Peds Flashcards
A pediatric client who is diagnosed with acute glomerulonephritis. The client is currently experiencing bilateral pitting edema of the lower extremities, hypertension, and proteinuria. Which is the best indicator of fluid loss or gain in this client?
a) Observing for an increase or decrease in edema
b) Measuring intake and output every shift
c) Monitoring weight daily
d) Assessing the blood pressure
c
b-Accurate intake and output may be difficult to monitor when providing care to a pediatric client who is acutely ill
Risk factors for acute otitis media?
Had formula rather than breast milk
household has smoker
The nurse is administering vaccinations to a pediatric client diagnosed with hemophilia.
➤Which nursing action(s) is appropriate? SATA
a) Give the vaccines subcutaneously with the smallest gauge possible.
b) Cover the injection site with a warm compress and apply pressure.
c)Administer naproxen for pain relief every 6 hours prn
d) Place firm pressure to each injection site for five minutes.
a,d
a-Not IM
b- a warm compress will increase the client’s risk for bleeding due to vasodilation. Ice, which promotes vasoconstriction
c-Acetaminophen can be safely administered
Hemophilia
a) s/s?
b) treatment?
a) blood doesn’t clot normally(bleeding)
Ineffective tissue perfusion
Joint stiffness
b) Avoid injection!!!
Ice packs+elevate the affected area(stiffness)
A pediatric client who is diagnosed with nocturnal enuresis. Which statement by the child’s parent indicates a need for additional teaching?
a) I will limit my child’s intake of chocolate.
b) I will limit my child’s fluid intake after dinner each evening
c) My child will wear a pull-up each night in case of bedwetting.
d)
c
a-Bladder irritants, including caffeine and chocolate should be avoided as they increase the likelihood of bedwetting
b-Fluid intake should be limited after dinner to decrease the likelihood of bedwetting
nocturnal enuresis=bedwetting or nighttime incontinence
The nurse is assessing a pediatric client with a differential diagnosis of precocious puberty.
➤When conducting the health history interview with the child and parent, which question(s) should be included to determine risk factors for the diagnosis? SATA
a) Is there a family history of early puberty?
b) Is there a family history of high cholesterol?
c) Does your child engage in frequent physical activity
d) Does your child have a history of meningitis or encephalitis?
e) Does anyone that your child has contact with use topical hormones?
a,d,e
d-a history of central nervous system (CNS) infection, such as meningitis or encephalitis
The nurse is caring for a one-month-old infant who is admitted with a diagnosis of pyloric stenosis.
➤What laboratory data does the nurse expect to see?SATA
a) A blood urea nitrogen (BUN) of 19 mg/dL ( 6.78 mmol/L
b) An elevated pH level
c) An elevated white blood cell (WBC) count
d) A hematocrit of 60%
e) A potassium of 3.0 mEq/L
a,b,d,e
Large amounts of vomiting are noted in the infant who is diagnosed with this condition resulting in dehydration and electrolyte imbalances
What is hypertrophic phloric stenosis? genetic disorder
blockage of the passage out of the stomach d/t thickening
-projective vomiting
-olive-shaped mass RUQ
-dry mucus membrane
The nurse is developing a plan of care for an adolescent client who has cystic fibrosis. Which potential complication should the nurse consider for this client? SATA
a) Abnormal growth
b) Diabetes insipidus
c) Respiratory infections
d) Nutritional deficiencies
e) Recurrent hypoxia
a,c,d,e
a-malabsorption of nutrients and fat-soluble vitamins; failure to thrive (FTT)
A toddler-age child who presents with a sore throat, inspiratory stridor, and an oral temperature of 103.1° F ( 39.5° C). Which is the nurse’s priority action?
a) Obtain an accurate temperature with a rectal thermometer
b) Obtain an accurate temperature with a rectal thermometer
c) Visually examine the child’s throat for evidence of any drainage or exudate
b
The tripod position opens the child’s airway and helps air flow. Allowing the child to assume this position in the parent’s lap will also decrease anxiety.
Tripod position=orthopneic position=前屈み
A pediatric client who is newly diagnosed with asthma about the administration of albuterol. Which statement by the parent indicates a need for additional instruction?
a) I will give this medication to prevent an asthma attack
b) My child might experience nervousness with this medicatio
c) I will administer the medication using a nebulizer, as prescrib
d) My child might experience an increased heart rate with this medication
a
Not prevent
albuterol =bronchodilator
d-Tachycardia, or an increased heart rate, is a side effect
Which clinical manifestation of heart failure is critical for the nurse to teach the parent of an infant who recently underwent surgical repair of tetralogy of Fallot? SATA
a) A flat abdomen
b) An increase in vomiting
c) An increased amount of urine output
d) Pale and cool hands, feet
e) Periorbital edema
f) Rapid weight gain
d,e,f
a-Ascites, not a flat abdomen
c-Decreased, not increased urine output
a) What is congenital heart defects?
b) What TRouBLe mean of Tetralogy of Fallot?
a) Problem structure of heart/birth defects
b) Shunt blood Right to Left
B as blue=cyanotic
All start with T is toruble
The nurse is providing education to the parents of a pediatric client scheduled for cast removal.
➤Which parental statement demonstrates an understanding of the teaching?
a) I will notify the doctor if my child develops brown, flaky skin
b) I will cleanse my child’s skin with alcohol each day to prevent infection.
c) It is ok to use lotion on my child’s skin to address any dryness that is noted
c
The use of a moisturizing lotion decreases dryness and itching after cast removal;
a- an expected finding and occurs as secretions and dead skin accumulate under the cast and is not a symptom of infection. Once this skin is shed, the new skin is often tender.
b- cleans the skin daily with warm, soapy water while avoiding excessive rubbing
The nurse is assessing a pediatric client diagnosed with Guillain-Barre syndrome.
➤Which finding requires pediatrician notification?
a) Ptosis
b) Myalgia
c) Aphasia
d) Dysphagia
d
A pediatric client who experiences difficulty swallowing, or dysphagia requires the nurse to notify the practitioner as enteral feedings are likely to be required to decrease the child’s risk for aspiration.
Guillain-Barre syndrome?
a short-term but often life-threatening disorder that affects the nerves in the body. Muscle weakness, pain, and short-term paralysis of the muscles in the face chest, and leg and those used to swallow.
A client with cerebral palsy (CP) who has new orders for an orthotic device to decrease the risk for contractures.
➤Which action decreases the risk for impaired skin integrity? SATA
a) Follow the ordered on and off schedule for the device
b) Ensure that a cotton undergarment is worn under the device.
c) Provide frequent assessments of skin covered by the device
d) Monitor the neurovascular status for the extremity with the device.
e) Apply ice to the extremity during the prescribed off schedule for the device.
a,b,c
d
Impaired circulation is not a complication associated with a properly fitted and applied adaptive positioning device. This action is more appropriate for a pediatric client who requires a cast and is at risk for compartment syndrome.
Bilirubin
a) elevated level?
b) toxic level?
c) when do HCP want to be hospitalized?
a) 10-20
b) greater than 20
c) 14-15
