PEDS test 3 sherpath
A 13-month-old female is brought to the hospital because the parents suspect spasmodic croup. What information would help the nurse determine appropriate interventions for this child? A) Family History B) Onset of symptoms C) Presence of mucus D) Exposure to bacteria E) When coughing occurs
A) Family History Because spasmodic croup may have a genetic predisposition, asking about family history can help the nurse determine interventions for a 13-month-old child with suspected croup. B)Onset of symptoms Because spasmodic croup usually has a sudden onset, asking about onset of symptoms can help the nurse determine interventions for a 13-month-old child with suspected croup. C)Presence of mucus Because spasmodic croup is associated with mucosal inflammation, asking about presence of mucus can help the nurse determine interventions for a 13-month-old child with suspected croup. E) When coughing occurs Because coughing with spasmodic croup usually occurs at night, asking when coughing occurs can help the nurse determine interventions for a 13-month-old child with suspected croup.
A 10-year-old patient with aplastic anemia presents with the following vital signs: blood pressure of 118/70, heart rate of 112, respiratory rate of 28, temperature of 102.3° F. The nurse can anticipate which orders from the provider? A)Obtain a blood culture. B)Collect a stool sample. C)Administer antibiotics. D)Administer an antipyretic. E)Obtain a complete blood count (CBC).
A)Obtain a blood culture. Patients with aplastic anemia are at increased risk for infection. A blood culture would be obtained to determine the source of infection. C) Administer antibiotics. Patients with aplastic anemia are at increased risk for infection. Prophylactic antibiotics should be administered to prevent or treat a potential infection. D) Administer an antipyretic. A temperature of 102.3° F is a sign of infection. The provider would order an antipyretic to treat the fever. E) Obtain a complete blood count (CBC). Patients with aplastic anemia have alterations in red blood cells, white blood cells, and platelets. A CBC should be obtained to determine the severity of the disease.
On assessment of a patient with aplastic anemia, the nurse notes peripheral pulses 1+, cool extremities, and capillary refill of 4 seconds. Which actions should the nurse take? A)Obtain vital signs. B)Administer an antibiotic. C)Administer an analgesic. D)Notify the health care provider. E)Complete a neurologic examination.
A)Obtain vital signs. Weak peripheral pulses, prolonged capillary refill, and cool skin indicate poor tissue perfusion. Vital signs should be obtained for more information on the patient's hemodynamic status. D)Notify the health care provider. Peripheral pulses, prolonged capillary refill, and cool skin indicate poor tissue perfusion. The nurse would notify the health care provider of abnormal assessment findings E)Complete a neurologic examination. Peripheral pulses, prolonged capillary refill, and cool skin indicate poor tissue perfusion. The nurse would perform a neurological exam to determine the effectiveness of cerebral perfusion.
The nurse is caring for a child with beta-thalassemia, who had a splenectomy 3 weeks ago. The patient reports malaise and has a runny nose and a cough. The nurse notes a temperature of 101.2° F, heart rate of 116, blood pressure of 106/88, and respiratory rate of 26. In which order should the nurse implement interventions?
Assess lung sounds Obtain complete blood cell count Administer an antibiotic Administer antipyretic
The nurse is educating a parent of a child newly diagnosed with sickle cell anemia. Which statements, made by the parent, indicate teaching was effective? A) "My child should avoid range of motion exercises." B)"I keep bottles of water with me whenever we go out." C) "I made an appointment for the year 4 immunizations." D)"I will call our health care provider as soon as I notice any cough or fever." E)"We only play in the snow for about 20 minutes at a time."
B) "I keep bottles of water with me whenever we go out." Children with sickle cell anemia should stay well hydrated and therefore this statement does not indicate a need for further teaching. C)"I made an appointment for the year 4 immunizations." Children with sickle cell anemia should be routinely vaccinated to prevent infection. D)"I will call our health care provider as soon as I notice any cough or fever." Any sign of infection should be reported to the health care provider immediately. E)"We only play in the snow for about 20 minutes at a time." Patients with sickle cell anemia should avoid prolonged exposure to the cold.
The clinic nurse wants to develop a teaching program for parents of patients at risk for developing iron deficiency anemia (IDA). Which patient does the nurse correctly identify as being at greatest risk for developing IDA? A) A 4-year-old child who will only eat cereal B)A 5-year-old child who lives in a home built in 1942 C) A 4-year-old child whose father has sickle cell anemia D) A 6-year-old child whose mother had gestational diabetes
B) A 5-year-old child who lives in a home built in 1942 Older homes are more likely to have lead paint and pipes. Lead exposure is a risk factor for iron deficiency and IDA.
The mother of a 10-month-old reports that the child has been pale, tires quickly, and sometimes has difficulty breathing. Which orders would the nurse anticipate for this patient? A)Give an oral iron supplement. B)Collect blood for complete blood count (CBC) C)Maintain NPO (nothing by mouth) status for this patient. D)Prepare the patient for insertion of in intravenous line. E)Obtain vital signs, including pulse oximetry, and notify the provider of any concerning results.
B) Collect blood for complete blood count (CBC) To help confirm a diagnosis of iron deficiency anemia, the nurse should expect an order for a CBC. D) Prepare the patient for insertion of in intravenous line The patient will likely require insertion on an IV line for the administration of fluids to increase volume and perfusion. E) Obtain vital signs, including pulse oximetry, and notify the provider of any concerning results The nurse would expect to collect a complete set of vital signs, including pulse oximetry, to determine the presence of impaired perfusion secondary to iron deficiency anemia.
