PedsSlides

12 yrs: feel out of place

- know difficult time, sit & talk, ask to tell you how they feel, let them know that talking may make them feel better.

A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, which of the following would the nurse include as being involved? sata A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity E) Defiance F) Anxiety

A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity

When assessing adolescents for health risks, the nurse must keep in mind the factors related to the prevalence of adolescent injuries. Which of the following accurately describe these factors? Sata A) Increased physical growth B) Insufficient psychomotor coordination C) Tiredness, lack of energy D) Lack of impulsivity E) Peer pressure F) Inexperience

A) Increased physical growth B) Insufficient psychomotor coordination E) Peer pressure F) Inexperience

The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order? A) Inspection, palpation, percussion, auscultation B) Inspection, percussion, palpation, auscultation C) Palpation, percussion, inspection, auscultation D) Inspection, auscultation, palpation, percussion

A) Inspection, palpation, percussion, auscultation Recall ass: inspect, palpate, percussion and auscultation

A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. Which of the following would the nurse expect the physician to prescribe? Select all answers that apply. A) Intravenous immunoglobulin B) Ibuprofen C) Acetaminophen D) Aspirin E) Alprostadil

A) Intravenous immunoglobulin C) Acetaminophen D) Aspirin Aspirin: 80mg/kg/day every 6 hours Discharge aspirin: 5mg/kg/day in four doses for 6 weeks (platelets) IVIG 2g/kg/one time over 12 hours Acetaminophen may be used for fever per text.

The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A) Magical thinking B) Centration C) Transduction D) Animism

A) Magical thinking :)

The nurse is administering a crushed tablet to an 18-month-old infant. Which of the following is a recommended guideline for this intervention? A) Mix the crushed tablet with a small amount of applesauce. B) Place the crushed tablet in the infant's formula. C) Mix the crushed tablet with the infant's cereal. D) Crushed tablets should only be mixed with water.

A) Mix the crushed tablet with a small amount of applesauce. CF: Pancreatic enzymes ½ hour before meals (food must be present) Young children may need capsule opened and give in applesauce.

The nurse is administering a crushed tablet to an 18-month-old infant. Which of the following is a recommended guideline for this intervention? A) Mix the crushed tablet with a small amount of applesauce. B) Place the crushed tablet in the infant's formula. C) Mix the crushed tablet with the infant's cereal. D) Crushed tablets should only be mixed with water.

A) Mix the crushed tablet with a small amount of applesauce. Crushing pills- check first- can you? Crushed pills - give with smooth easy to swallow ingredient ex: applesauce

Pediatric Considerations

Children develop hypoxia faster.

The nurse has developed a teaching plan for the family of a 2-year-old boy who holds his breath when he gets frustrated. Which of the following will be most important to include in this plan? A) Provide cuddle time whenever the child begins to act out. B) Explain the child's behavior to the parents. C) Encourage the parents to interact more with the child. D) Stay close to prevent injury when he gets frustrated.

D) Stay close to prevent injury when he gets frustrated.

The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: A) Decorticate posturing B) Nystagmus C) Doll's eye D) Sunsetting

D) Sunsetting Sunsetting is when the sclera of the eyes is showing over the top of the iris. slide: Dolls eyes is sclera above iris ICP

The nurse is choosing foods for a toddler's diet that are high in vitamin A. Which of the following could be added to the menu? Select all answers that apply. A) Applesauce B) Avocados C) Broccoli D) Sweet potatoes E) Spinach F) Carrots

D, E, F D) Sweet potatoes E) Spinach F) Carrots

A nurse is reviewing blood work on a patient with a cyanotic heart defect. Which of the following results would most likely be seen in a patient experiencing polycythemia? Increased RBC Increased WBC Decreased WBC Decreased RBC

Increased RBC Tetralogy of Fallot: why polycythemia? Polycythemia can occur in patients with a cyanotic heart defect. The body tries to compensate for having low oxygen levels and produces more red blood cells (RBCs). This would cause an increased result on the lab tests. This problem does not affect the white blood cells (WBCs).

Therapeutic Techniques: Atopic Dermatitis

Reduction of allergen exposure Reduction of pruritus Patient education Skin care

The nurse is discussing hippotherapy to the parents of a special needs child. Which statements indicate an understanding of the information provided? Select all that apply.

"It promotes the development of balance and better muscle strength." "Children commonly feel more confident with this type of therapy." "Physical therapists often work closely with children during this therapy." Special : Hippotherapy (Riding) 1.Benefits physical and psychological 2.Used for a variety of conditions 3.May improves self-esteem

pain management for burn

(Tylenol as directed) analgesic/antibiotic with dressing

How to administer eye drop med

Hold 3 inches from eye. Instruct to look down Turn head so med flows to outer eye Do not heat ear or eye drops.

Assessment of newborn/infant

If you have sleeping baby assess what you can! Invasive things last: ex mouth and throat area.

Aplastic anemia

Immediate discontinuation of any drug or chemical

An 8-month-old has a ventricular septal defect. Which nursing diagnosis would best apply? A.) Impaired gas exchange related to a right-to-left shunt B.) Impaired skin integrity related to poor peripheral circulation C.) Ineffective airway clearance related to altered pulmonary status D.) Ineffective tissue perfusion related to inefficiency of the heart as a pump

Ineffective tissue perfusion related to inefficiency of the heart as a pump A ventriculoseptal defect permits blood to flow across a septum, creating an ineffective pump. Decreased cardiac output: Ineffective tissue perfusion

Varicella

Keep nails short. May cover with gloves? Antipyretics. Monitor I & O.

