Test 4 Pedi Flashcards
Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which action?
Avoid using for more than 3 days.
Which is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?
Give small amounts of favorite fluids frequently to prevent dehydration.
The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant displays which clinical manifestation?
Signs of an earache
A child is diagnosed with influenza, probably type A disease. Management includes which recommendation?
Amantadine hydrochloride (Symmetrel) to reduce symptoms
Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by:
a feeling of fullness in the ear.
Parents have understood teaching about prevention of childhood otitis media if they make which statement?
“We will be sure to keep immunizations up to date.”
An infant’s parents ask the nurse about preventing OM. Which should be recommended?
Avoid tobacco smoke.
The nurse is assessing a child with acute epiglottitis. Examining the child’s throat by using a tongue depressor might precipitate which symptom or condition?
Complete obstruction
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. The nurse’s rationale for this action is described primarily in which statement?
The mother’s presence will reduce anxiety and ease child’s respiratory efforts.
A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of which diagnosis?
Bronchitis
Which frequency is recommended for childhood skin testing for tuberculosis (TB) using the Mantoux test?
Periodically for children who reside in high-prevalence regions
Which consideration is the most important in managing tuberculosis (TB) in children?
Pharmacotherapy
The mother of a toddler yells to the nurse, “Help! He is choking to death on his food.” The nurse determines that lifesaving measures are necessary based on which symptom?
Inability to speak
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:
monitoring pulse ox
The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which is essential in this child’s care?
monitor arterial blood gases
A nurse is admitting an infant with asthma. The nurse understands that asthma in infants is usually triggered by:
a viral infection
A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma?
there is heightened airway reactivity
A child is admitted to the hospital with asthma. Which assessment findings support this diagnosis?
nonproductive cough, wheezing
Parents of two school-age children with asthma ask the nurse, “What sports can our children participate in?” The nurse should recommend which sport?
swimming
Parents of a child with cystic fibrosis ask the nurse about genetic implications of the disorder. Which statement, made by the nurse, expresses accurately the genetic implications?
If it is present in a child, both parents are carriers of this defective gene.
A nurse is teaching nursing students about clinical manifestations of cystic fibrosis (CF). Which is/are the earliest recognizable clinical manifestation(s) of CF?
meconium ileus
A child is being admitted to the hospital to be tested for cystic fibrosis (CF). Which tests should the nurse expect?
Sweat chloride test, stool for fat, chest radiograph films
Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?
sweat chloride test
A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?
Before chest physiotherapy (CPT)
A child with cystic fibrosis (CF) is receiving recombinant human deoxyribonuclease (DNase). Which is an adverse effect of this medication?
voice alters
Pancreatic enzymes are administered to the child with cystic fibrosis (CF). Nursing considerations should include to:
pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?
diet should be high in carbohydrates and protein
Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible?
carotid
Effective lone-rescuer CPR on a 5-year-old child should include
two breaths to every 30 chest compressions
The heimlich maneuver is recommended for airway obstruction in children older than ___ year(s).
1
A nurse is teaching an adolescent how to use the peak expiratory flowmeter. The adolescent has understood the teaching if which statement is made?
“I will record the readings at the same time every day.”
A school-age child has been admitted with an acute asthma episode. The child is receiving oxygen by nasal prongs at 2 liters. How often should the nurse plan to monitor the child’s pulse oximetry status?
continuous
A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is HIV positive. Which induration size indicates a positive result for this child 48–72 hours after the test?
> /= 5mm
An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which interventions? (Select all that apply.)
- cluster care to conserve energy
- administration of antibiotics
The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which intervention should be included in the child’s care? (Select all that apply.)
- encourage to drink 8 onces of formula every 4 hours
- cluster care to encourage adequate rest
- place on noninvasive oxygen monitoring
The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which action should the nurse include in the child’s postoperative care plan? (Select all that apply.)
- Notify the surgeon if the child swallows frequently.
- Place the child on the abdomen until fully wake.
- Allow the child to have diluted juice after the procedure.
A nurse is caring for a school-age child with left unilateral pneumonia and pleural effusion. A chest tube has been inserted to promote continuous closed chest drainage. Which interventions should the nurse implement when caring for this child? (Select all that apply.)
- Assessing the chest tube and drainage device for correct settings
- Administering prescribed doses of analgesia
- Monitor for need of supplemental oxygen
A nurse is interpreting the results of a child’s peak expiratory flow rate. Which percentage, either at this number or less than this number, is considered to be a red zone? (Record your answer in a whole number.)