A 10-year-old patient presents to the pediatric clinic with maxillary hyperplasia, malocclusion, hypochromic anemia, and elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Which additional assessments should the nurse perform? A)Administer desferoxamine. B)Measure oxygen saturation. C)Perform a complete abdominal assessment. D)Evaluate peripheral pulses in all extremities. E)Evaluate parent's understanding of treatment.
B) Measure oxygen saturation. Maxillary hyperplasia, malocclusion, and hypochromic anemia indicate extramedullary erythropoiesis related to prolonged beta-thalassemia, which can affect tissue perfusion. Oxygen saturation is suggestive of peripheral tissue perfusion. C)Perform a complete abdominal assessment. Elevated AST and ALT levels indicate liver dysfunction. It is important for the nurse to assess for hepatosplenomegaly, a complication of beta-thalassemia and other disease processes. D))Evaluate peripheral pulses in all extremities. Maxillary hyperplasia, malocclusion, and hypochromic anemia indicate extramedullary erythropoiesis related to prolonged beta-thalassemia, which can affect tissue perfusion. Peripheral pulses are suggestive of peripheral tissue perfusion. E)Evaluate parent's understanding of treatment. Maxillary hyperplasia, malocclusion, and hypochromic anemia indicate extramedullary erythropoiesis related to prolonged beta-thalassemia, which requires strict compliance with treatment and follow-up requirements. The nurse should evaluate the parent's understanding of treatment to determine the need for further teaching.
A parent of a breastfed infant with iron deficiency anemia (IDA) questions the need for iron supplementation. Which response by the nurse is most appropriate? A) "Children's diets lack iron, so they have to take pills instead." B)"Your baby's bone marrow function is not fully developed yet." C)"Because the infant is growing so rapidly, his body needs extra iron." D)"Other vitamin supplements do not contain iron, so you need special pills instead."
C) "Because the infant is growing so rapidly, his body needs extra iron." Because children must produce additional red blood cells (RBCs) to accommodate for their physical growth, their need for iron, which is used in synthesis of new hemoglobin for RBC production, is increased.
A 2-year-old patient diagnosed with beta-thalassemia requires chelation therapy. The child's parents state, "So we bring her here for the needle to be placed for each treatment." Which response by the nurse is most appropriate? A)"Chelation therapy will be a one-time occurrence." B)"Your child will be given a tablet four times each day." C)"You will be taught how to prepare medications for chelation therapy." D)"Chelation therapy can only be performed during an inpatient hospital visit."
C) "You will be taught how to prepare medications for chelation therapy." The nurse should inform the parents that they will be properly educated on administration of home chelation therapy, so frequent visits to the provider's office will not be necessary.
The nurse receives an intershift report on four assigned patients with iron deficiency anemia (IDA). After a review of each patient's history, combined with the shift report information, which patient should the nurse see first? A) A 5-year-old with headache and fatigue B) A 16-year-old who menstruates for an average of 5 days each month C) A 3-month-old with an intestinal malformation and slight pallor D) An 11-year-old with joint pain who has grown 4 inches in the past 6 months
C) A 3-month-old with an intestinal malformation and slight pallor Premature infants and those with gastrointestinal impairment are at increased risk for IDA due to the prevalence of immature red blood cells and the inability to absorb iron. Pallor indicates inadequate perfusion and must be further assessed and treated.
A patient with sickle cell anemia presents with pallor, lethargy, headache, and a history of fainting spells. Which provider order would the nurse anticipate? A) Assess pain level every shift. B) Assess exertional heart rate on a treadmill C)Collect blood for type and cross-matching. D)Administer 3% saline solution intravenously at a rate of 25 mL/hr.
C) Collect blood for type and cross-matching. The patient is displaying signs of a vaso-occlusive crisis, and blood transfusion is an expected treatment. Before administration, the patient's blood type must be determined.
The nurse notes the vital signs of a patient with sickle cell anemia (SCA) after splenectomy to be as follows: heart rate, 122; respiratory rate, 24; blood pressure, 80/48; and temperature of 100.3° F. The patient appears drowsy but is easy to arouse. Based on this assessment, which initial action should the nurse take? A) Administer an antipyretic. B) Auscultate the patient's lung sounds. C) Contact the health care provider (HCP). D) Prepare the patient for insertion of an intravenous (IV) line.
D) Prepare the patient for insertion of an intravenous (IV) line. Tachycardia, tachypnea, and hypotension indicate possible fluid volume deficit from blood loss during surgery. The nurse would prepare the patient for IV fluid administration per protocol.
The nurse in a pediatric hematology unit admits a patient with sickle cell anemia, transferred from the emergency department. Which finding warrants immediate additional assessment by the nurse? A)Knee pain and a hemoglobin of 10.1 B)Abdominal pain and serum glucose level of 86 C) Anorexia and urinalysis that is positive for protein D)Shortness of breath and a white blood cell (WBC) count of 16,000
D) Shortness of breath and a white blood cell (WBC) count of 16,000 Shortness of breath can indicate respiratory compromise in patients with sickle cell crisis, and a WBC count of 16,000 indicates a possible infection. These findings warrant immediate assessment at this time.
The nurse is completing discharge teaching of a patient who originally presented with symptoms of aplastic anemia. Which statement, made by the parents, indicates teaching was effective? A) "My child is a competitive wrestler." B)"Our favorite thing to do together is go to the mall." C)"We don't believe in vaccinations for our children." D)"We bought a new soft-bristle toothbrush yesterday."
D)"We bought a new soft-bristle toothbrush yesterday." Children with aplastic anemia should use soft toothbrushes to prevent bleeding from the gums. This statement indicates that teaching was effective.
