“A mother tells the nurse that her child does not want anything to do with toilet training and yells “NO!” consistently when she tries to toilet train. The child is 2 years old. According to Erikson, the nurse interprets that the child is experiencing which psychosocial crisis?”
a. autonomy vs shame and doubt
b. initiative vs guilt
c. industry vs inferiority
d. trust vs mistrust
Autonomy vs shame and doubt<\/p>\n\n\n\n
A 2-year-old child is admitted to the hospital with juvenile rheumatoid arthritis (JRA). During the focused assessment, the nurse makes it a priority to note the presence of which of the following?”
a. increased irritability and the child’s insistence to be carried out
b. complaints of joint stiffness
c. history of daily temperature elevations
d. description of how difficult it is to move around after periods of inactivity
increased irritability and the child’s insistence to be carried out<\/p>\n\n\n\n
A mother of a toddler who is hospitalized with mild dehydration must leave her child to go to work. Which behavior would the nurse expect to observe in the toddler immediately after the mother’s departure?
a. silently curled in bed with a blanket
b. loudly crying and kicking both legs
c. playing quietly with a favorite toy
d. sucking thumb and rocking back and forth
loudly crying and kicking both legs<\/p>\n\n\n\n
“A newborn infant is diagnosed with hypospadias, and the mother asks the nurse about the disorder. The nurse bases the response on which of the following?”
a. it is a congenital anomaly in which the actual opening of the urethra meatus is below the normal placement on the glans penis
b. it occurs when one or both testes fail to descend through the inguinal canal into the scrotal sac
c. it is a congenital anomaly in which the actual opening of the urethral meatus is dorsal to the urethral opening
d. it is a congential anomaly characterized by the extrusion of the urinary bladder to the outside of the body
it is a congenital anomaly in which the actual opening of the urethra meatus is below the normal placement on the glans penis<\/p>\n\n\n\n
A home care nurse is providing instructions to a child with cystic fibrosis about how to perform the “huff” maneuver; the child asks the nurse about the purpose of this type of breathing. The nurse makes which response to the child?
a. “this type of breathing is used to mobilize secretions so that they can be easily coughed out”
b. “this type of breathing prolongs inspiration time”
c. “this type of breathing moves air out of the lower lungs”
d. “this type of breathing moves air through the lungs”
“this type of breathing is used to mobilize secretions so that they can be easily coughed out”<\/p>\n\n\n\n
A home care nurse is instructing the mother of a child with cystic fibrosis (CF) about the appropriate dietary measures. The nurse tells the mother that the child needs to consume a:
a. low calorie, low fat diet
b. high calorie, high protein diet
c. low calorie, low protein diet
d. high calorie, restricted fat
high calorie, high protein diet<\/p>\n\n\n\n
Breathing exercises and postural drainage is prescribed for a child with cystic fibrosis. A nurse implements these procedures by telling the child to:
a. perform the postural drainage, then the breathing exercises
b. perform the breathing exercises, then the postural drainage
c. schedule the procedures so they are 4 hours apart
d. perform postural drainage in the morning and breathing exercises in the evening
perform the postural drainage, then the breathing exercises<\/p>\n\n\n\n
A nurse is reviewing the results of a sweat test performed on a child with cystic fibrosis (CF). The nurse would expect to note which finding?
a. a sweat sodium concentration less than 40 mEq\/L
b. a sweat potassium concentration less than 40 mEq\/L
c. a sweat potassium concentration greater than 40 mEq\/L
d. a sweat sodium concentration greater than 60 mEq\/L
a sweat sodium concentration greater than 60 mEq\/L<\/p>\n\n\n\n
Methylphenidate (Ritalin) is prescribed for a child with a diagnosis of attention deficit hyperactivity disorder (ADHD). The nurse provides instructions to the mother regarding the administration of the medication and tells the mother to administer the medication:
a. before dinner and at bedtime
b. before breakfast and before the noontime meal
c. in the morning after breakfast and at bedtime
d. at the noontime and evening meals
before breakfast and before the noontime meal<\/p>\n\n\n\n
“Methylphenidate hydrochloride (Ritalin) is prescribed for a 10-year-old child diagnosed with attention deficit hyperactivity disorder, and the nurse provides instructions to the mother about administration of the medication. The nurse determines that the mother understands the instructions when the mother states:”
a. I will give my child the medication at bedtime so that he will be rested and alert for school the next day
b. I will give my child the medication after meals to obtain the full effects of the medication
c. I will give my child the medication at breakfast and lunch to prevent insomnia
d. I will give my child the medication with water to prevent kidney damage
I will give my child the medication at breakfast and lunch to prevent insomnia<\/p>\n\n\n\n
Methylphenidate (Ritalin) is prescribed for a child with attention deficit hyperactivity disorder (ADHD). The nurse provides instructions to the mother regarding the administration of the medication. Which statement by the mother would indicate a need for further instructions?
a. I will administer the medication with the noontime meal
b. I will keep the medication tightly capped and away from direct heat
c. I should inform the school nurse that my child is taking this medication
d. I should avoid giving the medications on Saturdays and Sundays to provide a medication holiday
I should avoid giving the medications on Saturdays and Sundays to provide a medication holiday<\/p>\n\n\n\n
A client with diplopia has been given an eye patch to promote better vision and prevent injury. The nurse teaches the client to do which of the following as part of correct use of this item?
a. wear the patch continuously, alternating eyes each day
b. wear the patch continuously, alternating eyes each week
c. use the patch only when vision is exceptionally blurry
d. put the patch on for an hour, and then take it off for an hour
wear the patch continuously, alternating eyes each day<\/p>\n\n\n\n
A student nurse examines an Asian American infant’s eyes and notes that the infant’s eyes are crossed. The registered nurse asks the student to interpret the finding. Which statement by the student indicates an understanding of this assessment finding?
a. it probably isn’t strabismus but appears that way because of the child;s ethnic background
b. you will want to call the pediatrician immediately because this could lead to detached retina
c. it probably is strabismus because the baby’s mother has abused tranquilizers
d. strabismus isn’t life threatening but it requires surgery in the first 2 months to prevent the crossed eyes from being a life long condition
it probably isn’t strabismus but appears that way because of the child;s ethnic background<\/p>\n\n\n\n
A nurse notes that a client’s eyes are continuously moving back and forth within the eye sockets. The nurse documents in the medical record that the client has:
a. ataxia
b. nystagmus
c. pronator drift
d. hyperreflexia
nystagmus<\/p>\n\n\n\n
“A nurse is providing instructions to the mother of a child with a diagnosis of strabismus of the left eye, and the nurse reviews the procedure for patching the child. The nurse determines that the mother understands the procedure if the mother makes which statement?”
a. I will place the patch on the right eye
b. I will place the patch on both eyes
c. I will place the patch on the left eye
d. I will alternate the patch from the right to the left eye every hour
I will place the patch on the right eye<\/p>\n\n\n\n
A nurse develops a plan of care for a one-month-old infant hospitalized for intussusception. Which nursing measure would be most effective to provide psychosocial support for the parent-child relationship?
a. encourage the parents to go home and get some sleep
b. encourage the parents to room-in with their infant
c. provide educational materials
d. initiate home nutritional support as early as possible
encourage the parents to room-in with their infant<\/p>\n\n\n\n
“A 12-year-old child is seen in the health care clinic. During the assessment, which finding would suggest to the nurse that the child is experiencing a disruption in the development of self-concept?”
a. the child has a part-time babysitting job
b. the child enjoys playing chess and mastering new skills with this game
c. the child has many friends
d. the child has an intimate relationship with a significant other
the child has an intimate relationship with a significant other<\/p>\n\n\n\n
A nurse is preparing to care for a child from a culture different from the nurse’s. What is the best way to address the cultural needs of the child and family when the child is admitted to the health care facility?
a. ask questions and explain to the family why the questions are being asked
b. explain to the family that while the child is being treated, they need to discontinue cultural practices because they may be harmful to the child
c. ignore cultural needs because they are not important to health care professionals
d. only address those issues that directly affect the nurse’s care of the child
ask questions and explain to the family why the questions are being asked<\/p>\n\n\n\n
“A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To assess adequacy of support for the child’s psychosocial needs, the nurse would ask the parents which question?”
a. what signs and symptoms has your child been having?
b. Will a family member be able to stay with the child most of the time?
c. How long have you known your child’s diagnosis?
d. what are your child’s favorite books, activities and toys?
