Chapter 26 - Pediatric Surgery
a. Aspiration with airway obstruction - ANS-Children are more prone to foreign-body ingestion
than adults. What is the most significant risk?
a. Aspiration with airway obstruction
b. Esophageal impaction
c. Mucosal tear
d. Poisoning
a. Blood pressure within acceptable range - ANS-The pediatric patient is at risk for imbalanced
fluid volume related to invasive surgery and accompanying blood loss. Select the outcome
indicator that would best reflect that the goal of maintained fluid balance was attained.
a. Blood pressure within acceptable range
b. Bounding peripheral pulses
c. Three wet diapers in 24 hours
d. Intact mucous membranes
a. Central venous line
b. Implanted port - ANS-Vascular access in pediatric patients may be established
intraoperatively for short-term (weeks) or long-term (months, years) use. Select all the examples
of a long-term (months, weeks) use vascular access catheter.
a. Central venous line
b. Implanted port
c. Peripherally inserted central venous catheter (PICC)
d. Power injection port
a. Dr. Erik Erikson; Dr. Jean Piaget - ANS-A child's comprehension of, and responses to, the
environment are based on his or her developmental age. Many theorists have provided
excellent guidelines for assessing the pediatric patient's developmental level in order to use
appropriate interventions. The infant develops the belief that the world can be counted on to
meet basic needs through the trust versus mistrust concept based on the stages of
psychosocial and emotional needs. This theoretical framework of stages was described by
______________, while the stages based on changes in cognition and ability to think were
described by _____________.
a. Dr. Erik Erikson; Dr. Jean Piaget
b. Dr. John Watson; Dr. Albert Bandura
c. Dr. Jean Piaget; Dr. John Watson
d. Dr. Karl Jung; Dr. Sigmund Freud
a. explain and demonstrate the adolescent pediatric pain tool. - ANS-A 14-year-old boy is
scheduled for spinal fusion with implantation of rods from T10 to L2. During the preoperative
interview and assessment, he asks the perioperative nurse how bad his pain will be when he
, wakes up and if he will have enough pain medicine available. He also wonders how the nurse
will know when his pain is severe enough to give him pain medicine. The perioperative nurse
assures the patient that he will have many options available to him to manage his pain after the
surgery. An appropriate risk reduction strategy that the nurse can implement during the
preoperative assessment is to:
a. explain and demonstrate the adolescent pediatric pain tool.
b. explain that he will have patient-controlled analgesia (PCA) and his parents can manage his
pain for him.
c. tell him to teach his parents what he knows about the pain scale.
d. request a consult with the pain service to explain the pain management plan to hi
a. Measure and record the urinary output and output from other drainage tubes
b. Weigh sponges on a gram scale and report estimated loss
c. Provide appropriate amounts of IV fluid replacement - ANS-During the planning process, the
perioperative nurse determines nursing interventions that will assist in meeting the appropriate
goal statement of the desired nursing outcome. What nursing intervention is appropriate, when
implemented, in protecting the pediatric patient from fluid volume imbalance?
a. Measure and record the urinary output and output from other drainage tubes
b. Weigh sponges on a gram scale and report estimated loss
c. Provide appropriate amounts of IV fluid replacement
d. Calculate the estimated total blood volume for the patient according to the patient's age
a. Nissen fundoplication - ANS-Infants and children with severe gastroesophageal (GE) reflux
can have life-threatening complications, including obstructive apnea, aspiration pneumonia,
esophagitis, and failure to thrive. What is the name of the procedure, performed open or
laparoscopically, that is designed to create a competent antireflux barrier?
a. Nissen fundoplication
b. Roux-en-Y bypass
c. Pyloromyotomy with pyloroplasty
d. Sphincterotomy
a. painful stimuli such as eye surgery or abdominal retraction. - ANS-Young children are
predisposed to parasympathetic hypertonia (increased vagal tone), which can be induced by:
a. painful stimuli such as eye surgery or abdominal retraction.
b. anxiety stimuli such as separation from a parent.
c. environmental stimuli such as loud noise or flashes of light.
d. thermal stimuli such as ambient excessive heat or cold.
a. perform a careful assessment of family history to identify risk for developing malignant
hyperthermia (MH). - ANS-A 12-year-old boy is scheduled for a laparoscopic hernia repair.
During the preoperative assessment and interview, the perioperative nurse notes that he has
mild myotonia congenita. The patient's mother states that she is worried about the anesthesia
because her husband's brother died many years ago when he became very feverish during
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