Peds Final BP 21

The nurse is collecting data from a 5-year-old client and mother. What are the normal cognitive and motor development expectations that should be observed by a nurse in a 5-year-old child? Select all that apply

1. They know their full address and telephone number 2. They are comfortable with themselves and their relationships with others

The nurse is collecting data from a 5-year-old client and mother. What are the normal cognitive and motor development expectations that should be observed by a nurse in a 5-year-old child? Select all that apply.

1. They know their full address and telephone number 2. They are comfortable with themselves and their relationships with others.

The nurse caring for hospitalized children knows that these children need protection from contagious diseases. What infection control measures are recommended in this situation?

1. Wash hands thoroughly if in contact with any body fluids 2. Change disposable gowns at least once a shift

What are the recommended infection control measures for children that need protection from contagious diseases?

1. Wash hands thoroughly if in contact with any body fluids. 2. Change disposable gowns at least once a shift.

How long should a client be encouraged to hold a cleansing enema?

5 to 10 minutes

What information accurately describes a cleansing enema? Select all that apply

> A: It lubricates for evacuation > B: It softens the stool in the large intestine > D: It stimulates intestinal peristalsis

Ataxic CP

Causes problems with balance and gait Gait is unsteady & walking is difficult Tremors cause these clients to have difficulty controlling their hands and arms when they reach for an object.

Prenatal testing for Tay-Sachs Disease

Chorionic Villus Sampling (CVS); can be done between the 10th and 12th weeks of pregnancy. Amniocentesis can be done between the 15th and 18th weeks of pregnancy.

When taking vital signs on different aged children, what is a recommended guideline?

Take an oral or tympanic temperature for children older than 6 years

Positive Gowers sign

The child uses the upper extremity muscles to compensate for weak hip muscles.

When asked about playing, the parents of a 3-year-old share that he plays with his toys in the same area as other children but never interacts with the other kids. The nurse documents that the child engages in what form of play?

solitary play

When discussing the concrete operations stage of development, which examples of childhood behavior should the nurse present? Select all that apply

1. The ability to understand the concepts of weight and volume 2. They develop the ability to think in the abstract

a nurse is caring for a child with spina bifida. the child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response?

"The cause is unknown, and there are many environmental factors that may contribute to it. intake of folic acid during pregnancy helps prevent spina bifida."

A nurse is caring for an adolescent, what kind of focused care should she keep in mind? Select all that apply.

1. Adolescents like to be treated like adults instead of children. 2. Adolescents may voice individual concerns and should be talked to separately. 3. They may present with problems like acne, menstrual dysfunction, inadequate nutrition, sexually transmitted diseases, suicidal ideation, or chemical abuse.

A nurse is caring for a child with a fever of 101oF. What interventions should the nurse perform when caring for this child? Select all that apply.

1. Attempt to keep the child from crying. 2. Encourage fluids. 3. Do not use antipyretics unless ordered by the healthcare provider

The LPN is monitoring a child who is on IV therapy via central line for dehydration. Which nursing interventions are appropriate for this situation? Select all that apply

1. Change the central line dressing every 24 hours if using gauze 2. If using a transparent dressing, change the central line dressing any time it becomes wet or loose 3. Use sterile technique to change a central line dressing

A child is on IV therapy via central line for dehydration, what nursing interventions are appropriate for the LPN to perform?

1. Change the central line dressing every 24 hours if using gauze. 2. If using a transparent dressing, change the central line dressing any time it becomes wet or loose. 3. Use sterile technique to change a central line dressing.

The nurse is providing education to the mother of a toddler who is brought to the pediatrician for a well visit. What topics would be included in the client education based on the child's developmental level? Select all that apply.

1. Discipline and limit setting 2. Dental visits 3. Behavior patterns 4. Poison prevention

A nurse is required to administer a suppository to a child to promote bowel movements. What should the nurse do to effectively administer the suppository? Select all that apply.

1. Lubricate the suppository with water-soluble lubricant before insertion. 2. Press the anal sphincter gently to hold the suppository. 3. Explain the procedure to the child.

During a visit to the pediatrician's office, a mother inquires about adding solid foods to the diet of her 6-month-old infant. What does the nurse inform the mother? Select all that apply

1. New foods should be introduced one at a time weekly 2. Meats will be added after 1 year of age 3. Avoid introducing typically allergenic foods until after 1 year of age.