Will a family member be able to stay with the child most of the time?<\/p>\n\n\n\n
A community health nurse is providing instructions to a group of mothers regarding the safe use of car seats for toddlers. The nurse determines that the mother of a toddler understands the instructions if the mother states which of the following?
a. The care seat can be placed in a face-forward position when the height of the toddler is 27 inches
b. The car seat should never be placed in a face-forward position
c. the car seat can be placed in a face-forward position at any time
d. The car seat is suitable for the toddler until the toddler reaches the weight of 40 pounds
The car seat is suitable for the toddler until the toddler reaches the weight of 40 pounds<\/p>\n\n\n\n
“When administering a liquid medication to an uncooperative toddler, the nurse would implement which strategy?”
a. allow the parents to remain the room
b. remove the child to another room away from the parents
c. restrain the child in a high chair
d. restrain the child in a papoose restraining device
allow the parents to remain the room<\/p>\n\n\n\n
A toddler is admitted to the hospital for fever of unknown origin. The mother’s time at the hospital is limited to the hours that her other children are in school. The nurse shows an understanding of a toddler’s psychosocial development by making which statement to the mother?
a. it is better to leave without saying good-bye, so your child will not be upset
b. your child is too old to be having separation anxiety. Crying is just a way for children to control parents
c. your child is egocentric, which allows a child to self comfort
d. games like peek-a-boo and hide and seek will help your child understand that you will return
games like peek-a-boo and hide and seek will help your child understand that you will return<\/p>\n\n\n\n
A mother of a 3-year-old child calls a neighbor who is a nurse and tells the nurse that her child just ate the mouse poison that was stored in a cabinet. The nurse would instruct the mother to take what action immediately?
a. call the poison control center
b. give the child a glass of carbonated beverage to drink
c. take the child to the ER
d. try to determine how much mouse poison the child consumed
call the poison control center<\/p>\n\n\n\n
The community health nurse is providing a yearly summer educational session to parents in a local community. The topic of the session is prevention and treatment measures for poison ivy. The nurse instructs the parents that if the child comes in contact with poison ivy they should:
a. immediately bring the child to the ER
b. not be concerned if a rash is not noted on the skin
c. shower the child immediately, lathering and rinsing the child several times
d. apply calamine lotion immediately to the exposed skin areas
shower the child immediately, lathering and rinsing the child several times<\/p>\n\n\n\n
A home care nurse visits a 3-year-old child with chickenpox. The child’s mother tells the nurse that the child keeps scratching the skin at night and asks the nurse what to do. The nurse tells the mother to:
a. apply generous amounts of cortisone cream to prevent itching
b. place soft cotton gloves on the child’s hands at night
c. keep the child in a warm room at night so the covers will not cause the child to scratch
d. give the child a glass of warm milk at bedtime to help the child sleep
place soft cotton gloves on the child’s hands at night<\/p>\n\n\n\n
A clinic nurse is providing home care instructions to the mother of a 3-year-old child with a diagnosis of vomiting and diarrhea due to gastroenteritis. The nurse instructs the mother to give the child which of the following to maintain hydration status?
a. popsicles
b. soda pop
c. apple juice
d. pedialyte
pedialyte (oral electrolyte solution)<\/p>\n\n\n\n
A nurse is collecting data on a child suspected of having rheumatic fever. The nurse plans to obtain specific data regarding recent illnesses in the child and asks the parent which question?
a. has the child had a recent streptococcal infection of the throat?
b. has the child had a recent ear infection?
c. has the child had a recent case of otitis media?
d. has the child had a recent case of pneumonia
has the child had a recent streptococcal infection of the throat?<\/p>\n\n\n\n
A child is admitted to the hospital with a diagnosis of acute rheumatic fever. The nurse analyzes the laboratory results and determines that which of the following findings would confirm the likelihood of acute rheumatic fever?
a. increased leukocyte count
b. decreased hemoglobin count
c. increased antibody level
d. decreased erythrocyte sedimentation rate
increased antibody level<\/p>\n\n\n\n
A child is admitted to the hospital with a diagnosis of acute rheumatic fever. The nurse reviews the blood laboratory findings knowing that which of the following will confirm the likelihood of this disorder?
a. increased leukocyte count
b. decreased hemoglobin count
c. increased antistreptolysin-O (ASO)
d. decreased erthrocyte sedimentation rate
increased antistreptolysin-O (ASO)<\/p>\n\n\n\n
A nurse is assessing a child admitted to the hospital with a diagnosis of rheumatic fever. The nurse asks the child’s mother which significant question during the assessment?
a. has your child had difficulty urinating?
b. has any family member had a sore throat within the past few weeks?
c. has any family member had a gastrointestinal disorder in the past few weeks?
d. has your child been exposed to anyone with chickenpox?
has any family member had a sore throat within the past few weeks?<\/p>\n\n\n\n
An infant brought to the emergency room is unresponsive and in respiratory distress. The nurse opens the infant’s airway by which method?
a. hyperextension
b. jaw thrust
c. tongue-jaw lift
d. head tilt\/ chin lift
tongue-jaw lift<\/p>\n\n\n\n
“A child with a tracheal obstruction is brought to the emergency room by emergency medical services. The child has aspirated a marble, and the foreign body is removed in the emergency room by direct laryngoscopy. After the procedure, the nurse informs the mother of the child that:”
a. the child will need to be hospitalized for observation
b. the child may go home with a prescription for antibiotics
c. the child will need to return to the hospital for a chest x-ray in 1 week
d. the child will require a bronchoscopy for follow up evaluation in 1 month
the child will need to be hospitalized for observation<\/p>\n\n\n\n
A nurse is teaching the client taking medications by inhalation about the advantages of a newly prescribed spacer device. The nurse determines the need for further teaching if the client states that the spacer device:
a. reduces the frequency of medication to only once per day
b. reduces the chance of yeast infection because large drops arn’t deposited on the oral tissues
c. disperses medication more deeply and uniformly
d. reduces the need to coordinate timing between pressing the inhaler and inspiration
reduces the frequency of medication to only once per day<\/p>\n\n\n\n
A client is taking albuterol (Ventolin) by inhalation but cannot cough up secretions. The nurse teaches the client to do which of the following to best help clear the bronchial secretions?
a. administer an extra dose before bedtime
b. take in increased amounts of fluids every day
c. get more exercise each day
d. Use a dehumidifier in the home
take in increased amounts of fluids every day<\/p>\n\n\n\n
“A client taking albuterol (Ventolin) experiences a severe episode of wheezing, which the nurse interprets as bronchospasm. A telephone call is made to the physician’s office to report the occurrence. The nurse does which of the following while waiting for the physician to return the call?”
a. administer the next dose of albuterol as scheduled
b. withholds the next dose of albuterol
c. administer a double dose of albuterol
d. administers half the dose of albuterol
withholds the next dose of albuterol<\/p>\n\n\n\n
“A client is unable to expectorate sputum for a sputum sample, and the nurse is preparing to obtain the sample via saline inhalation. The nurse instructs the client to inhale the warm saline vapor via nebulizer by:”
a. hold the nebulizer under the nose
b. keeping the lips closed lightly over the mouthpiece
c. keeping the lips closed tightly over the mouthpiece
d. alternating one vapor breath with one breath from room air
keeping the lips closed lightly over the mouthpiece<\/p>\n\n\n\n
A 5-year-old child is admitted to the hospital for heart surgery to repair the tetralogy of Fallot. The nurse reviews the child’s record and notes that the child has clubbed fingers. The nurse understands that the clubbing is most likely caused by:
a. peripheral hypoxia
b. delayed physical growth
c. chronic hypertension
d. destruction of bone marrow
peripheral hypoxia<\/p>\n\n\n\n
“A 10-month-old infant is hospitalized for respiratory syncytial virus (RSV). Using knowledge of growth and development according to Erik Erikson and Jean Piaget, the nurse should do which of the following to meet the infant’s developmental needs?”
