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Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp
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, Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp
1. Which Intervention Is Appropriate For The Infant Hospitalized With Bronchiolitis?
a. Position On The Side With Neck Slightly Flexed.
b. Administer Antibiotics As Ordered.
c. Restrict Oral And Parenteral Fluids If Tachypneic.
d. Give Cool, Humidified Oxygen. ANS: D
Cool, Humidified Oxygen Is Given To Relieve Dyspnea, Hypoxemia, And Insensible Fluid Loss From
Tachypnea. The Infant Should Be Positioned With The Head And Chest Elevated At A 30- To 40-Degree
Angle And The Neck Slightly Extended To Maintain An Open Airway And Decrease Pressure On The
Diaphragm. The Etiology Of Bronchiolitis Is Viral. Antibiotics Are Given Only If There Is A Secondary
Bacterial Infection. Tachypnea Increases Insensible Fluid Loss. If The Infant Is Tachypneic, Fluids Are
Given Parenterally To Prevent Dehydration.
2. An Infant With Bronchiolitis Is Hospitalized. The Causative Organism Is Respiratory Syncytial
Virus (RSV). The Nurse Knows That A Child Infected With This Virus Requires What Type Of Isolation?
a. Reverse Isolation
b. Airborne Isolation
c. Contact Precautions
d. Standard Precautions ANS: C
RSV Is Transmitted Through Droplets. In Addition To Standard Precautions And Hand Washing,
Contact Precautions Are Required. Caregivers Must Use Gloves And Gowns When Entering The Room.
Care Is Taken Not To Touch Their Own Eyes Or Mucous Membranes With A Contaminated Gloved Hand.
Children Are Placed In A Private Room Or In A Room With Other Children With RSV Infections. Reverse
Isolation
, Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp
Focuses On Keeping Bacteria Away From The Infant. With RSV, Other Children Need To Be Protected From
Exposure To The Virus. The Virus Is Not Airborne.
3. A Child Has A Chronic Cough And Diffuse Wheezing During The Expiratory Phase Of Respiration.
This Suggests What Condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign Body In Trachea ANS: A
Asthma May Have These Chronic Signs And Symptoms. Pneumonia Appears With An Acute Onset,
Fever, And General Malaise. Bronchiolitis Is An Acute Condition Caused By Respiratory Syncytial
Virus. Foreign Body In The Trachea Occurs With Acute Respiratory Distress Or Failure And Maybe Stridor.
4. Which Nursing Diagnosis Is Most Appropriate For An Infant With Acute Bronchiolitis
Due To Respiratory Syncytial Virus (RSV)?
a. Activity Intolerance
b. Decreased Cardiac Output
c. Pain, Acute
d. Tissue Perfusion, Ineffective (Peripheral) ANS. A
Rationale 1: Activity Intolerance Is A Problem Because Of The Imbalance Between Oxygen Supply And
Demand. Cardiac Output Is Not Compromised During An Acute Phase Of Bronchiolitis. Pain Is Not Usually
Associated With Acute Bronchiolitis. Tissue Perfusion (Peripheral) Is Not Affected By This Respiratory-
Disease Process.
Rationale 2: Activity Intolerance Is A Problem Because Of The Imbalance Between Oxygen Supply And
Demand. Cardiac Output Is Not Compromised During An Acute Phase Of Bronchiolitis. Pain Is Not Usually
Associated With Acute Bronchiolitis. Tissue Perfusion (Peripheral) Is Not Affected By This Respiratory-
Disease Process.
, Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp
Rationale 3: Activity Intolerance Is A Problem Because Of The Imbalance Between Oxygen Supply And
Demand. Cardiac Output Is Not Compromised During An Acute Phase Of Bronchiolitis. Pain Is Not Usually
Associated With Acute Bronchiolitis. Tissue Perfusion (Peripheral) Is Not Affected By This Respiratory-
Disease Process.
Rationale 4: Activity Intolerance Is A Problem Because Of The Imbalance Between Oxygen Supply And
Demand. Cardiac Output Is Not Compromised During An Acute Phase Of Bronchiolitis. Pain Is Not Usually
Associated With Acute Bronchiolitis. Tissue Perfusion (Peripheral) Is Not Affected By This Respiratory-
Disease Process.
Global Rationale: Activity Intolerance Is A Problem Because Of The Imbalance Between Oxygen Supply
And Demand. Cardiac Output Is Not Compromised During An Acute Phase Of Bronchiolitis. Pain Is Not
Usually Associated With Acute Bronchiolitis. Tissue Perfusion (Peripheral) Is Not Affected By This
Respiratory- Disease Process.
Chapter 2: Asthma
1. The Nurse Is Caring For A Child Hospitalized For Status Asthmaticus. Which Assessment
Finding Suggests That The Childs Condition Is Worsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing ANS: A
The Nurse Would Assess The Child For Signs Of Hypoxia, Including Restlessness, Fatigue, Irritability, And
Increased Heart And Respiratory Rate. As The Child Tires From The Increased Work Of Breathing
Hypoventilation Occurs Leading To Increased Carbon Dioxide Levels. The Nurse Would Be Alert For Signs
Of
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