by the healthcare provider. C. the family will adapt their lifestyle to the needs of the nurse. D. independent decisions regarding emergency care of the child are made by the nurse.
A. the family is in charge. The nurse must realize that the family is in charge. The family is in charge and the healthcare providers must realize this matter. The nurse must be flexible and adaptable to the family's lifestyle. Informed consent must be provided by the family for emergency care - any care.
When caring for a child with an intravenous (IV) infusion, the most appropriate nursing interventions are to: (Select all that apply.) A. use an infusion pump with a microdropper to ensure the prescribed infusion rate. B. monitor rate by checking infusion pump programming. C. observe the insertion site frequently for signs of infiltration. D. change the insertion site every 24 hours. E. avoid restraining the child to prevent undue emotional stress.
A. use an infusion pump with a microdropper to ensure the prescribed infusion rate. B. monitor rate by checking infusion pump programming. E. avoid restraining the child to prevent undue emotional stress.
The most appropriate nursing intervention for a child following a tonsillectomy is to A. watch for continuous swallowing. B. encourage gargling to reduce discomfort. C. position the child on the back for sleeping. D. apply warm compresses to the throat.
A. watch for continuous swallowing.
Working with parents in preparation for discharge of a hospitalized child who will need to have wet to dry dressing changes performed at home will require that the nurse include which element in the plan of care? A) Provide the parents with a detailed instruction sheet regarding the dressing change procedure as the method of instruction. B) Arrange for a step by step training sequence for wet to dry dressing changes with the parents of the child with return demonstration to evaluate understanding. C) Arrange for home health nurse to change dressings as the parents may not understand the complexity of the task. D) Arrange for follow up with the child's pediatrician prior to the next scheduled dressing change so that the parents can receive further instruction.
B) Arrange for a step by step training sequence for wet to dry dressing changes with the parents of the child with return demonstration to evaluate understanding. Arranging for step-by-step sequenced instructions along with return demonstration should be included in the plan of care for the discharge of this child who requires wet to dry dressing changes. Arranging for home health to provide this service may not be possible in terms of insurance coverage. Providing the parents with a detailed instruction sheet should be given but it not the sole method of instruction as it is important to assess and implement tasks so as to make sure that the parents have a thorough understanding of the process. And while follow up with the pediatrician is part of the discharge process, it is the hospital's responsibility to provide thorough discharge instructions and training.
A child has a long standing history of abuse which has triggered many emotional problems. Which type of therapy would be indicated to possibly help the child explore these emotional problems? A) Creative expression B) Play therapy C) Therapeutic play D) Dramatic play
B) Play therapy Play therapy is used for patients who have psychological problems facilitated by trained professionals to encourage expression of feelings. Dramatic play is used as a method of communication and interaction whereby children play with puppets and/or objects to gain understanding. Therapeutic play helps the child to learn to deal with fears and apprehension but is nondirective in nature. Creative expression is a method whereby children can use other media such as drawing and painting to express their feelings.
In helping a child to adapt to a hospitalization experience, the best approach would be to A) let the parents bring in food from home that the child is used to eating for all meals. B) establish a daily routine and schedule with the child and parent to help maintain consistency. C) allow the child to select his room on the unit. D) allow the child to bring in all of his favorite toys to the hospital so as to represent a more familiar environment.
B) establish a daily routine and schedule with the child and parent to help maintain consistency. By providing a daily routine and schedule, the nurse helps to support consistency. It is not realistic for the child to bring in all of his favorite toys or allow the child to make a room selection on the unit. Bringing food in from home for all meals is not realistic and may not be advised based on therapeutic treatment.
An adolescent is admitted to the hospital for a fractured femur. The most appropriate nursing intervention(s) in caring for this adolescent is/are to (Select all that apply.) Select all that apply. A) provide written material about the hospital. B) explain the upcoming surgery to the adolescent using anatomically correct models. C) provide education for the parents of what to teach so they can share with their adolescent. D) offer flexible routines to encourage interaction. E) provide an opportunity for the adolescent to try on surgical attire.
B) explain the upcoming surgery to the adolescent using anatomically correct models. D) offer flexible routines to encourage interaction. E) provide an opportunity for the adolescent to try on surgical attire.
