Test 14

Question 1

1) Hirschsprung Disease: manifestations(Slide 9)

Answer 1

Manifestations
• Failure of the newborn to have a stool in the first 24 hours, bile-stained emesis, and generalized abdominal distention.
• Gastroenteritis with diarrheal stools, ulceration of the colon, and severe constipation with ribbonlike or hard pellet stools in older child

Question 2

1) Hirschsprung Disease: client education

Answer 2

• Treatment involves 2 steps surgery.
• The client will have a temporary ostomy.

Question 3

2) Intussusception: manifestations(Slide 10)

Answer 3

• Stools will have blood and mucus in them, client might exhibit anorexia.

Question 4

3) Appendicitis: manifestations(Slide 11)

Answer 4

• In the older child may be pain and tenderness in the RLQ of the abdomen, nausea, vomiting, fever and constipation.
• The young child has difficulty localizing the pain, may act restless and irritable, and may have a slight fever, a flushed face and a rapid pulse.
• Usually, the WBC count is slightly elevated; decreased bowel sounds; tachycardia.

Question 5

4) Lead poisoning: manifestations and acute (Slide 15)

Answer 5

Manifestations
• Irritability, hyperactivity, aggression, impulsiveness, or disinterest in play.
• Learning difficulties, and distractibility.

Acute Manifestations
• Convulsion, mental retardation, blindness, paralysis, anorexia, constipation, decreased urinary output (If kidney involved), coma and death.

Question 6

5) Type 1 diabetes: client education(Slide 18)

Answer 6

• Administer insulin SQ.
• Avoid injecting area that will be exercised soon after
• Increased fluids during illness
• Observe for ketoacidosis and test urine for ketones.
- Manifestations: Change in LOC
• Check glucose q3hrs during illness.
• Obtain yearly flu vaccine.

Question 7

6) Priority care with pediatric respiratory disorders

Answer 7

• Good hand washing

Question 8

7) Manifestations for epiglottitis

Answer 8

• Drooling and dysphagia, can be caused by HIB-encourage vaccinations.

Question 9

7) Manifestations for foreign body aspiration

Answer 9

• Tachypnea
• Irritability

Question 10

7) Manifestations for laryngotracheobronchitis(Slide 9 & 13)

Answer 10

• Often Viral

Question 11

8) RSV manifestations

Answer 11

• Dyspnea occurs as well as a dry and persistent cough, extremely shallow respirations, air hunger, and cyanosis.
• Suprasternal and subcostal retractions are present with respirations as high as 60 to 80 breaths per minute.

Question 12

8) RSV nursing considerations(Slide 11)

Answer 12

• The child is hospitalized, placed in a private room on contact and droplet transmission precautions, and treated with high humidity by mist tent, rest, and increased fluids.
• Ribavirin: an antiviral drug may be used

Question 13

9) Montelukast K,H,K

Answer 13

• Take a night.
• Not a rescue medication
• Work in the first 24 hours
• Can uses as young as 12 months of age.

Question 14

9) Albuterol K,H,K

Answer 14

• Rescue med fast acting
• Hold breath 10 sec after inhaling.
• More than one wait 20-30 seconds in between
• Tilt head back
• Hold it with the dominate hand.
• No sharing
• Can cause Hyperglycemia.

Question 15

10) Asthma (acute) manifestations(Slide 15)

Answer 15

Episodic in mild asthma (2-3x/week), throughout the day in severe persistent asthma
• Dyspnea
• Expiratory Wheeze
• Cough
• Limitation with activity
• Diagnostic evaluation: peak flow

Question 16

11) Asthma (acute) nursing actions

Answer 16

• Drug therapy to prevent/relieve bronchospasm.

Question 17

12) CF client education(Slide 18)

Answer 17

• The child diet is high protein and carbohydrates, and salt and fats are allowed

Question 18

12) CF nursing managements

Answer 18

• Chest physiotherapy, administer antibiotic and inhalation therapy.
• Excellent hand washing
• Avoid places with high risk of infection.

Question 19

13) CF pancreatic enzymes K,H,K

Answer 19

• Pancreatic enzymes to help digest the fat in their foods.
• Given with each meal and snack.

Question 20

14) CF diagnostic tests

Answer 20

• The sweat chloride test: which shows elevated sodium chloride levels in the sweat.

Question 21

15) Celiac diet(Slide 5)

Answer 21

Diet education of gluten products
• Barley, rye, oats, wheat

Question 22

16) Pyloric stenosis and manifestations(Slide 8)

Answer 22

• The vomiting increases in frequency and force, becoming projectile.
• Irritable
• Loses weight rapidly.
• Muscle waste
• Becomes dehydrated.

Question 23

17) Hypoglycemia manifestations

Answer 23

• Headache
• Shallow breathing
• Tremors
• Sweating
• Tachycardia
• Lightheaded

Question 24

17) Hypoglycemia nursing actions/client education(Slide 18)

Answer 24

• Observe for hypoglycemia and treat 15-20g fasting carbohydrates.

Question 25

18) Croup Syndromes manifestations(Slide 9)

Answer 25

• Hoarseness, “barking” cough, inspiratory stridor, and varying degrees of respiratory distress including retractions, fever, irritability.

Question 26

18) Croup Syndromes (Slide 9)

Answer 26

• Described by anatomic area primarily affected:
- Epiglottitis, Laryngitis, Laryngotracheobronchitis (LTB), and tracheitis

• Assess for need of immediate medical attention when:
- Increased stridor: child might lean forward and breath with tongue out; increased restlessness; increased heart rate and respiratory rate.