a. wash hands, wear a mask and keep the infant as quiet as possible
b. follow the home feeding schedule and allow the infant to be held only when the parents visit
c. restrain the infant continuously to prevent tubes from being dislodged
d. provide a consistent routine, as well as touching, rocking, and cuddling throughout the hospitalization
provide a consistent routine, as well as touching, rocking, and cuddling throughout the hospitalization<\/p>\n\n\n\n
A nurse is developing a postoperative plan of care for an infant who will undergo a pyloromyotomy for the treatment of hypertrophic pyloric stenosis. The nurse documents in the plan that the infant should be placed in which position in the postoperative period?
a. supine with the head of the bed elevated
b. prone with the head of the bed elevated
c. flat on the nonoperative side
d. flat on the operative side
prone with the head of the bed elevated<\/p>\n\n\n\n
A clinic nurse is performing an assessment on a child. Which finding indicates the presence of an inguinal hernia?
a. painless inguinal swelling that appears when the child cries or strains
b. complaints of difficulty defecating
c. complaints of a dribbling urinary stream
d. absence of the tests with scrotum
painless inguinal swelling that appears when the child cries or strains<\/p>\n\n\n\n
The nurse is providing instructions to the parents of a child with a hernia regarding measures that will aid in reducing the hernia. The nurse determines that the parents understand these measures if they state which of the following?
a. we will be sure to give our child a fleet enema every day to prevent constipation
b. we will make sure that our child participates in physical activity every day
c. we will provide comfort measures to reduce any crying periods by our child
d. we will encourage our child to cough every few hours on a daily basis
we will provide comfort measures to reduce any crying periods by our child<\/p>\n\n\n\n
A nurse is caring for a child after an inguinal hernia repair. Which finding would indicate that the surgical repair was effective?
a. abdominal distention
b. absence of inguinal swelling with crying
c. a clean, dry incision
d. an adequate flow of urine
absence of inguinal swelling with crying<\/p>\n\n\n\n
A nurse is providing home care instructions to the parents of an infant who had surgical repair of an inguinal hernia. The nurse instructs the parents to do which of the following to prevent infection at the surgical site?
a. change the diapers as soon as they become damp
b. report a fever immediately
c. soak the infant in a tub bath twice a day for the next 5 days
d. restrict the infant’s physical activity
change the diapers as soon as they become damp<\/p>\n\n\n\n
“When obtaining a history from parents of a 5 month old child suspected of having intussusception, which assessment area would be most important for the nurse to address?”
a. pattern of abdominal pain
b. known allergies
c. dietary intake during the past 24 hours
d. usual pattern of bowel movements
pattern of abdominal pain<\/p>\n\n\n\n
A nurse is assessing a child after hydrostatic reduction for intussusception. The nurse would expect to observe which finding after this procedure?
a. severe colicy-type pain with vomiting
b. currant jelly like stools
c. passage of barium or water soluble contrast with stools
d. severe abdominal distention
passage of barium or water soluble contrast with stools<\/p>\n\n\n\n
“A nurse is caring for a child with intussusception. During care, the child passes a normal brown stool. The most appropriate nursing action is to:”
a. report the passage of a normal brown stool to the physician
b. prepare the child and parents for the possibility of surgery
c. note the child’s physical symptoms
d. prepare the child for hydrostatic reduction
report the passage of a normal brown stool to the physician<\/p>\n\n\n\n
A nurse is preparing a plan of care for a child being admitted to the hospital with a diagnosis of congestive heart failure (CHF). The nurse avoids including which of the following in the plan?
a. limiting the time the child is allowed to bottle-feed
b. elevating the head of the bed
c. waking the child for feeding to ensure adequate nutrition
d. providing oxygen during stressful periods
waking the child for feeding to ensure adequate nutrition<\/p>\n\n\n\n
A nurse caring for a child with congestive heart failure provides instructions to the parents regarding the administration of digoxin (Lanoxin). Which statement by the mother indicates a need for further instructions?
a. if my child vomits after I give the medication, I will not repeat the dose
b. I will check my child’s pulse before giving the medication
c. I will check the dose of the medication with my husband before I give the medication
d. I will mix the medication with food
I will mix the medication with food<\/p>\n\n\n\n
A nurse prepares to administer digoxin (Lanoxin) to a newborn infant with a diagnosis of congestive heart failure. The nurse notes that the apical rate is 140 beats per minute. Which of the following nursing actions is appropriate?
a. administer the digoxin because the apical rate is within normal limits
b. recheck the apical rate in 1 hour and administer the medication at that time
c. notify the physician because the apical rate is lower than the normal range
d. hold the medication, because the apical rate is normal, indication that the medication is not needed
administer the digoxin because the apical rate is within normal limits<\/p>\n\n\n\n
A nurse is caring for a child with a diagnosis of congestive heart failure (CHF). The nurse avoids which action in caring for the child?
a. allowing uninterrupted rest periods
b. limiting the time the child is allowed to bottle-feed
c. providing oxygen during stressful periods
d. keeping the head of the bed flat
keeping the head of the bed flat<\/p>\n\n\n\n
list two contraindications to live virus immunization
immunocompromised child
a child in a household with an immunocompromised individual<\/p>\n\n\n\n
list three classic signs and symptoms of measles
photophobia
confluent rash that begins on the face and spreads downward
Koplik spots on the buccal mucosa<\/p>\n\n\n\n
list the signs and symptoms of iron deficiency
anemia; pale conjunctive; pale skin; atrophy of papillae on tongue; brittle, ridged, or spoon-shaped nails; and thyroid edema<\/p>\n\n\n\n
identify food sources of vitamin A
liver, sweet potatoes, carrots, spinach, peaches and apricots<\/p>\n\n\n\n
what disease occurs with vitamin C deficiency?
Scurvy<\/p>\n\n\n\n
What measurements reflect present nutritional status?
weight, skin-fold thickness, and arm circumference<\/p>\n\n\n\n
List the signs and symptosm of dehydration in an infant
Poor skin turgor, absence of tears, dry mucous membranes, weight loss, depressed fontanel, and decreased urinary output<\/p>\n\n\n\n
list the laboratory findings that can be expected in a dehydrated child
loss of bicarbonated\/decreased pH
loss of sodium (hyponatremia)
loss of potassium (hypokalemia)
elevated Hct and elevated BUN<\/p>\n\n\n\n
How should burns in child be assessed?
by using the Lund-Browder chart, which takes into account the changing proportions of the child’s body<\/p>\n\n\n\n
How can the nurse best evaluate the adequacy of fluid replacement in children?
monitoring urine output<\/p>\n\n\n\n
how should a parent be instructed to child-proof a house?
lock all cabinets
safely store all toxic household items in a locked cabinets
examine the house from the child’s point of view<\/p>\n\n\n\n
What intervention should the nurse perform first in caring for a child who has ingested a poison?
assessment of the child’s respiratory, cardiac, and neurological status<\/p>\n\n\n\n
What early signs should the nurse assess for if lead poisoning is suspected?
anemia, acute cramping, abdominal pain, vomiting, constipation, anorexia, headache, lethargy, hyperactivity, aggression, impulsiveness, decreased interest in play, irritability, short attention span<\/p>\n\n\n\n
describe the purpose of bronchodilators
to reverse bronchospasm<\/p>\n\n\n\n
what are the physical assessment findings for a child with asthma?
Expiratory wheezing, rales, tight cough, and signs of altered blood gases<\/p>\n\n\n\n
What nutritional support should be provided for a child with cystic fibrosis?
pancreatic enzyme replacement, fat-soluble vitamins, and moderate to low carbohydrates, high protein, moderate to high fat diet<\/p>\n\n\n\n
Why is genetic counseling important for the family of a child with cystic fibrosis?
because the disease is autosomal recessive in its genetic pattern<\/p>\n\n\n\n
List seven signs of respiratory distress in a pediatric client
restlessness
tachycardia
tachypnea
diaphoresis
flaring nostrils
retractions
grunting<\/p>\n\n\n\n
describe the care of a child in a mist tent
monitor child’s temperature, keep tent edges tucked in, keep clothing dry, assess respiratory status, look at child inside tent<\/p>\n\n\n\n
what position does a child with epiglottitis assume?
upright sitting, with chin out and tongue protruding (tripod positioning)<\/p>\n\n\n\n
Why are IV fluids important for a child with an increased respiratory rate?