Each duration of suctioning a tracheostomy tube should be performed for no longer than: A. 3 seconds B. 5 seconds C. 10 seconds D. 15 seconds
B. 5 seconds
You are educating nursing student regarding fluid requirements for pediatric patients who present with comorbidities. Increased need for fluid requirements would be consistent with treatment management for which conditions? (Select all that apply.) A. CHF B. DKA C. SIADH D. DI E. Burns
B. DKA D. DI E. Burns Increased fluid requirements would occur in response to DKA, DI and burns. CHF and SIADH would lead to decreased fluid requirements.
What clinical manifestations would the nurse expect to find in a newborn who has developed necrotizing enterocolitis (NEC)? A. Hyperthermia B. Gastric residual and melena C. The passage of ribbon-like stools D. Projectile vomiting
B. Gastric residual and melena The most prominent signs of NEC are abdominal distention, gastric residuals, and blood in the stools (melena). NEC resembles septicemia; the newborn may "not look well," in addition to having nonspecific signs such as lethargy, poor feeding, hypotension, hypothermia, bile-stained vomitus, and oliguria. The newborn with NEC is more likely to be seen with hypothermia, not hyperthermia. The passage of ribbon-like stools is seen in newborns and infants born with Hirschsprung disease. Projectile vomiting is seen in newborns and infants with pyloric stenosis.
A nurse is preparing to administer a gavage feeding to an infant. Which type of restraining method would be indicated? A. Car seat restraint B. Mummy restraint C. Jacket restraint D. Arm restraints
B. Mummy restraint
An infant with neurologic impairment and delay is receiving several medications. A proton pump inhibitor is one of the medications the infant is receiving. Which medication(s) is/are proton pump inhibitor(s)? (Select all that apply.) A. Ranitidine (Zantac) B. Omeprazole (Prilosec) C. Pantoprazole (Protonix) D. Glycopyrrolate (Robinul) E. Bethanechol (Urecholine)
B. Omeprazole (Prilosec) C. Pantoprazole (Protonix) Omeprazole (Prilosec) utilizes a proton pump inhibitor that blocks the action of acid- producing cells. Pantoprazole (Protonix) utilizes a proton pump inhibitor that blocks the action of acid- producing cells. Ranitidine (Zantac) is a histamine-2 (H2) receptor blocker, not a proton pump inhibitor. Ranitidine (Zantac) inhibits the action of histamine at the H2 receptor site in the stomach that results in the inhibition of gastric acid secretion. Glycopyrrolate (Robinul) is an anticholinergic agent that is used to inhibit excessive salivation. Bethanechol (Urecholine) is a prokinetic drug and remains controversial in use.
A nurse has been assigned as the home health nurse for a technologically dependent child. The nurse recognizes that the background of this family differs widely from the nurse's own. The nurse views some of their lifestyle choices as less than ideal. What is the most appropriate nursing intervention? A. Assign the nurse a different family to follow. B. Respect the differences C. Assess why the family is different D. Determine whether the family is dysfunctional
B. Respect the differences The nurse must respect the family's culture and background. The family is the constant in the child's life, and cultural awareness and sensitivity are critical to a nurse's care of a child and family. The nurse may have some influence on care necessary for the child, but it is inappropriate to assign the nurse to a different family. Nurses must be able to work with families from all cultural groups and respect the differences between the families' cultural norms and those of the nurse's own culture. The nurse will assess the differences, but respecting these differences is what is important. Cultural differences do not make a family dysfunctional, unless the cultural practices are putting the child at risk.
The most appropriate time to perform bronchial postural drainage is A. immediately before all aerosol therapy. B. before meals and at bedtime. C. Immediately on arising and at bedtime. D. thirty minutes after meals and at bedtime
B. before meals and at bedtime.
A 4-year-old child has ingested a toxic dose of iron. The parent reports that the child vomited and complained of gastric pain an hour ago but "feels fine" now. The parent is not certain when the child ingested the iron tablets. The most appropriate recommendation by the nurse to the parent is to A. observe the child closely for 2 more hours. B. bring the child to the hospital immediately. C. administer activated charcoal. D. administer ipecac to induce vomiting if the child does not vomit again within 1 hour.
B. bring the child to the hospital immediately. The child should be transported to the hospital immediately for assessment and possible gastric lavage. The period of concern for complications of iron toxicity is from 30 minutes to 6 hours. Activated charcoal does not bind iron and, therefore, is not a course of treatment for this child. Ipecac is not recommended for poisonings.
