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4th Semester > Peds Exam 2 > Flashcards

Peds Exam 2 Flashcards

1
Q

A child on the unit is diagnosed with tetrology of fallot and the child has increased RBCs. The nurse understands this is because…

A

TOF is cyanotic so kidneys are triggered and excrete erythropoietin. —> polycythemia.

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2
Q

A child presents to the unit and is extremely irritable. Upon assessment, the nurse finds bright red chapped lips, and peeling skin in multiple places. What diagnosis does the nurse suspect?

A

Kawasaki Disease

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3
Q

A child is diagnosed with Kawasaki disease. What abnormal labs are expected?

A

Increased ESR, CRP, and platelets.

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4
Q

A nurse is educating the family of a child with Kawasaki disease. Which teaching should the nurse include regarding potential complications of the disease?

A

Kawasaki disease can cause coronary artery aneurysm and cardiomyopathy.

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5
Q

What 3 meds are used for Kawasaki disease and what are their uses?

A
  • IVIG: Improve immunity response
  • Aspirin (ASA): Prevent coagulation
  • Acetaminophen: Treat fever
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6
Q

What nursing care is relevant to Kawasaki disease?

A

Strict I&O, daily weight, promote comfortability, promote rest and quiet. Oral care to manage bright red chapped lips. Clear liquid diet and soft foods.

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7
Q

What is the most important part of pre-op care for cleft palate repair?

A

Adequate nutrition and infant-parent bonding.

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8
Q

What is the priority of care regarding post-op cleft palate repair?

A

Prevention of injury to the suture line. Nothing in mouth, minimize crying, position on side or spin w/ HOB elevated.

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9
Q

A nurse is told that a patient has failed to pass meconium and has absence of ganglion cells in the intestine.. the nurse should know that these are characteristics of what disease?

A

Hirschsprung Disease.

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10
Q

A nurse understands that hypospadias is what?

A

Presence of an abnormal urethral opening on the ventral (bottom) side of the penis.

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11
Q

What complication is r/t Hirschsprung disease?

A

Enterocolitis

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12
Q

A nurse is educating the family of a child with hirschsprung disease regarding the next steps, what should the nurse include?

A

4-stage surgery will be needed and the child will have an ileostomy or colostomy.

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13
Q

The nurse should recognize the following differences between adult and pediatric pulmonary anatomy:

A
  • Tracheal lumen 4mm vs 20mm in adults
  • Chest wall is very pliable (muscles supporting airway are weaker.
  • Infants are obligatory nose breathers.
  • Larger more flaccid tongue
  • Funnel shaped larynx
  • Bronchi and bronchioles are shorter and narrower
  • Fewer alveoli
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14
Q

A nurse should recognize that together; VSD, pulmonary stenosis, hypertrophy of R ventricle, and overriding aorta, are called…

A

The fatal four

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15
Q

A child with TOF has a chest X-ray. The nurse should expect what finding?

A

Boot-shaped heart.

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16
Q

What assessment findings are expected w/ TOF?

A
  • Loud, harsh systolic murmur.
  • Dyspnea, easy fatigue, color changes w/ feeding.
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17
Q

What are the abnormal lab values associated w/ TOF?

A

Polycythemia; Elevated H&H and RBC.

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18
Q

A nurse is caring for a patient w/ TOF that is having TET spells, what is the appropriate action?

A

Place child in knee to chest position.

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19
Q

Why are prostaglandins given to patients w/ TOF?

A

Keeps PDA open to increase pulmonary blood flow.

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20
Q

The nurse has a patient that is experiencing electrolyte imbalance and metabolic alkalosis r/t dehydration and prolonged vomiting. The vomiting is nonbilious and the patient is hungry soon after vomiting. What condition does the nurse suspect?

A

Hypertrophic pyloric stenosis

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21
Q

What are nursing priorities r/t pyloric stenosis?

A

IVF, NGT, NPO, strict I&O. Resume PO feedings 1-2 days post-op.

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22
Q

A nurse is reviewing the chart of a patient on the unit. The patient has proteinuria, hyperlipidemia, and facial edema that progresses to generalized throughout the day. What condition does the nurse suspect?

A

Nephrotic syndrome

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23
Q

What finding is expected with nephrotic syndrome and is r/t proteinuria?

A

Frothy urine.

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24
Q

What medications are used for nephrotic syndrome?

A
  • Corticosteroids (prednisone)
  • Diuretics (usually lasix)
25
Q

A nurse sees that a patient has orders for theophylline, IV mag sulfate, heliox, and ketamine. What condition would cause the patient to have these meds ordered?

A

Status asthmaticus.

26
Q

What are priorities when caring for a patient with status asthmaticus?

A

Prepare for ICU admission, initiate cardiorespiratory monitoring, check ABGs, and be prepared for emergency intubation.

27
Q

In a tachypeic infant, what does a slowing RR often indicate?

A

Tiring, CO2 retention. Apnea or respiratory arrest will follow.

