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PEDS > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

What symptoms should a nurse be observing for a toddler that is being evaluated for SIADH

A

Fluid retention
Hyponatremia

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2
Q

What are some manifestations a nurse should expect to see on a child with acquired hypothyroidism

A

Intolerance to cold
Constipation
Fatigue

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3
Q

What clinical manifestations occur in a child with ADH deficiency

A

Hypotension

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4
Q

How will a nurse know if desmopressin is working

A

Lower urine output

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5
Q

What should the nurse do if DKA is expected in a child?

A

Check blood sugar with fingerstick
Give insulin via IV
Give bolus of isotonic fluid

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6
Q

What should the nurse teach the parent and a child with Addison’s disease that they should take?

A

Corticosteroids

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7
Q

Give an example of a blood gas that would be seen with DKA

A

Metabolic acidosis
pH is under 7.35.
HCO3 is under 22

Example: pH 7.30, PCO2 40, HC03 20

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8
Q

What is it called when a blood sugar drops at 2am for a child with type 1 diabetes?

A

Somogyi effect

High blood sugar in am

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9
Q

What can a nurse see with diabetes insipidus?

A

Low (decreased) urine specific gravity

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10
Q

What remark said by a parent of a child with hyperparathyroidism that the nurse would see they need more teaching

A

Eat yogurt daily

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11
Q

How would you teach a 4 year old child about injections for their diabetes mellitus?

A

Demonstrate on a doll with Needleless syringes

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12
Q

What would you recommend to an adolescent who has type one diabetes

A

Annual flu shot

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13
Q

What might be a statement made by a parent that they understand about diabetes mellitus

A

Child will be shaky when hypoglycemic

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14
Q

What should the nurse include in the teaching of type one diabetes do a school-age child?

A

Check ketones in urine

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15
Q

What instructions should the nurse provide for a child who is taking Ferris sulfate?

A

Take with OJ

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16
Q

What diet should a child avoid with iron deficiency anemia?

A

Foods with milk

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17
Q

What instructions should the nurse include in the teaching in a discharge planning of a child who has sickle cell anemia after an acute crisis episode?

A

Offer fluid several times a day

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18
Q

What should the nurse include in the plan of care for a child who has sickle cell anemia?

A

Observe for hypokalemia

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19
Q

How will someone act when they have a blood sugar of 280

A

Lethargic

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20
Q

Things to know about leukemia, sickle cell, anemia, and hemophilia

A

Temperature, Bruising, Platelets,
VIII, WBC count, Pain, Petechiae

Sickle cell:
Pain, SOB, fatigue, pallor, jaundice, cold hands and feet, dizzy, headache, swollen joints, hematuria, elevated WBC, decreased Hgb,

Hemophilia:
Bleeding disorder with prolonged clot time, deficiency in factor VIII (type A), deficiency in factor IX (type B), lack of con willebrand, joint pain and stiffness, impaired motility, bruising, headache, slurred speech, decreased LOC,prolonged aptt, platelets and prothrombin time are within expected ranges, while blood clotting g some is within expected or prolonged

Leukemia:
Low grade fever, pallor, increases bruising, petechiae, listlessness, enlarged liver, lymph nodes and joints, pain (abdominal, leg, joint), constipation, headache, vomiting and anorexia, unsteady hate, hematuria, mouth ulcers, enlarged kidney and testies, ICP, anemia, low platelets, neutropenia (low neutrophils), leukemia. Blasts( immature WBC),

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21
Q

Cranial radiation

A

Nonessential, essential, contraindicated

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22
Q

What type of insulin should a nurse treat a child with diabetic keto acidosis with

A

Regular via IV

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23
Q

What other patient can be placed with a child who has leukemia

A

A Child on neutropenic precautions

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24
Q

What should a patient be placed on who has low platelet count

A

Bleeding precautions

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25
Q

What should the nurse do first before administering insulin- when does the parent need further teaching?

A

When they say they should aspirate before giving insulin

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26
Q

What should a nurse tell the parents of a child with iron deficiency anemia and what should a child have checked routinely

A

you want to observe them daily and monitor blood for several weeks

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27
Q

Priority question, who should the nurse see first

A

10 year old with sickle cell, anemia and severe chest pain

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28
Q

What will the client who has hemophilia “A” receive before a wisdom tooth extraction?

A

Recumbent packed RBCs

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29
Q

What should the client be doing if the client has Addison’s disease?

A

Daily weight

30
Q

What is Addison’s disease caused by?

A

Lack of production of aldosterone by adrenal glands

31
Q

What are some warning signs of cancer?

A

Non healing sores
Change in bowl patterns
Change in borders of moles
Nagging cough

32
Q

What should the nurse expect if an adolescent is shaky, has difficulty speaking, and a blood level of 55?

A

Tachycardia

33
Q

What not to do if a parent finds an abdominal mass

A

Do not palpitate

34
Q

What food should be encouraged to eat if a toddler has iron deficiency anemia?

A

Tunafish

35
Q

What food should the nurse provide teaching on that prevents protein energy malnutrition?

A

Tuna
Cottage cheese
Omelettes
Milkshakes

Everything but strawberry banana smoothie

36
Q

What dietary changes should a client make if she is receiving chemotherapy

A

Do not drink fluids an hour before treatment

37
Q

What should the nurse be teaching about aplastic anemia?

