Unit 5 PEDS

A burned child is in the emergency department. The nurse calculates the fluid requirement for the next 24 hours to be 2700 ml. At what rate does the nurse set the pump for initially?

168.8 mL/hour (divide total replaced fluid by 2) (then divide by 8 because needs replaced within 8 hours)

SATA: Where do the lesions of atopic dermatitis most commonly occur in the infant? Select all that apply. a. Cheeks b. Buttocks c. Extensor surfaces of arms and legs d. Back e. Trunk

A. Cheeks C. Extensor surfaces of the arms and legs E. Scalp

SATA: A nurse is teaching parents about prevention of diaper dermatitis. Which should the nurse include in the teaching plan?

A. Clean the diaper area gently after every diaper change with a mild soap B. Use a protective ointment to clean dry intact skin E. Wash cloth diapers in hot water with a mild soap and double rinse

SATA: A nurse working in a trauma center would facilitate referrals to a burn center for which of the following children?

A. Electrical B. Chemical D. Burn in the perineal area

SATA: A child has a cast applied to the left forearm. What interventions should the nurse include in the home care instructions for the parents?

A. Keep small toys away from the cast C. Assess the cast daily for unusual odor D. Elevate the extremity on pillows for the first 24 to 48 hours

SATA: A child is in skeletal traction. Which intervention should the nurse implement to prevent complications of immobility?

A. Reposition the child every 2 hours D. Administer stool softeners as prescribed E. Encourage coughing and deep breathing

What should the nurse teach an adolescent who is taking retin-A to treat acne?

Apply sunscreen before going outdoors

Which instruction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy?

Arrange for tutoring and school work

A nurse is assessing cranial nerve VII. How does the nurse perform this assessment?

Ask the child to smile or "show your teeth"

When infants are seen for fractures, which nursing intervention is a priority? a. No intervention is necessary. It is not uncommon for infants to fracture bones. b. Assess the family's safety practices. Fractures in infants usually result from falls. c. Assess for child abuse. Fractures in infants are often nonaccidental. d. Assess for genetic factors.

Assess for child abuse. Fractures in infants are often nonaccidental

When assessing the child with atopic dermatitis, the nurse should ask the parents about a history of which of the following?

Asthma

What is the major concern guiding treatment for the child with Legg-Calve-Perthes disease?

Avoid permanent damage

Which statement is accurate concerning a child's musculoskeletal system and how it may be different from an adult's?

Because soft tissues are resilient in children, dislocations and sprains are less common than in adults

Patient and parent education for the child who has a synthetic cast should include a. Applying a heating pad to the cast if the child has swelling in the affected extremity b. Wrapping the outer surface of the cast with an Ace bandage c. Splitting the cast if the child complains of numbness or pain d. Covering the cast with plastic and waterproof tape to keep it dry while bathing or showering

Covering the cast with plastic and waterproof tape to keep it dry while bathing or showering

What actions should the nurse perform while caring for a school-age child who sprained his ankle playing football? Select all that apply. a. Turn the child every 1 to 2 hours. b. Assist with range-of-motion exercises every 2 hours. c. Apply ice to the affected ankle. d. Wrap the ankle with an Ace bandage. e. Elevate the affected extremity.

C. Apply ice to the affected ankle D. Wrap the ankle with an ACE bandage E Elevate the affected extremity

SATA: A nurse is instructing parents on the treatment of pediculosis (head lice). Which should the nurse include in the teaching plan?

C. Retreat the hair and scalp with a pediculicide in 7 to 10 days D. Items that cannot be washed should be dry cleaned or sealed in plastic bags for 2 to 3 weeks E. Combs and brushes should be boiled in water for at least 10 minutes

When changing an infant's diaper, the nurse notices small bright red papules with satellite lesion on the perineum, anterior thigh, and lower abdomen. This rash is characteristic of :

Candidiasis

The processes of burn shock continues until what physiologic mechanism occurs?

Capillaries regain their seal

Which is an important nursing consideration when caring for a child with impetigo?

Carefully wash hands and maintain cleanliness when caring for an infected child

The management of a child who has just been stung by a bee or wasp should include the application of which of the following?

Cool compress

What best describes a full-thickness (third-degree) burn?

Destruction of all layers of skin evident with extension into subcutaneous tissue

During a well-child visit, the nurse identifies that an 18-month old infant is bowlegged. What action by the nurse is the most appropriate?

Document the finding in the chart (normal)

What nursing intervention holds the highest priority in the initial care of a child with a major burn injury?

Establishing and maintaining the child's airway

When assessing a child for an upper extremity fracture, the nurse should know that these fractures most often result from

Falls

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, what response by the nurse is correct?

Frequent, serial casting is tried first

Ringworm, frequently found in schoolchildren, is caused by a(n) a. Virus b. Fungus c. Allergic reaction d. Bacterial infection

Fungus

When providing education for the parents of a child with Duchenne muscular dystrophy, the nurse plans to include

Genetic counseling for all female children

Which statement by the mother of an adolescent being discharged after spinal fusion for severe scoliosis indicates the need for further teaching?

I am glad we chose surgery. Now it is all over and done

Which statement made by a parent indicates an understanding about the management of a child with cellulitis on the arm?

I have been putting a warm soak on my son's arm every 4 hours

In caring for a child with an open fracture, the nurse should carefully assess for

Infection

When taking a history on a child with a possible diagnosis of cellulitis, what should be the priority nursing assessment to help establish a diagnosis?

