Final Exam Flashcards
Assessment for adolescent that came in with RR distress: what shows improvement?
Clear breath sounds
o2 sat improved
RR improved
HR improved
BP has improved
taking Oral intake
may still have crackles
What kind of orders can you anticipate for post care of a pt with HX of cardia valve damage and recent dental work? Came in with low grade fever, not wanting to eat. Petechiae and joint pain?
Anticipated
Antibiotics
Echocardiogram
Blood culture
Dental hygiene yes
Have him rest
How would we know that we had effective treatment with respiratory distress infants? (2yr old)
Clear breath sounds
RR regulate
HR normal(below 140)
O2 sats improved
retractions normal
nasal flaring(yes)
Improvement(no more cough)
NGN Taking care of leukemia pt what would you want to report to dr.? He came in with upper respiratory infection
Report
O2 sats 92
WBC elevated
Retractions
RR rate elevated
petechiae or pale
Do not report
Skin assessment is normal no bruising
Breath sounds clear no report
Hemoglobin normal
NGN (drop down) RSV pt how would you know if they were progressing on bronchitis or pneumonia
retractions
Respiratory
Lethargic
Strep
retractions YES
Respiratory(high)
Lethargic YES
Strep not cause of RSV
Compare seizure vs mild asthma. Seizure and change in epileptic medication, what do you want to report?
you want to follow up therapeutic levels for what medication?
Pt comes in afebrile white count within expected ranges has had cough for about a month and the cough comes on with mild exercise that’s induce through asthmas(asthma attack) would you expect this child to:
Liver failure
Steven johnson syndrome
Pneumothorax
Slight Wheeze
Breath sounds
Report: increase seizure activity
Want to follow up on: Dilantin(phenytoin) yes check therapeutic range
Expect child to:
Liver failure NO
Steven johnson syndrome NO
Pneumothorax- NO
Slight Wheeze
Breath sounds
NGN The nurse is reviewing an assessment finding for these diagnosis leukemia, sickle cell, and hemophilia
Bruising
Bleeding
Elevated WBC
Pain
Temperature
Leukemia: all of them
Sickle cell: elevated WBC, pain, temperature
Hemophilia: bruising, bleeding, pain
NGN What do you need to do when pt is discharged with intussusception?(discharge teaching)
Watch for bloody stools
Low fiber
IV antibiotics
Need Pancreatic enzymes
Contact precautions
Urine specimen
Watch for bloody stools YES
Low fiber- YES
IV antibiotics- YES
Need Pancreatic enzymes- NO
Contact precautions-NO
Urine specimen- NO
SATA Characteristics of duchenne muscular dystrophy?
Waddling gait
Lordosis
Calf muscles hypertrophy
SATA Tetralogy of fallot may have blue spells because of what anatomical defects? (Aorta affected)
Decreased pulmonary blood flow
Pulmonic stenosis
Shunting of desaturated blood from right to left
Overriding aorta
Squat to move volume of blood up
What do you expect to see in a 6 month old new well visit?
Closed posterior fontanels
What pain scale to use for a 6 month old, new well visit?
FLACC scale
Caring for school age and check mouth child is refusing to eat complain of mouth being sore and you see white in the mouth what is this called?
Thrush or candidiasis
Principal symptom of pinworm infections?
Perineal itching
You have a School age child who is admitted with vaso-occlusive sickle cell crisis. What would you include in his care?
Adequate hydration and pain management
6 week old with pyloric stenosis, what would you see?
Projectile vomiting
Preparing preschooler to have a cast be placed, what therapeutic actions can you use?
Wrap cast on doll or toy before
Kawasaki disease child what can long term therapy could put them at risk?
administering aspirin, which can cause bleeding Reye’s syndrome
Clinical finding with bedbugs?
Red rash
What happens when the ductus arteriosus is surgically closed?What is the goal of surgical closure of the ductus arteriosus?
Prevents the return of oxygenated blood to the lungs
What defect gives you an increased pulmonary blood flow?
ASD- atrial septal defect (Allows blood to go towards the pulmonary)
How can you minimize separation anxiety in the hospital with an infant or toddler?
Encourage parents to room in
You are giving a steroid to an idiopathic thrombocytopenic purpura child what do you monitor for? What can steroids disguise?
Infection
NGN 5 y/o with vaso-occlusive crisis of sickle cell w/ joint pain and fever for 3 days. Tylenol given, but doesn’t seem to work. What things would you need additional action on?
Remain in bed
PO fluids
Voided 200 mL of urine
Uncooperative
Chest pain and joint pain of 4
Nasal flaring and subcostal and substernal retraction
Bilateral expiration and inspiration wheezing upon auscultation
Uncooperative
Chest pain and joint pain of 4
Nasal flaring and subcostal and substernal retraction
Bilateral expiration and inspiration wheezing upon auscultation
NGN Hirschsprung’s disease(constipated)
2 actions and 2 parameters What would you anticipate to do for this child?
Constipation
Actions: Rectal biopsy, Pull through procedure
Monitor: Measure abdominal girth to watch for distention, Abdominal tenderness, FEVER and agitation
Diff breathing and irritability.
Adolescent how much taller can you get?(menarche) 95% of girls height.
1 year after your period
What would be a concern if you were seeing a pt in a clinic that mom says about his 6 year old?
The child has to squint to see the board
Infant who has a 2 day history of vomiting and fever. What is a reliable indicator of fluid loss?
Measure the body weight (weight loss)
According to Erikson, what is the plan of care for a 10 year old who will be hospitalized for an extended period Of time? (psychosocial needs)
Encourage the client to complete school work
Cerebral palsy child getting ready for discharge: what would be a priority in the plan of care?
Make adjustments in the environment
What do you do for a child having a seizure?