The child is at risk for dehydration and acid-base imbalances<\/p>\n\n\n\n
Children with chronic otitis media are at risk for developing what problem?
hearing loss<\/p>\n\n\n\n
What is the most common postoperative complication following a tonsillectomy? Describe the signs and symptoms of this complication
Hemorrhage
frequent swallowing, vomiting fresh blood, and clearing throat<\/p>\n\n\n\n
Differentiate between right-to-left and a left-to-right shunt in cardiac disease
a right-to-left shunt bypasses the lungs and delivers unoxygenated blood to the systemic circulation causing cyanosis
a left-to-right shunt moves oxygenated blood back through the pulmonary circulation<\/p>\n\n\n\n
list the four defects associated with tetralogy of fallot
VSD
overriding aorta
pulmonary stenosis
right ventricular hypertrophy<\/p>\n\n\n\n
list the common signs of cardiac problems in an infant
poor feeding
poor weight gain
respiratory distress
infections
edema
cyanosis<\/p>\n\n\n\n
what are the two objectives in treating CHF?
reduce the workload of the heart
increased cardiac output<\/p>\n\n\n\n
Describe nursing interventions to reduce the workload of the heart
give small, frequent feedings or gavage feedings
plan frequent rest periods
maintain a neutral thermal environment
organize activities to disturb child only as indicated<\/p>\n\n\n\n
what position would best relieve the child experiencing a tet spell?
knee-chest position or squatting<\/p>\n\n\n\n
what are common signs of digoxin toxicity?
diarrhea
fatigue
weakness
nausea
vomiting
check for bradycardia before administering<\/p>\n\n\n\n
list five risks in cardiac catheterizaiton
arrhythmia
bleeding
perforation
phlebitis
obstruction of the arterial entry site<\/p>\n\n\n\n
what cardiac complications are associated with rheumatic fever?
aortic valve stenosis and mitral valve stenosis<\/p>\n\n\n\n
What medications are used to treat rheumatic fever?
penicllin, erythromycin, and aspirin<\/p>\n\n\n\n
What are the physical features of a child with down syndrome?
simian creases in palms, hypotonia, protruding tongue, and upward-outward slant of eyes<\/p>\n\n\n\n
Describe scissoring
a common characteristic of spastic cerebral palsy in infants; legs are extended and crossed over each other, feet are plantar flexed<\/p>\n\n\n\n
What are two nursing priorities for a newborn with myelominingocle?
prevention of infection of the sac and monitoring for hydrocephalus (measure head circumference, check fontanel, assess neurologic functioning)<\/p>\n\n\n\n
List the signs and symptoms of increased ICP in older children
irritability
change in LOC
motor dysfunction
headache
vomiting
unequal pupil response
seizures<\/p>\n\n\n\n
What teaching should parents of a newly shunted child receive?
information about signs of infection and increased ICP; understanding that shunt should not be pumped and that child will need revisions with growth; guidance concerning growth and development<\/p>\n\n\n\n
State the three main gals in providing nursing care for a child experiencing a seizure
maintain patent airway, protect form injury and observe carefully<\/p>\n\n\n\n
what are the side effects of Dilantin?
gingival hyperplasia
dermatitis
ataxia
GI distress<\/p>\n\n\n\n
Describe the signs and symptoms of a child with meningitis
fever, irritability, vomiting, neck stiffness, opisthotonos, positive Kernig sign, positive brudzinski signs; infant may not show all<\/p>\n\n\n\n
What antibiotics are usually prescribed for bacterial meningitis?
ampicilin, ceftriazzone, chloramphenicol<\/p>\n\n\n\n
How is a child usually positioned after brain tumor surgery?
Flat or on either side<\/p>\n\n\n\n
Described the function of an osmotic diuretic
osmotic diuretics remove water form the CNS to reduce cerebral edema<\/p>\n\n\n\n
What nursing interventions increase intracranial pressure?
suctioning and positioning, turning<\/p>\n\n\n\n
describe the mechanism of inheritance of Duchenne muscular dystrophy
duchenne muscular dystrophy is inherited as an X-linked recessive trait<\/p>\n\n\n\n
What is the Gowers sign?
Gowers sign is an indicator of muscular dystrophy; to stand, the child has to “walk” hands up legs<\/p>\n\n\n\n
compare the signs and symptoms of acute glomerulonephritis (AGN) with those of nephrosis
AGN: gross hematuria, recent strep infection, hypertension and mild edema
Hephrosis: severe edema, massive protinuria, frothy-appearing urine, anorexia<\/p>\n\n\n\n
What antecedent event occurs with AGN?
Beta-hemolytic streptococcal infection<\/p>\n\n\n\n
Compare the dietary interventions for AGN and nephrosis
AGN: low sodium diet
nephrosis: high protein, low salt diet<\/p>\n\n\n\n
what is the physiologic reason for the lab finding of hypoproteinemia in nephrosis?
hypoproteinemia occurs because the glomeruli are permeable to serum protieins<\/p>\n\n\n\n
Describe safe monitoring of prednisone administration and withdrawal
long-term prednisone should be given every other day. Signs of edema, mood changes, and GI distress should be noted and reported. The drug should be tapered, no discontinued suddenly<\/p>\n\n\n\n
What interventions can be taught to prevent UTI in children?
avoid bubble baths; void frequently; drink adequate fluids, especially acidic fluids such as apple or cranberry juice; and clean genital area form front to back<\/p>\n\n\n\n
describe the pathophysiology of vesicoureteral reflux
a malfunction of the valves at the end of the ureters, allowing urine to reflux out of the bladder into the ureters and possibly into the kidneys<\/p>\n\n\n\n
What are the priorities for a client with a Wilms tumor?
protect the child from injury to the encapsulated tumor. Prepare the family and child for surgery<\/p>\n\n\n\n
Explain why hypospadias correction is performed before the child reaches preschool age
preschoolers fear castration, achieving sexual identity, and acquiring independent toileting skills<\/p>\n\n\n\n
describe feeding techniques for a child with cleft lip or palate
use lamb’s nipple or prosthesis
feed child upright, with frequent bubbling<\/p>\n\n\n\n
list the signs and symptoms of esophageal atresia with TEF
chocking, coughing, cyanosis, and excess salivaiton<\/p>\n\n\n\n
What nursing actions are initiated for the newborn with suspected esophageal atresia with TEF?
maintain NPO immediately and suction secretions<\/p>\n\n\n\n
Describe the postoperative nursing care for an infant with pyloric stenosis
maintain IV hydration and provide small, frequent feedings of glucose or electrolyte solutions or both within 4 to 6 hours. Gradually increase to full-strength formula
Position infant on right side in semi-fowler position after feeding<\/p>\n\n\n\n
describe why a barium enema is used to treat intussusception
reduces the telescoping of the intestine through hydrostatic pressure without surgical interventions<\/p>\n\n\n\n
Describe the preoperative nursing care for a child with Hirschsprung disease
check vital signs and take axillary temperatures
provide bowel cleansing program and teach about colostomy
observe for bowel perforation
measure abdominal girth<\/p>\n\n\n\n
What care is needed for a client with a temporary colostomy?
family needs education about skin care and appliances
referral to an enterostomal therapist is appropriate<\/p>\n\n\n\n
What are signs of anorectal malformation?
newborn who does not pass meconium within 24 hours; meconium appearing through a fistula or in the urine; an unusual appearing and dimple<\/p>\n\n\n\n
what are the priorities for a child undergoing abdominal surgery?
maintain fluid balance (I\/O, NG suction, monitor electrolytes); monitor vital signs; care for drains; if present assess bowel function; prevent infection of incision area and other postoperative complications; and support child and family with appropriate teaching<\/p>\n\n\n\n
describe the information families should be given when a child is receiving oral iron prepartions
give oral iron on an empty stomach and with vitamin C
use straws to avoid discoloring teeth
tarry stools are normal
increase dietary sources of iron<\/p>\n\n\n\n
list dietary sources of iron
meat, green leafy vegetables, fish, liver, whole grains, legumes<\/p>\n\n\n\n
what is the genetic transmission pattern of hemophilia?
