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From Flashcardlet > PN 2200 > Flashcards

PN 2200 Flashcards

1
Q

If the ID bracelet applied on admission is taken off by the child or if it falls off, identification should be

A
  1. verified (with the charge nurse)

2. a new bracelet applied

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2
Q

Ear Drops: In children

A

down and back

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3
Q

Ear Drops: In older children (> 3 yo), pull the upper pinna (auricle) __ to straighten the canal.

A

up and back

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4
Q

Ear Drops: Place child in __ position with unaffected ear (up/down)

A
  1. supine position

2. down

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5
Q

Designed to introduce food directly into the stomach through the abdominal wall by means of a surgically placed tube or button

A

gastrostomy

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6
Q

Gastronomy Feeding: Whenever possible, hold the patient quietly after feeding. Reposition in (1)__ position or (2)__ to promote gastric emptying

A
  1. Fowler’s

2. on right side

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7
Q

Gastronomy Feeding: Before feeding, and after aspirating residual stomach contents - Replace residual and *decrease present formula by equal amount, or *delay feeding for a short time if the amount of residual is large:

Newborns __mL for newborns,
Older children > __ mL

A

Newborn: 10 - 25 mL

Older children: > 50 mL

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8
Q

Gastronomy Feeding: Overloading the stomach can cause (1)__ and increases the danger of (2). If residual continues or increases, (3)

A
  1. reflux
  2. aspiration
  3. report to physician
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9
Q

Gastronomy Feeding: If no residual is obtained, inject ___ into the tubing to clear, and test residual again.

A

2 to 5mL of water

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10
Q

Gastronomy Feeding: Continue to add formula to the syringe before it empties completely to prevent ____.

A

excess air from entering the tubing

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11
Q

Record in the medical record (5)

A
  1. Type (gastrostomy feeding)
  2. Amount given, the
  3. Amount and Characteristics of Residual
  4. How child tolerated the procedure.
  5. Intake and Output
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12
Q

Gastronomy: The tube is inserted ____ cm according to the size and age of the child.

A

from 0.4 to 1.6cm (1 to 4 inches)

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13
Q

Gastronomy: Infants and small children may be unable to retain the solution; therefore it may be necessary to ___

A

hold the buttocks together for a short time

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14
Q

The Fleet Enema contains (2) and has an osmotic action that can result in (3)__.

A
  1. sodium biphosphate
  2. sodium phosphate
  3. metabolic acidosis
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15
Q

An oral polyethylene-glycol lavage solution such as (2) can be used to CLEANSE THE BOWEL, as can a solution of (3), without causing a risk for an electrolyte imbalance.

A

GoLytely or NuLytely,
magnesium citrate
magnesium citrate

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16
Q

Supporting the hand on the patient’s forehead, the medication is instilled into ____

A

the CENTER of the LOWER lid (conjunctival sac)

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17
Q

Gastronomy Feeding: Brown or green drainage may indicate ___

A
  1. that the tube has slipped through the Pylorus into the Duodenum.
    (This could cause an obstruction and is reported immediately)
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18
Q

Traction: A __ restraint may be used to prevent the child from turning from side to side.

A

jacket

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19
Q

The physician may order __ restraints to prevent the infant from scratching the lip and from placing his/her fingers or objects in the mouth.

A

elbow

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20
Q

Restraints may be used for infants and children to (2).

The reason for the restraint must be explained to the parents and the child.

A
  1. facilitate examinations or treatments

2. to maintain safety

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21
Q

Restraints are not a substitute for close observation, and should involve ___

A

the fewest joints possible in order to enable free movement (necessary for growth and development)

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22
Q

IV medications can cause phlebitis or infiltration may occur. The nurse must observe the child’s IV site every __.

A

hour

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23
Q

Phlebitis: The nurse must observe the child’s IV site for ___

A

reddened areas or signs of inflammation

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24
Q

(3) at or around the IV site may indicate infiltration

A
  1. Leakage at the IV site
  2. tense tissue turgor
  3. cool, blanched skin
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25
Q

IV Infusion: Nurse Responsibilities

A
  1. monitor the rate of the IV flow
  2. observe IV site hourly,
  3. identify responses of the child
  4. document findings
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26
Q

Ability to play cooperatively begins to emerge at __ years.

A

3-5 years

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27
Q

Separation anxiety occurs in infants age __ and is most pronounced __.

A
  1. 6 months and older

2. at the toddler age

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28
Q

Three stages of separation anxiety

A
  1. protest
  2. despair
  3. denial or detachment
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29
Q

Separation Anxiety/Stages: If the __ stage is prolonged, an irreversible disruption of parent–infant bonding may occur.

A

detachment/denial

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30
Q

Stage of Separation Anxiety: Child becomes more interested in their surroundings, their toys, and their playmates. On the surface, it appears the child has adjusted to the separation.

A

detachment/denial

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31
Q

Separation Anxiety/Denial: It is important for the nurse to understand that the child is using a coping mechanism to ____.

A

detach and reduce the emotional pain.

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32
Q

The nurse encourages a school-age child to draw a picture after a painful procedure. The best rationale for this intervention is that the nurse is ____

A

providing a way for the child to express his feelings (Art therapy)

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33
Q

Play and toys can be of therapeutic value in (3)

A
  1. retraining muscles
  2. improving eye–hand coordination
  3. helping children crawl and walk (push-pull toys)
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34
Q

Imaginary playmates are common and normal during the __ period and serve many purposes, such as relief from loneliness, mastery of feats, and provision of a “scapegoat.”