Nutritional Health in Toddlers

Let the child choose between two... Toddlers often prefer the same food as this provides a sense of security. Scrambled eggs good source of protein and they can pick them up. finger food maybe

Toddler with Unique Needs

Let them do as much as they can so they can develop/feel that sense of autonomy. Offer activities that allow them to use what abilities they have.

cystic fibrosis (CF)

Pancreas: Secretions become so thick that CF patients are not able to produce enzymes to digest fats, proteins and some sugars resulting in bulky/greasy stools (Steatorrhea) Sweat gland: Na+ in perspiration increases 2-5X normal resulting in salty perspiration

Fifth Disease

Parovirus B19 - slapped face Tx: supportive Avoid pregnant women

Anaphylactic shock

Physical symptoms Assess breathing - major concern! (bronchospasm can occur - think albuterol) Are you thinking - shock - blood loss (most common thought) Need fluid replacement of LR Urticaria and angioedema

when do anterior and posterior fontanels close?

Posterior: after birth to 8 weeks. Anterior 9-18moths

The nurse is managing children who have chronic diseases in a neighborhood clinic. Which of the following are examples of chronic conditions? Select all answers that apply. A) Diabetes mellitus B) Myocardial infarction C) Rheumatoid arthritis D) Compound fracture E) Acute asthma F) Bronchopneumonia

A) Diabetes mellitus C) Rheumatoid arthritis E) Acute asthma Most common chronic illness in children (Comes from the Greek word for "panting") usually before 5 yrs Chronic disease as are RA and DM

A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. Which of the following would be most appropriate for the nurse to include in the child's plan of care? SAta A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands C) Touching the child on his shoulder before letting the child know someone is there D) Using the child's body parts to refer to the area where he may have postoperative pain E) Speaking to the child in a voice that is slightly louder than the usual tone of voice

A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands D) Using the child's body parts to refer to the area where he may have postoperative pain/explain procedure

The nurse is assessing a 2-day-old newborn and suspects Down syndrome based on which of the following? Sata A) Flat facial profile B) Downward slant to the eyes C) Large tongue compared to mouth D) Simian crease E) Epicanthal folds F) Rigid joints

A) Flat facial profile - wide set eyes C) Large tongue compared to mouth - protrusion D) Simian crease - wide hands E) Epicanthal folds - extra eyelid fold Common clinical manifestations of Down syndrome include flat facial profile, upward slant to the eyes (oblique palpebral fissures), tongue that is large in comparison to the mouth size, simian, crease, epicanthal folds, and loose joints.

An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority? A) Notifying the doctor immediately B) Applying ice C) Elevating the arm D) Giving additional pain medication as ordered

A) Notifying the doctor immediately After casting : unrelenting pain is an emergency -notify doctor

The nurse is developing a plan of care for a child with thalassemia. Which of the following would the nurse expect to include? sata A) Packed RBC transfusions B) Deferoxamine therapy C) Heparin therapy D) Opioid analgesics E) Platelet transfusions F) Intravenous immunoglobulin

A) Packed RBC transfusions B) Deferoxamine therapy maybe? slide 5

The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which of the following actions would help reduce her stress related to the procedure? sata A) Pretend to perform the procedure on her doll. B) Explain the procedure to her in medical terms. C) Do not allow her to see or touch the equipment. D) Teach her the steps of the procedure. E) Tell her not to pay attention to any sounds she might hear. F) Introduce her to the health care personnel.

A) Pretend to perform the procedure on her doll. D) Teach her the steps of the procedure. F) Introduce her to the health care personnel.

The nurse teaches parents of adolescents that adolescents need the support of parents and nurses to facilitate healthy lifestyles. Which of the following should be a priority focus of this guidance? A) Reducing risk-taking behavior B) Promoting adequate physical growth C) Maximizing learning potential D) Teaching personal hygiene routines

A) Reducing risk-taking behavior

The nurse is providing care to a child experiencing shock. Which of the following intravenous solutions would the nurse expect to administer? A) Ringer lactate B) Dextrose 5% and water C) Dextrose 5% and normal saline D) Dextrose 10% and water

A) Ringer lactate

A child requires supplemental oxygen therapy at 8 liters per minute. Which delivery device would the nurse most likely expect to be used? A) Simple mask B) Venturi mask C) Nasal cannula D) Oxygen hood

A) Simple mask Simple mask - 8L/min. Venturi mask - specific percentage of oxygen, from 24% to 50%. Nasal cannula - no more than 4L/min Oxygen hood - requires 10-15L/min Mask to use - use simple mask Think about amount of oxygen - 8L would you use nasal cannula or mask?

The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which of the following comments provides the most compelling reason to get the vaccination? A) "These bacteria live in every human." B) "Young children are especially susceptible to these bacteria." C) "You have a choice of two excellent vaccines." D) "Your child needs this final dose for protection."