it is an X-linked recessive chromosomal disorder transmitted by the mother and expressed in male children<\/p>\n\n\n\n
Describe the sequence of events in a vaso-occulsive crisis in sickle cell anemia
a vaso-occulsive crisis is caused by the clumping of red blood cells, which blocks small blood vessels; therefore, the cells cannot get through the capillaries, causing pain and tissue and organ ischemia. Lowered oxygen tension affects HgbS, which causes sickling of the cells<\/p>\n\n\n\n
explain why hydration is a priority in treating sickle cell disease
hydration promotes hemodilution and circulation of the red cells through the blood vessels<\/p>\n\n\n\n
what should families and clients do to avoid triggering sickling episodes?
keep child well hydrated
avoid known sources of infection
avoid high altitudes
avoid strenuous exercises<\/p>\n\n\n\n
Nursing interventions and medical treatment for a child with leukemia are based on what three physiologic problems?
anemia (decreased erythrocytes)
infection (neutropenia)
bleeding thrmbocytopenia (decreased platelets)<\/p>\n\n\n\n
How is congenital hypothyroidism diagnosed?
newborn screening revealing a low T4 and a high TSH<\/p>\n\n\n\n
What are the symptoms of congenital hypothyroidism in early infancy?
large, protruding tongue; coarse hair; lethargy; sleepiness and constipation<\/p>\n\n\n\n
What are the outcomes of untreated congenital hypothyroidism?
Mental retardation and growth failure<\/p>\n\n\n\n
What are the metabolic effects of PKU?
CNS damage, mental retardation and decreased melanin<\/p>\n\n\n\n
What two formulas are prescribed for infants with PKU?
Lofenalac
Phenex-1<\/p>\n\n\n\n
List foods high in phenylalanine content
meat, milk, diary products, and eggs<\/p>\n\n\n\n
What are the three classic signs of diabetes?
polydipsia
polyphagia
polyuria<\/p>\n\n\n\n
Differentiate the signs of hypoglycemia and hyperglycemia
hypoglycemia: tremors, sweating, headache, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around mouth, nightmares
hyperglycemia: polydipsia,polyuria, ployphagia, blurred vision, weakness, weight loss, and syncope<\/p>\n\n\n\n
describe the nursing care of a child with ketoacidosis
provide care for an unconscious child, administer regular insulin IV in normal saline, monitor blood gas values and maintain strict I\/O<\/p>\n\n\n\n
describe developmental factors that would impact the school-age child with diabetes
need to be like peers; assuming responsibility for own care; modification of diet; snacks and exercise in school<\/p>\n\n\n\n
what is the relationship between hypoglycemia and exercise?
during exercise, insulin uptake is increased and the risk for hypoglycemia occurs<\/p>\n\n\n\n
list normal findings in a neurovascular assessment
warm extremity, brisk capillary refill, free movement, normal sensation of the affected extremity and equal pulses<\/p>\n\n\n\n
what is compartment syndrome?
damage to nerves and vasculature of an extremity due to compression<\/p>\n\n\n\n
What are the signs and symptoms of compartment syndrome?
abnormal neurovascular assessment; cold extremity, severe pain, inability to move the extremity and poor capillary refill<\/p>\n\n\n\n
Why are fractures of the epiphyseal plate a special concern?
Fractures of the epiphyseal plate (growth plate) may affect the growth of the limb<\/p>\n\n\n\n
How is skeletal traction applied?
skeletal traction is maintained by pins or wires applied to the distal fragment of the fracture<\/p>\n\n\n\n
What discharge instructions should be included concerning a child with spica cast?
check child’s circulation
keep cast dry
do no place anything under cast
prevent cast soilage during toileting or diapering
do not turn child using an abductor bar<\/p>\n\n\n\n
what are the signs and symptoms of congenital dislocated hip in infants?
unequal skin folds of the buttocks, ortolani sign, limited abduction of the affected hip and unequal leg lengths<\/p>\n\n\n\n
How would the nurse conduct a scoliosis screening?
Ask the child to bend forward form the hips, with arms hanging free. Examine the child for a curve in the spine, a rib hump, and hip asymmetry<\/p>\n\n\n\n
What instructions should a child with scoliosis receive about a skeletal brace?
the child should be instructed to wear brace 23 hours per day; wear T-shirt under brace; check skin for irritation; perform back and abdominal exercises; and modify clothing. The child should be encouraged to maintain normal activities as able<\/p>\n\n\n\n
What care is indicated for a child with juvenile rheumatoid arthritis?
prescribed exercise to maintain mobility; splinting of affected joins; and teaching about medication management and side effects of drugs<\/p>\n\n\n\n
“A hospitalized toddler cries when anyone enters the room, and kicks, yells, and clings to the parents if they try to leave. Based on these data, the nurse determines that the priority nursing diagnosis is:”
a. fear related to unfamiliar surroundings
b. deficient divisional activity related to developmental stage
c. compromised family coping related to the sick child
d. delayed growth and development related to overprotective parenting
a. fear related to unfamiliar surroundings<\/p>\n\n\n\n
A 9-month-old infant is admitted to a pediatric unit with a diagnosis of dehydration and malnutrition and suspected failure to thrive. Child neglect is suspected. Which of the following would be most important for the nurse to observe when the parents visit the infant?
a. the parents’ level of concern about the child
b. the parents’ patterns of visitation
c. the parents’ interactions with one another
d. clues regarding the nutritional patterns of the other children in the family
a. the parents’ level of concern about the child<\/p>\n\n\n\n
A nurse instructs a parent regarding the appropriate actions to take when the toddler has a temper tantrum. Which statement by the parent indicates a successful outcome of the teaching?
a. I will send my child to a room alone for 10 minutes after every tantrum
b. I will reward my child with candy at the end of each day without a tantrum
c. I will give frequent reminders that only bad children have tantrums
d. I will ignore the tantrums as long as there is no physical danger
d. I will ignore the tantrums as long as there is no physical danger<\/p>\n\n\n\n
A nurse develops a plan of care for a one-month-old infant hospitalized for intussusception. Which nursing measure would be most effective to provide psychosocial support for the parent-child relationship?
a. encourage the parents to go home and get some sleep
b. encourage the parents to room-in with their infant
c. provide educational materials
d. initiate home nutritional support as early as possible
b. encourage the parents to room-in with their infant<\/p>\n\n\n\n
When giving an intramuscular injection to a 4-year-old child the nurse should:
a. use the vastus lateralis muscle only
b. allow the child to choose between a lying or a standing position
c. obtain assistance to administer the injection
d. distract the child with conversation or a toy
c. obtain assistance to administer the injection<\/p>\n\n\n\n
“A 4-year-old child with cancer is admitted to the hospital for radiation therapy and surgery. To assess adequacy of support for the child’s psychosocial needs, the nurse would ask the parents which question?”
a. what signs and symptoms has your child been having?
b. Will a family member be able to stay with the child most of the time?
c. how long have you known your child’s diagnosis?
d. What are your child’s favorite books, activities and toys?
b. Will a family member be able to stay with the child most of the time?<\/p>\n\n\n\n
A 4-year-old child is reluctant to take deep breaths after abdominal surgery. The most effective measure to encourage deep breathing is to:
a. have the child pretend he is the big, bad wolf blowing the little pig’s house down
b. give the child colorful latex balloons to blow up
c. tell the child to exhale forcefully through the peak flow meter
d. administer chest percussion in several postural drainage positions
a. have the child pretend he is the big, bad wolf blowing the little pig’s house down<\/p>\n\n\n\n
A 4-year-old child who was recently hospitalized is brought to the clinic by his mother for a follow-up visit. The mother tells the nurse that the child has begun to wet the bed ever since the child was brought home from the hospital. The mother is concerned and asks the nurse what to do. The appropriate nursing response is which of the following?
