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
What jaundice?
What kernicterus?
Excess bilirubin in the skin
bilirubin moves to the brain. This is occur bilirubin gets more than 20. It kills baby
Pathological jaundice?
Physiological jaundice?
a) NB comes out yellow
b) NB gets yello 2-3 days later
Infant toy
a) 0-6M
b) 6-9M
c) 9-12M
a) Music mobile
sensory-motor
b) Jack in the box
object permanence
c) Speaking toy
vocalization
Toddlers toy
1-3 years
Anything push/pull
Work on gross motor skills
Parallel play(think terrible two)
Preschoolers
3-6 years
Use colored pencils
Work on fine motor skills
Cooperative play(play role)
School-age
7-11 years
3Cs
Creative-give them blank paper to draw, lego
Collective-baseball cards,
Competitive-winner/loser
A child undergoes the removal brain tumor. During the post-ope, his HR is elevated, BP has significantly decreased. What nurse should do?
a) Notify the surgeon
b) Place the child in a supine position
c) Place the child in Trendelenburg’s position
d) Increase the flow rate of IV fluid
He is in shock!!!!
a
b,c,d cause incrase ICP
A pt with Hirschsprung’s disease. s/s?
a) diarrhea
b) projective vomiting
c) regurgitation of feeding
d) foul-smelling ribbon-like stool
d
Congenital anomaly. Absence of ganglion cells in the rectum and other areas of the intestine, Chronic constipation beginning in the first month of life
A pt with tracheoesophageal fistula. s/s?
a) increase in crying
b) coughing at nighttime
c) choking with feedings
d) sever projective vomiting
c
3C-coghing and choking,cyanosis
a) tracheoesophageal fistula?
b) fistula?
a) an abnormal connection between the esophagus and trachea
b) an abnormal connection between two body parts that don’t normally connect
A pt with imperforate anus. s/s?
a) bile-stained fecal emesis
b) the passage iof currant jelly-like stools
c) failure to [ass meconium stool in the first 24hrs
c
a birth defect that occurs when a baby is born without a normal anal opening
A pt with intussusception. s/s?
a) watery diarrhea
b) ribbon like stools
c) bright red blood and mucus in the stools
c
severe abdomen pain,crampy and intermittent, causing the child to draw in the knees to the chest
intessusception
part of the intestine folds into the section directly in front of it
Which intervention would the nurse include when creatin care plan for a child with hepatitis? SATA
a)providing a low-fat, well-balanced diet
b) Teaching the child effective handwashing technique
c) Notifying HCP if jaundice
d) Instructing the parents to avoid administer ing meds unless prescribed
e) arranging for indefinite homeschooling because the child will not be able to return to school
a,b,d
b-normal dose of medication may become dangerous. Administering medication who have liver disease means we double-dose them!!
e-child will allowed return to the school a week after the onset of jaundice
After tonsillectomy, the nurse reviews the order and which prescription would be question?
a) Monitor for bleeding
b) Suction 2qhrs
c) Avoid milk or milk products
d) Give clear, cool liquids when awake and alert
b
Suction equipment needs to be available but suctioning is not performed unless there is an airway obstruction because of the risk of trauma to the surgical site
c-milk product should avoid because its coting the throat
A pt with strabismus. s/s?
a) The child has difficulty hearing
b) The child consistently tilts the head to see
c) The child consistently turns the head to hear
b
the eyes are not aligned because of a lack of coordination of extraocular muscle
other s/s are crossed eyes, diplopia, photophobia
A child with acute otitis of the right ear. Which interventions would the nurse in the plan of care?
a) Provide a soft diet
b) Position the child on the left side
c) Administer an antihistamine
d) Irrigate the right ear with normal saline
e) Administer ibuprofen as prescribed
f) Instruct parents about the need to administer the prescribed antibiotics for the full course of therapy
a,e,f
b-the child is positioned in the affected side to facilitate drainage
Asthma attack s/s?
a) Persistent cough
b) Apprehension
c) Dry skin
d) Tachypnea
f)Tripod position
g) Chet tightness
f) Rapid fluent speech
a,b,d,f,g
Asthma
a) What are the immediate risk of developing?
b) What treatment should have?
a) Respiratory arrest
hypoxia
b) Frequently(not 1hr!) check on LOC
Auscultate lungs every 5 mints
a) What is silent asthma?
b) what should we do under silent asthma?
a) a severe form of asthma that can occur without coughing or wheezing
a) Assess pulse, Notify EMS, administer nebulizer treatment
BP doesn’t mush deal
The parent stated I think my child may have the croup. Which parental statement requires immediate follow-up?
a) My child is restless, and the child’s head is wet with perspiration
b) My child sounds hoarse and has a temp 101.1
c) My child cries and has a barking cough
d) MY child has noisy breathing and is irritable
a
increasing restlessness, profuse sweating, flaring nares, and increased RR indicate distress.
All other symptoms are expected
PT with Kawasaki disease, which complication is the high risk for the development of which problem?
s/s?
Coronary artery aneurysms
This is cardiovascular disease
High fever(not response med)
C conjunctivitis, so redness of the eyes.
R rash
E extremity changes (redness, peeling)
A Adenopathy(enlarge lymph nodes)
M Mucosal change
Kawasaki disease teratment
intravenous immunoglobulin(IVIG)
high dose aspirin
3 years old appropriate toy?
a) wagon
b) a sports video
c) crayons and a coloring book
what their play style?
a
wagons, lawnmowers, little strollers
DO NOT pick using a finger motor(coloring etc)
Parallel play
-play alongside others but not with
What skill should be the focus? and what is the best toy?
a) 0-6 month
b) 6-9 month
c) 9-12 month
a) sensory-motor
musical mobile
if they don’t have musical toy then pick large and soft
b) objective permanence
cover uncover toy(worse is musical mobile because they will pull)
c) vocalization
speaking toys
Never pick activity such as build, sort, stack, make under 9M
Which interventions are appropriate for the care of an infant? SATA
a) Provide swaddling
b) Takin in a loud voice
c) Hang mobiles with black and white contrast design
d) Caress the infant while bathing or during diaper changes
e) Allow the infant to cry for at least 10 mins before responding
a,c,d
a-swaddding おくるみ
d-愛撫
What skill should be the focus? and what is the best toy?
a) toddlers
b) preschoolers
e) school age
a) gross motor skills
running, jumping
best toy=push-pull toys
b) fine-motor skills
working on balance
co-operative play and pretend play
c) 3 Cs
Creative(LEGO!)
Competitive
Collective
A child with Reye’s syndrome. What intervention?
a) Assessing hearing loss
b) Monitoring urine output
c) Changing position q2hrs
d) providing a quiet atmosphere with dimmed lighting
d
causes confusion, swelling in the brain, and liver damage
d/t viral illness
