Peds Final Review

Bryant's traction

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?

Reduce the excretion of urinary protein

A child is diagnosed with nephrotic syndrome. When planning the child's care, the nurse understands that the primary goal of treatment is to:

Elevating the foot of the bed

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?

Hypokalemia

A child with type 1 diabetes develops diabetic ketoacidosis and receives a continuous insulin infusion. Which condition represents the greatest risk to this child?

Seizures

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?

Deficient fluid volume related to dehydration

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:

Monitor fluid intake and output

A child, age 5, is to receive potassium added to the I.V. fluid. Before initiating this therapy, the nurse first should:

Decreased cardiac output

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?

Demonstrating the procedure and having the client perform a return demonstration

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?

Frequent swallowing

A preschool-age child underwent a tonsillectomy 4 hours ago. Which data collection finding would make the nurse suspect postoperative hemorrhage?

Providing fluids

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?

Performing postural drainage

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?

A barium enema

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:

Remove objects from the child's surroundings

A toddler is having a tonic-clonic seizure. What should the nurse do first?

"Our child must maintain these dietary restrictions for life."

After the nurse explains dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching?

The tongue

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?

A check of the pH fluid aspirated from the tube

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?

Abdominal distention

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?

4 seconds

The nurse assesses capillary refill in a client admitted with pneumonia and dehydration. Which capillary refill duration is considered abnormal and should be reported?

Increased urine output

The nurse is evaluating a child with acute poststreptococcal glomerulonephritis (APSGN) for signs of improvement. Which finding typically is the earliest sign of improvement?

Antibiotics

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?

Prepared puddings

The nurse is providing dietary teaching for the parents of a child with celiac disease. This child should avoid:

Oxygen saturation

To check the effectiveness of incentive spirometry, the nurse can use a pulse oximeter to monitor the client's:

"Your child's height and weight should be checked again in 1 month."

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?

Ensuring respiratory patency

When planning care for a child with epiglottitis, the nurse should assign highest priority to:

Decreased blood pressure

When the nurse collects data on a 2-year-old child with suspected dehydration, which condition should be reported to the physician immediately?

Risk for infection

Which nursing diagnosis takes highest priority for a child in the early stages of burn recovery?

"My child's abdomen seems bigger, and his diapers are much tighter."

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?

Heart rate, respiratory rate, and blood pressure

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?

Encourage increased fluid intake

A client hospitalized with pneumonia has thick, tenacious secretions. To help liquefy these secretions, the nurse should:

Frequently monitoring the child's level of consciousness (LOC)

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?

Plan on administering a dose of tetanus vaccine

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:

A tongue blade

Following a physical assessment, a toddler is diagnosed with epiglottitis. Which piece of equipment is removed from the toddler's room?

Side-lying

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?

Preventing bleeding episodes

For a child with hemophilia, what is the most important nursing goal?

The child exhibits clear breath sounds

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?

Leukemia

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:

Hand washing

Which of the following techniques is most effective in preventing nosocomial infection transmission when caring for a preschooler?