When patient teaching, what can a nurse inform the mother about adding solid foods to her 6-month-old infant? Select all that apply.

1. New foods should be introduced one at a time weekly. 2. Meats will be added after 1 year of age. 3. Avoid introducing typically allergenic foods until after 1 year of age

Which interventions should the nurse implement when using an arm board for the child with an IV? select all that apply

1. Pad the board with a towel and fasten it with tape 2. Secure the armboard after inserting and securing the IV.

The nurse is caring for children who are scheduled for surgery. Which of the following are recommended guidelines for reducing anxiety in these clients? Select all that apply

1. Report test results to the family caregivers and the child, if possible. 2. Avoid performing painful or frightening procedures in the child's bed or the playroom

The nurse is caring for children who are scheduled for surgery. Which of the following are recommended guidelines for reducing anxiety in these clients? Select all that apply.

1. Report test results to the family caregivers and the child, if possible. 2. Avoid performing painful or frightening procedures in the child's bed or the playroom.

What measures need to be taken immediately for a child scheduled to undergo surgery? Select all that apply.

1. Take and record vital signs and weight. 2. The child should wear an appropriate gown and must wear an identification band. 3. Remove any hairpins, barrettes, or jewelry

the nurse is performing a physical assessment of a teenager. what unique focus of adolescent care should the nurse keep in mind when caring for adolescents? SATA

1. adolescents like to be treated like adults instead of children adolescents may voice individual concerns and should be talked to separately 3. they may present with problems like acne, menstrual dysfunction, inadequate nutrition, sexually transmitted diseases, suicidal ideation, or chemical abuse.

during the physical assessment of a 2.5-month-old-infant, the nurse suspects the child may have hydrocephalus. which signs or symptoms would have been observed to suspect this? select all that apply

1. dramatic increase in head circumference 2. seizures 3. malnutrition

a nurse is caring for a 3-year-old diagnosed with viral meningitis. which signs and symptoms does the nurse anticipate finding when gathering data? SATA

1. fever 2. nuchal rigidity

which of the following symptoms are associated with an URI? Also, what priority action must be done by the nurse? SATA

1. notify the surgeon of the findings 2. cough, runny nose 3. fever

when teaching the parents of a child with PKU, the nurse would instruct them to include which of the following goods in the child's diet? SATA

1. oranges 2. cauliflower

The nurse is applying a restraint on a child who is ordered to remain on bed rest and is not cooperating with the nursing staff. Which of the following are safety guidelines for this procedure? Select all tasks that apply

1. physician's order is usually required for a restraint 2. The child's skin and circulation must be checked every hour 3. Restraint must be released and reapplied every 1 to 2 hours

the nurse is discussing behavior patterns with the parents of a toddler. which issues should the nurse include in the discussion? SATA

1. separation anxiety 2. negativism 3. temper tantrums

a nurse is caring for a 3-year-old child placed in a splint brace for correcting develomental dysplasia. which of the following nursing considerations should the nurse keep in mind when carinf for the client?

1. take precautions when handling the child 2. protect the brace from getting wet

which of the following signs would indicate child abuse on a 5 year old getting a physical by a provider?

1. the child withdraws when touched and avoids eye contact 2. parental description of accident does not match injury 3. injuries in various stages of healing are documented

a nurse is collecting data on a neonate born 3 hours ago. which finding would lead the nurse to suspect that the neonate may have developmental dysplasia of the hip? SATA

1. the knee on the affected side is lower 2. buttock has an additional crease on the affected side 3. the child's knees are not level

a child presents in the ER with symptoms of Reye's syndrome. which of the following are suspected causes of this disease? SATA

1. use of aspirin during viral illness 2. inherited metabolic disorders

a 1-year-old infant is hospitalized with a diagnosis of eczema. which signs and symptoms does the nurse expect to observe? SATA

1. vesicles with crusting and excoriation 2. itching

Which of the following is correct about a diagnosis of the whooping cough?

1. whooping cough is transmitted through direct contact and through droplets 2. bronchopneumonia is a serious complication of the disease 3. the initial symptoms include bronchitis and temperature elevation

A patient is admitted to the healthcare facility with diabetes insipidus. Based on this information, what would the nurse anticipate as the best value of urinary specific gravity in such a case?