Recent infections or signs of infection

A child with osteomyelitis asks the nurse, "What is a 'sed' rate?" What is the best response for the nurse? a. "It tells us how you are responding to the treatment." b. "It tells us what type of antibiotic you need." c. "It tells us whether we need to immobilize your extremity." d. "It tells us how your nerves and muscles are doing."

It tells us how you are responding to the treatment

Juvenile arthritis should be suspected in a child who exhibits a. Frequent fractures b. Joint swelling and pain lasting longer than 6 weeks c. Increased joint mobility d. Lurching and abnormal gait, limited abduction

Joint swelling and pain lasting longer than 6 weeks

A child has small red macules and vesicles that become pustules around the child's mouth and cheek. Older lesions are crusted and honey-colored. What should the nurse teach the parents about this condition?

Keep the child home from school for 24 hours after starting antibiotics

A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend

Keeping the child quiet and coming to emergency department

Which term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine?

Kyphosis

What procedure is contraindicated in the care of a child with a minor partial-thickness burn injury wound?

Leaving all loose tissue or skin intact

The nurse knows that treatment of Osgood-Schlatter disease includes

Limitation of knee bending or kneeling

The primary treatment for warts is

Local destruction

What is the most appropriate intervention for an adolescent with mild scoliosis?

Long-term monitoring

A boy who has fractured his forearm is unable to extend his fingers. The nurse knows that this

May indicate compartment syndrome

With what beverage should the parents of a child with ringworm be taught to give griseofulvin?

Milk

The nurse is assessing a 14-year-old who plays football and complains of knee pain when running and climbing stairs during football practice. The nurse should anticipate which action for this condition?

NSAIDS or knee immobilizer

Parents of a child with lice infestation should be instructed carefully in the use of antilice products because of which potential side effect?

Neurotoxicity

Impetigo ordinarily results in

No scarring

A 4-year-old which with a long leg cast complains of "fire" in his cast. Which action by the nurse is most appropriate?

Notify the provider immediately

A child has painful, fluid-filled vesicles on the upper lip. What medication does the nurse anticipate teaching parents about?

Oral antiviral agent

During painful episodes of juvenile arthritis, a plan of care should include what nursing intervention? a. A weight-control diet to decrease stress on the joints b. Proper positioning of the affected joints to prevent musculoskeletal complications c. Complete bed rest to decrease stress to joints d. High-resistance exercises to maintain muscular tone in the affected joints

Proper positioning of the affected joints to prevent musculoskeletal complications

The primary clinical manifestation of scabies is

Pruritus

A child experiences frostbite of the fingers after prolonged exposure to the cold. Which intervention should the nurse implement first?

Rapid rewarming of the fingers by placing in warm water

Discharge planning for the child with juvenile arthritis includes the need for

Routine opthlamic examinations to assess for visual problems

A priority nursing intervention when caring for a child in a Pavlik harness is

Skin care

The pediatric nurse understands that cellulitis is most often caused by

Streptococcus or Staphylococcus organisms

What should the parents of an infant with thrush (oral candidiasis) be taught about medication administration?

Swab nystatin suspension onto the oral mucous membranes after feedings

A nurse knows that which exercise is best for a child with juvenile arthritis?

Swimming

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise the father to: a. apply warm compresses. b. carefully scrape off stinger. c. take child to emergency department. d. apply a thin layer of corticosteroid cream.

Take the child to the emergency department

A mother whose 7-year-old child has been placed in a cast for a fractured right arm reports that he will not stop crying even after taking acetaminophen with codeine. He also will not straighten the fingers on his right arm. The nurse tells the mother to a. Take him to the emergency department. b. Put ice on the injury. c. Avoid letting him get so tired. d. Wait another hour; if he is still crying, call back.

Take the child to the emergency department

Which factor should the nurse include when teaching a parent about the care of a newborn in a Pavlik harness for hip dysplasia?

The harness maintains the hips in flexion, abduction, and external rotation

When a child with a musculoskeletal injury on the foot is assessed, what is most indicative of a fracture? a. Increased swelling after the injury is iced b. The presence of localized tenderness distal to the site c. The presence of an elevated temperature for 24 hours d. The inability of the child to bear weight

The inability of the child to bear weight

Which nursing intervention is appropriate to assess for neurovascular competency in a child who fell off the monkey bars at school and hurt his arm?

The skin color, temperature, movement, sensation, and capillary refill of the extremity

Which factor is important to include in the teaching plan for parents of a child with Legg-Calve-Perthes disease?

There is a disturbance in the blood supply to the femoral epiphysis

A nurse is teaching parents the difference between pediatric fractures and adult fractures. Which observation is true about pediatric fractures?

They seldom are complete breaks

Rocky mountain spotted fever is caused by the bite of a

Tick

What assessment finding best indicates that a 66-pound child with a serious burn has met goals for the priority nursing diagnosis??

Urine output is 45 ml/hour

Which nursing assessment is applicable to the care of a child wit herpetic gingivostomatitis?

Urine output, mucous membranes, and skin turgor

The skin condition commonly known as "warts" is the result of an infection by which organism?

Virus

A 6-year-old patient who has been placed in skeletal traction has pain, edema, and fever. The nurse should assess which of the following?

Warmth at site of pain

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What should the nurse suggest to remove this material? a. Wash the area with warm water and soap. b. Vigorously scrub leg. c. Apply powder to absorb material. d. Carefully pick material off leg.

Wash the area with warm water and soap

When assessing a child with osteogenesis imperfecta, the nurse should expect to observe

discolored teeth

The depth of a burn injury may be classified as:

superficial, superficial partial, deep partial thickness, or full thickness