a. you need to discipline the child
b. this is a normal occurrence following hospitalization
c. we will need to discuss this behavior with the physician
d. the child probably has developed a urinary tract infection
b. this is a normal occurrence following hospitalization<\/p>\n\n\n\n
A client with gastroesophageal reflux disease (GERD) has just received a breakfast tray. The nurse setting up the tray for the client notices that which of the following foods is the only one that will increase the lower esophageal sphincter (LES) pressure and thus lessen the client’s symptoms?
a. fresh scrambled eggs
b. nonfat milk
c. whole wheat toast with butter
d. coffee
b. nonfat milk<\/p>\n\n\n\n
A nurse instructs a mother on measures to take to reduce the incidence of gastroesophageal reflux (GER) in a child. Which statement by the mother indicates a need for further teaching?
a. I will give my child small feedings often throughout the day
b. I will buy bottle nipples that have smaller holes for my child
c. I will add a small amount of cereal to my child’s formula
d. I will give my child a pacifier and maintain an upright position after meals
b. I will buy bottle nipples that have smaller holes for my child<\/p>\n\n\n\n
“A client with gastroesophageal reflux disease (GERD) complains of chest discomfort that feels like heartburn, especially following each meal. After teaching the client to take antacids as prescribed, the nurse suggests that the client lie in which position during sleep?”
a. with the head of the bed elevated 6 to 8 inches
b. flat
c. supine with the head of the bed flat
d. on the stomach with the head of the bed flat
a. with the head of the bed elevated 6 to 8 inches<\/p>\n\n\n\n
“A nurse gathers assessment data from a client admitted to the hospital with gastrointestinal reflux disease (GERD) who is scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse determines that the client may be at risk for which complication?”
a. diarrhea
b. belching
c. aspiration
d. abdominal pain
c. aspiration<\/p>\n\n\n\n
A nurse caring for a child with congestive heart failure provides instructions to the parents regarding the administration of digoxin (Lanoxin). Which statement by the mother indicates a need for further instructions?
a. if my child vomits after I give the medication, I will not repeat the dose
b. I will check my child’s pulse before giving the medication
c. I will check the dose of the medication with my husband before I give the medication
d. I will mix the medication with food
d. I will mix the medication with food<\/p>\n\n\n\n
A nurse is preparing a plan of care for a child being admitted to the hospital with a diagnosis of congestive heart failure (CHF). The nurse avoids including which of the following in the plan?
a. limiting the time the child is allowed to bottle-feed
b. elevating the head of the bed
c. walking the child for feeding to ensure adequate nutrition
d. providing oxygen during stressful periods
c. walking the child for feeding to ensure adequate nutrition<\/p>\n\n\n\n
A nurse is caring for a child with a diagnosis of congestive heart failure (CHF). The nurse avoids which action in caring for the child?
a. allowing uninterrupted rest periods
b. limiting the time the child is allowed to bottle-feed
c. providing oxygen during stressful periods
d. keeping the head of the bed flat
d. keeping the head of the bed flat<\/p>\n\n\n\n
A nurse prepares to administer digoxin (Lanoxin) to a newborn infant with a diagnosis of congestive heart failure. The nurse notes that the apical rate is 140 beats per minute. Which of the following nursing actions is appropriate?
a. administer the digoxin because the apical rate is within normal limits
b. recheck the apical rate in 1 hour and administer the medication at that time
c. notify the physician because the apical rate is lower than the normal range
d. hold the medication, because the apical rate is normal, indicating that the medication is not needed
a. administer the digoxin because the apical rate is within normal limits<\/p>\n\n\n\n
When does birth length double?
By 4 years.<\/p>\n\n\n\n
When does the child sit unsupported?
8 months.<\/p>\n\n\n\n
When does a child achieve 50% adult height?
2 years.<\/p>\n\n\n\n
When does a child throw a ball overhand?
18 months.<\/p>\n\n\n\n
When does a child speak two- to three-word sentences?
2 years.<\/p>\n\n\n\n
When does a child use scissors?
4 years.<\/p>\n\n\n\n
Note: I had this question on my OB HESI.<\/p>\n\n\n\n
When does a child tie his or her shoes?
5 years.<\/p>\n\n\n\n
When does the infant develop stranger anxiety?
7 to 9 months.<\/p>\n\n\n\n
Fine pincer grasp appears\u2026?
\u2026at 10 to 12 months.<\/p>\n\n\n\n
When should the infant be expected to start crawling?
10 months.<\/p>\n\n\n\n
The infant (birth to 1 year) is in what stage of psychosocial development?
Trust vs. Mistrust<\/p>\n\n\n\n
The toddler (1-3 years) is in what stage of psychosocial development?
Autonomy vs. Shame and Doubt<\/p>\n\n\n\n
The preschool child (3-6 years) is in what stage of psychosocial development?
Initiative vs. guilt.<\/p>\n\n\n\n
The school-age child (6-12 years) is in what stage of psychosocial development?
Industry vs. Inferiority<\/p>\n\n\n\n
The adolescent (12-18 years) is in what stage of psychosocial development?
Identity vs. role confusion<\/p>\n\n\n\n
Concepts of bodily injury:<\/p>\n\n\n\n
Toddlers (1-3 years) fear\u2026?
\u2026intrusive procedures.<\/p>\n\n\n\n
Concepts of bodily injury:<\/p>\n\n\n\n
Preschoolers (3-6 years) fear\u2026?
\u2026body mutilation.<\/p>\n\n\n\n
Concepts of bodily injury:<\/p>\n\n\n\n
School-age (6-12 years) children fear..?
\u2026Loss of control of their bodies.<\/p>\n\n\n\n
Concepts of bodily injury:<\/p>\n\n\n\n
Adolescents (12-18 years) fear\u2026?
\u2026Major concern is change in body image.<\/p>\n\n\n\n
Moro reflex disappears when?
Around 4 months of age.<\/p>\n\n\n\n
Handedness is established during what age bracket?<\/p>\n\n\n\n
(Infant, toddler, preschool, school-age, adolescent)
Handedness is established in the preschool-age child (3-6 years)<\/p>\n\n\n\n
Appropriate toys and play for the hospitalized infant (birth to 1 year)?
Mobiles, rattles, squeaking toys, picture books, balls, colored blocks, activity boxes.<\/p>\n\n\n\n
Appropriate toys and play for the hospitalized toddler (1 to 3 years)?
Push-pull toys, toy telephones, stuffed animals, etc<\/p>\n\n\n\n
Toddlers benefit from being taken to the hospital playroom when able, because mobility is important to their development.<\/p>\n\n\n\n
Appropriate toys and play for the hospitalized preschooler (3-6years)?
Coloring books, puzzles, cutting and pasting, clay\u2026 etc.<\/p>\n\n\n\n
Appropriate toys and play for the hospitalized school-aged child (6-12 years)?
Board and card games, hobbies, video games.<\/p>\n\n\n\n
Children can be expected to dress themselves completely when they reach what age group?
School-age children (6-12 years)<\/p>\n\n\n\n
When can a child be expected to feed themselves with a spoon and cup?
2 years.<\/p>\n\n\n\n
When does the anterior fontanel close?
12-18 months. (1 – 1 1\/2 years)<\/p>\n\n\n\n
When does the posterior fontanel close?
Sometime between birth and 8ish weeks (2-3 months)<\/p>\n\n\n\n
(Yellow NCLEX-RN Review book, pg. 339)<\/p>\n\n\n\n
Which fontanel closes first?
