Pediatric Nursing- A Case-Based Approach, 2nd Edition by (Tagher, 2024), Verified Chapters 1 - 34, Complete Newest Version
Pediatric Nursing- A Case-Based Approach, 2nd Edition by (Tagher, 2024), Verified Chapters 1 - 34, Complete Newest Version
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Edition by (Tagher, 2024), Verified Chapters 1 - 34, Complete
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An 18-Month-Old is discharged from the hospital after having a febrile seizure
secondary to exanthem subitum (Roseola). On discharge, the mother asks the nurse
if her 6-year-old twins will get sick. Which teaching about the transmission of roseola
would be most accurate?
1. The child should be isolated at home until the vesicles have dried.
2. The child does not need to be isolated from the older siblings.
3. Administer acetaminophen to the older siblings to prevent seizures.
4. Monitor older children for seizure development. - ANSWER: . 2. The route of
roseola transmission is unkown, and the disease is more commonly seen in children
6 months to 3 years of age, so siblings do not need to be isolated.
Which would be the priority intervention for a child suspected of having varicella
(chickenpox)?
1. Contact Precautions
2. Contact and Droplet Respiratory Precautions?
3. Droplet respiratory precautions?
4. Universal Precautions and standard precautions. - ANSWER: 2. Varicella
(Chickenpox) is highly contagious. Contact & Droplet respiratory precautions should
be started immediately because the primary source of transmission is secretions of
the respiratory tract (droplet) and also by contaminated objects.
Caladryl - ANSWER: A lotion containing diphenhydramine. Should not be applied if
child has already been given benadryl (diphenhydramine) because it can cause
toxicity.
Which s&s would the nurse expect with rheumatic fever?
1. Ankle and Knee Joint Pain.
2. Negative group A beta strep culture.
3. Large, red "bulls eye" - appearing rash.
4. stiff neck with photophobia. - ANSWER: Ankle and knee joint pain.
The parents of a 12-month old with HIV are concerned about him receiving routine
immunizations. What will the nurse tell them about immunizations? - ANSWER: "You
are concerned about your child receiving immunizations. Let me explain why your
child will NOT receive routine immunizations today"
,The nurse acknowledges a client's fears and then discusses the concerns to clarify
any misconceptions. Immunizations and influenza vaccine are recommended to
prevent infection. Immunocompromised HIV-infected children should not receive
MMR and varicella live vaccines.
Nursing Assessment suspects the newborn has cystic fibrosis. Which interventions
would the nurse begin.
1. Observe frequency and nature of stools.
2. Provide Chest PT
3. Observe for weight gain.
4. Assess parent's compliance with fluid restrictions.
5. Assess respiratory system frequently. - ANSWER: 1 & 3
Cystic fibrosis is an inherited autsomal trait, causing exocrien gland dysfunction. 7-
10% present meconium ileus, so assessing stool frequency and consistency is
important.
Assessing weight is important in newborns because they lose up to 10% of their birth
weight, and can take 2 weeks for them to regain their birth weight.
Assessing the newborn's respiratory system frequently would be monitored as
frequently as other infants if the newborn has no respiratory symptoms. Chest PT
would not be initiated in a newborn without a definitive diagnosis.
Can a mother breastfeed their infant if they have PKU? - ANSWER: Yes. Breast milk
has low amounts of phenylalanine, so the mother can breast as long as the infants
phenylalanine level is monitored.
Vaccines given routinely at 15 months. - ANSWER: Hib & DTaP
Which priority intervention for the newborn of a mother positive for hepatitis
antigen? - ANSWER: The newborn should receive both hepatitis B vaccine and
hepatitis B immune globulin within 12 hours of birth to prevent hepatitis B infection.
signs of intussusception - ANSWER: bloody stools or "currant jelly stools", diarrhea,
Large palpable sausage shaped mass in the abdomen, abdominal distention,
grunting, dehydration Fever, and pain (legs pulled towards abdomen)!
Treatment for Intussusception - ANSWER: Barium or air enema
Nursing Care for Intussusception - ANSWER: Document I & O
Monitor for peritonitis & perforation
Monitor and record stools
,Biggest complications of Intussusception - ANSWER: Peritonitis and Perforation
Risk factors for intussusception - ANSWER: Cystic Fibrosis
Ages 3 months to 3 years old.