B) "Young children are especially susceptible to these bacteria." (can cause meningitis)

A group of nursing students are reviewing information about inflammatory bowel disease in preparation for a class discussion on the topic. The students demonstrate understanding of the material when they identify which of the following as characteristic of Crohn disease? Select all answers that apply. A) Distributed in a continuous fashion. B) Most common between the ages of 10 to 20 years C) Elevated erythrocyte sedimentation rate D) Low serum iron levels E) Tenesmus F) Loss of haustra within bowel

B) Most common between the ages of 10 to 20 years C) Elevated erythrocyte sedimentation rate D) Low serum iron levels

The nurse is preparing to perform a physical examination of a child with asthma. Which of the following techniques would the nurse be least likely to perform? A) Inspection B) Palpation C) Percussion D) Auscultation

B) Palpation Exam: inspect, percuss, auscultate, avoid palpation

After teaching the parents of a child diagnosed with celiac disease about nutrition, the nurse determines that the teaching was effective when the parents identify which foods as appropriate for their child? Select all answers that apply. A) Wheat germ B) Peanut butter C) Carbonated drinks D) Shellfish E) Jelly F) Flavored yogurt

B) Peanut butter C) Carbonated drinks D) Shellfish E) Jelly

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which of the following as most helpful in determining the extent of the child's hypoxia? A) Pulmonary function test B) Pulse oximetry C) Peak expiratory flow D) Chest radiograph

B) Pulse oximetry Pulse Ox: most useful (tachycardia, tachypnea)

The nurse is teaching a new mother about the development of sensory skills in her newborn. Which of the following would alert the mother to a sensory deficit in her child? A) The newborn's eyes wander and occasionally are crossed. B) The newborn does not respond to a loud noise. C) The newborn's eyes focus on near objects. D) The newborn becomes more alert with stroking when drowsy.

B) The newborn does not respond to a loud noise. Newborn /infant will respond to loud noise

The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action? A) They increase liver enzymes. B) They can mask signs of infection. C) They cause bone marrow suppression. D) They decrease renal function.

B) They can mask signs of infection. Giving corticosteroids can mask signs of infection.

The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A) Deep-breathing exercises B) Upright positioning C) Coughing D) Chest percussion

B) Upright positioning

The nurse is preparing to administer an intramuscular injection to an 8-month-old infant.Which site would the nurse select? A) Rectus femoris B) Vastus lateralis C) Dorsogluteal muscle D) Deltoid

B) Vastus lateralis

The nurse is assessing a 5-year-old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, which of the following would be least appropriate for the nurse to perform? A) Providing 100% oxygen B) Visualizing the throat C) Having the child sit forward D) Auscultating for lung sounds

B) Visualizing the throat Never attempt to visualize the epiglottis directly with a tongue blade or obtain a throat culture This can cause airway obstruction

A nurse is preparing a presentation for a local parent group about burn prevention and care in children. Which of the following would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? A) Using cool water over the burned area until the pain lessens B) Applying ice directly to the burned skin area C) Covering the burn with a clean, nonadhesive bandage D) Giving the child acetaminophen for pain relief

B. Apply ice directly to the burned skin area. With a superficial burn, ice should not be applied to the skin. Using cool water over the burn area; covering with a clean, nonadhesive bandage; and using acetaminophen for pain relief are appropriate to include in the presentation.

A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. Which of the following would the nurse do first? A) Inspect the child's skin color B) Assess for a patent airway C) Observe for symmetric breathing D) Palpate the child's pulse

B. Assess for a patent airway When performing a primary survey, the nurse first assesses the child's airway for patency and then intervenes accordingly to ensure that the airway is patent. Next the nurse would evaluate the child's skin color, respiratory effort, and symmetry of breathing and breath sounds. Then the nurse would determine the pulse strength, perfusion status, and heart rate.

Which statement best describes beta-thalassemia major (Cooley anemia)? a. All formed elements of the blood are depressed. b. Inadequate numbers of red blood cells are present. c. Increased incidence occurs in families of Mediterranean extraction. d. Increased incidence occurs in persons of West African descent.

C Major: (Cooleys or Mediterranean) Greater incidence in those of Mediterranean background.

The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability? A) "He is not speaking in complete sentences." B) "We can understand a lot of what he says, but no one else can." C) "He seems to be speaking words less and less frequently." D) "He is unable to sit still for a short story."

C) "He seems to be speaking words less and less frequently."

A child with persistent otitis media with effusion is to undergo insertion of pressureequalizing tubes via a myringotomy. The child is to be discharged later that day. After teaching the parents about caring for their child after discharge, which statement indicates that the teaching was successful? A) "The tubes will stay in place for about a month and then fall out on their own." B) "His chances for ear infections now have dramatically decreased." C) "He should wear earplugs when swimming in a pool or a lake." D) "We should keep the ears protected with cotton balls for the first 24 hours."

C) "He should wear earplugs when swimming in a pool or a lake." Earplugs when in water

The school nurse is walking through the lunchroom when one of the children says she feels strange after switching her lunch with her friend. Which assessment would be most important? A) Asking if she has a rash anywhere B) Checking if she has any nausea C) Determining if her throat itches D) Asking if she has abdominal pain

C) Determining if her throat itches Food allergies - did child eat something different? Assess itching of throat.

A group of students are working on a presentation for a local health fair about safety for children. When developing this presentation, the students would address which of the following as the most common cause of pediatric injury? A) Sports B) Firearm use C) Falls D) Automobile accidents

C) Falls

After teaching a group of nursing students about shock in children, the instructor determines that the teaching was successful when the students identify which type of shock as most common? A) Septic B) Cardiogenic C) Hypovolemic D) Distributive

C) Hypovolemic Are you thinking - shock - blood loss (most common thought)

A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the physician will most likely order which medication? A) Alprostadil B) Heparin C) Indomethacin D) Spironolactone

C) Indomethacin Note: Indomethacin used to close.