28
Q

A patient admitted to the unit has gross hematuria, elevated BUN and creatinine, and a positive ASO titer. What question should the nurse ask?

A

Has the child had recent pharyngitis, strep infection, or been around anyone with a known strep infection?

29
Q

The nurse assesses a patient and upon assessment, the child is hypertensive, has a temp of 101.3, and is edematous. During admission, the patient’s mother states that he had strep throat not too long ago. What does the nurse suspect?

A

Acute post-streptococcal glomerulonephritis.

30
Q

A nurse should recognize that holosystolic harsh murmur along LSB and a palpable thrill in the chest are r/t to what?

A

Ventricular Septal Defect (VSD)

31
Q

What does VSD cause in terms of blood flow?

A

L to R shunt —> increased blood flow to RV and lungs.

32
Q

A child with asthma has been wheezing for the past 10 minutes and suddenly stops. The nurse should:

A

Immediately take action. Silent chest = no air movement.

33
Q

What are the guidelines regarding treatment of dehydration?

A
  • Mild: 50mL/kg oral rehydration solution (ORS) within 4 hours.
  • Moderate: 100mL/kg ORS within 4 hours
  • Replacement of diarrhea losses: 10mL/kg for each stool.
34
Q

A nurse performs a head to toe assessment and discovers a harsh, continuous, machine-like murmur that is loudest under the left clavicle at the first or second intercostal space. What condition is this likely to be associated with?

A

Patent Ductus Arteriosus (PDA)

35
Q

Which medication is given to treat PDA?

A

Indomethacin. NSAIDs inhibit synthesis of prostaglandins, allowing the ductus arterioles to close.

36
Q

What test should be done for a patient suspected to have cystic fibrosis? What findings indicate presence of the disease?

A

Sweat chloride test. Chloride >40 mEq for infants, >60 mEq for all other ages. Sodium >90 mEq.

37
Q

What is given to decrease viscosity of mucus to improve lung function?

A

Dornase alfa

38
Q

What vitamins need supplementation in patients w/ CF?

A

Fat soluble vitamins. Vitamins A, D, E, and K

39
Q

In a patient with CF, what is given within 30 minutes of eating to promote digestion and absorption of nutrients?

A

Pancreatic enzymes

40
Q

What is the main cause behind the symptoms of Kawasaki disease?

A

Systemic vasculitis

41
Q

What are the three features of hemolytic uremic syndrome (HUS)?

A

Hemolytic anemia, thrombocytopenia, and acute renal failure.

42
Q

A nurse is caring for a child w/ recent hx of parainfluenza infection with inspiratory stridor and a barking cough. What medications should the nurse expect to administer?

A

Dexamethasone and racemic epinephrine.

43
Q

What is the hallmark sign of intussusception?

A

Sausage shaped mass in upper mid abdomen. Should also expect sudden episodic pain and red jelly stools.

44
Q

What treatment is appropriate for intussusception?

A

IVF, NGT, and air enema. Surgery for recurrent cases.

45
Q

Between phimosis and paraphimosis, which is more immediately concerning?

A

Paraphimosis. Surgical reduction is required.

46
Q

How many calories/kg/day are recommended for infants w/ heart failure?

A

15o cals/kg/day. Small frequent feedings.

47
Q

When should feedings be administered via OG or NG when feeding a patient with heart failure?

A

After 20 minutes.

48
Q

What are the three parts of the pediatric assessment triangle?

A

Appearance, work of breathing, and circulation to skin.

49
Q

Albuterol, ipatropium, IV methylprednisolone, and PO prednisone are what type of asthma medications?

A

Acute

50
Q

Formoterol, fluticasone, cromolyn, and montelukast are meds that are appropriate for:

A

Daily/preventative use for someone w/ asthma.

51
Q

What test is used to assess asthma management effectiveness?

A

PIFR

52
Q

What test is the most accurate for diagnosing asthma?

A

PFT

53
Q

An infant patient has a HR of 210, present p-waves, and normal QRS complex. What is this rhythm?

A

Sinus tachycardia

54
Q

A child has a HR of 200, flattened P waves, and narrow QRS complex. What rhythm is this?

A

Supraventricular Tachycardia (SVT)

55
Q

A nurse is having a patient attempt vagal maneuvers such as ice to face or blowing through an obstructed straw. What type of SVT does this patient have?

A

Compensated

56
Q

A patient has uncompensated SVT. What should the nurse except to do?

A

Administer adenosine or perform synchronized cardioversion.

57
Q

A patient on the unit has a high fever, appears ill, has been drooling and having trouble speaking. The mother states that she hasn’t been coughing and all of this just happened so fast. What does the nurse suspect?

A

Epiglottitis.

58
Q

If a patient has epiglottitis, what should be present on neck x-ray?

A

Thumb sign

59
Q

What is a common assessment finding r/t foreign body aspiration?

A

Unilateral breath sounds.

4th Semester (10 decks)

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