A

preschool

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35
Q

Imaginary playmates serve many purposes, such as

A
  1. relief from loneliness
  2. mastery of feats
  3. provision of a “scapegoat.”
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36
Q

The nurse suggests that the best time for parents to begin to prepare a 5 yo for surgery and hospitalization is:

a) as soon as the surgery is scheduled
b) about 4 days before surgery
c) about 2 wks before surgery
d) on the night before admission to the hospital

A

b) about 4 days before surgery

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37
Q

Frequent swallowing following a T&A is indicative of ___

A

bleeding from the surgical site.

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38
Q

Evidence of bleeding after a tonsillectomy and adenoidectomy (5)

A
  1. increased Pulse
  2. increased Respirations
  3. Restlessness
  4. Frequent swallowing
  5. Vomiting bright red blood
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39
Q

Inherited, recessive trait where both parents carry the the gene; an exocrine gland dysfuction that increases viscosity of mucous glad secretions

A

CF (cystic fibrosis)

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40
Q

Diagnostic test for CF

A

Sweat test

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41
Q

Asthmatic child taking theophylline: complains of stomach ache, tachycardia, sweating profusely. These are signs of ____

A

drug toxicity

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42
Q

Therapeutic purpose of theophylline

A

Bronchodilator

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43
Q

4 Instructions when taking a Bronchodilator

A
  1. Do not crush, chew
  2. Same time/day
  3. Monitor blood levels
  4. Watch for dysrhythmias/tremors
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44
Q

Coarctation of the Aorta: Expected finding when measuring BP in all four extremities

A

BP is lower in the legs (distal) than in the arms (proximal)

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45
Q

Constriction/Narrowing of the Aortic Arch, or Descending Aorta

A

Coarctation of the Aorta

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46
Q

If Coarctation of the Aorta is left untreated, (3) may occur

A
  1. HTN
  2. CHF
  3. Ineffective Endocarditis
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47
Q

Tetralogy of Fallot: The squatting position increases ____

A

return of venous blood back to the heart (alters systemic venous return)

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48
Q

4 Defects of Tetrology of Fallot

A
  1. Stenosis - Pulmonary Artery
  2. Hypertrophy - Rt Ventricle
  3. Dextroposition - Aorta to the Rt
  4. VSD
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49
Q

Tetrology of Fallot: Stenosis of the Pulmonary Artery causes ___

A

decreased blood to the Lungs

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50
Q

Tetrology of Fallot: Hypertrophy of the Rt Ventricle causes ____

A

Rt Ventricle enlarges to work harder

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51
Q

Tetrology of Fallot: Dextroposition of the Aorta means that it is displaced to the Rt, and causes ___

A

blood from both Ventricles enters the Aorta

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52
Q

How does Kawasaki’s Disease (KD) affect the heart and blood vessels?

A

*Inflammation of Cardio Vessels > *Weakens the Vessel Walls > resulting in *Aneurysm

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53
Q

Rheumatic Fever (RF): Involuntary, purposeless movements of the limbs

A

Sydenham’s Chorea

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54
Q

RF is a complication of untreated ____

A

group A strep of the throat

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55
Q

RF: Signs and Symptoms

A
  1. Migratory Polyarthritis (joints)
  2. Skin eruptions
  3. Chorea (nervous disorder)
  4. Carditis (inflamm of the heart)
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56
Q

The nurse is careful to apply only the Rx amount of Ointment to the skin of a 2 yo because the infant’s skin, compared to the adult’s, has ___

A

greater absorption

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57
Q

A plastic diaper (increases/decreases) absorption of medicine applied in the diaper area

A

increases

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58
Q

Plastic diaper covering: Use caution with (2) ointments applied to the skin

A
  1. Hydrocortisone

2. Hexachlorophene

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59
Q

isotretinoin (Accutane): Therapeutic purpose

A

Anti-acne Agent

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60
Q

isotretinoin (Accutane): Contraindication

A

Pregnancy, or At Risk for Pregnancy

FETAL DEFORMITIES!!

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61
Q

Oral Contraceptive to take with Accutane, and Action

A

Ortho Tri-cyclen

*Reduces Androgen levels

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62
Q

An allergy to __ would contraindicate the use of silver sulfadiazine (Silvadene)

A

Sulfa

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63
Q

Topical Agent for Burns:

Penetrates eschar, Painful (15-30 mins), Draws water out of tissues, Do not apply to Face, Risk of Metabolic Acidosis

A

mafenide acetate 10% (Sulfamylon)

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64
Q

Topical Agent for Burns:

Expensive, No sting, Softens eschar, Do not use if allergic to Sulfa drugs, Remove old before reapplying

A

silver sulfadiazine 1% (Silvadene)

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65
Q

Topical Agent for Burns:

Low-cost prophylactic antibiotic, Painless, Apply bid

A

Bacitracin

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66
Q

3 Topical Agents for Burns

A
  1. silver sulfadiazine 1% (Silvadene)
  2. mafenide acetate 10% (Sulfamylon)
  3. Bacitracin
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67
Q

Childhood form of Muscular Dystrophy

A

Duchenne’s Muscular Dystrophy

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68
Q

3 Characteristic Manifestations of Duchenne’s MD

A
  1. Weakness (falls frequently, clumsy)
  2. Contractures
  3. Gower’s
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69
Q

Absent protein in Duchenne’s MD

A

Dystrophin

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70
Q

Possibility of Child Abuse: 3 Inconsistencies about injuries

A
  1. Bruises at various stages of healing
  2. Delay in seeking care
  3. Hx not compatible with injury/development
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71
Q

GAIT: At __ mos, the wide base narrows; more stable.

