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Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp
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TEST BANK ij




Pediatric Nursing, A Case- Based Approach, 1st
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Edition ByTagher Knapp
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, Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp ij ij ij ij ij ij ij ij ij




Chapter 1: Bronchiolitis ij ij




1. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
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a. Position on the side with neck slightly flexed. ij ij ij ij ij ij ij




b. Administer antibiotics as ordered. ij ij ij




c. Restrict oral and parenteral fluids if tachypneic. ij ij ij ij ij ij




d. Give cool, humidified oxygen. ANS: D ij ij ij ij ij




Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from
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tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree
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angle and the neck slightly extended to maintain an open airway and decrease pressure on the
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diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a secondary
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bacterial infection. Tachypnea increases insensible fluid loss. If the infant is tachypneic, fluids are
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givenparenterally to prevent dehydration.
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2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial
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virus(RSV). The nurse knows that a child infected with this virus requires what type of isolation?
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a. Reverse isolation ij




b. Airborne isolation ij




c. Contact Precautions ij




d. Standard Precautions ANS: C ij ij ij




RSV is transmitted through droplets. In addition to Standard Precautions and hand washing,
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Contact Precautions are required. Caregivers must use gloves and gowns when entering the room.
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Care is taken not to touch their own eyes or mucous membranes with a contaminated gloved hand.
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Children are placed in a private room or in a room with other children with RSV infections. Reverse
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isolation
ij

, Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp ij ij ij ij ij ij ij ij ij




focuses on keeping bacteria away from the infant. With RSV, other children need to be protected
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fromexposure to the virus. The virus is not airborne.
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3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration.
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Thissuggests what condition?
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a. Asthma

b. Pneumonia



c. Bronchiolitis

d. Foreign body in trachea ANS: A ij ij ij ij ij




Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute
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ij onset,fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory
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ij syncytial



virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stridor.
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4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due
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torespiratory syncytial virus (RSV)?
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a. Activity Intolerance ij




b. Decreased Cardiac Output ij ij




c. Pain, Acute ij




d. Tissue Perfusion, Ineffective (peripheral) ANS. A
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Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply and
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demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij




usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
ij ij ij ij ij ij ij ij ij ij ij ij ij




respiratory- disease process.
ij ij ij




Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply and
ij ij ij ij ij ij ij ij ij ij ij ij ij ij




demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij




usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
ij ij ij ij ij ij ij ij ij ij ij ij ij




respiratory- disease process.
ij ij ij

, Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp
ij ij ij ij ij ij ij ij ij




Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply and
ij ij ij ij ij ij ij ij ij ij ij ij ij ij




demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij




usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
ij ij ij ij ij ij ij ij ij ij ij ij ij




respiratory- disease process.
ij ij ij




Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply and
ij ij ij ij ij ij ij ij ij ij ij ij ij ij




demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij




usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
ij ij ij ij ij ij ij ij ij ij ij ij ij




respiratory- disease process.
ij ij ij




Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen supply
ij ij ij ij ij ij ij ij ij ij ij ij ij




anddemand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not usually
ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij




associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this respiratory-
ij ij ij ij ij ij ij ij ij ij ij ij ij




disease process.
ij ij




Chapter 2: Asthma ij ij




1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment
ij ij ij ij ij ij ij ij ij ij ij ij




findingsuggests that the childs condition is worsening?
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a. Hypoventilation

b. Thirst



c. Bradycardia

d. Clubbing ANS: A ij ij




The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability, and
ij ij ij ij ij ij ij ij ij ij ij ij ij ij




increased heart and respiratory rate. As the child tires from the increased work of breathing
ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij




hypoventilation occurs leading to increased carbon dioxide levels. The nurse would be alert for signs of
ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij ij

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