study guide for exam 2 peds
which question should the nurse ask first when obtaining a history from the mother of 10 year-old child with fever, malaise, and swelling around the eyes
Does the child urinate as much as usual. most likely the nurse suspects that child is exhibiting signs and symptoms of AGN, such periorbital edema and fever. other s/s include loss of appetite, dark colored urine, pallor, headaches and abdominal pain. to confirm this suspicion, the nurse would ask about the child urinary elimination. typically, the child with AGN experiences a decrease in urine output.
The parent of a child with celiac disease ask "how long must he stay on his diet. which response by the nurse is the best?
For the rest of his life Rational: Most children with celiac disease requires that they maintain in some type of diet for the rest of their lives.
the charge nurse is reviewing the laboratory results of a child admitted with Nephrotic syndrome with nurse new to pediatric unit. The nurse is aware that teaching is required when the new nurse states that an expected finding in NS is
Hyperalbuminenia. the child with NS would present hypoalbuminemia due to a decrease of albumin in the blood stream and to increase the glumerular permeability. NS is characterized by edema, massive proteinuria, hypoalbuminemia, hypoproteinemia, hyperlipedemia and altered immunity.
after teaching the mother of a child with celiac disease management which statement by the mother indicates successful teaching.
I will plan to feed my child foods that contain rice. Rational: Damage to its intestinal mucosa in celiac disease is caused by gliadin, a part of gluten protein found in wheat, rye, barley and oats. Foods containing these grains must be eliminated entirely from diet of the children. Foods containing rice and corn are good substitute.
a recent history of which problem should alert the nurse to gather additional information about the possibility of UTI in a 2 years old child who is exhibiting fever and fussiness?
abdominal pain frequently accompanies UTI in children 2 yrs of ages. other associated sign and symptoms include decrease in appetite, vomiting fever and irritability.
Nursing care management of the child with bacterial meningitis includes which interventions?
administration of IV antibiotics, decreasing environmental stimuli and neurological checks every 4 hours. antibiotics are indicated for treatment of bacterial meningitis. client with bacterial meningitis often have increased ICP. It is necessary to maintain adequate hydration. Neurological checks are necessary to monitor any changes in the child's level of consciousness.
has the child had sore throat
asking about recent sore throat would provide additional information, confirm the suspicion AGN because the most common type is acute post streptococcal glomerulonephritis, which follows a strep throat by 10-14 days
Which meal would appropriate for a 15 year old with AGN with severe hypertesion
baked chicken with rice, beans, orange juice. The best food selection would include no added salt. because sodium cant be excreted to oliguria and to avoid hypertension, a low salt diet is recommended.
What should be a part of the nurse teaching plan for a child with epilepsy being discharge regimen of phenytoin.
brush teeth after meal. Phenytoin can cause gingival hyperplasia.
while assessing the penis of a child who has had surgery for repair of hypospadias, the nurse observes the appearance of the penis. The nurse should report which aspect to the surgeon?
dusky blue at the tip may indicate problem with circulation and the nurse notify the surgeon
the nurse is teaching the mother of the preschool age child with celiac disease about gluten free diet. the nurse determines that the mother understands the diet if she tells the nurse
eggs and orange juice. rational: children with celiac disease cannot digest the protein in common grains such as wheat, rye and oats> eggs and orange juice would be appropriateg
the parent of toddler with NS asks the nurse what can be done about the child's swollen eyes.
elevate the HOB of the child
A child with Nephrosis is taking prednisone. The nurse should teach the caregivers to report which adverse effects? select all that apply.
hematemesis, respiratory infection, bleeding gums. adverse effects of steroid therapy include edema of the face and trunk, increased susceptibility to infection, gastric and intestinal bleeding, sodium and water retention, hypertension. Steroid can also cause vision problems. urinary output is decreased due to retention of sodium,
During a clinic visit, the mother of an infant with hydrocele states that the infant scrotum is smaller now than when he was born. After teaching the mother about infant condition, which statement by the mother indicates that the teaching has been effective.
it seems like the fluid is being reabsorbed. Rational: a hydrocele is a collection of fluid in the tunica vaginalis of the testicle or along the spermatic cord that result from a patent processus vaginalis. As fluid is being absorbed scrotal size decreases
a school age client admitted to the hospital because of decrease urine output and periorbital edema is diagnosed with acute poststreptococcal glumerolunephritis. which assessment gives the nurse the best indication of the child fluid balance
obtain daily weight measurement. weight is the best indicator of fluid balance.