The nurse is administering immunizations to children in a neighborhood clinic. Which of the following is the most frequent route of administration? A) Oral B) Intradermal C) Intramuscular D) Topical

C) Intramuscular Most immunizations are IM

The nurse working in the emergency room monitors the admission of children. Statistically, for which one of the following disorders would children younger than 5 years most commonly be admitted? A) Mental health problems B) Injuries C) Respiratory disorders D) Gastrointestinal disorders

C) Respiratory disorders

A group of nursing students are reviewing information about childhood infectious diseases. The students demonstrate understanding of this information when they identify which of the following as a common childhood exanthema? A) Mumps B) Rabies C) Rubella D) West Nile virus

C) Rubella

The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child? A) Show him the stethoscope. B) Describe the examination room. C) Use his name before touching him. D) Allow him to explore the exam room.

C) Use his name before touching him.

Arteriogram Left femoral artery:

Check pedal pulse Left Check puncture site Dr will give results

The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant's apical pulse rate was: A) 140 beats per minute B) 120 beats per minute C) 100 beats per minute D) 80 beats per minute

D) 80 beats per minute hold digoxin adult at 60 but infant is 80

After teaching the parents of a child with varicella zoster, the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? A) After day 5 of the rash B) When the rash is completely healed C) Once the rash appears D) After the lesions have crusted

D) After the lesions have crusted

The nurse is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. Which of the following would the nurse include as a major congenital anomaly? A) Overlapping digits B) Polydactyly C) Umbilical hernia D) Cleft palate

D) Cleft palate

The nurse caring for young children in a hospice setting is aware of the following statistics related to the occurrence of death in children. Which one of the following statements accurately reflects one of these statistics? A) Each year, about 50,000 children die in the United States; of those, about 15,000 are infants. B) It is unusual for a child's chronic illness to progress to the point of becoming a terminal illness. C) Despite strides made, diabetes remains the leading cause of death from disease in all children older than the age of 1 year. D) Congenital defects and traumatic injuries are the most common causes of diseases leading to death.

D) Congenital defects and traumatic injuries are the most common causes of diseases leading to death. in children

The nurse is providing discharge teaching regarding formula preparation for a new mother. Which of the following guidelines would the nurse include in the teaching plan? A) Always wash bottles and nipples in hot soapy water and rinse well; do not wash them in the dishwasher. B) Store tightly covered ready-to-feed formula can after opening in refrigerator for up to 24 hours. C) Warm bottle of formula by placing bottle in a container of hot water, or microwaving formula. D) Do not add cereal to the formula in the bottle or sweeten the formula with honey.

D) Do not add cereal to the formula in the bottle or sweeten the formula with honey. Note: No honey for children under 1 year of age

A nurse is preparing a presentation for an expectant parent group about neural tube defects and prevention. Which of the following would the nurse emphasize? A) Smoking cessation B) Aerobic exercise C) Increased calcium intake D) Folic acid supplementation

D) Folic acid supplementation ◦Low levels of folic acid (screen maternal AFP) supplement!

A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. Which of the following would the nurse have most likely assessed? A) High fever B) Dysphagia C) Toxic appearance D) Inspiratory stridor

D) Inspiratory stridor

The school nurse is preparing a talk on the influence of the media on school-age children to present at the next PTO meeting. Which of the following facts might the nurse include in the introduction? A) Children in the United States spend about 6 hours a day either watching TV or playing video games. B) A child will see 2,000 murders by the end of grade school and 20,000 commercials a year. C) A school-age child cannot determine what is real from what is fantasy; therefore, TV and video games can lead to aggressive behavior. D) Parents should limit television watching and video-game playing to 2 hours per day.

D) Parents should limit television watching and video-game playing to 2 hours per day.

A 4-year-old boy has a febrile seizure during a well-child visit. Which of the following would be a priority? A) Hyperextending the child's head while placing him on his side B) Using a tongue blade to pry open the child's jaw C) Loosening the child's clothing to ensure a patent airway D) Protecting the child from harm during the seizure

D) Protecting the child from harm during the seizure regardless of type of seizure protect from injuries the first and vital action give information in small amounts at a time regardless of type of seizure - overwhelming for family

The nurse is preparing a plan of care for a 5-year-old boy with chickenpox. Which of the following nursing interventions should be questioned? A) Administer antipyretics as ordered. B) Keep the child's fingernails short. C) Monitor fluid intake and output. D) Provide alcohol baths as needed.

D) Provide alcohol baths as needed. really? :) should be questioned !! NO that's why you are questioning it :)! Keep nails short. May cover with gloves? Antipyretics. Monitor I & O.

5. The nurse is monitoring a child who has received epidural analgesia with morphine. The nurse is careful to monitor for which of the following adverse effects of the medication? A) Epidural hematoma B) Arachnoiditis C) Spinal headache D) Respiratory depression

D) Respiratory depression

The nurse is developing a teaching plan for the parents of a child with a myelomeningocele who will require clean intermittent catheterization. Which of the following would the nurse include? A) Applying petroleum jelly to lubricate the catheter B) Cleaning the reusable catheter with peroxide after each use C) Storing the reusable cleaned catheter in a brown paper bag D) Soaking the catheter in a vinegar and water solution to sterilize

D) Soaking the catheter in a vinegar and water solution to sterilize ◦Position infant to protect sac - keep moist - no pressure also called spina bifida: neuro deffect

A 4-year-old girl with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing her for this procedure, you would want to prepare her to a) void during the procedure. b) anticipate a headache afterward. c) drink three glasses of water during the procedure. d) have a local anesthetic injected prior to the procedure.

void during the procedure. A voiding cystourethrogram requires the child to void during the procedure so that bladder emptying and urethra flow can be assessed.

The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply.

