Peds - Resp Q
The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding?
Frequent swallowing Tonsillectomy is the surgical removal of the tonsils. Frequent swallowing, restlessness, a fast and thready pulse, and vomiting bright red blood are signs of bleeding. An elevated blood pressure and complaints of discomfort are not indications of bleeding.
A pediatric nurse in the ambulatory surgery unit is caring for a child following a tonsillectomy. The child is complaining of a dry throat. Which item should the nurse offer to the child?
Green gelatin
A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action?
Let the mother hold the child and direct the cool mist over the child's face.
A school nurse is teaching parents about emergency treatment for epistaxis. Which best action should the nurse take to assist the parents in understanding the emergency treatment?
Ask the parents to demonstrate, on a mannequin, where to apply continuous pressure if a nosebleed occurs.
An ambulatory care nurse is preparing a list of instructions for the parents of a child who is being discharged after a tonsillectomy. The nurse should place which instruction(s) on the list? Select all that apply
Avoid hot fluids. Avoid raw vegetables. Rest in bed or on a couch for 24 hours.
A mother calls the pediatrician's office requesting an appointment for her 8-year-old child. She states he has asthma and is telling her he had trouble breathing last night and does not want to go to school. In triaging this child, which is the most important question to initially ask the mother?
"Is your child telling you at this time he is having trouble breathing?"
The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent?
"The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
A child is scheduled for a tonsillectomy in a day surgical unit. On the day after surgery, the mother calls the surgical unit and expresses concern because the child has a bad mouth odor. Which response is most appropriate?
"Bad mouth odor is normal and may be relieved by drinking more liquids."
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?
Decreased wheezing
The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action?
Move the infant to a room with another child with RSV.
During clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about cystic fibrosis?
This disease causes dilation of the passageways of many organs.
After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action?
Turn the child to the side. After tonsillectomy, if bleeding occurs, the nurse immediately turns the child to the side to prevent aspiration and then notifies the health care provider. NPO status would be maintained, and an antiemetic may be prescribed; however, the initial nursing action would be to turn the child to the side.
After a tonsillectomy, a child is brought to the pediatric unit. The nurse should appropriately place the child in which position?
Prone The child should be placed in a prone or side-lying position after tonsillectomy to facilitate drainage
The nurse is reviewing the laboratory results for a child scheduled for tonsillectomy. The nurse determines that which laboratory value is most significant to review?
Prothrombin time A tonsillectomy is the surgical removal of the tonsils. Because the tonsillar area is so vascular, postoperative bleeding is a concern. Prothrombin time, partial thromboplastin time, platelet count, hemoglobin and hematocrit, white blood cell count, and urinalysis are performed preoperatively. The prothrombin time results would identify a potential for bleeding. Creatinine level, sedimentation rate, and blood urea nitrogen would not determine the potential for bleeding.
The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position?
Side-lying- helps facilitate drainage A tonsillectomy is the surgical removal of the tonsils. The child should be placed in a prone or side-lying position after the surgical procedure to facilitate drainage.
A nurse is providing instructions to the mother of a child with croup regarding treatment measures if an acute spasmodic episode occurs. Which statement made by the mother indicates a need for further teaching?
"I should place a steam vaporizer in my child's room." Cool mist humidifiers are recommended over steam vaporizers, which present a danger of scald burns. Steam from running water in a closed bathroom or from a vaporizer will assist in keeping secretions thin so that they can be easily expectorated
The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF?
A chronic multisystem disorder affecting the exocrine glands CF is a chronic multisystem disorder that affects the exocrine glands. The mucus produced by these glands (particularly those of the bronchioles, small intestine, and pancreatic and bile ducts) is abnormally thick, causing obstruction of the small passageways of these organs. It is transmitted as an autosomal recessive trait.
The nurse employed in an emergency department is monitoring a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the chin thrust out. How should the nurse interpret this finding?
An airway obstruction clinical manifestations suggestive of airway obstruction include tripod positioning (leaning forward supported by arms, chin thrust out, mouth open), nasal flaring, tachycardia, a high fever, and sore throat.
The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the health care provider did not prescribe antibiotics. Which response should the nurse make?