The POSTERIOR fontanel.<\/p>\n\n\n\n
It closes in birth to 2-3 months. The anterior fontanel closes in 12-18 months.<\/p>\n\n\n\n
A baby has a steady head by __<\/em><\/strong> How would you elicit the rooting reflex? What would you expect to observe when eliciting the rooting reflex in an infant? Note: Reflex is difficult to elicit when infant has been fed.<\/p>\n\n\n\n How would you elicit the palmar reflex? How would you elicit the Tonic Neck or “Fencing” reflex, and what is the characteristic response? What is a positive Babinski reflex? When should the Babinski reflex disappear? Two to three word sentences should be expected when a child is how many years old? Three to four word sentences should be expected when a child is how many years old? Visual acuity approaches 20\/20 when the child reaches what age group?<\/p>\n\n\n\n (infant, toddler, preschooler, school-age, adolescent) Use facts and principles related to ___<\/em><\/strong><\/em> in planning teaching interventions. School age children are in Erickson’s stage of , meaning they like to do and accomplish things. _<\/em><\/strong> are also becoming important for children of this age Age group concepts of bodily injury:<\/p>\n\n\n\n _<\/em><\/strong> are a major cause of death in children and adolescents. Teach parents and children<\/em><\/strong> and prevention techniques Pertinent information should be obtianed prior to giving certain because _<\/em><\/strong><\/em><\/strong> to previous ____<\/em><\/strong><\/em><\/strong> or current health condition may contraindicate current __<\/em><\/strong><\/em><\/strong> What contraindicates administration of DTAP? What contraindicates administration of MMR? Pertussis fatalities continue to occur in ________<\/em><\/strong><\/em><\/strong> in the US Common cold does not contraindicate for _<\/em><\/strong> Children with __<\/strong><\/em><\/strong> pose a serious threat to their unborn siblings. Common childhood problems are encountered by nurses caring for children in community of hospital settings. The child’s __<\/strong> directly influences the severity and management of these problems Add _<\/strong><\/em><\/strong> to fluids in peds with diarrhea only when there is adequte urine output Urinary output for infants and children should be _<\/em><\/strong> The use of _<\/strong><\/em><\/strong> is no longer recommended More _<\/strong> is absorbed on an empty stomach. A child needs _<\/em><\/strong> of the usual calorie intake for normal growth and development Do not examine the throat of a child with In planning and providing nursing care a _____<\/em><\/strong><\/em><\/strong> is always the priority of care regardless of the age! The nurse should be sure _<\/strong><\/em><\/strong> _<\/em><\/strong> have been determined prior to tonsillectomy. More importantly, the nurse should ask whether there has been A child from birth to two years conceptualizes the death process as A preschool child conceptualizes the death process as Involving death, a schoolage child can Involving death, an adolescent may Rubeola (Measles)<\/p>\n\n\n\n Rubeola (Measles)<\/p>\n\n\n\n 5 Signs and symptoms<\/p>\n\n\n\n Remember: Three “Cs” & Koplik’s spots are the key for identifying measles.<\/p>\n\n\n\n Roseola (Exanthema Subitum)<\/p>\n\n\n\n Roseola (Exanthema Subitum)<\/p>\n\n\n\n 2 Signs and symptoms?<\/p>\n\n\n\n Disease is self-limiting and treatment is supportive. Remember: fever first, then rash.<\/p>\n\n\n\n Mumps<\/p>\n\n\n\n Mumps<\/p>\n\n\n\n 5 signs and symptoms<\/p>\n\n\n\n Remember: Key is parotid gland swelling.<\/p>\n\n\n\n Pertussis (Whooping Cough)<\/p>\n\n\n\n Scarlet Fever<\/p>\n\n\n\n Scarlet Fever<\/p>\n\n\n\n 7 signs and symptoms<\/p>\n\n\n\n Remember: Key is the strawberry tongue<\/p>\n\n\n\n Erythema Infectiosum (Fifth Disease)<\/p>\n\n\n\n Erythema Infectiosum (Fifth Disease)<\/p>\n\n\n\n Signs and symptoms Stage 1: Erythema on face, chiefly on cheeks. “Slapped cheek” appearance. Disappears by 1 – 4 days. REMEMBER: Pregnant women need to avoid infected persons. Key to identification is “slapped cheek” appearance. Child is not usually hospitalized as disease is self-limiting.<\/p>\n\n\n\n Infectious Mononucleosis<\/p>\n\n\n\n Infectious Mononucleosis<\/p>\n\n\n\n 3 signs and symptoms and 1 important complication to teach parents to monitor for.<\/p>\n\n\n\n TEACH PARENTS TO MONITOR FOR SPLENIC RUPTURE: Marked by abdominal pain, left upper quadrant pain, referred left-shoulder pain.<\/p>\n\n\n\n Chickenpox (Varicella)<\/p>\n\n\n\n REMEMBER: Child is no longer contagious once lesions have dried and crusts have formed.<\/p>\n\n\n\n Chickenpox (Varicella)<\/p>\n\n\n\n 3 signs and symptoms<\/p>\n\n\n\n Rubella (German Measles)<\/p>\n\n\n\n Rubella (German Measles)<\/p>\n\n\n\n 4 signs and symptoms and 1 very important intervention to remember<\/p>\n\n\n\n Key for identification is rash covering entire body and spots on soft palate.<\/p>\n\n\n\n REMEMBER: ISOLATE CHILD FROM PREGNANT WOMEN.<\/p>\n\n\n\n Diphtheria<\/p>\n\n\n\n Diphtheria<\/p>\n\n\n\n 4 signs and symptoms and 2 important interventions<\/p>\n\n\n\n Interventions: Strict isolation for hospitalized child. Administer diphtheria antitoxin only AFTER a skin or conjunctival test rules out sensitivity to horse serum.<\/p>\n\n\n\n Rocky Mountain Spotted Fever<\/p>\n\n\n\n Rocky Mountain Spotted Fever<\/p>\n\n\n\n 2 signs and symptoms<\/p>\n\n\n\n Key: Rash on ankles, wrists, palms and soles. Remember it is not communicable. Provide parents teaching about preventing tick bites.<\/p>\n\n\n\n H1N1 Vaccine: When are children old enough to receive it? Human Papillomavirus Vaccine<\/p>\n\n\n\n How many injections comprise the full course of vaccination and at what age should girls receive it? What age should boys receive it? Girls can receive it around age 11 to 12. Guards against cervical cancer and genital warts in females and genital warts in males.<\/p>\n\n\n\n Contraindications for HPV vaccine?<\/p>\n\n\n\n Pinworm Infection Simple fx Greenstick fx Communated fx Compound fx Birth weight _<\/em><\/strong> at 6 months and<\/em><\/strong> at 12 months Birth length increases by _<\/strong> at 12 months A baby will turn their head over at _<\/em><\/strong> months Hand-to-hand transfers occur when? An infant will crawl at An infant will walk at Cooing will be seen at Monosyllabic Babbling will happen at _ months. Links syllables at __<\/strong><\/em><\/strong>. Babies can say “mama” and “dada,” plus a few other words at Daytime toilet training should be taught at Girls’ growth spurt as early as _ years. Boys catch up around age<\/em><\/strong> Girls finish growing around . Boys finish growing around <\/em><\/strong><\/em><\/strong>. Concerning new foods, babies should ________________<\/em><\/strong><\/em><\/strong> Autosomal Recessive Diseases Concerning Autosomal Recessive Diseases, there is a _<\/strong> chance a child will inherit the disease if the parents have: AS (trait only) X AS (trait only) Concerning Autosomal Recessive Diseases, there is a _<\/strong> chance a child will inherit the disease if the parents have: AS (trait only) X SS (disease) Some Autosomal Dominant Diseases are If one parent has the disease\/trait of Autosomal Dominant Diseases there is a _<\/em><\/strong> chance the child will inherit (and express) the disease. X-linked recessive diseases are In X-Linked Recessive Diseases, females are but _<\/em><\/strong> have the disease. In X-Linked Recessive Diseases, males the disease