A

18 months

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72
Q

GAIT: At __, child can hop on one foot and arms swing

A

4 years

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73
Q

GAIT: At __, child resembles that of an adult; equal strides

A

6 years

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74
Q

Toe walking over 3 years of age may indicate ___

A

a muscle problem

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75
Q

5 Post-Op Instructions for a Tympanostomy/Myringotomy

A
  1. Keep ears dry
  2. Ear plugs (bathing, swimming)
  3. Analgesic/Ibuprophen (comfort)
  4. Do not blow nose (7-10 days)
  5. Notify HCP if tubes fall out (not an emgcy)
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76
Q

Type of Seizure: A blank stare, beginning and ending abruptly, lasting only a few seconds; Often mistaken for Daydreaming, lack of attention, deliberate ignoring of adult instructions

A

Absence (petit mal)

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77
Q

Type of Seizure: Sudden cry (or aura), fall, rigidity, followed by muscle jerking; shallow, irreg breathing; possible loss of bladder or bowel control; lasts seconds to minutes

A

generalized tonic-clonic (grand mal)

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78
Q

Grand mal seizures are followed by

A
  1. some confusion
  2. period of sleep (postictal lethargy), and then
  3. return to full consciousness
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79
Q

Childhood Epilepsy is classified into (2)

A
  1. partial seizures

2. generalized seizures

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80
Q

Generalized seizures involve a ____.

A

loss of consciousness.

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81
Q

The most common generalized seizure is the ___

A

tonic-clonic or grand mal.

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82
Q

A grand mal epilepsy has three distinct phases:

A
  1. An aura (subjective sensation)
  2. A tonic-clonic seizure
  3. Postictal lethargy—a short period of sleep after
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83
Q

__ seizures cause a temporary loss of awareness that results in a lack of continuity in the learning environment.

A

Petit mal, or Absence seizures

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84
Q

Type of Seizures: Consciousness may be intact or slightly impaired.

A

Partial seizures

account for 40% of childhood seizures

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85
Q

Often mistaken for alterations in behavior or “tics,” which usually involve only the face or shoulders.

A

Simple partial seizures (Jacksonian)

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86
Q

Can be manifested by motor activities, sensory signs, or psychomotor (behavioral) activity.

A

Complex partial seizures

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87
Q

A hemoglobin level

A

8g/dL

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88
Q

The most common nutritional deficiency of children in the US today is __ caused by ___

A
  1. anemia

2. insufficient amounts of iron in the body.

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89
Q

Iron-deficiency anemia may be caused by

A
  1. severe hemorrhage
  2. inability to absorb the iron received
  3. excessive growth requirements
  4. inadequate diet
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90
Q

8 good sources of Iron

A
  1. Boiled egg yolk
  2. liver
  3. leafy green vegetables
  4. Cream of Wheat
  5. dried fruits
  6. dry beans
  7. crushed nuts
  8. whole-grain bread
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91
Q

4 symptoms of iron-deficiency anemia are

A
  1. pallor
  2. irritability
  3. anorexia
  4. decrease in activity
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92
Q

Oral iron supplements should not be ingested with ___ because it interferes with iron absorption

A

milk or milk products

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93
Q

__ aids in the absorption of iron

A

Vitamin C

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94
Q

Liquid preparations of Iron are taken ___ to prevent ___

A
  1. through a straw

2. discoloration of the teeth

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95
Q

The stools of infants who are taking oral iron supplements are __.

A

tarry green

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96
Q

Sickling (clumping) caused by decreased blood oxygen levels may be triggered by

A
  1. dehydration
  2. infection
  3. physical or emotional stress
  4. exposure to cold
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97
Q

Two types of sickle cell disease:

A
  1. Sickle Cell Trait (asymptomatic)

2. Sickle Cell Anemia (more severe, necessitates intermittent hospitalization

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98
Q

T/F: Sickle Cell Trait can develop into Sickle Cell Disease

A

False

Sickling is more rapid and extreme with Sickle Cell Disease. In Sickle Cell Trait, the Hb and RBC counts are normal

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99
Q

In Sickle Cell Trait, the abnormality is inherited from (one/both) parent(s)

A

one parent

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100
Q

In Sickle Cell Anemia/Disease, the abnormality is inherited from (one/both) parent(s)

A

both parents

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101
Q

Sickle Cell Anemia: The Hb ranges from ___ g/dL or lower

A

6 - 9 g/dL

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102
Q

4 Manifestations of Sickle Cell Anemia

A
  1. Pale
  2. Tires easily
  3. Little appetite
  4. Unusual swelling, fingers and toes
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103
Q

Children with sickle cell disease have a risk for stroke as a complication of ___

A

a vasoocclusive sickle cell crisis.