The nurse observes erythema, pain, and edema at a child's intravenous (IV) infusion site with streaking along the vein. The nurse's priority action is to A. check for a good blood return. B. immediately stop the infusion. C. ask another nurse to check the IV site. D. increase IV drip with normal saline for 1 minute and recheck.
B. immediately stop the infusion.
A child has been diagnosed with hepatitis A and received treatment. Based on this information the nurse determines that A. the illness was transmitted via blood route. B. immunity has been acquired for this type. C. crossover immunity is present for all types of hepatitis. D. the patient will now be a carrier for this type.
B. immunity has been acquired for this type. Once a patient has been exposed and treated, they develop immunity to this type but there is no crossover immunity to other hepatitis types. Hepatitis A if transmitted through fecal-oral route and is not blood borne. There is no carrier state for Hepatitis A.
An immediate intervention to teach parents for when an infant chokes on a piece of food would be to A. have infant lie quietly while a call is placed for emergency help. B. position infant in a head-down, face-down position and administer five quick back slaps. C. administer mouth-to-mouth resuscitation. D. give some water by a cup to relieve the obstruction.
B. position infant in a head-down, face-down position and administer five quick back slaps.
Management of the child with a peptic ulcer often includes A. milk at frequent intervals. B. proton pump inhibitors. C. antacids 1 and 3 hours before meals and at bedtime. D. coping with stress and adjusting to chronic illness.
B. proton pump inhibitors. Proton pump inhibitors block the production of acid. They are well tolerated and have infrequent side effects. Milk is not beneficial in the management of peptic ulcer disease. Proton pump inhibitors are more effective than antacids. Coping with stress is beneficial, but peptic ulcer disease is treatable.
A case manager is assigned to coordinate the care of a child with a complex medical condition. The family is told that one of the goals is to control costs. This goal should be recognized as A. unsafe. B. realistic. C. impossible. D. inappropriate.
B. realistic Management of costs is one part of case management. With a case manager providing coordination and continuity across care settings and facilitating access to needed medical services, cost control is a realistic outcome. Cost management will only be unsafe if treatment and equipment necessary for the child's care are denied. Cost management is a realistic goal for the case manager, not an impossible one. Cost management is a realistic goal for the case manager, not an inappropriate one, unless treatment or equipment necessary for the child's care is denied.
The mother of a 20-month-old tells the nurse that the child has a barking cough at night. The child's temperature is 37ºC (98.6ºF). The mother states the child is not having difficulty breathing. The nurse suspects croup and should recommend A. controlling the fever with acetaminophen (Tylenol) and call the primary care provider if the cough gets worse tonight. B. trying a cool-mist vaporizer at night and watching for signs of difficulty breathing. C. trying over-the-counter cough medicine and coming to the clinic tomorrow if there is no improvement. D. bringing the child to the hospital to be admitted and to be observed for impending epiglottitis.
B. trying a cool-mist vaporizer at night and watching for signs of difficulty breathing.
Bronchiolitis
Bronchiolitis is an acute viral infection with maximum effect at the bronchiolar level. The infection typically begins with upper respiratory symptoms due to the bronchioles swelling and filling with mucus and occurs primarily in winter and early spring. -Most cases of bronchiolitis are caused by RSV, adenoviruses, parainfluenza viruses, and human metapneumovirus.
A toddler is hospitalized for an upcoming surgical procedure. Which method might provide the best way to inform the child about the surgery? A) Having the child sign his name with an "X" on an actual surgical consent form. B) Taking the child to the operating theater to view a surgery. C) Allowing the child to dress up using surgical gown and mask. D) By using anatomical drawings as illustrations and allowing the child to color them with markers.
C) Allowing the child to dress up using surgical gown and mask. The concept of dramatic play is used to provide information to children who are having complex health issues or who have to undergo surgical procedures or therapies. It allows for children to be able to respond and interact with the possibility of puzzling or frightening experiences related to the unknown. The use of anatomical drawings may be too realistic for the toddler even though markers would be allowed for coloring. Having the child sign an "X" on an actual surgical consent would not be understood this developmental level. Taking the child to view a surgery at this age may cause more anxiety.
Because the absorption of fat-soluble vitamins is decreased in cystic fibrosis, which vitamin supplementation is necessary? A. C, D B. A, E, K C. A, D, E, K D. C, folic acid
C. A, D, E, K
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? A. Bring the child to the hospital for intravenous fluids. B. Alternate giving ORS and carbonated drinks. C. Continue to give ORS frequently in small amounts. D. Institute a nothing by mouth (NPO) status for the child for 8 hours, and resume ORS if vomiting has subsided.