Complication of Mal-Rotation & Valvolus - ANSWER: Pain related to rotation of
intestines around the mesenteric artery can cut off circulation, leading to potential
septic intestinal necrosis.
Which pediatric GI disorder presents with green bilious vomiting? - ANSWER: Mal-
Rotation and Valvolus
GI disorders that present with bloody stools? - ANSWER: Mal-Rotation/Valvolus &
Intussusception.
Obstructive GI disorders where a palpated sausage shaped mass is felt on the
abdomen. - ANSWER: Mal-Rotation and Valvolus. Symptoms for these disorders are
similar but Mal-Rotation requires surgical intervention.
Preoperative care for Mal-Rotation/Valvolus - ANSWER: Hydration, IV antibiotics, NG
tube.
Post-Operative Care for Intussusception - ANSWER: Bowel sounds should return in
four hours, progressive diet, hydration.
Priority nursing diagnosis for intussusception - ANSWER: Acute Pain!
Which response about safety measures is the most appropriate advice for the 2 year
old's mother who had her older home remodeled to reduce the lead level? Select all
that apply.
1. Wash & dry the child's hands and face before he eats.
2. it is best to use cold water to prepate the child's food to decrease lead level.
3. diet does not matter in reduce lead levels in the child.
4. Drinking two cups of milk per day helps decrease lead levels. - ANSWER: 1 & 3.
Washing and drying hands and face especially before eating, decreases lead
ingestion. Hot water absorbs more lead readily than hot water. Diet does matter;
regular meals, adequate iron and calcium, and less fat help the child absorb less
lead. Drinking 2 cups of milk per day is important for children but does not help
decrease lead level.
Which would the nurse explain to parents about the inheritance of cystic fibrosis?
1. The child of parents who are both carriers of the gene for CF has a 50% chance of
acquiring CF.
2. The child of a mother who has CF and a father who is a carrier of the gene for CF
has a 50% chance of acquiring CF. - ANSWER: 2. If the child is born to a parent with
, CF and the other is a carrier, the child has a 50% chance of acquiring the disease and
50% chance of being a carrier of the disease.
Number 1. is wrong. If a child is born to a parents who are both carriers of the CF
gene, the child has a 25% chance of acquiring the disease and a 50% chance of being
a carrier of the disease.
A 2 year old has just been diagnosed with CF. The parents ask the nurse what early
respiratory symptoms they should expect to see in their child. Which is the nurse's
best response?
1. Barrel shaped chest
2. Chronic productive cough
3. bronchiectasis
4. wheezing - ANSWER: Wheezing respirations and a dry nonproductive cough are
common early symptoms of CF.
A barrel shaped chest is a long-term respiratory problem that occurs with recurrent
hyperinflation. A chronic productive cough is common as pulmonary damage
increases. Bronchiectasis develops in advanced stages of CF.
Test taking hint: "chronic: implies the disease process is advanced rather than in
initial stages.
The parent of a child with Cystic Fibrosis (CF) asks the nurse what will be done to
relieve the child's constipation. Which is the nurse's best response?
1. Your child likely has an obstruction and will require surgery.
2. Your child will be given IV fluids.
3. Your child will be given MiraLAX
4. Your child will be placed on fluid restrictions. - ANSWER: 3. MiraLAX will be
ordered.
IV fluids may be ordered if the client is NPO for any reason. however, IV fluids will
not relieve the constipation. CF patient's commonly receive stool softeners or
osmotic solution orally to relieve their constipation.
A school age child has been diagnosed with strep throat. The parent asks the RN
when the child can go back to school. Which is the nurse's best response? - ANSWER:
Children with strep are no longer contagious 24 hours after initiation of antibiotic
therapy.
The RN is revieing discharge insturctuon with a parent of a child who has a
tonsillectomy a few hours ago. The parents tell the nurse that the child is a big eater,
and they want to know what foods to give their child for the next 24 hours. What is
the nurses's best response?
1. no restrictions at all
2. clear liquids only
3. restricted to ice cream and cold liquids
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