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104
Q

Sickle Cell Crisis: First manifestations of crisis (5)

A
  1. appears acutely ill
  2. severe abdominal pain
  3. Muscle spasm
  4. leg pain, or
  5. painful swollen joints
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105
Q

The sickle cell crises recur periodically throughout childhood; they tend to (increase/decrease) with age.

A

decrease with age

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106
Q

Sickle Cell Anemia - Pt Care/Teaching Points (6)

A
  1. Immunizations are important
  2. Refrain from becoming overly tired
  3. Avoid flying in airplane (unpressurized) or exercising (high altitude)
  4. Avoid extra stress, exposure to cold
  5. Avoid overheating (> dehydration)
  6. Oral intake of iron is of no value
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107
Q

Important immunizations for child with Sickle Cell Anemia

A
  1. Haemophilus influenzae
  2. Hep A and Hep B
  3. pneumococcal vaccine
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108
Q

Sickle cell disease: Detected before birth by mandatory screening of all newborns. The ____ is commonly used for screening.

A

sickling test (Sickledex)

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109
Q

When the Sickledex is positive, ___ is used; it distinguishes between patients with the trait and those with the disease.

A

Hemoglobin electrophoresis (“fingerprinting”)

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110
Q

The classic symptom of ITP is ____

A

slowed blood clotting and easy bruising

result in petechiae and purpura

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111
Q

An acquired platelet disorder that occurs in childhood; platelets become coated with antiplatelet antibody, “perceived” as foreign material, and are eventually destroyed by the spleen

A

Idiopathic (immunological) thrombocytopenic purpura (ITP)

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112
Q

ITP: There may have been a recent history of (3)

A
  1. rubella
  2. rubeola
  3. viral respiratory infection
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113
Q

ITP: The platelet count is ___ Diagnosis is confirmed by bone marrow aspiration to rule out leukemia.

A

below 20,000/mm3

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114
Q

ITP: Diagnosis is confirmed by ___.

A

bone marrow aspiration to rule out leukemia

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115
Q

Platelet Count: Normal Range

A

150,000/mm3 and 400,000/mm3

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116
Q

ITP: When platelet counts are low, the greatest danger is spontaneous intracranial bleeding. ___ ___ are therefore a priority of care.

A

Neurological assessments

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117
Q

Treatment is not indicated in most cases of ITP. Spontaneous remission occurs in about ___.

A

6 weeks to 4 months

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118
Q

Drugs that interfere with platelet function

A
  1. aspirin
  2. phenylbutazone (Butazolidin)
  3. phenacetin
  4. acetylsalicylic acid
  5. caffeine (APC)
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119
Q

Complications of ITP include (3)

A
  1. bleeding from GI tract
  2. hemarthrosis
  3. intracranial hemorrhage
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120
Q

ITP TX: After administration of anti-D antibody the child should be observed for 1 hour for (4)

A
  1. fever
  2. chills
  3. headache
  4. alteration in VS
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121
Q

The most common symptoms during the initial phase of leukemia are (7)

A
  1. low-grade fever
  2. pallor
  3. bruising tendency
  4. leg and joint pain
  5. listlessness
  6. abdominal pain
  7. enlargement of lymph nodes
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122
Q

Chemotherapy-Leukemia: Care/Teaching

A
  1. infection prevention
  2. Adequate hydration (kidney damage)
  3. Routine immunization delayed while receiving immunosuppressive drugs
  4. report exposure to infections
  5. I/O record is
  6. Meticulous oral hygiene
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123
Q

Common complications of chemotherapy

A
  1. Nausea and vomiting
    (result in decreased appetite, weight loss, and generalized weakness)
  2. Alopecia
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124
Q

Four priority challenges in the care of leukemic children are:

A
  1. Complications of Anemia - decreased RBC infection
  2. Infection - Neutropenia
  3. Bleeding - decreased Platelets
  4. fractures from involvement of bone marrow
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125
Q

Interventions to prevent UTIs (7)

A
  1. Cleanse with each diaper change
  2. Front to back
  3. Avoid bubble baths
  4. Urinate immed. after bath
  5. White, cotton underwear
  6. Loose-fitting clothing
  7. Adequate fluid intake
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126
Q

Nephrotic Syndrome TX: Prednisone Action

A

to decrease Proteinuria (decreased edema)

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127
Q

While a child is receiving Prednisone to treat Nephrotic Syndrome, it is important for the nurse to assess the child for ___.

A

infection

steroids mask signs of infection

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128
Q

An allergic reaction (antigen-antibody) to a group A beta-hemolytic streptococcal infection; It may appear after scarlet fever or skin infections.

A 
Acute glomerulonephritis (AGN)
(formerly, Bright’s disease)
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129
Q

AGN

A

Acute glomerulonephritis

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130
Q

Most common form of nephritis in children; boys > girls

A

Glomerulonephritis

131
Q

Glomerulonephritis: (One/Both) kidney(s) are usually affected

A

Both

132
Q

Glomerulonephritis: The glomerulus becomes inflammed/blocked, resulting in ____

A

red blood cells and protein to enter the urine (hyperkalemia)

133
Q

Because of hyperkalemia associated with AGN, the nurse recommends that the child avoid food such as __, during periods of oliguria

A

bananas (high Potassium)

134
Q

AGN: When HTN and Edema are present, ____ is restricted

A

sodium and fluid

135
Q

The characteristic symptom of nephrosis

A

edema

136
Q

Nephrosis: Edema is first noticed ____

A

around the eyes and ankles

later becomes generalized

137
Q

Nephrosis: Signs and Symptoms (7)

A
  1. Weight gain (accumulation of fluid)
  2. Ascites
  3. Pale
  4. Irritable
  5. Listless
  6. Poor appetite
  7. BP usually normal
138
Q

Sickle Cell Crisis Type: Most common, Obstruction of blood flow by cells, Infarctions, and some degree of Vasospasm

A

Vasoocclusive (painful crises)

139
Q

Sickle Cell Crisis Type: Dactylitis, Painful joints/extremities, Abd pain, CNS strokes, Pulmonary disease, and/or Priapism may be present.

