saunders- peds

Which is a late sign of increased ICP?

-Bradycardia early signs include a slight change in level of consciousness, headache, nausea, vomiting, visual disturbances (diplopia), seizures.

The nurse is developing a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply.

-Time the seizure. -Stay with the child. -Move furniture away from the child.

bronchiolitis (RSV)

-contact precautions ~ good hand washing -isolation or cohort -gown, gloves. mask is not required

nephrotic syndrome: s/sx

-pallor -edema -anorexia -proteinuria -hypoalbuminia -hyperlidpemia

Reye's syndrome. patho:

-viral infection that causes encephalopthy (disease of the brain). s/sx: cerebral edema and fatty liver. -nurse should dim the lights and maintain a quiet environment to decrease irritation on cerebral tissue and neurons response.

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action?

worry about SUPERIOR MESENTERIC ARTERY SYNDROME--> s/sx like intestinal obstruction (vomiting and abdominal distention)

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."

club foot: interventions + education

"Treatment needs to be started as soon as possible." "I realize my infant will require follow-up care until fully grown." "I need to bring my infant back to the clinic in 1 month for a new cast." cast need to be weekly to adjust to growth period, not monthly

It is characterized by blood phenylalanine levels greater than 20 mg/dL

(normal level is 1.2 to 3.4 mg/dL in newborns and 0.8. 0.8 to 1.8 mg/dL thereafter). A result of 1 mg/dL is a negative test result.

TB results: positive

10 mm or more: < 4 years old 5 mm: any compromised immunity (ex. hiv) 15mm or more: > 4 years old

The nurse is performing an assessment on a 10-year-old child suspected to have Hodgkin's disease. The nurse understands that which assessment findings are specifically characteristic of this disease?

Abdominal pain and Painless, firm, and movable adenopathy in the cervical area

The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. When analyzing the results of the urinalysis, which should the nurse most likely expect to note?

Bacteriuria -Epispadias is a congenital defect involving abnormal placement of the urethral orifice of the penis. The urethral opening is located anywhere on the dorsum of the penis.

The nurse reviews the record of a child who is suspected to have glomerulonephritis and expects to note which finding that is associated with this diagnosis?

Brown-colored urine also: elevated aso titer, bun/crt, hypertension, edema and elevated specific gravity (concentrated urine)

A child is placed in skeletal traction for treatment of a fractured femur. The nurse develops a plan of care and includes which intervention?

Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied.

The nurse is caring for an infant with a diagnosis of bladder exstrophy. To protect the exposed bladder tissue, the nurse should plan which intervention?

Cover the bladder with a nonadhering plastic wrap. -bladder exstrophy: expose bladder tissues -want protection that does not dry out. -sterile water or petroleum jelly can dry out and cause further damage

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 -Decreased wheezing in a child with asthma may be interpreted incorrectly as a positive sign when it may actually signal an inability to move air. A "silent chest" is an ominous sign during an asthma episode. With treatment, increased wheezing actually may signal that the child's condition is improving.

The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease

Easy bruising occurs. Gum bleeding occurs. It is a hereditary bleeding disorder. Treatment and care are similar to that for hemophilia. The disorder causes platelets to adhere to damaged endothelium.

The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action?

Encourage the child to drink liquids.

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.

The clinic nurse reviews the record of a child just seen by a health care provider and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?

Exercise intolerance

The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

Failure to pass meconium stool in the first 24 hours after birth

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response?

Have the child perform simple isometric exercises during this time."- can also include:hot or cold packs and splinting and positioning the affected joint in a neutral position help reduce the pain close ended questions: all, must, additional. need to avoid these

The home care nurse provides instructions regarding basic infection control to the parent of an infant with human immunodeficiency virus (HIV) infection. Which statement, if made by the parent, indicates the need for further instruction?

I will clean up any spills from the diaper with diluted alcohol." -cleaning up any spills should be with BLEACH. not alcohol

A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription?

Intravenous infusion of factor VIII

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.

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care?

Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics. -it takes 24 hours for antibiotics to reach a therapeutic blood level

The mother with human immunodeficiency virus (HIV) infection brings her 10-month-old infant to the clinic for a routine checkup. The health care provider has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV. The nurse should make which most appropriate response to the mother?

Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are 3 years old."

A 7-year-old child is seen in a clinic, and the primary health care provider documents a diagnosis of primary nocturnal enuresis. The nurse should provide which information to the parents?

Most children outgrow the bed-wetting problem without therapeutic intervention.

most common opportunistic infection of children infected with HIV?

Pneumocystis jiroveci pneumonia

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

Which interventions should the nurse include when preparing a care plan for a child with hepatitis? Select all that apply.

Providing a low-fat, well-balanced diet.- correct Teaching the child effective hand-washing techniques.-correct Scheduling playtime in the playroom with other children. - incorrect because children should not share toys with other children because of standard and viral infections. Notifying the health care provider (HCP) if jaundice is present.- incorrect: jaundice is a normal finding Instructing the parents to avoid administering medications unless prescribed: correct- liver detoxify and excrete drugs Arranging for indefinite home schooling because the child will not be able to return to school: incorrect: child is sent home for about 1 weeks, or as doctor prescribed. NO INDEFINITIE HOME SCHOOLING

Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?