C. Continue to give ORS frequently in small amounts. Vomiting is not a contraindication to the use of ORS unless it is severe. The mother should continue to give the ORS in small amounts and at frequent intervals. For a school-age child with mild dehydration, rehydration can be safely done at home with oral solutions. Carbonated drinks should not be used. They may have a high carbohydrate content and contain caffeine, which is a diuretic and could exacerbate fluid loss and dehydration. NPO status is not indicated. Small, frequent intake of ORS is recommended.
What should the nurse include when teaching an adolescent with Crohn disease? A. Preventing the spread of illness to others and nutritional guidance B. Adjusting to chronic illness and preventing the spread of illness to others C. Coping with stress and adjusting to chronic illness D. Nutritional guidance and preventing constipation
C. Coping with stress and adjusting to chronic illness Crohn disease is a chronic disease with life-altering complications. The nursing interventions include helping the child cope with stress and adjust to the illness. Nutritional guidance is necessary, but Crohn disease is not infectious. Adjustment to chronic illness is necessary, but Crohn disease is not infectious. Nutritional guidance is necessary, but constipation is not an issue.
Which factor predisposes an infant to fluid imbalances? A. Decreased surface area B. Lower metabolic rate C. Immature kidney functioning D. Decreased daily exchange of extracellular fluid
C. Immature kidney functioning The infant's kidneys are unable to concentrate or dilute urine, to conserve or excrete sodium, and to acidify urine. The infant has a proportionately greater body surface area, which allows for greater insensible water loss. The infant has a higher metabolic rate. The infant has an increased amount of extracellular fluid. Approximately 60% of the fluid loss is from the extracellular space.
Which diet is most appropriate for the child with celiac disease? A. Salt-free diet B. Phenylalanine-free diet C. Low-gluten diet D. High-calorie, low-protein, low-fat diet
C. Low-gluten diet Celiac disease is characterized by intolerance of gluten, the protein found in wheat, barley, rye, and oats. A low-gluten diet is indicated for life. The diet for a child with celiac disease does not have to be salt free. A low-phenylalanine diet is indicated in phenylketonuria. The diet of a child with celiac disease should be high in calories and protein and low in fat, in addition to the low-gluten requirement.
The nurse needs to give an injection to a 4-year-old in the deltoid muscle. Based on the nurse's knowledge of preschool development, the most appropriate approach by the nurse is to: A. smile while giving the injection to help the child relax. B. tell the child that you will be so quick, the injection won't even hurt. C. explain with concrete terms such as "putting medicine under the skin." D. explain that child will experience "a little stick in the arm."
C. explain with concrete terms such as "putting medicine under the skin."
Standard precautions for infection control include A. gloves are worn anytime a patient is touched. B. needles are capped immediately after use and disposed of in a special container. C. gloves are worn to change diapers when there are loose or explosive stools. D. masks are needed only when caring for patients with airborne infections.
C. gloves are worn to change diapers when there are loose or explosive stools.
Several types of long-term central venous access devices are used in practice. The benefit of using a long-term central venous access device such as a Port-a-Cath is that A. implanted devices are easy to use for self-administered infusions. B. implanted devices do not require piercing the skin for access. C. implanted devices do not require limiting regular physical activity, including swimming. D. implanted devices cannot dislodge, even if child "plays" with the port site.
C. implanted devices do not require limiting regular physical activity, including swimming.
A neonate had corrective surgery 3 days ago for esophageal atresia. The nurse notices that after gastrostomy feedings, there is often a backup of feeding into the tube. The most appropriate intervention by the nurse is to A. position the child in a supine position after feedings. B. position the child on the left side after feedings. C. leave the gastrostomy tube open and suspended after feedings. D. leave the gastrostomy tube clamped after feedings.
C. leave the gastrostomy tube open and suspended after feedings.
The care of a newborn with a cleft lip and palate before surgical repair includes A. little to no sucking. B. gastrostomy feedings. C. providing nonnutritive and nutritive sucking. D. positioning infant in near-horizontal for feeding.
C. providing nonnutritive and nutritive sucking. Infants need nutritive and nonnutritive sucking. Nutritive and nonnutritive sucking is important to the infant. Gastrostomy feedings are not usually required or indicated. The appropriate positioning for the infant is the upright position.
