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Summary Pediatric Nursing Nclex)(Nusing D-D-N3)
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Pediatric Nursing Nclex)(Nusing D-D-N3)
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Pediatric Nursing NclexNursing (Florida National University)
,Pediatric Nursing NCLEX-RN Review Impetigo
This highly contagious bacterial infection of the skin is caused by beta-hemolytic
streptococci, Staphylococcus aureus, or both.
The most common sites are around the mouth, the hands, the neck, and the extremities.
Assessment findings include:
◦ Vesicles or pustules surrounded by edema and redness
◦ Lesions weeping cloudy serous fluid
◦ Honey-colored crusts
◦ Pruritus and burning
Nursing Considerations
Use contact precautions and stress the need for such precautions at home.
Allow lesions to air dry.
Teach the parents to apply antibiotic ointments and explain that the infection is
communicable for 48 hours after antibiotic ointment treatment is begun.
Tell the parents that the child must use separate towels, linens, and dishes.
Explain to the parents that the child's linens and clothing should be washed separately with
detergent in hot water
Pediculosis capitis Infestation (Head Lice)
Lice live and reproduce only on human beings and are transmitted by way of direct and
indirect contact (e.g., sharing of brushes, hats, towels, bedding).
The most common site of infestation is the occipital area; less frequently, the eyebrows and
eyelashes are affected.
Assessment findings include:
◦ Intense pruritus
◦ Small, gray specks that may crawl very fast
◦ Nits, visible as tiny silver or gray specks resembling dandruff
Nursing Considerations
Use of a pediculicide shampoo will be prescribed.
Tell the parents that bedding and clothing used by the child should be changed daily,
laundered in hot water with detergent, and dried in a hot dryer for 20 minutes.
Instruct the parents to store nonessential bedding and clothing in a tightly sealed plastic bag
for 10 days to 2 weeks, then wash these items as described above; toys that cannot be
washed or dry-cleaned should be sealed in a plastic bag for 2 weeks.
Tell the parents to discard hairbrushes and combs or soak them in hot water (130° F, [54.4°
C]) and to teach the child not to share clothing, headwear, or brushes and combs.
Instruct the parents to vacuum furniture and carpets frequently.
All contacts of the infested child should be examined.
Scabies
This skin disorder is caused by infestation with Sarcoptes scabei (a.k.a. itch mite).
Infestation is transmitted by way of close personal contact with an infected person.
Because of close personal contact among members of these populations, scabies is endemic
among schoolchildren and the institutionalized.
, Assessment findings include:
◦ Intense pruritus, especially at night
◦ Pustules
◦ Burrows, which appear as fine grayish-red lines on the skin
Nursing Considerations
A scabicide is applied topically (but lindane cream [Kwell] should not be used in children
younger than age 2 because of the risk of neurotoxicity and seizures).
Household members and contacts of the infested child must be treated at same time
as the child.
Stress the importance of frequent handwashing.
Explain to the parents that all clothing, bedding, and pillowcases used by the child must be
changed daily, washed in hot water with detergent, dried in a hot dryer, and ironed before
reuse.
Tell the parents to seal nonwashable toys and other items in plastic bags for at least 4 days.
Oncological Disorders
Nephroblastoma (Wilms Tumor): This tumor of the kidney may present unilaterally and
localized or bilaterally, sometimes with metastasis to other organs.
Treatment is a combination of surgery (partial to total nephrectomy) and chemotherapy
with or without radiation.
Assessment findings include:
◦ Abdominal swelling or mass (firm, nontender, confined to one side, and deep
within the flank)
◦ Abdominal pain
◦ Urine retention
◦ Hematuria
◦ Hypertension
◦ Nursing Considerations
Before Surgery
◦ Monitor the client’s vital signs, particularly blood pressure.
◦ Avoid palpation of the abdomen, which could disrupt the tumor capsule,
resulting in seeding elsewhere in the body.
◦ Measure the client’s abdominal girth daily each morning.
◦ After Surgery
◦ Monitor the client’s temperature.
◦ Monitor the blood pressure closely for signs of bleeding.
◦ Monitor intake and output, particularly urine production, closely.
◦ Be alert for signs of intestinal obstruction.
◦ Instruct the parents about signs of complications and the need to avoid contact
sports to prevent injury to the remaining kidney.
◦ Symptoms of lung involvement if metastasis has occurred
◦ Phenylketonuria: This genetic disorder, also known as PKU, causes central
nervous system damage, the result of accumulation of a toxic level of
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