• Children who weigh less than 40 pounds should use a car seat with harness and top tether • Many car seats are installed improperly, making them unsafe. • The back seat remains the safest place for children to ride. • Booster seats should be used with both a shoulder and lap belt. slide: Car seat up to 40#, then booster. Review position of shoulder harness not to injure child's face or throat No child left in car

discharge instructions: Often follow up appointments are made at this time.

◦ Discharge planning begins soon after admission.

Recognize "teachable moments." maybe

◦clarify family's needs (parent and child). ◦select a teaching strategy. ◦give personalized guidance. ◦seek and provide feedback. ◦evaluate effectiveness of teaching.

A group of nursing students are reviewing information about atopic dermatitis. Which of the following indicate that the students understand the information? Select all that apply. a) Changes in temperature can contribute to flare-ups. b) The reaction occurs in response to specific allergens. c) Scratching initiates the reaction, which then becomes pruritic. d) Excessively humid environments often lessen the severity of the reaction. e) The disorder is chronic with periods of remissions.

a) Changes in temperature can contribute to flare-ups. b) The reaction occurs in response to specific allergens. e) The disorder is chronic with periods of remissions. maybe!

lead poisoning

5mg/dL or higher. PREVENTABLE. Usually under 6 yrs.

A group of students are reviewing information about respiratory arrest in children. The students demonstrate understanding of this information when they identify which of the following as a common cause involving the upper airway? Select all answers that apply. A) Croup B) Asthma C) Pertussis D) Epiglottitis E) Pneumothorax

A) Croup D) Epiglottitis Respiratory arrest often associated with croup and epiglotti.

Thalassemias Minor: Mild anemia

Symptoms: may have none, paleness. May not need treatment. No iron supplement

The nurse contacts a child life specialist (CLS) to work with children on a pediatric ward. What is the primary goal of the CLS? A) Decrease anxiety and fear during hospitalization and painful procedures B) Keep children who are hospitalized distracted from pain C) Perform medical procedures using atraumatic principles D) Act as a liaison between the nurse and the child

A) Decrease anxiety and fear during hospitalization and painful procedures

visually impaired patient

visually impaired patient approach using named prior to actually touching

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which of the following would be the priority before the test? A) Checking with the parents for any allergies B) Ensuring adequate hydration C) Giving the girl an enema D) Screening her for pregnancy

A) Checking with the parents for any allergies IV pyelogram - check allergies

Toddlers Sleep

12 hours at night with naps 1-2X/day Sometimes resist napping... They do not want to miss out Resist napping as part of developing negativism

A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which of the following? Select all answers that apply. A) Complaints of stiff neck B) Photophobia C) Absent headache D) Negative Brudzinski sign E) Vomiting

A) Complaints of stiff neck B) Photophobia E) Vomiting

Kawasaki Disease

39.9 C for 5 days classic!

The nurse is caring for preschoolers in a day care center. Of which of the following developmental milestones of this age group should the nurse be aware? Select all answers that apply. A) Counting 10 or more objects B) Correctly naming at least four colors C) Understanding the concept of time D) Knowing everyday objects E) Understanding the differences of others F) Forming concepts as logical as an adult's

A) Counting 10 or more objects B) Correctly naming at least four colors C) Understanding the concept of time D) Knowing everyday objects

Toddler Emo Development

@4 -more likely to become involved in arguments More certain of their roles @ 5yrs-Begin to develop "best friends" (who they walk to school with or live near) Elementary Rule generally pertain to this age: 2 or 4 will play, 3 or 5 will quarrel

A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. Which of the following would be most helpful? Select all answers that apply. A) Allowing for breaks when tics occur B) Providing for "time-outs" during the day C) Using a tape recorder to take notes D) Ensuring a specified amount of time for test taking E) Implementing a reward system for behavior

A) Allowing for breaks when tics occur C) Using a tape recorder to take notes Together the school nurse and parents should arrange for classroom accommodations such as allowing for "tic breaks," taking untimed tests or tests in another room, or using note takers or tape recorders. Time-outs and reward systems are more appropriate for the child with ADHD.

During a physical assessment of a 5-month-old child, the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. Which of the following is the correct time for the dentist visit? A) By the first birthday B) By the second birthday C) By entry into kindergarten D) By entry into first grade

A) By the first birthday The American Academy of Pediatric Dentistry recommends that a dentist examine the infant by his or her first birthday. Besides assessing routine oral health care, establishing a dental contact by the first birthday provides a resource for emergency dental care if it is needed.

The school nurse providing school health screenings knows that the 7- to 11-year-old is in Piaget's stage of concrete operational thoughts. What should this age group accomplish when developing operations? Select all that apply. A)Ability to assimilate and coordinate information about the world from different dimensions B)Ability to see things from another person's point of view and think through an action C)Ability to use stored memories of past experiences to evaluate and interpret present situations D)Ability to think about a problem from all points of view, ranking the possible solutions while solving the problem E)Ability to think outside of the present and incorporate into thinking concepts that do exist as well as concepts that might exist F)Ability to understand the principle of conservation—that matter does not change when its form changes

A, B, C, F maybe slide 24

27. A nurse suspects that an adolescent may have community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA). Which of the following would the nurse expect to assess? Select all answers that apply. A) Participation in contact sport B) Recent cut on the lower leg C) History of a recent sort throat D) Raised fluctuant lesions E) Erythematous rash over the trunk and face

A, B, D A) Participation in contact sport B) Recent cut on the lower leg D) Raised fluctuant lesions Children & adolescent often engage in sports. Skin contact. Injuries such as being kicked in the leg. Note raised fluctuant lesions.