Antibiotics are not indicated unless a bacterial infection is present."
The mother of an 8-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen (Motrin IB) is not effective. Which instruction should the nurse provide to the mother?
Encourage the child to lie on the right side.
A child is scheduled for a tonsillectomy. A nurse plans care, knowing that which condition would be a priority because it presents the highest risk of aspiration during surgery?
Presence of loose teeth
A nurse is caring for a hospitalized infant with a diagnosis of bronchiolitis. In which position should the nurse place the infant?
Head and chest at a 30-degree angle with the neck slightly extended The nurse should position the infant with the head and the chest at a 30- to 40-degree angle with the neck slightly extended to maintain an open airway and to decrease pressure of the diaphragm
The student nurse is caring for an infant with a tracheostomy and preparing to suction the infant. The nursing instructor should intervene if the nursing student stated she would take which action to perform this procedure?
Limit insertion and suctioning time to 15 seconds to prevent hypoxia.
A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the health care provider, should the nurse question?
Obtain a throat culture. The throat of a child with suspected epiglottitis should not be examined or cultured because any stimulation with a tongue depressor or culture swab could cause laryngospasm, thus completing airway obstruction. Humidified oxygen and antipyretics are components of management. Axillary rather than oral temperatures should be taken to avoid stimulation and resultant laryngospasm.
Breathing exercises and postural drainage are prescribed for a hospitalized child with cystic fibrosis (CF). What instruction should the nurse include in the client's teaching plan?
Perform the postural drainage first and then the breathing exercises. The postural drainage will mobilize secretions, and the breathing exercises will then assist with expectoration.
The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply.
Place the infant in a private room. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.
After a tonsillectomy, the nurse reviews the health care provider's (HCP's) postoperative prescriptions. Which prescription should the nurse question?
Suction every 2 hours.-- suctioning is not performed unless there is an airway obstruction as unnecessary suctioning can injure the surgery site. A tonsillectomy is the surgical removal of the tonsils. After tonsillectomy, suction equipment should be available, but suctioning is not performed unless there is an airway obstruction because of the risk of trauma to the surgical site. Monitoring for bleeding is an important nursing intervention after any type of surgery. Milk and milk products are avoided initially because they coat the throat, cause the child to clear the throat, and increase the risk of bleeding. Clear, cool liquids are encouraged.
The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction?
The child is leaning forward, with the chin thrust out.
The nurse in the ambulatory care unit is caring for a child after a tonsillectomy. The child's mother tells the nurse that the child is complaining of a dry throat and would like something to relieve the dryness. Which item should the nurse provide for the mother to give to the child?
Yellow noncitrus Jell-O After tonsillectomy, clear, cool liquids should be given. Citrus, carbonated, and extremely hot or cold liquids should be avoided because they may irritate the throat. Milk and milk products, including pudding, are avoided because they coat the throat, which causes the child to clear the throat, thereby increasing the risk of bleeding. Red liquids should be avoided because they give the appearance of blood if the child vomits.
A nurse is reviewing the health care provider's prescriptions for a child following a tonsillectomy. Which prescription should the nurse question?
Suction the child frequently if coughing.
A mother arrives at the clinic with her 3-year-old child. The mother tells the nurse that the child has had a fever and a cough for the past 2 days and that this morning the child began to wheeze. Viral pneumonia is diagnosed. Based on the diagnosis, the nurse anticipates that which will be a component of the treatment plan?
Supportive treatment With viral pneumonia, treatment is supportive. More severely ill children may be hospitalized and given oxygen, chest physiotherapy, and IV fluids. Antibiotics are not given. Bacterial pneumonia, however, is treated with antibiotic therapy.
A nurse has provided instructions to the mother of a child with cystic fibrosis (CF) about appropriate dietary measures. Which statement by the mother indicates an understanding of these dietary measures?
The diet needs to be high in calories." Children with CF are managed with a high-calorie, high-protein diet. Pancreatic enzyme replacement therapy and water-soluble vitamin supplements (A, D, E, and K) are administered. If nutritional problems are severe, supplemental tube feedings or parenteral nutrition is administered. Fats are not restricted unless steatorrhea cannot be controlled by administration of increased pancreatic enzymes