A 2 1/2-year-old ventilator-dependent child will be discharged home soon. The family expresses concern that their child might change the ventilator settings by exploring the control knobs and buttons. Based on the nurse's knowledge of child development, the most appropriate intervention by the nurse is to A. teach the child not to touch controls B. explain that the child cannot be left alone because of the risk of the child changing the settings C. recommend ways to cover the controls to reduce the risk of the child changing the settings D. reassure the family that developmentally the child is unable to change the ventilator settings
C. recommend ways to cover the controls to reduce the risk of the child changing the settings
Treatment methods used for status asthmaticus focus on A. supportive oxygen therapy to maintain saturation at 90%. B. resolving acid-base disturbances that have led to alkalosis. C. restoring hydration. D. decreasing airway compliance.
C.. restoring hydration. Rationale: Treatment methods for status asthmaticus are aimed at improving ventilation, decreasing airway resistance, relieving bronchospasm, correcting dehydration and acidosis, decreasing anxiety and treating any underlying concurrent infection. Oxygen saturation should be maintained at greater than 90%, typical acid-base disturbances result in acidosis, not alkalosis.
A child with a serious chronic illness will soon be discharged home. The case manager requests that the family provide total care for the child for a couple of days while the child is still hospitalized. Based on the principles of family-centered care, which statement addresses this principle? A) Inappropriate because the family will have to assume the care soon enough and this may increase their stress unnecessarily. B) Inappropriate because of legal issues when parents care for their children on hospital property. C) Appropriate because families are usually eager to get involved. D) Appropriate because it can be beneficial to the transition from hospital to home.
D) Appropriate because it can be beneficial to the transition from hospital to home. This is appropriate. At least two family members should be comfortable caring for the child before discharge. Caring for the child with the nurse available to answer questions and provide support and guidance will make the transition home for the parents and child easier. The family needs to learn the skills necessary to care for the child at home. Their eagerness is important, but it is not the reason to provide total care for their child while still hospitalized. The family members will be able to learn to care for their child with the supervision of nursing staff. Legal issues related to caring for their child in the hospital setting are not relevant. Learning to care for their child before discharge is essential to properly prepare the family to assume the care and minimize their stress level as much as possible.
With regard to separation anxiety displayed in a child who is hospitalized, which behavior would indicates the stage of despair? A) Child clings to parents for comfort. B) Child tells nurses and staff to "go away." C) Child is constantly crying and sobbing. D) Child no longer cries.
D) Child no longer cries. Demonstrating regressive behavior is a characteristic of the stage of despair. All of the other options indicate a stage of protest.
Which behavior would most likely be manifested in a young child experiencing the protest phase of separation anxiety? A) Forming superficial relationships B) Depression and sadness C) Inactivity D) Exhibit loud crying
D) Exhibit loud crying In the protest phase of separation anxiety, the child aggressively responds to separation from a parent by clinging and holding onto the parent and screaming for the parent. Inactivity is a sign of despair in a young child, not protest. A depressed, sad child indicates despair, not the protest phase. The formation of superficial relationships indicates that a young child is in the phase of detachment, not protest.
A 12-year-old child is admitted for an emergency appendectomy and rushed into surgery. The parents tell the nurse that they also have a 4-year-old son at home and wonder if they should tell him about his older brother being in the hospital. The best response by the nurse to this query would be to? A) Have the parents go home and bring their 4-year-old back to the hospital so he can be present throughout this family stress experience. B) Have the parents bring their son in during visiting hours and arrange for a tour of the hospital unit. C) Tell the parents to refrain from telling the 4-year-old as he will not be able to understand the concepts of hospitalization and surgery. D) It is important to tell their 4-year-old son about his older brother using words and terms that he can understand at his age.
D) It is important to tell their 4-year-old son about his older brother using words and terms that he can understand at his age. It is important to share a hospitalization experience with siblings, however being mindful of their developmental and cognitive level. And while the 4-year-old can be taken into the hospital setting and even receive a tour of the hospital unit, the experience should not be tied into a "show and tell" event. The 4-year-old child does not have to present throughout the entire hospitalization experience as that may produce unnecessary stress in altering his environment and daily routine.
