Pediatric Burns and Immunizations Flashcards
Burns
A child has partial-thickness burns of the face and upper chest. Which is the priority nursing assessment for the first 24 hours?
Pulmonary distress
Inhalation burns are usually present with facial burns, regardless of the depth; the immediate threat to life is asphyxia resulting from irritation and edema of the respiratory passages and lungs.
Burns
A child is admitted to the hospital with deep partial-thickness burns involving the face and chest. The nurse bases a plan of care on concerns related to the child’s injury. Place the following concerns in order of importance.
Impaired gas exchange
Disturbed fluid balance
Presence of pain
Potential for infection
Compromised body image
A compromised airway may occur with burns to the face and chest as a result of inhalation of hot gases and smoke, which causes mucosal damage and edema. Because of fluid and electrolyte losses during the first 24 to 36 hours and the resulting shift od electrolytes, fluid and electrolyte balance become a priority after airway maintenance and pain management. Deep partial-thickness burns are painful; pain management is a priority after maintenance of a patent airway and promotion of gas exchange. Infection prevention becomes a priority after airway mainenance, pain management, and maintenance of fluid and electrolyte balance; the potential for infection increases as the postinjury period progresses because of the damaged dermis. Body image becomes more of a priority after immediate physiologic needs have been met.
Burns
What is the priority nursing action for a child with severe burns on the arms who is scheduled for therapeutic escharotomy?
Monitoring radial pulses
Eschar is rigid and may restrict circulation and lead to loss of limb perfusion.
Burns
The parent of a 3-year-old brings the child to the urgent care center for treatment of a burn sustained in the kitchen. Which information would the nurse provide to the parent to prevent further injuries?
Looking up matches, cigarettes, and candles
Ways to prevent burns would be to lock up and put matches, cigarettes, and candles out of the reach of children.
Burns
Which statement made by a parent of a toddler indicates the child is at risk for a burn injury?
“My toddler likes to take the batteries out of toys.”
Batteries can cause burns and should be kept out of the reach of a toddler.
Burn
A 3-year-old child is admitted to the burn unit with partial- and full-thickness burns over 30% of the body. For which complication would the nurse assess during the first 48 hours?
Shock
The immediate postburn period is marked by dramatic alterations in circulation because of large fluid losses through the denuded skin, vasodilation, and edema formation; the precipitous drop in cardiac output can result in shock.
Vaccinations
Which statement would the nurse determine indicates that the parent of a 3-year- old child understands when the child needs their next vaccinations?
“We need to come back to the clinic in 1 year for more vaccinations.”
The child who is up to date on vaccinations at 3.5 years of age will need to return to the clinic for an annual influenza vaccination.
Vaccinations
Which immunizations would the nurse expect a 5-month-old infant to have already received?
Rotavirus, DTaP, Haemophilus influenzae, polio, pneumococcal
According to the 2018 Centers for Disease Control and Prevention (Canada: Public Health Agency of Canada) immunization schedule, a 5-month-old infant should have received the following vaccines: rotavirus, DTaP (diptheria, tetanus, and pertusis), Hib (Haemophilus influenzae), Hepatisis B, IPV (polio), and PCV (pneumococcal).
Had Picture
An infant has missed several well-baby visits and needs catch-up immunization(s). Before administering the immunization(s), the nurse assesses the child, and reviews the child’s history and agency policy. Which is the nurse’s next action.
Administer the second in the series of three vaccines
Immunizations may be administered even if the child has mild disease symptoms. There is no need to restrart the vaccination series.
Vaccinations
Which immunization would the nurse anticipate administering to a 4-year-old client?
Inactive poliovirus #4
The nurse would prepare education for the parent of a 4-year old child for the inactive poliovirus #4 booster because this is the final dose of poliovirus and administered to children between 4 to 6 years of age.
Vaccinations
Which is the correct response to a parent whose child is undergoing chemotherapy and is not up to date on required immunizations for school?
“This isn’t the best time to finish the immunizations, because your child’s immune system is suppressed.”
Chemotherapy compromises the immune system. The vaccines may be administered after the completion of the chemotherapy protocol, once the immune system has returned to the previous state.
Vaccinations
Against which condition is a 6-month-old with up-to-date immunizations not protected?
Measles
The MMR vacine (measles, mumps, rubella) is not given until 12 to 15 months of age.
Vaccinations
The child who is human immunodeficiency virus (HIV) positive has CD4 count that shows severe immunosuppression. Which immunizations can the child be given safely at this time? Select all that apply.
SATA
Hepatitis A
Polio vaccine (IPV)
Diptheria, tetanus, pertussis (DTaP)
The varicella and MMR vaccines should not be administered in the presence of severe immunosuppression because they are live vaccines. Hepatitis A, IPV, and DTaP are not live vaccines; therefore they are appropriate for any child, regardless of immune status.
