peds final
A child, age 15 months, is admitted to the health care facility. During the initial data collection, which statement by the mother most strongly suggests that the child has a Wilms' tumor?
"My child's abdomen seems bigger, and his diapers are much tighter."
After the nurse explains dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching?
"Our child must maintain these dietary restrictions for life."
A child, age 4, with a recent history of nausea, vomiting, and diarrhea is admitted to the pediatric unit with a diagnosis of gastroenteritis. During data collection, the nurse detects tenting. This finding supports a nursing diagnosis of:
Deficient fluid volume related to dehydration.
The nurse assesses capillary refill in a client admitted with pneumonia and dehydration. Which capillary refill duration is considered abnormal and should be reported?
4 seconds
A normal lab value for PaO2 is
75 to 100
Before administering a tube feeding to a toddler, which of the following methods should the nurse use to check the placement of the nasogastric (NG) tube?
A check of the pH of fluid aspirated from the tube
infant safety
A firm mattress and fitted sheet are all you need for your baby's crib. Remove blankets and toys.Learn to use your child's car seat the right way. Use this checklist to help. Make sure you have both a working smoke alarm and a carbon monoxide alarm on every level of your home, and in all sleeping areas. Test the alarms to make sure they work.Place your baby's crib and other furniture away from windows and blinds. Your baby is safer without any strings or cords within reach.Set your water heater to 120F to avoid scalds.
Following a physical assessment, a toddler is diagnosed with epiglottitis. Which piece of equipment is removed from the toddler's room?
A tongue blade
The nurse is preparing to discharge a child who has rheumatic fever. Which medication would the nurse expect to be prescribed to prevent recurrence of rheumatic fever?
Antibiotics
A 14-month-old child weighing 26 lb (11.8 kg) is admitted for traction to treat congenital hip dislocation. When preparing the client's room, the nurse anticipates using which traction system?
Bryant's traction
A child with a fractured left femur receives a cast. A short time later, the nurse notices that the toes on the child's left foot are edematous. Which nursing action would be most appropriate?
Elevating the foot of the bed
A preschool-age child underwent a tonsillectomy 4 hours ago. Which data collection finding would make the nurse suspect postoperative hemorrhage?
Frequent swallowing
A toddler with hemophilia is hospitalized with multiple injuries after falling off a sliding board. X-rays reveal no bone fractures. When caring for the child, what is the nurse's highest priority?
Frequently monitoring the child's level of consciousness (LOC)
Types Of Seizures
Generalised tonic-clonic seizure Focal seizure Atonic seizure Absence seizure Epileptic spasms Gelastic seizure Status epilepticus Psychogenic non-epileptic seizure Frontal lobe epilepsy Childhood absence epilepsy Abdominal epilepsy Epilepsia partialis continua
Which of the following techniques is most effective in preventing nosocomial infection transmission when caring for a preschooler?
Hand washing
treatment options for multiple sclerosis
IV steroidsinterferon injections (Rebif)glatiramer acetate (Copaxone)dimethyl fumarate (TecfideraMany others, depending on the patient's symptoms.
The nurse is evaluating a child with acute poststreptococcal glomerulonephritis (APSGN) for signs of improvement. Which finding typically is the earliest sign of improvement?
Increased urine output
CPR in children
Keep your other hand on the child'sforehead, keeping the head tilted back. Press down on the child's chest so that it compresses about one third to one half the depth of the chest. Give 30 chest compressions. Each time, let the chest rise completely.
nursing assessment priorities for head Injury
Maintain a patent airway. Assist with endotracheal intubation or tracheotomy as necessary.Administer medications as ordered.Protect the patient for further injury by using side rails.Assist the unsteady patient with walking.Insert an indwelling urinary catheter if ordered.If the patient is unconscious, insert a nasogastric tube to prevent aspiration.Monitor the patient's intake and output as needed to help maintain a normovolemic state.Monitor vital signs continuously and check for additional injuries.Observe the patient for headache, dizziness, irritability, and anxiety.Monitor fluid and electrolyte levels and replace them as necessary.Carefully observe the patient for CSF leakage.Tell the patient to return to the hospital immediately if he experiences a persistent worsening headache, forceful or constant vomiting, blurred vision, any change in personality, abnormal eye movements, and twitching.
For a child with hemophilia, what is the most important nursing goal?
Preventing bleeding episodes
What are the 4 types of multiple sclerosis?
Relapsing-remitting multiple sclerosis (RRMS),Secondary-progressive multiple sclerosis (SPMS), the most common typePrimary-progressive multiple sclerosis (SPMS)Progressive-relapsing multiple sclerosis (PRMS)
A toddler is having a tonic-clonic seizure. What should the nurse do first?
Remove objects from the child's surrounding
A child, age 3, with lead poisoning is admitted to the facility for chelation therapy. The nurse must stay alert for which of the following adverse effects?
Seizures
CPR in infants
Shout and gently tap the child on the shoulder. If there is no response and not breathing or not breathing normally, position the infant on his or her back and begin CPR. Give 30 gentle chest compressions at the rate of 100-120/minute. Use two or three fingers in the center of the chest just below the nipples.