1.005

The nurse is administering a tap water enema to the client. Which symptom of circulatory overload should the nurse carefully monitor the client for during and after the enema is administered?

A bounding pulse

ADHD

ADHD, also known as ADD, is a condition associated with three categories of symptoms: inattentiveness, impulsivity, and hyperactivity. Always begins in childhood and may continue through adolescence and adulthood. There are 3 predominant types of ADHD: inattentive, hyperactive-impulsive, and combined inattentive with hyperactive-impulsive behaviors To be diagnosed the symptoms must be severe, occur for at least 6 months, and significantly affect the child's developmental milestones. .

What an IQ test predicts

Academic achievement

Dysfluency term

An interruption in the natural flow of speaking. An example is a child who stutters.

You will complete a 24-hour urine specimen collection by performing which of the following tasks?

Asking the patient to void one last time and saving the urine, Recording the amount of urine collected

What fluids would be recorded as output? Select all that apply

Vomitus Bleeding Thoracentesis Urine

A patient who is on bed rest is unable to void when using the bedpan. What nursing measures should the nurse implement to help the patient urinate? Select all that apply

B: Pour warm water over the genitalia > C: Assist the patient in sitting upright on the bedpan. > D: Let the patient hear the sound of running water

Nursing considerations for suicide

Be aware of early signs of depression. Listening is more effective than talking to individuals about sadness, unhappiness, or depression Consider using a no-suicide contract, wherein the person agrees not to attempt suicide for a specified period and will contact help immediately if he or she feels suicidal.

A 40-year-old client has an episode of vomiting. On observation of the vomitus, it contained bright red blood. What is the most likely cause of this finding?

Bleeding in the esophagus

A 35-year-old client has an episode of vomiting. On observation of the vomitus, coffee ground material was noticed. What is most likely the cause of this finding?

Bleeding in the lower digestive tract

The nurse would base a response to a parent about how his child got hepatitis A on the information that the child:

ate shrimp while they were in Mexico

A client has an order for digital removal of impacted feces. Upon reviewing the order and the client's status, the nurse knows that digital removal of feces is contraindicated in which patients? Select all that apply.

Cardiac conditions, Reproductive surgery, Genitourinary surgery Pelvic fractures

Spastic Cerebral Palsy

Characteristics of CP generally include the following to varying degrees: Spasticity—stiff muscles and exaggerated reflexes Rigidity—stiff muscles with normal reflexes Ataxia—lack of muscle coordination Athetosis—slow, writhing movements Tremors—involuntary muscle movements Contractures—muscles and tendons become inflexible leading to deformity, rigidity, and disuse of extremity Rapid variations of muscle contractions and relaxations—too stiff or too floppy Abnormal gait—difficulty walking: walking on toes, scissors-like gait with knees crossing or a wide gait Increased stretch reflexes Muscle weakness Limited range of motion Bilateral favoritism, using only one side of body to reach or move Lack of muscle tone of affected extremities Delayed motor development: unable to sit, crawl, or walk per milestone schedules Poor fine motor abilities Dysarthria—speech abnormalities Dysphagia—problems with swallowing and eating, excessive drooling Abnormal sense perception: touch or pain Difficulty with vision or hearing Urinary incontinence Seizures Oral disorders Psychiatric disorders

While instructing a female patient on the process to obtain a clean-catch midstream urine specimen you will explain to prepare the peritoneum by

Cleaning from front to back and to cleanse each side with a separate wipe or separate area of the wipe, saving the last for the urethral area itself

A patient has a retention (indwelling) urinary catheter. The nurse is instructed to obtain an uncontaminated urine specimen from the patient. To accomplish this task, the nurse should?

Collect the specimen from the aspiration port of the drainage tube with a syringe

Treatment for neonatal abstinence syndrome

Depends upon the severity of the symptoms, they type of drug or drugs involved, and the overall health of the infant. s/s need to be prioritized according to which symptom is most life-threatening In severe cases the neonate may be hospitalized in a NICU and receive pharmacotherapy, that is, decreasing small doses of an opiate until symptoms abate But in-hospital treatments may interfere with maternal-child bonding and increase time spent in the hospital Phenobarbital may be useful if the child has opioid withdrawal seizures. Nonpharmacologic treatment is preferred The nurse will monitor vital signs, sleeping habits, feeding patterns, and weight gain Environmental stimuli such as lights, noise, and handling must be minimized to prevent neurologic stress Non-Nutritive sucking (i.e. pacifier) and swaddling are generally comforting to the infant If the child has difficulty feeding or does not gain weight, frequently high-calorie formula or nasogastric tube feedings are initiated.