A 10 year old with AGN reports headache and blurred vision. The nurse should immediately
obtain the child blood pressure..hypertension in AGN occurs due to inability of the kidney to remove fluid and sodium ; the fluid reabsorbed, causing fluid volume excess
When developing a teaching plan for the parents of a 12 months old infant with hypospadias and chrordee repair what information is most important to include.
prevent the child fro disrupting the catheter by using soft restraint.
During assessment of child with celiac disease, the nurse would most likely note which physical findings?
protuberant abdoment rational: the intestines of child with celiac disease fill with accumulated undigested food and flatus causing the characteristic protuberant.
which foods would be appropriate for 12 months old child with celiac disease.
rice cereal pancakes and waffles are made from flour that typically derived from wheat and therefore should be avoided.
the nurse is planning care with the parents of a child who requires continuous peritoneal dialysis? which findings should be discussed with HCP
the child reports having a previous surgery for ruptured appendix. may alter the effectiveness of treatment.
a 15 year old has been diagnosed with acute glomerulonephritis and has ben hospitalized for a day. which finding requires immediate action.
urine specific gravity of 1.030. An adolescent with AGN has a high urine specific gravity related to oliguria caused by inflammation of glomeruli. The client will have periorbital edema, but not generalized edema. The urine in AGN is scanty averaging about 400 ml in 24 hours, which lead to fluid volume excess and hypertension
A 1 year old child is schedule for surgery to correct hypospadias and chordee. The nurse explains to the parents that this is the preferred time for surgical based on which factor.
The child is too young to develop castration anxiety. The preferred time for surgery is between the ages of 6-18 months, before the child develops castration and body images anxiety. if the condition is not repaired, the child will have difficulty with toilet training because urine is not eliminated through the tip of the penis.
Valporic Acid (Depakote)
This medication may cause hepatic toxicity. Therefore, serum liver enzyme levels are monitored.
A 6 month old child is discharged with a urinary stent after procedure to repair a hypospadias. the nurse should tell the parents to.
avoid tub baths until the stent is removed. Rational: the parents should keep the penis as dry as possible until the stent is removed
the nurse monitoring an infant with meningitis for signs of intracranial pressure.
irritability, bulging fontanels and emesis.
when developing a discharge plan for a child with chronic renal failure and the family the nurse should emphasize restriction of which
phosphorus. with minimal or absent of kidney function the serum phosphate level rises, the ionized calcium levels falls in response. This cause increased secretion of parathyroid hormone which releases calcium from the bones.
which diet plan would be appropriate for the nurse to discuss with the family of a child with acute renal failure
high fat and carbohydrate. the child with acute renal failure needs extra calories to reduced tissue catabolism, metabolic acidoses and uremia, but low in protein, potassium and sodium
which parent statement would suggest to the nurse that a child may have celiac disease and should be referred to HCP?
his stools are large and smelly rationale: celiac disease is a disorder involving intolerance to the protein gluten, which is found in wheat, rye, oats and barley. The stools of child with celiac disease are characteristically malodorous, pale, large (bulky) and soft (loose) Belly is malabsorption typically protuberant
after teaching the parents about urethral catheter placed after surgical repair of their son's the hypospadias, the nurse determine the teaching was successful when the mother states that the catheter
keeps the new urethra from closing
the toddler with NS exhibits generalized edema. Which measure should the nurse institute for this child with impaired skin integrity related to edema
separate opposing skin surface with soft cloth. The child with NS and severe edema is usually maintained on bed rest.
The parent of a neonate with hypospadias and chordee which to have him circumcised. Which explanation should the nurse to incorporate into the discussion with the parents concerning to delay circumcision.
the foreskin is used to repair the deformity surgically. Rational: Hypospadias is a condition which urethral opening is on the ventral side of the penis or below the glans penis. Chordee refers to a ventral curvature of the penis that results from fibrous band tissue that has replaced normal skin. Circumcision is delayed because the foreskin which is removed , often is used to reconstruct the urethra
a 10 year old child has hospitalized with acute post streptococcal glomerulonephritis during the acute stage has elevated blood pressure and low urine output for 14 hours. the nurse should
assess the child's neurologic status because hypertensive encephalopathy is major potential complication of AGN. Seizure precautions also should be instituted
A parent of child with APSGN asks how a strep infection caused the child to have kidney problem.
by product of immune complexes that fought the infection are depositing in the kidneys. APSGN is an immune complex disease. Large antigen-antibody complexes are formed that deposit in glomerular capillary loops leading to obstruction.