Following a tonsillectomy, a client returns to the medical-surgical unit. The client is lethargic and reports having a sore throat. Which position would be most therapeutic for this client?
Side-lying
Types of traction
Skeletal Traction. Skeletal traction involves placing a pin, wire, or screw in the fractured bone. ...Skin Traction. Skin traction is far less invasive than skeletal traction. ...Cervical Traction. During cervical traction, a metal brace is placed around your neck.
Types of fractures
Stable fracture. The broken ends of the bone line up and are barely out of place.Open, compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture. The bone may or may not be visible in the wound.Transverse fracture. This type of fracture has a horizontal fracture line.Oblique fracture. This type of fracture has an angled pattern.Comminuted fracture. In this type of fracture, the bone shatters into three or more pieces.
SS of meningitis in kids older than 2
Sudden high feverStiff neckSevere headache that seems different than normalHeadache with nausea or vomitingConfusion or difficulty concentratingSeizuresSleepiness or difficulty wakingSensitivity to lightNo appetite or thirstSkin rash (sometimes, such as in meningococcal meningitis)
For a child with tracheobronchitis, the nurse formulates a nursing diagnosis of Ineffective airway clearance related to thick secretions. After implementing interventions, the nurse expects which client outcome?
The child exhibits clear breath sounds
An unconscious client is admitted to the emergency department. The nurse suspects which source is the cause of airway obstruction in this client, as it is the most common source of airway obstruction in the unconscious victim?
The tongue
diagnosing for legg calve perthes disease
These types of tests are vital to the diagnosis of Legg-Calve-Perthes disease and may include: X-rays. Initial X-rays may look normal because it can take one to two months after symptoms begin for the damage associated with Legg-Calve-Perthes disease to become evident on X-rays.
Multiple sclerosis symptoms and signs depend on where the nerves are demyelinated and may include:
Visual changes including double vision or loss of visionNumbnessTingling or weakness (weakness may range from mild to severe)ParalysisVertigo or dizzinessErectile dysfunction (ED, impotence)Pregnancy problemsIncontinence (or conversely, urinary retention)Muscle spasticityIncoordination of musclesTremorPainful involuntary muscle contractionsSlurred speechFatigue
A toddler is brought to the emergency department with sudden onset of abdominal pain, vomiting, and stools that look like red currant jelly. To confirm intussusception, the suspected cause of these findings, the nurse expects the physician to order:
a barium enema.
seizure treatment
anticonvulsant drug therapy, The drug is chosen based on its effectiveness in controlling seizures, side effects, and its degree of toxicity, The oldest and most popular drug is phenytoin (Dilantin), surgical intervention, Ketogenic diets (high in fat and low in carbohydrates and protein),
A client hospitalized with pneumonia has thick, tenacious secretions. To help liquefy these secretions, the nurse should:
encourage increased fluid intake.
scoliosis
is a neuro-muscular condition influenced by other factors, although it appears to be a bone condition
The nurse is teaching the mother of an ill child about childhood immunizations. The nurse should tell the mother that live virus vaccines shouldn't be administered to children with:
leukemia.
scoliosis nursing priorities
make sure not to take brace off unless showering, and if they itchy under the brace do not stick anything under there to scratch
treatment for legg calve perthes disease
medicine and reducing activity seems to work best on children under 6. children older than 6 or with more sever cases, surgery is the best option These surgeries either tilt the ball so it is deeper in the socket or rotate the socket so that it will cover the ball better when your child walks. Sometimes doctors try to do both.
A child, age 5, is to receive potassium added to the I.V. fluid. Before initiating this therapy, the nurse first should:
monitor fluid intake and output.
will you ever remove the weight on tractions without order?
no
cause for Legg calve perthes disease
occurs when too little blood is supplied to the ball portion of the hip joint (femoralhead). Without an adequate blood supply, this bone becomes unstable, and it may break easily and heal poorly.
To check the effectiveness of incentive spirometry, the nurse can use a pulse oximeter to monitor the client's?
oxygen saturation
PaO2 stands for
partial pressures of arterial oxygen
Following a fall from a horse during rodeo practice, an 18-year-old client is seen in the emergency department. He has a large, dirty laceration on his leg. The wound is vigorously cleaned, closed, and dressed. In the past, the client has received the full immunization regimen for tetanus toxoid. The nurse asks the client about his tetanus immunization history, and he says, "I had my last shot when I was 11 years old." The nurse should
plan on administering a dose of tetanus vaccine.
The nurse is providing dietary teaching for the parents of a child with celiac disease. This child should avoid:
prepared puddings.
What does CNS control?
responsible for integrating sensory information and responding accordingly.
meningitis prevention
vaccine
What is Bucks tractions
widely used in the lower limb for femoral fractures, lower backache, acetabular and hip fractures.
A child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to his mother. Which data should the nurse obtain first?