A

Vasoocclusive (painful crises)

140
Q

Vasoocclusive Sickle Cell Crisis: Medical Treatment

A

Morphine, Codeine or Vicodin

commonly prescribed with IV hydration

141
Q

Sickle Cell Crisis Type: Large amounts of blood pool in liver and spleen; Spleen becomes massive; Abd pain

Circulatory collapse and shock are present

A

Splenic sequestration Crisis

142
Q

Sickle Cell Crisis Type: Death may occur within hours of appearance of symptoms.

A

Splenic sequestration Crisis

143
Q

Sickle Cell Crisis Type: Bone marrow stops producing red RBCs; a number of infections may precipitate this (usually viral). Decreased reticulocyte count may be present.

A

Aplastic Crises

144
Q

Sickle Cell Crisis Type:

  • Rapid rate of hemolysis; rare condition.
  • Functional hyposplenism and overwhelming infection.
  • Progressive fibrosis of spleen reduces its function
  • Patient becomes more susceptible to infection
A

Hyperhemolytic Crisis

145
Q

A nephroblastoma; an embryonal adenosarcoma that is now known to be associated with certain congenital anomalies, particularly of the genitourinary tract.

A

Wilms’ tumor

seldom affects both kidneys

146
Q

Treatment of patients with Wilms’ tumor consists of a combination of (3)

A
  1. surgery
  2. radiation therapy
  3. chemotherapy
147
Q

Wilms’ tumor: One important consideration pertaining to this condition is the avoidance of ___

A

all unnecessary handling of the abdomen, because it can cause the tumor to spread.

148
Q

** Nephrosis **
No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

A

** Nephrosis **
No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

149
Q

An excessive amount of fluid in the sac that surrounds the testicle, and it causes the scrotum to swell

A

hydrocele

150
Q

When one or both testes fail to lower into the scrotum, the condition is termed ___.

A

cryptorchidism

151
Q

Surgery to move an undescended testicle into the scrotum and permanently fix it there; the surgery used to resolve testicular torsion.

A

Orchiopexy

152
Q

T/F: Cryptorchidism - the incidence of testicular tumors is increased in these patients during adulthood

A

TRUE

153
Q

Orchiopexy: Post-Op Care (4)

A
  1. Prevent contamination of the suture line
  2. Scrotal support
  3. Monitoring of the urine output
  4. Prevention of infection
154
Q

Urinary or Genital Surgery: Home Care (3)

A
  1. Tub baths may be contraindicated
  2. dressings inspected daily
  3. restrictions on play activities that involve straddle toys
155
Q

Children with __ are born with the urethral opening on the undersurface of the penis.

A

hypospadias

156
Q

A serious congenital defect in which the bladder lies exposed on the lower portion of the abdominal wall. Surgical correction of this defect is lifesaving.

A

Bladder exstrophy

157
Q

Obstruction of the urinary tract may lead to __ a distention of the kidney pelvis

A

hydronephrosis

158
Q

An abnormal collection of fluid in the peritoneal cavity; seen in advanced cases of Nephrosis and in other conditions

A

Ascites

159
Q

Routine abdominal palpation is omitted for a child diagnosed with __ __

A

Wilms’ tumor

160
Q

Early treatment of cryptorchidism is necessary to ____

A

preserve testicular function.

161
Q

The minimum urine output for INFANTS and TODDLERS is ___ mL/kg/h

A

2 - 3mL/kg/hr

162
Q

The minimum urine output for PRESCHOOLERS is ___ mL/kg/h

A

1 - 2mL/kg/hr

163
Q

The minimum urine output for School-age children and Adolescents is __ mL/kg/h

A

0.5 - 1mL/kg/hr

164
Q

The loss of an achieved level of functioning to a past level of behavior

A

Regression

Regression of growth and development during hospitalization can be expected

165
Q

The nurse would teach the parent to best administer an oral suspension by

A

using an oral syringe

placed midway back,placing the medication in the side of the infant’s mouth.

166
Q

The tympanic thermometer is considered more accurate because

A

the tympanic membrane shares circulation with the hypothalamus

167
Q

The __ restraint is the most appropriate for the insertion of an intravenous line in a scalp vein of an infant.

A

mummy

168
Q

A max dose of ___ should be injected in one site for an infant.

