PEDIATRIC NURSING - 1. When does birth length double? = by 4 years ...

PEDIATRIC NURSING

GROWTH AND DEVELOPMENT:

• When does birth length double? = by 4 years

• When does the child sit unsupported? = 8 months

• When does a child achieve 50% of adult height? = 2 years

• When does a child throw a ball overhand? = 18 months

• When does a child speak 2-3 word sentences? = 2 years

• When does a child use scissors? = 4 years

• When does a child tie his/her shoes? = 5 years

CHILD HEALTH PROMOTION:

• List 2 contraindications for live virus immunization.
• Immunocompromised child or a child in a household with an immunocompromised

individual.

• List 3 classic signs and symptoms of measles.
• Photophobia, confluent rash that begins on the face and spreads dowward, and

Koplik’s spots on the buccal mucosa.

• List the signs and symptoms of iron deficiency.
• Anemia, pale conjunctiva, pale skin color, atrophy of papillae on tongue,

brittle/ridged/spoon-shaped nails, and thyroid edema.

• Identify food sources for Vitamin A.
• Liver, sweet potatoes, carrots, spinach, peaches, and apricots.

• What disease occurs with vitamin C deficiency?
• Scurvy.

• What measurements reflect present nutritional status?
• Weight, skinfold thickness, and arm circumference.

• List the signs and symptoms of dehydration in an infant.
• Poor skin turgor, absence of tears, dry mucous membranes, weight loss, depressed

fontanel and decreased urinary output.

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• List the laboratory findings that can be expected in a dehydrated child.
• Loss of bicarbonate/decreased serum pH, losso f sodium (hyponatremia), loss of

potassium (hypokalemia), elevated Hct, and elevated BUN.

• How should burns in children be assessed?
• Use the Lund-Browder chart, which takes into account the changing proportions of

the child’s body.

• How can the nurse BEST evaluate the adequacy of fluid replacement in

children?

• Monitor urine output.

• How should a parent be instructed to “child proof” a house?
• Lock all cabinets, safely store all toxic household items in locked cabinets, and

examine the house from the child’s point of view.

• What interventions should the nurse do FIRST in caring for a child who has

ingested a poison?

• Assess the child’s respiratory, cardiac, and neurological status.

• List 5 contraindications to administering syrup of ipecac.
• Coma, seizures, CNS depression, ingestion of petroleum-based products, and

ingestion of corrosives.

• What instructions should be given by phone to a mother who knows her child

has ingested a bottle of medication?

• Administer syrup of ipecac if the child is conscious. Bring any emesis or stool to the

emergency room. Bring the container in which the medicine was stored to the emergency room.

RESPIRATORY DISORDERS:

• Describe the purpose of bronchodilators.
• Reverse bronchospasm

• What are the physical assessment findings for a child with asthma?
• Expiratory wheezing, rales, right cough, and signs of altered blood gases.

• What nutritional support should be provided for the child with cystic fibrosis?
• Pancreatic enzyme replacement, fat-soluble vitamins, and a high carbohydrate, high

protein, moderate fat diet.

• Why is genetic counseling important for the cystic fibrosis family?
• The disease is autosomal recessive in its genetic pattern.

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• List 7 signs of respiratory distress in a pediatric client.
• Restlessness, tachycardia, tachypnea, diaphoresis, flaring nostrils, retractions, and

grunting

• Describe the care of a child in a mist tent.
• Monitor child’s temperature. Keep tent edges tucked in. Keep clothing dry. Assess

child’s respiratory status. Look at child inside tent.

• What position does the child with epiglottis assume?
• Upright, sitting, with chin out and tongue protruding (“tripod” position).

• Why are IV fluids important for the child with an increased respiratory rate?
• The child is at risk for dehydration and acid/base imbalance.

• Children with chronic otitis media are at risk for developing what problem?
• Hearing loss

• What is the most common post-ope rative complication following a

tonsillectomy? Describe the signs and symptoms of this complication.

• Hemorrhage; frequent swallowing, vomiting fresh blood, and clearing throat.

CARDIOVASCULAR DISORDERS:

• Differentiate between a right to left and left to right shunt in cardiac disease.
• A left to right shunt moves oxygenated blood back through the pulmonary circulation.

A right to left shunt bypasses the lungs and delivers unoxygenated blood to the systemic circulation causing cyanosis.

• List the 4 defects associated with Tetralogy of Fallot.
• VSD, overriding aorta, pulmonary stenosis and right ventricular hypertrophy

• List the commons signs of cardiac problems in an infant.
• Poor feeding, poor weight gain, respiratory distress/infections, edema and cyanosis

• What are the 2 objectives in treating congestive heart failure?
• Reduce the workload of the heart and increase cardiac output.

• Describe nursing interventions to reduce the workload of the heart.
• Small, frequent feedings or gavage feedings. Plan frequent rest periods. Maintain a

neutral thermal environment. Organize activities to disturb child only as indicated.

• What position would best relieve the child experiencing a “tet” spell?
• Knee-chest position, or squatting.

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• What are common signs of digoxin toxicity?
• Diarrhea, fatigue, weakness, nausea and vomiting. The nurse should check for

bradycardia prior to administration.

• List 5 risks of cardiac catheterization.
• Arrythmia, bleeding, perforation, phlebitis, and obstruction of the arterial entry site.

• What cardiac complications are associated with rheumatic fever?
• Aortic valve stenosis and mitral valve stenosis.

• What medications are used to treat rheumatic fever?
• Penicillin, erythromycin, and aspirin.

NEUROMUSCULAR DISORDERS:

• What are the physical features of a child with Down syndrome?
• Simian creases of palms, hypotonia, protruding tongue, and upward/outward slant of

eyes.

• Describe “scissoring.”
• A common characteristic of spastic cerebral palsy in infants. The legs are extended

and crossed over each other, the feet are plantar flexed.

• What are 2 nursing priorities for a newborn with myelomeningocele?
• Prevention of infection of the sac and monitoring for hydrocephalus (measure head

circumference; check fontanel; assess neurological functioning).

• List the signs and symptoms of increased ICP in older children.
• Irritability, change in LOC, motor dysfunction, headache, vomiting, unequal pupil

response, and seizures.

• What teaching should parents of a newly shunted child receive?
• Signs of infection and increased ICP (decreased pulse, increased blood pressure).

Shunt should not be pumped. Child will need revisions due to growth. Provide guidance for growth and development.

• State the 3 main goals in providing nursing care for a child experiencing a

seizure.

• Maintain patent airway, protect from injury, and observe carefully.

• What are the side effects of Dilantin?
• Gingival hyperplasia of the gums, dermatitis, ataxia, and GI distress.

• Describe the signs and symptoms of a child with meningitis?
• Fever, irritability, vomiting, neck stiffness, opisthotonos, positive Kernig’s sign,

positive Brudzinski’s sign. Infant does not show all classic signs, but is very ill. This study source was downloaded by 100000810808742 from CourseHero.com on 05-23-2021 08:18:41 GMT -05:00

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