Heart rate, respiratory rate, and blood pressure
SS of meningitis in infants
High feverConstant cryingExcessive sleepiness or irritabilityInactivity or sluggishnessPoor feedingA bulge in the soft spot on top of a baby's head (fontanel)Stiffness in a baby's body and neck
A child with type 1 diabetes develops diabetic ketoacidosis and receives a continuous insulin infusion. Which condition represents the greatest risk to this child?
Hypokalemia
What is multiple sclerosis
Multiple sclerosis (MS) is a disease that causes demyelination (disruption of the myelin that insulates and protects nerve cells) of spinal nerve and brain cells.Although the exact case is unknown, it's considered to be an autoimmune disease
Nursing priorities for meningitis
Patients total bed rest with supine sleeping position without a pillow Rational: intacranial pressure changes, will be able to cause the risk for brain herniationMonitor signs of neurological status with GCS. Rational: It can reduce further brain damage.Monitor vital signs such as blood pressure, pulse, temperature, and caution in systolic hypertension. Rational: In normal circumstances, autoregulation maintains a state of systemic blood pressure changed by fluctuations. Autoreguler failure will lead to cerebral vascular damage that can be manifested by an increase followed by a decrease in systolic and diastolic pressure. While the increase in temperature to describe the journey of infection.Monitor intake and output Rational: hyperthermia can cause increased IWL and increase the risk of dehydration, especially in patients who are not aware, the nausea that reduce oral intake.
A toddler is admitted to the facility for treatment of a severe respiratory infection. The child's recent history includes fatty stools and failure to gain weight steadily. The physician diagnoses cystic fibrosis. By the time of the child's discharge, the child's parents must be able to perform which task independently?
Performing postural drainage
emediation: Question 28 See full question When collecting data on an 18-month-old child, the nurse determines that the child's height and weight fall below the 5th percentile on the growth chart. In all previous visits, the child's height and weight fell between the 30th and 40th percentiles. The child's mother expresses concern about the slowed growth rate. How should the nurse respond?
"Your child's height and weight should be checked again in 1 month."
SS of head Injuries
(minor) a headachelightheadednessa spinning sensationmild confusionnauseatemporary ringing in the ears (severe) a loss of consciousnessseizuresvomitingbalance or coordination problemsserious disorientationan inability to focus the eyesabnormal eye movementsa loss of muscle controla persistent or worsening headachememory losschanges in moodleaking of clear fluid from the ear or the nose
The licensed practical nurse removes a client's nasogastric (NG) tube according to the physician's order. The nurse should watch for which complication after removing an NG tube?
Abdominal distention
When the nurse collects data on a 2-year-old child with suspected dehydration, which condition should be reported to the physician immediately?
Decreased blood pressure
A client is admitted with the following vital signs: temperature, 102° F (38.9° C); heart rate, 144 beats/minute and irregular; and respiratory rate, 22 breaths/minute. Which nursing diagnosis takes highest priority when planning this client's care?
Decreased cardiac output
A client who speaks and understands minimal English has emergency gallbladder surgery. During discharge preparation, which nursing action would best help this client understand wound care instructions?
Demonstrating the procedure and having the client perform a return demonstration
A preschool-age child with sickle cell anemia is admitted to the health care facility in vaso-occlusive crisis after developing a fever and joint pain. What is the nurse's highest priority when caring for this child?
Providing fluids
Which nursing diagnosis takes highest priority for a child in the early stages of burn recovery?
Risk for infection
What to document during a seizure
Time the seizure started What the child was doing when the seizure began Any factor present just before the seizure (bright light, noise) Part of the body where seizure activity began Movement and parts of the body involved Any cyanosis Eye position and movement Incontinence of urine or stool Time seizure ended Child's activity after the seizure When the seizure ends, monitor the child, paying close attention to his or her level of consciousness, motor functions, and behavior. Document the information noted during the seizure activity. If the child is able to describe the aura, this information is important to document
cause of head injuries
Toddlers and young children may receive a head injury from a fall or child abuse; school-aged children and adolescents usually experience such an injury as a result of a bicycling, inline skating, or motor vehicle accident.
Spiral fractures are not common in
babies, and is a major sign of abuse
What does CNS made up of?
brain and spinal cord
What is CNS?
central nervous system
legg calve- perthes disease
childhood condition that affects the hip, where the thighbone (femur) and pelvis meet in a ball-and-socket joint. Legg-Calve-Perthes disease occurs when blood supply is temporarily interrupted to the ball part (femoral head) of the hip joint.
PNS ( parasympathetic nervous system )
controls secondary motary responses
When planning care for a child with epiglottitis, the nurse should assign highest priority to
ensuring respiratory patency.
Seizure nursing priorities and actions
keeping the child safe during a seizure is the highest priority, In the hospital setting, the side rails are padded, objects that could cause harm are kept away from the bed, oxygen and suction are kept at the bedside, the side rails are in the raised position, and the bed lowered when the child is sleeping or resting.If the child begins to have a seizure, place the child on his or her side with the head turned toward one side. Stay calm, remove any objects from around the child, protect the child's head, and loosen tight clothing.
A child is diagnosed with nephrotic syndrome. When planning the child's care, the nurse understands that the primary goal of treatment is to:
reduce the excretion of urinary protein