Position them laterally
What’s another name for pertussis?
Whooping cough
Seizure pt vomiting how do you position them?
Side lying
Psychosocial development Erikson, physiological stage for a toddler what would you see them doing?
Negative behavior of characterized by the need for autonomy
How can you discuss with teenagers to help with health promotion and taking what would you include in the teaching?
You need the child to increase sleep
Erikson’s stages in order
Trust vs mistrust
Autonomy vs shame
Initiative vs guilt
Industry vs inferiority
Identity vs role confusion
Evaluating a child who is descending stairs by placing both feet on each step by holding on to the handrail going down stairs?
3 year old
7 months old, what needs further evaluation?
Babbles in one syllable sounds
Autistic child which intervention for plan of care?
Reward system
Caring for a 6 month old who has a prescription for clear liquids by mouth after intussusception has been repaired, what kind of liquids would you give them?
Oral electrolyte
Toddler who mainly takes milk/day otherwise has poor Appetite for solid food. What is he at risk for?
Iron deficiency anemia
What do you expect to see on an 8 month old with cerebral palsy?
Sits with pillow props
SATA Steps to weigh infants on scale?
Disposable cover on scale
Zero your scale
Crown to heal
Gastrointestinal reflex baby what position should you put the child after feedings?
Place on seat, sitting upright
Assessing a male infant with a palpable mass in the upper right quadrant and blood and mucus on stools, what should you recognize?
Intussusception
Kawasaki disease of what system?
Cardiovascular
SATA Infant with Tracheoesophageal fistula what do you expect to see?(signs and symptoms)
Cough
Apnea
Cyanosis
Frothy secretions
What would you expect to see in a dehydrated infant S/S?
Irritable
4 year old in airborne precaution, what do you include in the plan of care?
Large puzzle pieces
6 month old with pain after the procedure, what findings should you anticipate?
Increase crying
10 year old with cardiac catheterization, what do you include in discharge instructions for pain?
Tylenol
Where do you take an infant’s heart rate
Apex of heart
Teaching a CNA about taking RR for 1 min why?
Irregular breathing
What are you concerned about scoliosis in post op reaction?
Body image
Child with flu, What would be concerning to you if you’re talking with a parent about what would indicate the child is at risk for reye’s syndrome?
I give my child aspirin to reduce fever
What would you tell a parent of a child with pediculosis capitis?
All used clothing, bedding and towels must be washed in hot water
2 month post of infant cleft lip, what would be your action for caring post op?
Encourage parents to hold or rock the child
What says you have done a good teaching for cystic fibrosis patient?
We will give our child pancreatic enzymes with snack and meal
12 month old in isolation (contact precautions) what toy would you give him?
Large building blocks
When does the birth weight double?
6 months
You have a child with acute gastroenteritis that is taking oral fluids. What kind of oral fluids will you give?
Oral rehydration solution
Leukemia child with critical low platelet count what do you watch out for?
Bleeding
You have a child with impetigo. What are you going to teach parents in discharge teaching?
Wash clothing in hot water
How do you know you had good teaching with a gastrointestinal reflux baby, the parents will tell you what they will do with the baby after feeding?
“I will keep my baby in a upright position”
2 month gets what scale after a surgical procedure?
FLACC
What would you report on a 15 month old you are seeing in a clinic?
The toddler cannot stand upright without support
Cystic fibrosis pt who’s getting chest physiotherapy what should they do prior to CPT?
Albuterol treatment
Motor vehicle accident infant with increased ICP what would you be concerned of monitoring for?
Increased sleep
RSV in a toddler what should the nurse do?(contact precautions)
Keep thermometer in toddlers room
Pyloric stenosis: what would you expect?
Projectile vomit
Spica cast on a 3 year old. What is your priority intervention?
Check circulation, sensation and motion of the toes
You are examining a 2 year old in a clinic. What should you do if you see the anterior fontanel open?
Report to the provider
What’s going to prevent strep pharyngitis from reoccurring?
Discard toothbrush and get a new one
Hematopoietic stem cell transplantation that patient is at risk for what?
Graft vs host disease
What would you teach a school age about a new diagnosis of asthma?
Avoid triggers that cause an attack
A toddler is having difficulty while in the hospital. What can you do to promote sleep?
Bedtime rituals
What can you anticipate to tell a family who is concerned about their child development As a toddler?
Separates easily from primary care for short periods
What would you see in a 11 month old who has a CNS infection?
Bulging anterior fontanel
What do you see with a skull fracture? What do you monitor?
Bleeding or edema
Major complication of a near drowning?
Aspiration
SATAWhat assessment finding do you see in Hodgkind’s disease
Fatigue
Weakness
Enlarged lymph nodes
What’s included in clotting times?
PTT and PT
If a teenager with terminal leukemia wants to withdraw life support and not continue with care but mom doesn’t what do you do?
Stop lifesaving measure and allow child to die naturally
SATA SCID genetic disorder with low immunity what would they present to the hospital as?
Oral thrush
Failure to thrive
Chronic diarrhea
What does it mean when they are doing autologous bone marrow transplantation?
Uses your own cells healthy bone marrow
15 year old patient speaks only Spanish. What do you do?
Request professional interpreter
What is a child’s right to health care? A child deserves a change for what?
Become productive adult and function in society
17 year refusing and mom wanting something else: Mom continues care and the child wants to stop leukemia treatment. What do you do?
Contact provided
Management of care, coordinating and supervising teach members for safe and cost effective manor, preventive safety measures to promote health and well being in a child
Management of care, coordinating and supervising teach members for safe and cost effective manor, preventive safety measures to promote health and well being in a child
Patient setting care, family, patient nursing staff, provider.
Patient setting care, family, patient nursing staff, provider.
Evidence based practice
Research and peer review sources