How long should the child be allowed to rest in between tracheostomy aspiration before being repeated? A. 5-15 seconds B. 10-20 seconds C. 20-40 seconds D. 30-60 seconds
D. 30-60 seconds
A child with asthma is having pulmonary function tests. What explains the purpose of the peak expiratory flow rate (PEFR)? A. Confirms the diagnosis of asthma B. Determines the cause of asthma C. Identifies the "triggers" of asthma D. Assesses the severity of asthma
D. Assesses the severity of asthma
Cystic fibrosis may affect one system or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations? A. Atrophic changes in the mucosal wall of the intestines B. Hypoactivity of the autonomic nervous system C. Hyperactivity of the apocrine glands D. Mechanical obstruction caused by increased viscosity of exocrine gland secretions
D. Mechanical obstruction caused by increased viscosity of exocrine gland secretions
What clinical manifestation would the nurse expect when a pneumothorax occurs in a neonate who is undergoing mechanical ventilation? A. Barrel chest B. Wheezing C. Thermal instability D. Nasal flaring and retractions
D. Nasal flaring and retractions
The nurse needs to take the blood pressure of a preschooler for the first time. What action would be best for gaining the child's cooperation? A. Take the blood pressure when a parent is there to comfort the child. B. Tell the child that this procedure will help the child to get well faster. C. Explain to the child how blood flows through the arm and why taking the blood pressure is important. D. Permit the child to handle equipment and see the dial move before putting the cuff in place.
D. Permit the child to handle equipment and see the dial move before putting the cuff in place.
The nurse is doing preoperative teaching with a child and the parents. The parents say the child "is dreading the shot for before surgery." On which of the following facts should the nurse's response be based? A. Preanesthetic medication can only be given intramuscularly. B. In children, the intramuscular (IM) route is safer than the intravenous (IV) route. C. The child will have no memory of the injection because of amnesia. D. Preanesthetic medication should be "atraumatic," using oral, existing IV, or rectal routes.
D. Preanesthetic medication should be "atraumatic," using oral, existing IV, or rectal routes.
A child has a nasogastric (NG) tube after surgery for acute appendicitis. What is the purpose of the NG tube? A. Maintain electrolyte balance B. Maintain an accurate record of output C. Prevent the spread of infection D. Prevent abdominal distention
D. Prevent abdominal distention The NG tube is used to maintain gastric decompression until intestinal activity returns. The NG tube may adversely affect electrolyte balance by removing stomach secretions. NG drainage is one part of the child's output. The nurse would need to incorporate the NG drainage with other output. There is no relationship between the NG tube and prevention of the spread of infection.
A child is exhibiting signs of clinical dehydration. Which laboratory value would support a diagnosis of hypertonic dehydration? A. Serum sodium level of 135 mEq/dL B. Plasma osmolality of 275 mOsm/L C. Calculation of loss of body fluid weight at 25 mL/kg D. Serum sodium level of 150 mEq/dL
D. Serum sodium level of 150 mEq/dL Hypertonic dehydration would result in an increase in serum sodium levels in proportion to fluid loss. Normal serum sodium level ranges between 135 and 145 mEq/dL. Normal plasma osmolality is within the 275 to 295 mOsm/L. Calculation of loss of body fluid weight in terms of moderate loss would be at 50 mL/kg with 100 mL/kg being severe.
The nurse is interviewing the parents of a 4-month-old infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in the crib with a blanket over the head, lying face down in bloody fluid from the nose and mouth. The parents indicate no problems when the infant was placed in the crib asleep. Which of the following causes of death does the nurse suspect? A. Suffocation B. Child abuse C. Infantile apnea D. Sudden infant death syndrome (SIDS)
D. Sudden infant death syndrome (SIDS)
The nurse is discussing home care with the mother of a 6-year-old child with hepatitis A. Part of the discharge teaching plan should include? A. Bed rest is important until 1 week after the icteric phase. B. The child should not return to school until 3 weeks after the icteric phase. C. Reassure the mother that hepatitis A cannot be transmitted to other family members. D. Teach infection control measures to family members.
D. Teach infection control measures to family members. Hepatitis A is a contagious disease, transmitted through the fecal-oral route. The nurse should teach infection control measures to family members. Hepatitis A does not usually have an icteric phase and often is subclinical. The period of communicability for hepatitis A is the latter half of the incubation period to 1 week after the onset of clinical illness; therefore, the child can return to school after that time frame. Hepatitis A is infectious through the fecal-oral route; therefore, family members may be susceptible to acquiring the disease if they fail to institute proper infection control measures.