The nurse is assessing the respiratory system of a newborn. Which of the following anatomic differences place the infant at risk for respiratory compromise? Select all answers that apply. A) The nasal passages are narrower. B) The trachea and chest wall are less compliant. C) The bronchi and bronchioles are shorter and wider. D) The larynx is more funnel shaped. E) The tongue is smaller. F) There are significantly fewer alveoli.

A,D,F A) The nasal passages are narrower. D) The larynx is more funnel shaped. F) There are significantly fewer alveoli.

The nurse is assessing the respiratory system of a newborn. Which of the following anatomic differences place the infant at risk for respiratory compromise? Select all answers that apply. A) The nasal passages are narrower. B) The trachea and chest wall are less compliant. C) The bronchi and bronchioles are shorter and wider. D) The larynx is more funnel shaped. E) The tongue is smaller. F) There are significantly fewer alveoli.

A,D,F. final A) The nasal passages are narrower D) The larynx is more funnel shaped.. F) There are significantly fewer alveoli. Children develop hypoxia faster.

The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which of the following topics would be most appropriate? A) Advising how to create a toddler-safe home B) Warning about small objects left on the floor C) Cautioning about putting the baby in a walker D) Telling about safety procedures during baths

A. Teach safe home for toddler! slides The most appropriate topic for this mother would be advising her on how to create a toddler-safe home. The child will very soon be pulling herself up to standing and cruising the house. This will give her access to areas yet unexplored. Warning about small objects left on the floor, telling about safety procedures during baths, and cautioning about using baby walkers would no longer be anticipatory guidance as the child has passed these stages.

Secondary Immunodeficiency Disorders

AIDS

Herpes Zoster

Acylovir: within 72 hours of the onset of rash (may help limit diseases)

A school-age child is brought to the office of the camp nurse with a small, superficial burn. Which of the following actions by the nurse would be the most appropriate action for the nurse to do first? a) Apply cold compresses to the area b) Apply a topical anesthetic ointment c) Cover the area with a sterile bandage d) Administer acetaminophen

Apply cold compresses to the area Cool water is an excellent emergency treatment for burns involving small areas. The immediate application of cool compresses or cool water to burn areas appears to inhibit capillary permeability and thus suppress edema, blister formation, and tissue destruction.

Coarctation of the aorta demonstrates few symptoms in newborns. Which of the following is an important assessment to make on all newborns to help reveal this condition? Observing for excessive crying Assessing for the presence of femoral pulses Recording an upper extremity blood pressure Auscultating for a cardiac murmur

Assessing for the presence of femoral pulses Blood flow greater up and less lower. What might you note? Infants with a narrowing (coarctation) of the aorta have decreased pressure in the lower extremities or absence of femoral pulses. Vitals increased upper body & decreased lower.

The nurse is providing parental teaching about home care for an 8-year-old boy with widespread sunburn on his back and shoulders. Which of the following responses indicates a need for further teaching? A) "Cool compresses may help cool the burn." B) "He should manually peel off any flaking skin." C) "Nonsteroidal anti-inflammatory drugs like ibuprofen are helpful." D) "He should avoid hot showers or baths for a couple of days."

B "He should manually peel off any flaking skin." If skin flaking occurs, the child should be discouraged from manually "peeling" the flaked skin as it can cause further injury. Using cool compresses, taking nonsteroidal anti-inflammatory drugs, and avoiding hot showers or baths are appropriate measures.

The school nurse is conducting vision screening for a 7-year-old girl and documents the condition "amblyopia." What would the nurse tell the parents about this condition? A) "Amblyopia is an uncorrected refractive error of the eye." B) "Amblyopia is reduced vision in an eye that has not been adequately used during early development." C) "Amblyopia is a malalignment of the eye, which occurs at birth." D) "Amblyopia is a clouding of the lens of the eye caused by trauma to the eye."

B) "Amblyopia is reduced vision in an eye that has not been adequately used during. Some problems frequently identified in school-age children include amblyopia (lazy eye), uncorrected refractive errors or other eye defects, and malalignment of the eyes (called strabismus). Amblyopia is reduced vision in an eye that has not been adequately used during early development. Inadequate use can result from conditions such as strabismus, being cross-eyed, or one eye being more nearsighted, farsighted, or astigmatic than the other eye. Amblyopia is the leading cause of visual impairment in children (National Eye Institute, 2008) and if untreated can result in vision loss.

The nurse is caring for a 2-month-old with a cleft palate. The child will undergo corrective surgery at age 3 months. The mother would like to continue breastfeeding the baby after surgery and wonders if it is possible. How should the nurse respond? A) "There is a good chance that you will be able to breastfeed almost immediately." B) "Breastfeeding is likely to be possible, but check with the surgeon." C) "After the suture line heals, breastfeeding can resume." D) "We will have to wait and see what happens after the surgery."

B) "Breastfeeding is likely to be possible, but check with the surgeon" ◦Surgery: excellent results! Specialists available ◦.MAJOR ISSUE: Nutrition prior and post surgery & takes longer to feed. Protect incision. Provide sucking needs. Check for other disorders

The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which finding would help confirm this diagnosis? A) Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis). B) A distinct "clunk" is heard with Barlow and Ortolani maneuvers. C) A high-pitched "click" is heard with hip flexion or extension. D) The thigh and gluteal folds are symmetric.

B) A distinct "clunk" is heard with Barlow and Ortolani maneuvers. A distinct "clunk" while performing Barlow and Ortolani maneuvers is caused as the femoral head dislocates or reduces back in to the acetabulum. A higher-pitched "click" may occur with flexion or extension of the hip. This is a benign, adventitious sound that should not be confused with a true "clunk" when assessing for developmental dysplasia of the hip. Abduction to 75 degrees, adduction within 30 degrees, and symmetric thigh and gluteal folds are normal findings.