but cannot _<\/em><\/strong><\/em><\/strong>. X-Linked Recessive Diseases there is _ chance daughters will be carriers, even though they cant ______<\/em><\/strong><\/em><\/strong> X-Linked Recessive Diseases there is _ chance sons will have the disease, even though they cant __<\/em><\/strong><\/em><\/strong> X-Linked Recessive Diseases there is an overall _ chance that each pregnancy will result in a __________<\/em><\/strong><\/em><\/strong> With Scoliosis, the child should be in a _<\/em><\/strong><\/em><\/strong> for _ hours a day, and<\/em><\/strong> after Surgery You would expect a child with Down Syndrome, or Trisomy 21, will have these characteristics You would expect a child with Cerebral Palsy to present with Hypothyroidism can lead to PKU can lead to Aspartame (NutraSweet) has __<\/strong><\/em><\/strong> in it and should not be given to a PKU patient The __<\/em><\/strong> will test the dried blood heel stick and screen for PKU In a child with _<\/em><\/strong><\/em><\/strong> the nurse should cover it with moist sterile water dressing, and __<\/strong><\/em><\/strong> of it. In Hydrocephalus the signs of increased ICP are ____<\/em><\/strong><\/em><\/strong> Indications of shock are ________<\/em><\/strong><\/em><\/strong>. Indications of IICP are ________<\/em><\/strong><\/em><\/strong>. The most sensitive sign of IICP is<\/p>\n\n\n\n IICP can be caused by Signs of IICP in infants include For infants with IICP, treat with _<\/em><\/strong><\/em><\/strong> shunt. Do not __<\/em><\/strong><\/em> the shunt. Older kids with IICP will have Muscular Dystrophy is an _<\/em><\/strong><\/em><\/strong> diease characterized by Children with Muscular Dystrophy will display __<\/strong> sign. Bacterial Meningitis is diagnosed with a Bacterial Meningitis can lead to because of <\/em>. The following signs will be seen: CF Kids taste and need _________<\/em><\/strong><\/em><\/strong> on their food. Children with Rubella can be a ________________<\/em><\/strong><\/em><\/strong>
4 months<\/p>\n\n\n\n
Touch infants lip, cheek, or corner of mouth with finger.<\/p>\n\n\n\n
Infant turns head toward stimulus and opens mouth.<\/p>\n\n\n\n
Place finger in palm of hand.<\/p>\n\n\n\n
With the infant supine, turn their head to one side. The arm and leg on that side should extend; opposite arm and leg should flex.<\/p>\n\n\n\n
All toes hyperextended, with dorsiflexion of big toe.<\/p>\n\n\n\n
SHOULD disappear by 1 year of age.<\/p>\n\n\n\n
2 years.<\/p>\n\n\n\n
3 years.<\/p>\n\n\n\n
Preschooler (3-6 years)<\/p>\n\n\n\n
growth and development<\/p>\n\n\n\n
industry, peers<\/p>\n\n\n\n\n
Age group concepts of bodily injury:<\/li>\n\n\n\n
Accidents, developmentally appropriate safety<\/p>\n\n\n\n
immunizations, reactions, immunizations, immunizations<\/p>\n\n\n\n
history of reactions, siezures, neurologic symptoms after previous vaccine, or systemic reactions<\/p>\n\n\n\n
history of anaphylactic reaction to eggs or meomycin contraindicate administration<\/p>\n\n\n\n
nonimmuniized infants<\/p>\n\n\n\n
TB testing<\/p>\n\n\n\n
Ruebella (German measles), the nurse should counsel all expectant mothers, especially those with young children, to be aware of the serious consquenses of exposure to German measles during pregnancy<\/p>\n\n\n\n
age<\/p>\n\n\n\n
potassium<\/p>\n\n\n\n
1-2 ml\/kg\/hr<\/p>\n\n\n\n
ipecac syrup<\/p>\n\n\n\n
lead, Hot water can contain higher levels of lead because it dissolves lead more quickly than cold water, so use only cold water for consumption (drinking and especially for making infant formula)<\/p>\n\n\n\n
150%<\/p>\n\n\n\n
epiglotitis (i.e. do not put a tongue blade or any object into the throat) because of the risk of obstructing the airway completely. Prepare for intubation or trach<\/p>\n\n\n\n
Patent airway<\/p>\n\n\n\n
\u2026PT and PTT, history of bleeding (prolonged or excessive), and whether there is a history of any bleeding disorders in the family<\/p>\n\n\n\n
Cannot grasp the concept of illness and death<\/p>\n\n\n\n
Involving physical harm<\/p>\n\n\n\n
begin to understand something is wrong<\/p>\n\n\n\n
express fear, withdrawal, and denial<\/p>\n\n\n\n\n
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Fifth Disease is marked by a rash that appears in three stages. Just prior to the rash appearance the child may experience mild fever, malaise, headache or runny nose.<\/p>\n\n\n\n
Stage 2: About 1 day after rash appears on face, maculopapular red spots appear, symmetrically distributed on the extremities; the rash progresses from proximal to distal surfaces and may last a week or more.
Stage 3: The rash subsides, but may reappear if skin becomes irritated by sun, heat, cold, exercise, or friction.<\/p>\n\n\n\n\n
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6 months. Children younger than six months are not old enough, but family members and caregivers should be vaccinated.<\/p>\n\n\n\n
HPV vaccine is administered in three injections over six months. First dose, then the second dose 2 months later, followed by the final dose 6 months after the first.<\/p>\n\n\n\n
Boys can receive it from age 9 to 18.<\/p>\n\n\n\n\n
Obtain rectal specimen by tape test in the morning when the child awakens<\/p>\n\n\n\n
Fx of the bone across its entire shaft with some possibly displacement without breaking the skin<\/p>\n\n\n\n
Incomplete fracture<\/p>\n\n\n\n
Complete fx across the shaft of the bone with splintering of the bone fragments<\/p>\n\n\n\n
Skin or mucous membrane has been broken<\/p>\n\n\n\n
Doubles at 6 months, and triples at 12 months<\/p>\n\n\n\n
50%<\/p>\n\n\n\n
5-6<\/p>\n\n\n\n
7 months<\/p>\n\n\n\n
10 months<\/p>\n\n\n\n
10-12 months<\/p>\n\n\n\n
2 months<\/p>\n\n\n\n
3-6 months
links syllables at 6-9 months<\/p>\n\n\n\n
9-12 months<\/p>\n\n\n\n
18months to 2 years<\/p>\n\n\n\n
girls: 10 years, boys: ~ 14<\/p>\n\n\n\n
Girls ~ 15
Boys ~ 17<\/p>\n\n\n\n
Be introduced one new food at a time.<\/p>\n\n\n\n
CF, PKU, Sickle Cell Anemia, Tay-Sachs, Albinism<\/p>\n\n\n\n
25%<\/p>\n\n\n\n
50%<\/p>\n\n\n\n
Huntington’s, Marfans, Polydactyl, Achondroplasia, Polycystic Kidney Disease<\/p>\n\n\n\n
50%<\/p>\n\n\n\n
Muscular Dystrophy, Hemophilia A<\/p>\n\n\n\n
carriers, dont ever<\/p>\n\n\n\n
Have, pass it on<\/p>\n\n\n\n
50%, have the disease<\/p>\n\n\n\n
50%, pass it on<\/p>\n\n\n\n
25%, child that has the disease<\/p>\n\n\n\n
Milwaukee Brace, 23 hrs\/day, Log rolling<\/p>\n\n\n\n
Simian creases on palms, hypotonia, protruding tongue, upward outward slant of eyes<\/p>\n\n\n\n
Scissoring = legs extended, crossed, feet plantar-flexed<\/p>\n\n\n\n
Mental Retardation<\/p>\n\n\n\n
Mental Retardation<\/p>\n\n\n\n
phenylalanine<\/p>\n\n\n\n
Guthrie Test<\/p>\n\n\n\n
Myelomeningocele, keep pressure off<\/p>\n\n\n\n
Opposite of shock<\/p>\n\n\n\n
Shock = Increased pulse and decreased BP
IICP = Decreased pulse and increased BP<\/p>\n\n\n\n\n
suctioning, coughing, straining, and turning<\/p>\n\n\n\n
Bulging fontanels, high pitched cry, increased hd circum, sunset eyes, wide suture lines, lethargy<\/p>\n\n\n\n
peritoneal shunt, do not pump<\/p>\n\n\n\n
a widened pulse pressure<\/p>\n\n\n\n
X-linked Recessive, waddling gait, hyper lordosis, and fat pseudohypertrophy of calves.<\/p>\n\n\n\n
Gower’s Sign (walking up own body)<\/p>\n\n\n\n
Lumbar puncture which shows increased WBC, protein, IICP and decreased glucose<\/p>\n\n\n\n
SIADH, too much ADH; Water retention, fluid overload, and dilutional hyponatremia<\/p>\n\n\n\n
salty, enzymes sprinkled<\/p>\n\n\n\n