50
The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator, which steps should the nurse take? Place in correct order. Provide answer using lowercase letters separated by commas (e.g., a, b, c, d, e, f).
a. Place on a hard surface.
d. Use the head tilt–chin lift maneuver and check for breathing.
f. Give two rescue breaths.
c. Feel carotid pulse while maintaining head tilt with the other hand.
e. Place heel of one hand on lower half of sternum with other hand on top.
b. Administer 30 chest compressions with two breaths.
A chest radiograph film is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, “What will the radiograph show about the heart?” The nurse’s response should be based on knowledge that the x-ray film will show:
permanent record of heart size and configuration
The nurse is assessing a child after a cardiac catheterization. Which complication should the nurse be assessing for?
cardiac arrhythmia
José is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:
adapted to his level of development so that he can understand.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
When the procedure is done, you will have to keep your leg straight for at least 4 hours.
The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is “too wet.” The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to:
apply direct pressure above catheterization site.
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
I have to stay on strict bed rest for 3 days
Surgical closure of the ductus arteriosus would:
prevent the return of oxygenated blood to the lungs.
Which defect results in increased pulmonary blood flow?
Atrial septal defect
The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?
Tetralogy of Fallot
Which is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?
Heart failure
Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
Peripheral edema
A nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor. Which drug should the nurse be administering?
Catopril (Capoten)
An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _____ beats/min.
70
A 6-month-old infant is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _____ beats/min.
90-110
The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is a common sign of digoxin toxicity?
Vomiting
The parents of a young child with heart failure tell the nurse that they are “nervous” about giving digoxin (Lanoxin). The nurse’s response should be based on which statement?
Parents must learn specific, important guidelines for administration of digoxin.
The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?
“You may need to increase the caloric density of your infant’s formula.”
An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse’s first action should be to:
place the child in the knee-chest position.
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which is an important objective to decrease this risk?
Prevent dehydration
Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. Which action should the nurse take?
Report findings to physician
Which is an important nursing consideration when chest tubes will be removed from a child?
Administer analgesics before procedure
Which is the most common causative agent of bacterial endocarditis?
Stretococcus viridans
Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?
Osler nodes
The primary nursing intervention to prevent bacterial endocarditis is to:
counsel parents of high-risk children about prophylactic antibiotics.
Which is a common, serious complication of rheumatic fever?
cardiac valve damage
The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?
polyarthritis
The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?
Administering penicilin
Which action by the school nurse is important in the prevention of rheumatic fever?
Refer children with sore throats for throat cultures
When caring for the child with Kawasaki disease, the nurse should know which information?
Therapeutic management includes administration of gamma globulin and aspirin.
Which occurs in septic shock?
increased cardiac output
Clinical manifestations of toxic shock syndrome include:
erythematous macular rash
A preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response?
“Your child must lie quietly; sometimes a mild sedative is administered before the procedure.”
The nurse is caring for an infant with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands?
Organize nursing activities to allow for uninterrupted sleep
Nursing interventions for the child after a cardiac catheterization should include which actions? (Select all that apply.)
- Assess the affected extremity for temperature and color.
- Maintain a patent peripheral intravenous catheter until discharge.
Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock? (Select all that apply.)
- Cool extremities and decreased skin turgor
- Confusion and somnolence
- Tachypnea and poor capillary refill time
The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)
- Decreased urinary output
- Sweating (inappropriate)
- Fatigue
Which is the acceptable mg/dl level, or below this level, low density lipoprotein (LDL) cholesterol for a child from a family with heart disease? (Record your answer in a whole number.)
110
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. Provide answer using lowercase letters separated by commas (e.g., a, b, c, d).
b. Place infant in knee-chest position.
a. Administer 100% oxygen by blow-by.
d. Give morphine subcutaneously or by an existing intravenous line.
c. Remain calm.
The nurse is teaching parents about the importance of iron in a toddler’s diet. Which explains why iron deficiency anemia is common during toddlerhood?
Milk is a poor source of iron
Which should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?
Adequate dosage will turn the stools a tarry green color.
Iron dextran is ordered for a young child with severe iron deficiency anemia. Nursing considerations include to:
inject deeply into a large muscle
The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breast-fed infant. Which should be suggested?
Iron-fortified infant cereal by age 4 to 6 months
An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of:
circulatory overload
The nurse is reviewing first aid with a group of school nurses. Which statement made by a participant indicates a correct understanding of the information?
“If a child has a nosebleed, I should have the child sit up and lean forward.”