The school nurse is preparing a program on sexuality and birth control for a class of 14-to 16-year-olds. Which of the following behaviors will have the most influence on how the information is presented? A) Teens are adjusting to new body images. B) Adolescents tend to take risks. C) Teenagers are able to think in the abstract. D) Adolescents understand that actions have consequences.

B) Adolescents tend to take risks. Sex education adolescent: 14- 16 yr old noted for being risk takers

When instructing the parents of a toddler about appropriate nutrition, which of the following would the nurse recommend? A) About 12 to 16 ounces of fruit juice per day B) Approximately 16 to 24 ounces of milk per day C) Fat intake of 30% to 40% of total calories D) An average of 10 to 12 grams of fiber per day

B) Approximately 16 to 24 ounces of milk per day Do NOT restrict Fats <2yo. >2yo should have 30-35% calories Fat Milk should be WHOLE milk until 2 y.o. after which 2% can be introduced

A nurse is instituting neutropenic precautions for a child. Which of the following would the nurse most likely include? Select all answers that apply. A) Placing the child in a semiprivate room B) Avoiding rectal exams, suppositories, and enemas C) Placing a mask on the child when outside the room D) Encouraging an intake of raw fruits and vegetables E) Discouraging fresh flowers in the child's room.

B) Avoiding rectal exams, suppositories, and enemas C) Placing a mask on the child when outside the room E) Discouraging fresh flowers in the child's room. Neutropenic precautions: avoid rectal exams, suppositories, enemas. Mask required for child if not in room. No flowers, fish etc in room.

The nurse is inspecting the fingernails of an 18-month-old girl. Which of the following findings indicates chronic hypoxemia? A) Nails that curve inward B) Clubbing of the nails C) Nails that curve outward D) Dry, brittle nails

B) Clubbing of the nails Hypoxia becomes chronic note clubbing of nails.

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A) Cloudy yellow B) Cola colored C) Pale to almost clear urine D) Light orange to moderately yellow colored

B) Cola colored Urinalysis - gross hematuria/cola colored

Which of the following would the nurse include in the preoperative plan of care for an infant with myelomeningocele? A) Positioning supine with a pillow under the buttocks B) Covering the sac with saline-soaked nonadhesive gauze C) Wrapping the infant snugly in a blanket D) Applying a diaper to prevent fecal soiling of the sac

B) Covering the sac with saline-soaked nonadhesive gauze ◦Position infant to protect sac - keep moist - no pressure

A nurse is conducting a physical examination of an infant and observes the urethral opening on the dorsal side of the penis. The nurse documents this finding as which of the following? A) Hypospadias B) Epispadias C) V aricocele D) Hydrocele

B) Epispadias Urethral opening on dorsal side. B epispadias

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which of the following would the nurse incorporate into the presentation as the most common cause? A) Klebsiella B) Escherichia coli C) Staphylococcus aureus D) Pseudomonas

B) Escherichia coli Primarily: Escherichia coli

The nurse is helping parents prepare a healthy meal plan for their toddler. Which of the following guidelines for promoting nutrition should be followed when planning meals? sata A) The child younger than 2 years of age should have his or her fat intake restricted. B) Extending breastfeeding into toddlerhood is believed to be beneficial to the child. C) Weaning from the bottle should occur by 6 to 12 months of age. D) Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. E) The toddler requires an average intake of 500 mg calcium per day. F) Toddlers tend to have the highest daily iron intake of any age group.

B) Extending breastfeeding into toddlerhood is believed to be beneficial to the child. D) Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. E) The toddler requires an average intake of 500 mg calcium per day.

Based on Erikson's developmental theory, which of the following is the major developmental task of the adolescent? A) Gaining independence B) Finding an identity C) Coordinating information D) Mastering motor skills

B) Finding an identity

The nurse is caring for an infant with suspected patent ductus arteriosus. Which of the following assessment findings would the nurse identify as helping to confirm this suspicion? A) Thrill at the base of the heart B) Harsh, continuous, machine-like murmur under the left clavicle C) Faint pulses D) Systolic murmur best heard along the left sternal border

B) Harsh, continuous, machine-like murmur under the left clavicle Note: Harsh, continuous, machine-like murmur (under left clavicle)

A nurse is conducting a screening program for autism in infants and children. Which of the following would the nurse identify as a warning sign? A) Lack of babbling by 6 months B) Inability to say a single word by 16 months C) Lack of gestures by 8 months D) Inability to use two words by 18 months

B) Inability to say a single word by 16 months Neurodevelopmental Disorder - diagnosis about 2 yrs old. Communication Difficulties. No words at 16 months, Toddler that speaks less and less frequently. Poor Social Interactions Frequent Repetitive and stereotyped movements

A mother brings her child to the health care clinic because she thinks that the child has conjunctivitis. Which assessment finding would lead the nurse to suspect bacterial conjunctivitis? Sata A) Itching of the eyes B) Inflamed conjunctiva C) Stringy discharge D) Photophobia E) Mild pain F) Tearing

B) Inflamed conjunctiva E) Mild pain

Three children in a family, ages 7 months, 4 years, and 9 years have been tested for lead poisoning. The two younger children's tests reflect elevated lead levels and they will be undergoing treatment. The children's mother questions why her younger children were not "spared" as their older sibling was. What response by the nurse is most correct? A)"Some children are better able to metabolize toxins such as lead after exposure." B)"Your older child has a stronger liver and kidneys, which have helped her to better rid her body of the lead." C)"Younger children are often impacted because of their play behaviors place them on the floors and they often put things into their mouths." D)"It is likely your older child may have had elevated levels earlier in life but has gotten over the condition."