A

1 mL

169
Q

When suctioning a tracheostomy, the nurse will apply suction for no more than ___

A

10 - 15 seconds

170
Q

Truthful answers will give a child a (1)__ and help establish (2)__

A
  1. realistic expectation

2. trust in the nurse

171
Q

The best site for giving an IM injection to a 15-month-old child

A

vastus lateralis muscle

free of major blood vessels and nerves

172
Q

The factor that affects the infant’s physiological response to medications is __ __ __

A

immature kidney function

173
Q

Immature kidney function prevents effective excretion of ____ in infants less than 1 year

A

drugs from the body

174
Q

Position for Lumbar Puncture procedure

A

On side with knees flexed

Head is brought down close to the flexed knees

175
Q

1 g is equivalent to __ mL of output.

A

1 mL

176
Q

The nurse understands that pain in infants can be assessed by ____

A

observation of behavior

177
Q

Erikson
1 : psychosocial development
2: cognitive development
3: moral development

A

1 : psychosocial development

178
Q

Piaget
1 : psychosocial development
2: cognitive development
3: moral development

A

2: cognitive development

179
Q

Kohlberg
1 : psychosocial development
2: cognitive development
3: moral development

A

3: moral development

180
Q

Fiber intake of the child should be based on __g fiber/ kg

A

0.5 g fiber/ kg

181
Q

When should a child be able to put 3+ words together into a sentence?

A

by 2 yo

182
Q

How many doses of Diphtheria, tetanus and acellular pertussis (Dtap) should a child receive?

A

5

183
Q

At what age should the first rotaviris immunization be given?

A

2 months

184
Q

Immunization schedule for Dtap

A 
2 mo
4 mo
6 mo
15 - 18 mo
4 - 6 yo
185
Q

Rotavirus: “Rotarix” is a __ dose series, given at ____

A

2-dose series

2, and 4 mo

186
Q

Rotavirus: “RotaTeq” is a __ dose series, given at ____

A

3-dose series

2, 4, 6 months

187
Q

A child less than 2 yo will not be given a flu immunization via the nasal route because _____

A

immune system is not ready

188
Q

The Nasal Spray (flu immunization) is a _____, and a child

A

weakened Live Virus

189
Q

When determining the size of portions, toddlers and young children should be offered ___ of solid food PER YEAR of age.

A

1 tablespoon

190
Q

During the School-age period, the average weight gain per year is generally ___

A

5.5 - 7 lbs

191
Q

School-age children: Piaget refers the thought process of this period as __ __, which involves __ and __.

A
  1. Cognitive thinking
  2. Logical thinking, and
  3. Understanding of cause and effect
192
Q

Emgcy TX: Avulsed Tooth

A
  1. Pick up by crown to (avoid damaging root)
  2. Place the tooth in milk
  3. Dentist office
193
Q

Young, NEUTERED female dogs produce (fewer/more) allergens than older, UNNEUTERED males

A

FEWER

194
Q

If an allergenic pet is already part of the family, the risks can be minimized by (2)

A
  1. frequent bathing

2. keeping pet outdoors (at least out of child’s bedroom).

195
Q

Least offensive pet for the allergic child

A

Poodle

does not have a shed cycle

196
Q

School-age: Nervous habits (tics), may appear. They are mainly a result of ____

A

tension/stress.

197
Q

The nurse suggests to the parents of an overweight 9 yo, that to help prevent obesity, they should ____

A

encourage physical activity (1 h/day)

198
Q

The most accidental deaths in adolescence are related to ___

A

automobiles

199
Q

One psychological task of Adolescence on which the nurse must focus when planning care is the development of a sense of ___

A

identity.

200
Q

Adolescence: Psychological Milestones - FIVE I’s

A
  1. Image of Self
  2. Identity
  3. Independence
  4. Interpersonal relationships
  5. Intellectual maturity
201
Q

Adolescence: Pre-occupation with ____ is normal, and accounts for ____

A
  1. self-image

2. the constant pimping

202
Q

Rapidly used Carbs (6)

A
  1. Corn Flakes
  2. Bagels
  3. Raisins
  4. Maple syrup
  5. Potatoes
  6. Rice
203
Q

Slow Carbs (5)

A
  1. Apples, Pears
  2. Green peas
  3. Chickpeas
  4. Skim milk
  5. Yogurt
204
Q

According to Piaget, the Cognitive aspect that is developed during adolescence is the ability to _____

A

consider hypothetical situations

think abstractly

205
Q

Restlessness in the Adolescent is, in part, attributable to (5)

A
  1. Drive to be accepted as an individual
  2. Urge for Independence
  3. Estab. of personal I.D.
  4. Intense Libido
  5. Rapid body changes
206
Q

Likely TX for positive throat culture for group A hemolytic streptococcus

A

Oral Penicillin, 10 days

207
Q

Child with Laryngeal Spasm: Initial Intervention

A

Place in high-humidity environment (bathroom with hot shower running)
- Humidity liquefies secretions and reduces spasms

208
Q

Tonsillectomy and Adenoidectomy: Most common postoperative complication

A

Hemorrhage

209
Q

Best choice for Fluid Replacement to offer a child who just had a Tonsillectomy:

a) chocolate milk
b) cola drink
c) orange juice
d) a popsicle

A

Popsicle

  • Small amounts of clear liquid
  • Synthetic fruit juices are not as irritating as Natural juices
210
Q

Acute Asthma Attack: Auscultating breath sound expected

A

Expiratory Wheezing

211
Q

Therapeutic Class: Cromolyn

A

Anti-inflammatory Inhalant

212
Q

Anti-inflammatory Inhalant for a child with exercise-induced asthma is taken ____

A 
before exercise (to prevent attacks/prophylactic)
- does nothing for the attack in progress
213
Q

CF: An inherited disease. (One/Both) parent(s) must be carrier of the CF gene

A

BOTH

214
Q

CF: Proper respiratory therapy

A
  1. Postural Drainage FOLLOWING Nebulization
  2. Schedule BEFORE meals, or
  3. 1 hour AFTER eating
    - prevent vomiting
215
Q

To facilitate digestion and absorption of nutrients, the child needs to take ___ with every meal and with snacks

A

pancreatic enzymes

216
Q

The asthmatic child who has been taking Theophylline complains of stomachache and tachycardia and is sweating profusely. These symptoms are recognized as __ __.

