Deck 2

Question 1

With appendicitis, a sudden relief of pain indicates an improvement in the child’s condition. T/F?

Answer 1

False

Question 2

Which observed action warrants additional teaching for a parent whose infant has GER/GERD?

Answer 2

Putting the baby to sleep right after meals

Question 3

A patient with celiacs disease should avoid?

Answer 3

Barley (cereal grain)

Question 4

Biliary atresia is treated with what surgical procedure?

Answer 4

Kasai

Question 5

What should the patient avoid placing in childs mouth following lip/cleft palate repair?

Answer 5

Pacifier, straws, spoon, and suction

Question 6

Which chronic GI disorder is characterized by the lack of ganglion cells in the intestine?

Answer 6

Hirschsprungs

Question 7

Normal urine output?

Answer 7

Approximately 1mL/kg/hr

Question 8

Cystic Fibrosis prescription for pancreatic enzymes

Question 9

Planning care for a 6-year-old with bacterial meningitis. Nursing interventions

Answer 9

Seizure precautions
positioning child
Isolating child with droplet precautions
Drawing blood cultures

Question 10

Hemolytic uremia syndrome (HUS) in 2-year-old who has GI symptoms

Answer 10

HUS is initially caused by an infection of E-coli

Question 11

Pediatric patient with MRSA on the left arm

Answer 11

Medication: Bactroban

Question 12

Methods of control and prevention of infection depend on?

Answer 12

Methods of transportation

Question 13

Plan of care for 4-year-old who requires airborne precautions

Answer 13

Large puzzle pieces

Question 14

Infant has severe dehydration from acute GI, you should expect?

Answer 14

13% weight loss

Question 15

Reviewing lab results of adolescent with chronic GI, you expect?

Answer 15

BUN 50mg/dl

Question 16

School nurse has child with pediculosis (an infestation of the hairy parts of the body or clothing with the eggs, larvae or adults of lice) that requires educating and teaching to the parent. What would you educate them on?

Answer 16

All used clothing, bedding, and towels must be washed in hot water

Question 17

2 month old infant post-op surgical repair of cleft lip, which action do you take when speaking to the parent?

Answer 17

Encourage the parent to rock the infant

Question 18

Child with otitis media (middle ear infection), assessment findings?

Answer 18

Tugging on effected ear lobe

Question 19

Adolescent with spinal bifida is paralyzed from the waist down. Nurse needs to do further teaching when the client states?

Answer 19

“I only need to cath myself twice a day” Catheterization should be completed every 4 hours

Question 20

Child with Hirschspurg disease is scheduled for surgery;

Answer 20

“I’m glad my child’s ostomy is temporary.”

Question 21

Discharge teaching about nutrition to a parent who has a child with cystic fibrosis noted understanding?

Answer 21

“We will give our child pancreatic enzymes with snacks and meals” Enzymes must be taken with all meals

Question 22

Tinea pedis

Answer 22

Red, scaling rash on soles and between the toes(athlete’s foot)
Treatment: Topical antifungal, foot hygiene

Question 23

Diaper Dermatitis

Answer 23

-Inflammatory reaction of the skin in the area covered by a diaper
-Hydration disturbance (often from prolonged exposure to urine)
-Consider on set and progression of rash, as well as treatments and responses to those
-Untreated, it will worsen
-Prevention is key!
-Treatment: Consider barrier creams to protect skin
-Avoid baby powder… risk of aspiration.

Question 24

Atopic Dermatitis (Eczema)

Answer 24

-Often associated with food allergies, allergic rhinitis, and asthma
-Onset of symptoms is before 2 years of age
-Management includes skin hydration, application of corticosteroids or immune modulators, oral antihistamines, and antibiotics if a secondary infection occurs
-Pathophysiology: skin reactions to an allergen or environmental triggers leading to an inflammatory response
-Itching comes before the rash, sweating may worsen it, as well as excessive humid or dry environments
-Signs: scratching, dry skin, scaly marks, irritability
-Nursing care: skin hydration, maintain skin integrity, and prevent infections

Question 25

Contact Dermatitis

Answer 25

-Cell-mediated response to antigenic substance exposure
-Not contagious
-Management directed toward management of itching and use of topical corticosteroids
-Note onset, progression, and description of rash

Question 26

Burns

Answer 26

-Classified according to extent of injury
-Superficial (formerly first degree)
-Partial thickness (second degree)
-Deep partial (third and fourth degree)
-Management: fluid resuscitation, wound care, prevention of infection, restoration of function, antibiotics
-Severe burns: assess respiratory compromise, get a brief history
-Mild burns: Note description, time, date and cause
-What are the signs of child abuse-induced burns?
-Labs: electrolytes, CBC, nutritional indices, blood gases, CO2 to detect respiratory compromise
-Is there concern for respiratory compromise?
-CO2 monitoring, cardiac/apnea monitoring, pulse ox
-Restore fluid volume based on body surface area burned
-Dextrose may be added for children
-Prevent hypothermia- keep child warm, consider warm fluids
-Cleaning the burn: provide pain medication, promote infection control, use mild soap and cool water
-Treatment may be extensive- consider physical and psychological challenges beyond the acute phase
-What should we teach families about prevention?

Question 27

Pediculosis capitis (head lice)

Answer 27

-Direct contact with hair of infested people
-Extreme pruritus, especially behind ears and nape of neck
-Wash hair with pediculicide- strictly follow recommendations, retreatment may be needed, 1% permethrin
-Isolation/Control measures

Question 28

S E P S I S

Answer 28

-What is sepsis? A systemic over response to infection resulting from bacteria and viruses
-May lead to septic shock (hypotension, low blood flow, and organ failure)
-Septic shock is a MEDICAL EMERGENCY in pediatrics!
-Prognosis depends on age and cause
-Note: it is standard of practice to rule out sepsis when a child is admitted to the hospital
-Pathophysiology: Circulating bacterial products or toxins occur as a result of sustained bacteremia