Red blood cells that are microcytic and hypochromic

he nurse has just administered ibuprofen (Motrin) to a child with a temperature of 38.8° C (102° F). The nurse should also take which action?

Remove excess clothing and blankets from the child.

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period?

Reposition the infant frequently. -increase head growth = pressure ulcer behind the head

The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question?

Restrict fluid intake. Give meperidine (Demerol), 25 mg intravenously, every 4 hours for pain. -Normeperidine, a metabolite of meperidine, is a central nervous system stimulant that produces anxiety, tremors, myoclonus, and generalized seizures when it accumulates with repetitive dosing.

The nurse is planning care for a child with hemolytic-uremic syndrome who has been anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to implement which measure?

Restrict fluids as prescribed. -CAPD: does not need a AV fistula -no good urine output--> do not administer potassium -no pain in peritoneal dialysis

Decerebrate (extension) posturing

Rigid extension and pronation of the arms and legs http://classconnection.s3.amazonaws.com/711/flashcards/2007711/jpeg/276619602082361560_knyw6wzb_c1350008260440.jpeg

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

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the health care provider's (HCPs) prescriptions and should contact the HCP to question which prescription?

Suction as needed. -nasotracheal suctioning can lead to infection if the catheter enters the brain through the fracture

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.- only suction when there is an airway obstruction d/t risk for trauma to the surgical site

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 clinic nurse is instructing the parent of a child with human immunodeficiency virus (HIV) infection regarding immunizations. The nurse should provide which instruction to the parent?

The inactivated influenza vaccine will be given yearly. -give influenza vaccine every year -do not give MMR and varicella because it is a live virus

Which diagnostic test result will confirm the diagnosis of Hodgkin's disease?

The presence of Reed-Sternberg cells in the lymph nodes

The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis?

Thicken the feedings by adding rice cereal to the formula.

After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action?

Turn the child to the side.

On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease?

acute: Conjunctival hyperemia subacute: cracked lips, desquamination of the skin

The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet?

answer: rice do not give: rye, wheat, oatmeal, barley -able to replace those with rice, corn millet

bacterial meingitis + lumbar puncture to obtain CSF

bacterial meningitis: an elevated pressure; turbid or cloudy cerebrospinal fluid; and elevated leukocyte, elevated protein, and decreased glucose levels.

diagnostic study for acute lymphocytic leukemia

bone marrow biopsy

esophageal atresia and tracheoesophageal fistula, the esophagus terminates before it reaches the stomach, ending in a blind pouch, and a fistula is present that forms an unnatural connection with the trachea.

coughing and choking with feedings and unexplained cyanosis-should be suspected to have tracheoesophageal fistula + excess salivation

any invasive procedure to a child with HF, need to administer 02

ex- drawing blood from electrolyte level testing

An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time?

left lateral side

enteric precautions

mode of transmission through the GI tract

the detection of HIV in infants is confirmed by which lab?

p24 antigen assay -western blot is to dected HIV antibodies -CD4+ cell count refers how well the immune system is doing

Cryptorchidism is a condition in which one or both testes fail to descend through the inguinal canal into the scrotal sac.

parents: check his temp, give medication to make him comfortable, check voiding to make sure there is no problem with tesites.

no lotion or powder to an incision site after a cardiac surgery

rationale: can cause skin breakdown and lead to an infection

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition?

remember: infant -limited range of motion

The nurse notes documentation that a child with meningitis is exhibiting a positive Kernig's sign. Which observation is characteristic of this sign?

the child is not able to extend the leg when the thigh is flexed anteriorly at the hip. Brudzinski's sign-Neck flexion causes adduction and flexion movements of the lower extremities.

The nurse is assisting a health care provider (HCP) examining an infant with developmental dysplasia of the hip perform an Ortolani maneuver. The nurse understands that this maneuver is performed for which purpose?

to indicate hip instability

Acute otitis media is an inflammatory disorder caused by an infection of the middle ear. The child often has fever, pain, loss of appetite, and possible ear drainage. The child also is irritable and lethargic and may roll the head or pull on or rub the affected ear. Otoscopic examination may reveal a red, opaque, bulging, and immobile tympanic membrane. Hearing loss may be noted particularly in chronic otitis media. The child's fever should be treated with ibuprofen (Motrin IB). The child is positioned on his or her affected side to facilitate drainage. A soft diet is recommended during the acute stage to avoid pain that can occur with chewing. Antibiotics are prescribed to treat the bacterial infection and should be administered for the full prescribed course. The ear should not be irrigated with normal saline because it can exacerbate the inflammation further. Antihistamines are not usually recommended as a part of therapy.

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If the urine output is less than 1 to 2 mL/kg/hour, potassium chloride should not be administered

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