Risk factors for suicide

Depression Previous suicide attempts Suicidal ideation (thoughts); History of mental disorders, particularl depression Family member or friends history of suicide; family hx of domestic violence or child abuse Feelings of hopelessness; Impulsive or aggressive tendencies Barriers to accessing mental health treatment Grief and loss of friends or family, unemployment, financial concerns. Hx of alcohol and substance abuse Medical illness w chronic issues that interfere with the quality of life (chronic pain, traumatic brain injury, end stage renal disease, diabetes, HIV/AIDS, SLE Easy access to lethal methods; Unwillingness to seek help bc of a perceived stigma attached to mental health Cultural and religious beliefs; Media attention to a celebrity who has commited suicide Isolation, a feeling of being cut off from others

When discussing the growth and development of an infant with a client, the nurse refers to various theories and phases of development. The nurse is reviewing the major points of Erikson's theory of development with the client. How should the nurse describe Erikson's theory of development to the client?

Each stage of development contains a psychosocial challenge or critical period during which the person must deal with major life change

What is Pica

Eating nonfood items is termed pica.

Nursing considerations for schizophrenia

Educating the client nd any caregivers will be an essential component of nursing care Long-term therapy is required; Family and caregivers will need supportive counseling A program of home care with respite care, medical assistance, and social service assistance is preferred to hospitalization. It is essential that the child and the caregivers maintain the regimen of medications It is important to differentiate the concept of medical management from the false hope that the disorder has gone away and the medications are no longer necessary.

Feeding the intellectually impaired child

Ensure correct positioning, preferably in a sitting position. For infant or child, flex the head slightly Teach individuals to suck by massaging the cheeks or by using a special nipple. A nipple or bottle is appropriate for the infant and young toddler; as the individual becomes older, use a cup or glass. A straw may be helpful. Encourage blowing too. Assist person to learn to drink from a cup by using sucking movements Teach or remind individual to chew. If necessary, manipulate the jaw up and down; demonstrate using mirror. Remind individual to swallow Place food on side of the mouth, not in the center. Do not rush. Encourage individual to use the lips to remove food from the spoon, to bite off pieces of food and to move food around in the mouth with tongue. Allow person to do as much self-feeding as possible. Keep the table neat and clean.

Which intervention is most important when using an infusion pump to deliver IV fluid therapy to a toddler?

Ensure that the catheter is in the vein.

The nurse is reviewing the steps and rationales of collecting a 24-hour urine specimen with a student nurse. The nurse asks the student nurse why each specimen of urine voided has to be recorded. Why does each urine specimen voided by the patient have to be recorded?

Ensures that all urine is collected and available for analysis

s/s of down syndrome

External signs and symptoms may be obvious, but a DS baby typically has additional health problems Obesity is common Heart defects may require surgery Leukemia and a variety of blood disorders are common Abnormalities in their immune system increase risks of infections diseases, such as pneumonia Sleep apnea is due to the soft tissue and skeletal abnormalities causing an obstructed airway Dementia, Alzheimer disease, and seizures may begin around the age of 50 years Additional problems occur throughout life, such as poor vision, ear infections, hearing loss, gastrointestinal blockages, thyroid problems, psoriasis or other skin problems, skeletal deformities, and early-onset menopause.

What is Tay-Sachs Disease

Fatal inherited metabolic disorder; occurs most commonly in young children, who have the most severe symptoms, but can become obvious in older age. Certain lipids accumulate in the body due to the absence of a fundamental enzyme, resulting in progressive destruction of the neurons of the brain, in turn causing damage to the eyes, ears, movement, and mental development. Destruction of neurons can occur in the fetus during pregnancy, but s/s may not become obvious until 3 to 6 months, when development slows. By about 2 yrs of age the child has had recurrent seizures and shows a diminished capacity to function mentally and physically. Motor abilities gradually gregress until the child can no longer crawl, turn over, or sit.