Prior to returning to school, an individualized home care plan (IHCP) needs to be developed for which child? A. The child recently identified with a penicillin allergy. B. The child being treated for pediculosis capitis (head lice). C. The child out of school for two week due to mononucleosis. D. The child recently diagnosed with insulin-dependent diabetes mellitus.
D. The child recently diagnosed with insulin-dependent diabetes mellitus. An IHCP is needed for the insulin-dependent child to ensure appropriate management of health care needs is in place. The child allergic to penicillin will not receive this medication anymore and a medication alert ID is necessary. An IHCP is not needed. The child treated for pediculosis capitis (head lice) can return to school and does not need an IHCP. The child who missed two weeks of school will need arrangements made for make-up work and an IHCP is not needed.
The nurse is caring for an infant with a tracheostomy when accidental decannulation occurs. The nurse is unable to reinsert the tube. What action should the nurse take next? A. Notify the surgeon. B. Perform oral intubation. C. Try inserting a larger tracheostomy tube. D. Try inserting a smaller tracheostomy tube.
D. Try inserting a smaller tracheostomy tube.
It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent A. otitis media. B. diabetes insipidus. C. nephrotic syndrome. D. acute rheumatic fever
D. acute rheumatic fever
A home health nurse is caring for a 2-week-old infant and notes on assessment that the infant has a string tied around the wrist. The nurse checks for adequate circulation. The most appropriate nursing intervention by the nurse is to A. ask the parents to remove the string. B. report the parents to Social Services for child endangerment. C. remove the string and inform the parents that the string is dangerous. D. ask the parents the meaning of the string and leave the string in place.
D. ask the parents the meaning of the string and leave the string in place. Families of various cultural backgrounds have specific beliefs about health care. These beliefs may differ from the nurse's beliefs and the nurse needs to honor the practices and seek clarification of the cultural practice. The nurse should honor the practices of the family. For the nurse to do otherwise would lead to loss of trust from the family. The nurse needs to provide education to the family that includes safety principles as the infant grows. The nurse should honor the practices of the family. For the nurse to do otherwise would lead to loss of trust from the family. The nurse needs to provide education to the family that includes safety principles as the infant grows. The nurse should honor the practices of the family. For the nurse to do otherwise would lead to loss of trust from the family. The nurse needs to provide education to the family that includes safety principles as the infant grows.
One of the goals for children with asthma is to prevent respiratory tract infection because infections A. lessen effectiveness of medications. B. encourage exercise-induced asthma. C. increase sensitivity to allergens. D. can trigger an episode or aggravate asthmatic state.
D. can trigger an episode or aggravate asthmatic state.
Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress the A. importance of reducing caloric intake to decrease cardiac demands. B. importance of relaxing discipline and limit-setting to prevent crying. C. need to be extremely concerned about cyanotic spells. D. desirability of promoting normalcy within the limits of the child's condition.
D. desirability of promoting normalcy within the limits of the child's condition. The child needs to have social interactions, discipline, and appropriate limit setting. Parents need to be encouraged to promote as normal a life as possible for their child. The child needs increased caloric intake after cardiac surgery. The child needs discipline and appropriate limit setting, as would be done with any other child his or her age. Because cyanotic spells will occur in children with some defects, the parents need to be taught how to assess for and manage them appropriately, thereby decreasing their anxiety and concern.
The nurse assesses a neonate immediately after birth. Clinical sign-symptom of tracheoesophageal fistula is A. jaundice B. bile-stained vomitus C. absence of sucking D. excessive amount of frothy saliva in the mouth
D. excessive amount of frothy saliva in the mouth Excessive salivation and drooling are indicative of tracheoesophageal fistulas. With a fistula, the child has difficulty managing the secretions, which may cause choking, coughing, and cyanosis. Jaundice is not usually associated with a tracheoesophageal fistula. Bile-stained vomitus is not usually associated with a tracheoesophageal fistula. The infant is able to suck with a tracheoesophageal fistula but is not able to manage the secretions.
The nurse working in an outpatient surgery center for children should understand that A. children's anxiety is minimal in such a center. B. waiting is not stressful for parents in such a center. C. accurate and complete discharge teaching is the responsibility of the surgeon. D. families need to be prepared for what to expect after discharge.
D. families need to be prepared for what to expect after discharge. Discharge instructions should be provided in both written and oral form and in the primary language of the patient and family. Instructions need to include normal responses to the procedure and when to notify the practitioner if untoward reactions occur. Although anxiety may be reduced because of the lack of an overnight stay, the child will still experience the stress associated with a medical procedure. The waiting period while the child is having the procedure is a stressful time for families in both outpatient and inpatient settings. Discharge instructions are a responsibility of both the surgeon and the nursing staff.