C)"Younger children are often impacted because of their play behaviors place them on the floors and they often put things into their mouths." Lead poisoning is a problem that affects children younger than age 6 the most due to the fact that they are crawling on the ground and putting things in their mouths, and their developing neurologic system is more sensitive to the effects of lead. The liver and kidney development is not an influence on the degree of lead found in children's blood specimens. Metabolism is not the greatest influence on the reason why only the younger children have been impacted by lead poisoning.

While assessing an 18-month-old during a well-child visit, the nurse notes that the toddler has a rounded "pot-belly" abdomen, marked lordosis or swayback, short, slightly bowed legs, and a large head. Based on these findings, what action should the nurse implement?

Document general physical appearance of a normally developed toddler. As a toddler becomes more experienced in walking, this will correct naturally. Sway back with pot belly. slide this is normal

Elevated Lead Levels are caused by

Eating, chewing, or sucking on objects covered with lead-based paint... Additional sources may include: Toys or Cribs (manufactured in other countries (where lead restrictions are not enforced) Home renovation (Dust or Fumes) Think oral stage. Pottery made with Lead glazes. Old family toys. Colored print in newspapers Older lead-based water pipes. Can be tested. Soils around the house/contaminated foods grown there

The nurse on a pediatric unit finds a child having extreme shortness of breath, a swollen tongue, and urticaria on her face and neck. The nurse notices her lunch tray to have a half-eaten peanut butter and jelly sandwich. The client is allergic to peanuts. What is the first medication the nurse should be prepared to administer?

Epinephrine The child is demonstrating an anaphylactic reaction. While all of the medications may be necessary, the first medication to be administer is epinephrine to counteract the analphylaxis. Urticaria and angioedema

Style of Thinking: Centration (ex: lion & tigers are not cats!)

Focus on Characteristics of an object but only one characteristic They feel they are always right

Head Circumference

Gains only 2 cm during 2nd year (12cm during 1st year!) maybe

A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding: a) Putting child safety locks on kitchen cabinets b) Placing house plants out of reach of children c) Removal or covering of flaking paint on the walls of the home d) Putting medicine away where children cannot reach it

Removal or covering of flaking paint on the walls of the home A child with a blood lead level over 5 μg/dL needs to be rescreened to confirm the level and then active interventions begun to prevent further lead exposure, such as removal of the child from the environment containing the lead source or removal of the source of lead from the child's environment.

Staphylococcus aureus!

Resistant to antibiotics. (Methicillin) Shared items making skin contact, hot tubs., anything that touches. Note razors. Can acquire in medical facility.

Presents as a mild URI, spreads to epiglottis

Severe inspiratory stridor Difficulty swallowing, severe sore throat, drool, anxious Hoarseness (whisper talk), high fever, neck forward No oral fluid - should be IV fluid Cool mist humidifier O2

What Is Anticipatory Guidance?

Sunscreen, Immunizations, dental visits, diet & exercise Bike/scooter safety (helmets & pads, poison Smoking & vaping, sex education, alcohol & drugs, internet safety

Asthma: May present with respiratory distress

Tachy - anxiety - wheeze (parents present may help relieve symptoms - helps relieve fear.) Think of parent as the support system regardless of age. Always provide air support

Fevers:

Under 102 probably no doctor involved Use Tylenol Fevers are not always bad unless to high

Urethral DefectsHypospadia

Urethral opening on ventral side. A hypospadias Urethral opening on dorsal side. B epispadias

Assessing Viral Infections #1

Viral exanthems (rashes)

Motor Development of 18 months

Walking if not by 18 months - refer NOTE: if child walking at 15 months but stops EVALUATE - could be neuro issue

The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. The nurse documents this finding as which of the following? a) Bladder exstrophy b) Hypospadias c) Epispadias d) Patent urachus

b) Hypospadias Urethral opening on ventral side. A hypospadias

Hypothyroidism tx

replace levothyroxine for life-cognitive impairement issue

breath holding

stay with the child when child is frustrated

The parent of 3 1/2-year-old preschooler tells the nurse that the child argues quite a bit and says that the child is always right. The nurse interprets this information as indicating: initiative. guilt. centering. conservation.

centering. Explanation: At age 3 years, cognitive development is still preoperational. Although children during this period do enter a second phase called intuitional thought, they lack insight to view themselves as others see them or put themselves in another's place. This is called centering. Because preschoolers cannot make this kind of mental substitution, they feel that they are always right and causes them to argue. Conservation is reflected in the child's ability to distinguish that two items of equal size are the same despite a change in form. Initiative is the developmental task of preschoolers and is reflected in the child's learning as much as possible about the world around them by trying new activities or having new experiences. Guilt occurs if children are punished or criticized for attempts at initiative.

stop the burn

cool water, remove chemical, undress completely

safety near drowning:

supervision CPR for babysitters bathroom door close toilet number #2 leading cause of accident accident

Prednisone general info

take with food masks infection do not stop abruptly weight gain noted

leukemia

treatment with chemo results in with for infection as they become neutropenic/immunized suppressed

Monitor

if alarm goes off and no heart beat what would you do? CPR ...this is a code.

Children and diabetes

insulin therapy SQ insulin pin diet carb counting exercise drawing insulin: clear to cloud : short first! double check with another nurse administration of insulin techniques needs to be demonstrated correctly over several days prior to discharge