A client diagnosed with diabetes has to void urine more often than usual. However, the volume of urine is not increased. What term should the nurse use to describe the client's condition in the electronic medical record?

Frequency

Characteristics that is shared in Down Syndrome and Fragile X Syndrome

Hands (Simian Creases) Mouth (High-arched palate) Eyes (epicanthal folds)

A mother asks the nurse what is the first solid food that can be given to the infant. What would be the best food for the nurse to tell the mother to introduce first to the infant?

Iron-fortified cereal

Autism signs and symptoms

May develop suddenly, without warning Some children succeed in reaching their developmental milestones for many months or years, but, for an unexplained reason, these abilities are lost The child initially becomes withdrawn, aggressive, and may lose previously acquired language skills Autistic children typically demonstrate a profound lack of social interaction and communication. They do not respond to verbal stimuli and do not like to cuddle or be touched They may show bizarre attachments to mechanical objects These children are believed to be preoccupied within themselves, perhaps having fixed delusions and hallucinations They sometimes become very upset or aggressive when interrupted.

Which are genetic diseases (a sata question)

Muscular dystrophy Duchene muscular dystrophy Becker muscular dystrophy Myotonic MD

Causes of plumbism

Plumbism is lead poisoning. Lead is a metal that can naturally be present in water, dirt, food, or air. Usually occurs slowly over a period of weeks or months. Individuals who work with batteries or are in the mining industry are at risk for the presence of lead. **Nursing Alert: Lead is contained in items other than paint, such as leaded pottery or dishes, home remedies, shoes, old toys, old eating utensils, old pipes and plumbing, soil containing lead from old chipped paint, sand and dirt on playgrounds, air pollution from unleaded gasoline, and family members who bring lead dust home on their clothes. A child who inhales the dust from scraped, leaded paint can suffer the same deleterious effects as the child who eats paint. The buildup of lead typically occurs gradually.

Which steps should a nurse follow to insert a straight urinary catheter?

Prepare the patient and equipment, create a sterile field, put on gloves, clean the urinary meatus, and insert the catheter until the urine flows

A patient with a retention catheter in situ complains that the catheter has come out. What actions should the nurse take if the catheter has fallen out? Select all that apply.

Report this immediately to the healthcare provider Discontinue of the patient is now able to void Insert a new, sterile retention catheter

A mother has just delivered her first baby and asks the nurse about routines at home. Based on this question, what information should the nurse teach the new mother about establishing routines with an infant?

Routines establish trust along with learning to expect

Which characteristics are associated with fecal impaction? Select all that apply.

Severe abdominal discomfort, Feeling of abdominal pressure, Inability to empty bowel completely, Diarrhea

Features of Down Syndrome

Small flattened nose Small head and neck Tongue that protrudes Eyes that slant upward (not typical of child's ethinic group) Brushfield spots (tiny white spots on the iris) Ears that are unusually shaped or small Short stature Slow growth; remains smaller than peers Delayed developmental milestones Tendency toward overweight and obesity Hypotonia (poor muscle tone, appears flabby) Extreme flexibility (joints can be hyperextended without causing pain) Broad, short hands with a single crease in the palm (called a simian line) Small hands and feet with fingers that are shorter than normal Wide space between the big toe and the rest of the toes Transverse crease across the soles of the feet.

A nurse is required to collect a 24-hour urine specimen from a client. Which of these is important for the nurse to keep in mind?

The collection starts and ends with an empty bladder

What is monitored when a patient is on Ritalin

The height and weight of the child on stimulants (Ritalin) should be measured at frequent intervals and plotted on a growth chart. Failure to gain in either area should be reported.

Treatment for Tourette's (read whole paragraph)

Treatment is not always necessary Neuroleptic drugs, such as haloperidol; to suppress severe or significant tics that interfere with ADLs. Long-term medication therapies are known to causes significant side effects (tardive dyskinesia) Individuals often adapt to or change behaviors that act as triggers. Tics tend to be minimized during calm focused activities; during sleep, tics are diminished but not absent.

The nurse is administering medications to children on a pediatric ward. Which of the following is a recommended guideline when administering medications to children?

When administering liquids, use the smallest syringe possible to ensure accuracy.

