Respiratory, GI, GU, Cardiac Flashcards
How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)?
The values indicate the child is
- Not compliant with taking her vitamins.
- Not compliant with taking her enzymes.
- Eating too many foods high in fat.
- Eating too many foods high in fiber.
- Not compliant with taking her enzymes.
If the child were not taking enzymes, the
result would be a large amount of undigested food, azotorrhea, and steatorrhea in the stool. Pancreatic ducts in CF patients become clogged with thick mucus
that blocks the flow of digestive enzymes
from the pancreas to the duodenum.
Therefore, patients must take digestive
enzymes with all meals and snacks to aid
in absorption of nutrients. Often, teens
are noncompliant with their medication
regimen because they want to be like
their peers.
Which would the nurse explain to parents about the inheritance of cystic fibrosis?
- CF is an autosomal-dominant trait passed on from the child’s mother.
- CF is an autosomal-dominant trait passed on from the child’s father.
- The child of parents who are both carriers of the gene for CF has a 50% chance of acquiring CF.
- The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.
- The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.
- The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.
If the child is born to a parent with CF and the other parent is a carrier, the child has a 50% chance of acquiring the disease and a 50% chance of being a carrier of the disease.
The parent of a 4-month-old with cystic fibrosis (CF) asks the nurse what time to begin the child’s first chest physiotherapy (CPT) each day. Which is the nurse’s best response?
- “Thirty minutes before feeding the child breakfast.”
- “After deep-suctioning the child each morning.”
- “Thirty minutes after feeding the child breakfast.”
- “Only when the child has congestion or coughing.”
- “Thirty minutes before feeding the child breakfast
CPT should be done in the morning prior to feeding to avoid the risk of the child vomiting.
The parent of an infant with cystic fibrosis (CF) asks the nurse how to meet the child’s increased nutritional needs. Which is the nurse’s best suggestion?
- “You may need to increase the number of fresh fruits and vegetables you give your child.”
- “You may need to advance your child’s diet to whole cow’s milk because it is higher in fat than formula.”
- “You may need to change your child to a higher-calorie formula.”
- “You may need to increase your child’s carbohydrate intake.”
- “You may need to change your child to a higher-calorie formula.”
Often infants with CF need to have a higher-calorie formula to meet their nutritional needs. Infants may also be placed on hydrolysate formulas that contain medium-chain triglycerides.
Which statement by the parents of a toddler with repeated otitis media indicates they need additional teaching?
- “If I quit smoking, my child may have a decreased chance of getting an ear infection.”
- “As my child gets older, he should have fewer ear infections, because his immune system will be more developed.”
- “My child will have fewer ear infections if he has his tonsils removed.”
- “My child may need a speech evaluation.”
- “My child will have fewer ear infections if he has his tonsils removed.”
Removing children’s tonsils may not have any effect on their ear infection. Children who have repeated bouts of tonsillitis can have ear infections secondary to the tonsillitis, but there is no indication in this question that the child has a problem with tonsillitis.
The nurse is reviewing discharge instructions with the parents of a child who had a tonsillectomy 24 hours ago. The parents tell the nurse that the child is a big eater, and they want to know what foods to give the child for the next 24 hours. What is
the nurse’s best response?
- “The child’s diet should not be restricted at all.”
- “The child’s diet should be restricted to clear liquids.”
- “The child’s diet should be restricted to ice cream and cold liquids.”
- “The child’s diet should be restricted to soft foods.”
- “The child’s diet should be restricted to soft foods.”
Soft foods are recommended to limit the child’s pain and to decrease the risk for bleeding.
What would the nurse advise the parent of a child with a barky cough that gets worse at night?
- Take the child outside into the more humid night air for 15 minutes.
- Take the child to the ER immediately.
- Give the child an over-the-counter cough suppressant.
- Give the child warm liquids to soothe the throat.
- Take the child outside into the more humid night air for 15 minutes.
The night air will help decrease subglottic edema, easing the child’s respiratory effort. The coughing should diminish significantly, and the child should be able to rest comfortably. If the symptoms do not improve after taking the child outside, the parent should have the child seen by a health-care provider.