A

drug toxicity

217
Q

The characteristic signs of Allergic Rhinitis include (4)

A
  1. nasal congestion
  2. clear, watery nasal discharge
  3. sneezing
  4. itching eyes
218
Q

Cluster of signs related to Chronic Allergy (5)

A
  1. Allergic Salute
  2. Mouth breathing
  3. Dark circles under eyes
  4. Reddened Conjuctiva
    (NO PRODUCTIVE COUGH)
219
Q

An opening between the right and left ventricles of the heart; Increased pressure within the left ventricle forces blood back into the right ventricle (left-to-right shunt).

A

Ventricular Septal Defect (VSD)

220
Q

Characteristic heart sound of VSD

A

A loud, harsh murmur,

combined with a systolic thrill

221
Q

Characteristic heart sound of PDA

A

machinery type of murmur

222
Q

A characteristic symptom of COA is a marked difference in BP that is

A

lower in the legs than in the arms.

223
Q

Administration of digoxin (Lanoxin):As a rule, if the pulse rate of an infant is ___ the medication is withheld and the physician is notified

A
224
Q

The areas of the heart affected by Carditis are the (2)

A
  1. heart muscle

2. mitral valve

225
Q

Fatigue during ____ is common to most infants with congenital cardiac problems.

A

feeding or activity

226
Q

How does Kawasaki disease affect the child’s heart and blood vessels?

A

inflammation weakens blood vessels

> leading to aneurysm

227
Q

Tetralogy of Fallot: Clubbing of the fingers develops in response to ___.

A

chronic hypoxia

228
Q

A child recovering from RF will need to receive monthly injections of __ for a minimum of ___year(s).

A
  1. penicillin G (200,000 units/dose)

2. 5 years

229
Q

Heart healthy diet: Limit FATS to no more than ____% of the total dietary intake.

A

30 %

230
Q

Infant with CHF: Modify feeding techniques to adapt for the child’s weakness and fatigue (4)

A
  1. Frequent, smaller feedings
  2. Soft nipple, enlarged holes
  3. Holding/cuddling encourages to feeding
  4. High-caloric formula
231
Q

After birth, a newborn with Tracheoesophageal fistula will _____.

A

vomit and choke on first feeding

232
Q

Aganglionic megacolon; occurs when there is an absence of ganglionic innervation to the muscle of a segment of the bowel.

A

Hirschsprung’s disease

233
Q

Hirschsprung’s disease: Because of the absence of nerve cells, there is a lack of normal ___.

A

peristalsis

234
Q

Hirschsprung’s disease: The result is chronic constipation, with ____ stools when passed

A

Ribbonlike stools

235
Q

In the infant, constipation, ribbonlike stools, abdominal distention, anorexia, vomiting, and failure to thrive may be evident of _____

A

Hirschsprung’s disease

236
Q

Hirschsprung’s disease: The development of ___ is a serious complication.

A

enterocolitis

237
Q

Inflammation of the small bowel and colon

A

enterocolitis

238
Q

3 Manifestations that may signal Enterocolitis

A
  1. fever
  2. explosive stools
  3. depletion of strength
239
Q

A slipping of one part of the intestine into another part just below it

A

Intussusception

240
Q

Sudden, severe Abd pain (loud cries), straining efforts, kicking/drawing of the legs toward Abd; Vomit is bilious; BM diminish, Little flatus passes; Currant jelly stools; Fever; Signs of shock

A

Intussusception

241
Q

Fetal intestine is attached to the yolk sac by the Vitelline duct. A SMALL BLIND POUCH may form if this duct fails to disappear completely. This condition is termed __ __.

A

Meckel’s diverticulum

242
Q

Meckel’s diverticulum: Most common sign

A

Painless bleeding from the rectum

243
Q

(2) are useful in diagnosing Meckel’s diverticulum

A
  1. Barium enema

2. Radionuclide scintigraphy

244
Q

A protrusion of part of the abdominal contents through the inguinal canal in the groin. It is more common in boys than in girls.

A

Inguinal hernia

245
Q

A protrusion of a portion of intestine through the umbilical ring

A

Umbilical hernia

246
Q

Vomiting = (Acidosis/Alkalosis)

A

Alkalosis

247
Q

Diarrhea = (Acidosis/Alkalosis)

A

Acidosis

248
Q

A child is brought to the pediatric clinic because he has been VOMITING for the past 2 days. An acid-base imbalance that the nurse would expect to occur from this persistent vomiting is:

A

Alkalosis

249
Q

__ __ is the outstanding symptom of Pyloric Stenosis

A

Projectile Vomiting

250
Q

Child has been scratching the anal area and complaining of itching, the nurse might suspect this child has __

A

pinworms

251
Q

One intervention to prevent the further spread of pinworms is to ____

A

keep the child’s fingernails short

- Pinworms are not spread from person to person.