A client is suspected of having a gastrointestinal infection. What stool characteristic supports that suspicion?

Yellowish or greenish

s/s of plumbism

blue or blue-black line on the gums near the teeth hyperirritability anorexia, nausea, vomiting intermittent vomiting (lead colic) abdominal pain joint pain headache fatigue and decreased play anemia, pallor, and decreased RBCs constipation behavior changes (sudden changes may indicate acute lead poisoning) ataxia (unsteady gait), weakness, or clumsiness decrease in intellectual and mental abilities (e.g., memory loss and poor school performance) impaired level of consciousness seizures coma encephalopathy (brain degeneration)

most common signs and symptoms of depression

changes in behavior: for ex: loss of interest in favorite activity, poor school performance, change of appearance, drinking alcohol, taking drugs, changes in language (more aggressive or passive) not eating or excessive eating; not sleeping or excessive sleeping continually appears to be sad and lonely states feelings of helplessness, hopelessness, worthlessness, or guilt increased sensitivity to rejections, low self-esteem, low self-worth extreme low energy or burst of activity withdrawal from friends, family, or social contacts (e.g., sports) inability to concentrate vague physical complaints, for example, stomachaches, headaches that do not get better with treatment risk-taking behaviors for ex: sexual promiscuity, racing cares, extreme sports vocal outbursts, crying, emotional sensitivity to comments from others talking about another person's suicide, for ex: a media celebrity or friend focusing on morbid, negative themes giving away possessions talking about committing suicide

which of the following precautions would a nurse use when caring for an infant with RSV bronchitis?

contact precautions

The nurse enters a hospitalized child's hospital room and finds that the child is sitting quietly in bed and appears very sad. The child is sucking his thumb, and clutching his blanket. What stage of separation anxiety is the child displaying?

despair

s/s of fetal alcohol syndrome

facial abnormalities, growth retardation, developmental delays, below-normal mental functioning, and dysfunctions of the central nervous system typical abnormal facial features include small wide-set narrow eyes with drooping upper lids; short upturned nose; flattened cheeks; small jaw

a 4-year-old girl is admitted to the hospital with symptoms that include inadequate physical growth, retarded motor development, inadequate social response, and delayed language development. the nurse recognizes these as symptoms of what ccondition?

failure to thrive

three main symptoms of ADHD

inattentiveness, impulsivity, and hyperactivity

what is correct regarding a diagnosis of red measles on a 5-year-old child?

it is transmitted through direct contact

a 7-year-old child is diagnosed with chickenpox. which of the following eruptions is the first to be seen in chickenpox?

papules

which type of parasite is a microscopic mite that burrows under the outer layer of the host's skin?

scabies

a 6-year-old child is brought to the clinic by his parents. the parents state, "He's had a sore throat for a couple of days and now his temperature has been over 102 degree F. He has a rash on his face and chest that looks like a sunburn but feels really rough, almost like sandpaper." which of the following would the nurse suspect?

scarlet fever

visible symptom of neurofibromatosis

symptoms are typically related to the type of neurofibromatosis and the growth and pressure of these tumors upon nerves. the individual may have extensive cafe au lait spots on the skin of the facial area and large neurofibromas on the legs. a cafe au lait spot is a harmless, light brown spot on the skin and is a strong indicator of NF1. They are present at birth and may appear during the first 5 years.

a nurse is caring for a 7-year-old client who has come to the pediatrician's office for treatment of a recurrent urinary tract infection. the client's mother states, "My child has started sucking her thumb and wetting the bed." based on this information, which of the following should the nurse consider?

the child may have experienced sexual abuse

Signs and Symptoms of ADHD

• Inattentiveness • Easily distracted and cannot focus on one single task • Seems forgetful; cannot remember where items were placed • Daydreams and becomes easily confused • Becomes bored with an activity shortly after starting it • Cannot seem to follow directions or understand something new • Has difficulty organizing a task or completing homework • Hyperactivity • Talks nonstop • Wants to be constantly moving • Cannot sit still; fidgets or squirms during meals or at school • Touches everything within sight • Impulsivity • Interrupts others conversations • Is emotionally inappropriate; shows no emotional restraint • Acts out with inappropriate comments • Shows impatience; cannot wait to be given attention