The school nurse is called to the cafeteria because a child "has eaten something he is allergic to." The child is in severe respiratory distress. The first action by the nurse is to A. determine what the child has eaten. B. administer diphenhydramine (Benadryl) PO stat. C. move the child to the nurse's office or hallway. D. have someone call for an ambulance and paramedic rescue squad or 9-1-1.
D. have someone call for an ambulance and paramedic rescue squad or 9-1-1.
A 4-year-old child is brought to the emergency department. The child has a "froglike" croaking sound on inspiration, is agitated, and is drooling. The child insists on sitting upright. The priority action by the nurse is to A. examine the child's oropharynx and report the assessment to the healthcare provider. B. make the child lie down and rest quietly. C. auscultate the child's lungs and make preparations for placement in a mist tent. D. notify the healthcare provider immediately and be prepared to assist with a tracheostomy or intubation.
D. notify the healthcare provider immediately and be prepared to assist with a tracheostomy or intubation.
The nurse is preparing a plan to teach a mother how to administer 1 1/2 teaspoons of medicine to her 6-month-old child. Based on the nurse's knowledge of administering pediatric medications, the nurse teaches the parent to use a A. household measuring spoon. B. regular silverware teaspoon. C. paper cup measure in 5-ml increments. D. plastic syringe (without needle) calibrated in milliliters.
D. plastic syringe (without needle) calibrated in milliliters.
A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because it A. liquefies secretions. B. improves oxygenation. C. promotes ventilation. D. soothes inflamed mucous membrane.
D. soothes inflamed mucous membrane.
When evaluating the extent of an infant's dehydration, the nurse should recognize that the symptoms of severe dehydration (15%) are A. tachycardia, decreased tears, 5% weight loss. B. normal pulse and blood pressure, intense thirst. C. irritability, moderate thirst, normal eyes and fontanels. D. tachycardia, parched mucous membranes, sunken eyes and fontanels.
D. tachycardia, parched mucous membranes, sunken eyes and fontanels. Symptoms of severe dehydration include tachycardia, parched mucous membranes, and sunken eyes and fontanels. In severe dehydration, there is a 15% weight loss in infants, not 5%, although the infant will exhibit tachycardia and decreased tears. Tachycardia, orthostatic hypotension and shock, and intense thirst would be expected in an infant with severe dehydration. The infant would be extremely irritable, with sunken eyes and fontanels, if severely dehydrated.
Dietary management of a child with inflammatory bowel disease (IBD) should include A. low protein B. low calorie C. high fiber D. vitamin supplements
D. vitamin supplements Multivitamins, iron, and folic acid supplementation are recommended for the child with IBD. A high-protein, high-calorie diet is needed to help correct nutritional deficits. A high-fiber diet is not recommended for IBD. Even small amounts of bran have been associated with a worsening of the child's condition.
Cystic fibrosis is characterized by:
Lung congestion and infection and malabsorption of nutrients by the pancreas
What is the most common cause of bronchiolitis?
Respiratory syncytial virus (RSV)
What stage of separation anxiety is characterized by the following behaviors: • Is inactive • Withdraws from others • Is depressed, sad • Lacks interest in environment • Is uncommunicative • Regresses to earlier behavior (e.g., thumb sucking, bedwetting, use of pacifier, use of bottle) Behaviors may last for variable length of time. Child's physical condition may deteriorate from refusal to eat, drink, or move.
Stage of Despair
What stage of separation anxiety is characterized by the following behaviors: • Shows increased interest in surroundings • Interacts with strangers or familiar caregivers • Forms new but superficial relationships • Appears happy It usually occurs after prolonged separation from parent; it is rarely seen in hospitalized children. Behaviors represent a superficial adjustment to loss.
Stage of Detachment
What stage of separation anxiety is characterized by the following behaviors: • Cries • Screams • Searches for parent with eyes • Clings to parent • Avoids and rejects contact with strangers • Verbally attacks strangers (e.g., "Go away") • Physically attacks strangers (e.g., kicks, bites, hits, pinches) • Attempts to escape to find parent • Attempts to physically force parent to stay • May last from hours to days • May be continuous and only cease with physical exhaustion • Approach of a stranger may make this worse.
Stage of Protest