A

Low bone marrow production of RBCs

38
Q

What communication therapy should the nurse provide for an adolescent with metastatic osteocarcinoma?

A

Tell me more about what you were thinking-continue the conversation

39
Q

What teaching should the nurse provide for a client who has testicular cancer

A

Risk factors:
15 to 35 years
Close relatives with it

40
Q

What should the nurse provide the client after radiation treatment?

A

Hydrating lotion

41
Q

What is consistent with leukocytosis?

A

Fever

42
Q

What should be included in the teaching for a client with neutropenia because of radiation therapy?

A

Bottled water is a good choice

43
Q

What should the nurse observe for a client who is being treated for lung cancer?

A

Signs of infection

44
Q

What should the nurse do if a 17-year-old refuses treatment for a relapse of leukemia

A

Notify the provider

45
Q

What should the nurse include in the care plan for a client who has leukemia and a platelet count of 130,000?

A

Limit IM injections

46
Q

What lab values it should be expected Following a hematologic event (the client who has a cute leukemia, and received an aggressive chemotherapy treatment 10 days ago)

A

Low platelets, leukocytes and erythrocytes

47
Q

What should the nurse monitor for the client who has myelosuppression after receiving chemotherapy

A

Bleeding gums

48
Q

What manifestations will a client have after experiencing severe nausea and vomiting after a course of chemotherapy

A

Metabolic alkalosis

49
Q

What interventions should the nurse include in the plan of care for a client who has immunosuppression following chemotherapy?

A

Limit the number of healthcare workers in the room and visitors

50
Q

What should the nurse include in the diet of a client who is taking chemotherapy and losing weight?

A

-Top fruit with yogurt
-Add cream to soup
-Use milk instead of water in recipes
-Dip meat in eggs and bread crumbs before cooking

51
Q

What should the nurse recommend regarding food for an older client who has WBC count of 2000 after three rounds of chemo?

A

Nothing raw
Serve cooked fruits

52
Q

What is a finding that the nurse should report to the provider as a possible sign of malignancy

A

Check the borders of bowls
Irregular borders are a sign

53
Q

Which lab value should give the nurse the best indication of the client’s renal function who has systemic lupus erythematous (SLE)

A

serum creatine

54
Q

What should the nurse expect to see of a client who has a systemic lupus?

A

Butterfly rash
Which is a red rash across the nose and cheeks

55
Q

What is the highest priority for a nurse to report to the provider for a client who has lupus (SLE)?

A

Peripheral edema

56
Q

What discharge teaching for a client who has a Lupus (SLE) should the nurse provide

A

Use mild protein shampoo

57
Q

What should the nurse monitor on a client with a platelet count of 9000?

A

Monitor for bleeding

58
Q

What will happen if the nurse does not administer diphenhydramine prior to a transfusion of RBC

A

Stop allergic reaction (urticaria)

59
Q

What is a manifestation of an allergic reaction?

A

Pruritus with amoxicillin

60
Q

What lab value is the nurse looking for a client who reports anorexia and is experiencing malnutrition?

A

Albumin will be altered

61
Q

What should the nurse expect from a patient who is malnourished

A

Low mental status

62
Q

What should the nurse seeing a client who has HIV infection Dementia and has progressed to AIDS

A

Night sweats

63
Q

What lab value as a priority for a client who has HIV

A

CD4 T cell count 180

64
Q

What should the nurse monitor for a client who has HIV infection and is prescribed zidovudine as part of anti-retroviral therapy

A

Aplastic anemia

65
Q

What test confirms HIV?

A

Western blot

66
Q

What should the nurse expect in a client who has failure to thrive?

A

Not gaining weight

67
Q

What should be part of the background component when using SBAR tool regarding “failure to thrive”?

A

-Current weight
-How much formula they were given
-They should gain 0.2 K each week

68
Q

What discharge teaching to the nurse provide for a child with juvenile idiopathic arthritis

A

Prednisone every other day

69
Q

What should the nurse teach a child who has eczema?

A

Use topical corticosteroids

70
Q

NGN: leukemia

A

Risk factors:
Childhood, male, FHx, Down syndrome

Findings:
Low fever, pallor, increase bruising, petechiae, listlessness, or larger liver lymph nodes and joints, abdominal leg and joint pain, constipation, headache, vomiting, anorexia, instead gate, hematuria, mouth ulcers, enlarged kidney and testicles, ICP

Lab test:
CBC, anemia, thrombocytopenia, neutropenia, leukemia blasts, blood smear

Diagnostic:
Bone marrow aspiration or biopsy. Topical anesthetic (45 mins - 1 hr before), conscious sedation, position based on site(iliac crest is most common), apply pressure to site 5-10 mins, pressure dressing, assess VS, monitors for bleeding first 24 hours

CSF analysis:
Lumbar puncture, Emily bladder, sterile, topical anesthetic (1 hr prior), side laying with keens to chest and back arched, can sedate, monitor VS and for bleeding, flat position for 39 minutes, can causes headache, drink water if it does.

Meds:
Chemo, corticosteroids, methotrexate. Antiemetics

Adverse effects:
Mucosal ulcer
Skin break down
Neuropathy
Pain
Loss of appetite
Hemorrhage cystitis
Alopecia

Therapeutic procedures:
Radiation
Hematopoietic stem cell transplant

71
Q

NGN: AIDS

A

PEDS (6 decks)

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