Chapter 13 - Health Problems of Toddlers and Preschoolers Flashcards
A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?
a. Reassure the father that Visine is harmless.
b. Direct him to seek immediate medical treatment.
c. Recommend inducing vomiting with ipecac.
d. Advise him to dilute Visine by giving his daughter several glasses of water to drink.
b. Direct him to seek immediate medical treatment.
Visine is a sympathomimetic and if ingested may cause serious consequences. Medical treatment is necessary. Inducing vomiting is no longer recommended for ingestions. Dilution will not decrease risk.
The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?
a. Tinnitus
b. Disorientation
c. Stupor, lethargy, and coma
d. Edema of the lips, tongue, and pharynx
d. Edema of the lips, tongue, and pharynx
Edema of the lips, tongue, and pharynx indicates a corrosive ingestion. Tinnitus is indicative of aspirin ingestion. Corrosives do not act on the central nervous system.
A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is what?
a. Hepatic dysfunction
b. Dehydration secondary to vomiting
c. Esophageal stricture and shock
d. Bronchitis and chemical pneumonia
d. Bronchitis and chemical pneumonia
Lighter fluid is a hydrocarbon. The immediate danger is aspiration. Acetaminophen overdose, not hydrocarbons, causes hepatic dysfunction. Dehydration is not the primary danger. Esophageal stricture is a late or chronic consequence of hydrocarbon ingestion.
What is a clinical manifestation of acetaminophen poisoning?
a. Hyperpyrexia
b. Hepatic involvement
c. Severe burning pain in stomach
d. Drooling and inability to clear secretions
b. Hepatic involvement
Hepatic involvement is the third stage of acetaminophen poisoning. Hyperpyrexia is a severe elevation in body temperature and is not related to acetaminophen poisoning. Acetaminophen does not cause burning pain in stomach and does not pose an airway threat
An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
a. Giving half of the solution and then repeating the other half in 1 hour
b. Mixing with a flavorful beverage in an opaque container with a straw
c. Serving it in a clear plastic cup so the child can see how much has been drunk
d. Administering it through a nasogastric tube because the child will not drink it because of the taste
b. Mixing with a flavorful beverage in an opaque container with a straw
What is a significant secondary prevention nursing activity for lead poisoning?
a. Chelation therapy
b. Screening children for blood lead levels
c. Removing lead-based paint from older homes
d. Questioning parents about ethnic remedies containing lead
b. Screening children for blood lead levels
What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning?
a. Maintain bed rest.
b. Maintain isolation precautions.
c. Keep an accurate record of intake and output.
d. Institute measures to prevent skeletal fracture.
c. Keep an accurate record of intake and output.
The iron chelates are excreted though the kidneys. Adequate hydration is essential. Periodic measurement of renal function is done. Bed rest is not necessary. Often the chelation therapy is done on an outpatient basis. Chelation therapy is not infectious or dangerous. Isolation is not
indicated. Skeletal weakness does not result from high levels of lead.
What is the most common form of child maltreatment?
a. Sexual abuse
b. Child neglect
c. Physical abuse
d. Emotional abuse
b. Child neglect
A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child?
a. Monitoring the parents whenever they are with the child
b. Reassuring the parents that the cause of the disorder will be found
c. Teaching the parents how to obtain necessary specimens
d. Supporting the parents as they cope with diagnosis of a chronic illness
a. Monitoring the parents whenever they are with the child
When only one child is abused in a family, the abuse is usually a result of what?
a. The child is the firstborn.
b. The child is the same gender as the abusing parent.
c. The parent abuses the child to avoid showing favoritism.
d. The parent is unable to deal with the childs behavioral style.
d. The parent is unable to deal with the childs behavioral style.
The parents of a 7-year-old boy tell the nurse that lately he has been cruel to their family pets and actually caused physical harm. The nurses recommendation should be based on remembering what?
a. This is an expected behavior at this age.
b. This is a warning sign of a serious problem.
c. This is harmless venting of anger and frustration.
d. This is common in children who are physically abused.
b. This is a warning sign of a serious problem.
Cruelty to family pets is not an expected behavior. Hurting animals can be one of the earliest symptoms of a conduct disorder. Abusing animals does not dissipate violent emotions; rather, the acts may fuel the abusive behaviors. Referral for evaluation is essential. This behavior may be
seen in emotional abuse or neglect, not physical abuse
A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect?
a. Unintentional injury
b. Shaken baby syndrome
c. Congenital neurologic problem
d. Sudden infant death syndrome (SIDS)
b. Shaken baby syndrome
Shaken baby syndrome causes internal bleeding but may have no external signs. Unintentional injury would not cause these injuries. With unintentional injuries, external signs are usually present. Congenital neurologic problems would usually have signs of abnormal neurologic anatomy. SIDS does not usually have identifiable injuries.
What statement is correct about young children who report sexual abuse?
a. They may exhibit various behavioral manifestations.
b. In more than half the cases, the child has fabricated the story.
c. Their stories should not be believed unless other evidence is apparent.
d. They should be able to retell the story the same way to another person
a. They may exhibit various behavioral manifestations.
What is probably the most important criterion on which to base the decision to report suspected child abuse?
a. Inappropriate response of child
b. Inappropriate parental concern for the degree of injury
c. Absence of parents for questioning about childs injuries
d. Incompatibility between the history and injury observed
d. Incompatibility between the history and injury observed
The nurse is caring for a child with suspected ingestion of some type of poison. What action should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?
a. Empty the mouth of pills, plants, or other material.
b. Question the victim and witness.
c. Place the child in a side-lying position.
d. Call poison control
a. Empty the mouth of pills, plants, or other material.