252
Q

T/F:

Pinworms are spread from person to person.

A

FALSE

253
Q

Intussusception: Currant jelly stools are common about ___ after the onset of the obstruction

A

12 hours

254
Q

ascariasis

A

roundworm

255
Q

The child can ingest roundworm eggs from __ __.

A

contaminated soil

256
Q

Roundworm: The condition is caused by (2)

A
  1. unsanitary disposal of human feces

2. poor hygiene practices

257
Q

Roundworm: Diagnosis is made by

A

confirmation of the eggs in the patient’s stool

258
Q

Roundworm: Treatment (2)

A
  1. albendazole, or

2. 3-day oral dose of nitazoxanide.

259
Q

Celiac disease causes malabsorption. Stools that are _____ may indicate malabsorption.

A

large, bulky, and frothy

260
Q

A grain that can be eaten by a child with celiac disease is ___

A

rice

261
Q

Celiac Disease Nutrition: These children will have a lifelong restriction of (4)

A
  1. wheat
  2. oats
  3. Barley
  4. Rye
262
Q

The priority goal of care in Gastroenteritis is preventing ____

A

fluid and electrolyte imbalance

263
Q

Separation Anxiety accurs after age ___, and is most pronounced in the ___.

A
  1. 6 months

2. Toddler

264
Q

If an accident happens as a result of mischief on his or her part, the Preschooler may feel ___

A

guilty

“I got sick because I was bad”

265
Q

Room Assignment: Adolescents usually do better in

a) a single room
b) rooms with one or more roommates

A

b) rooms with one or more roommates
- closes to his/her age
- also lives with similar illness

266
Q

4 yocries when mother tells him it’s time for operation. This is an expected reaction because the preschooler is particularly fearful of

a) loss of control
b) unfamiliar routines
c) invasive procedures
d) restricted motility

A

c) invasive procedures / bodily harm

267
Q

Best site to use when assessing Pulse Rate on a 12 mo infant is the __ pulse

A

apical

268
Q

___ pulses are advised for children under 5 years old

A

Apical

269
Q

Clean-catch Specimen: 4 Guidelines

A
  1. Sterile container
  2. Cleanse perineum with antiseptic
  3. Rinse/dry (to prevent contamination from antiseptic)
  4. Midstream specimen
270
Q

Emergency action for Airway Obstruction in the infant is to give ___

A

5 back blows. followed by 5 chest thrusts

271
Q

At what age are children capable of assuming more responsibility for personal belongings?

A

9 years old

272
Q

Piaget: School-age children are in the __ __ stage of cognitive development

A

Concrete Operations

273
Q

Helping the School-age child _____, that is keeping him from mastery can limit frustration.

A

focus on the problem

- quitting or having someone else finish is detrimental

274
Q

Using ___ is essential when planning sex education classes for School-age children

A

simple terms

- slang/street terms need to be clarified

275
Q

Most children give up the habit of thumb-sucking by ____

A

the time they reach school

276
Q

Helpful measures for the child with Enuresis

A
  1. rewarding dry nights - chart progress
  2. Limit Liquids after dinner
  3. Void before bed
  4. counseling
  5. hypnosis
  6. behavior modification
  7. pharmacotherapy
277
Q

Involuntary urination after the age at which bladder control should have been established

A

Enuresis

278
Q

Secondary enuresis refers to a _________.

A

recurrence in a child who has been dry for a period of 1 year or more

279
Q

daytime, wetting

A

Diurnal

280
Q

nighttime, wetting

A

Nocturnal

281
Q

T/F:

Large, construction toys are suitable for the Preschool age child

A

TRUE

farm play set with large pieces

282
Q

Playing independently within a group

A

Parallel play

283
Q

Playing in loosely associated groups

A

Associative play

284
Q

Both parallel play and associative play are typical of a __ year old

A

3 year old

285
Q

Self-consoling behaviors for the toddler, particularly at bedtime and during separation from parents (2)

A
  1. Clinging to favorite possessions

2. Repetitive rituals

286
Q

To encourage a Toddler to practice independence, the nurse would recommend that the child’s mother ____

A

offer him a choice between 2 items

too many can confuse toddler

287
Q

The posterior fontanelle closes at ___ months of age

A

2 - 3 months

288
Q

The infant usually doubles his birth weight by ___

A

6 months of age

289
Q

The infant usually triples his birth weight by ___

A

12 months of age

290
Q

The nurse would expect a 4 mo to be able to ___

A

lift head and shoulders

development is cephalocaudal

291
Q

The infant can usually sit with support at about __ mo of age

A

5 months

292
Q

The infant can usually sit alone at about __

A

8 months

293
Q

Introducing solid food: only one new food is offered in a ____

A

4 to 7 day period (to determine tolerance)

294
Q

The __ month old tries to creep, has developed pincer movement, and can grasp a spoon without keeping food on it

A

9 month old

295
Q

The ___ is able to speak two word sentances

A

24 month old

296
Q

The palmar grasp reflex disappears at about __

A

4 months

297
Q

By age___, the child masters spoon-feeding.

A

2 years

298
Q

Pincer grasp is well established by __

A

12 months

299
Q

The basic unit of structure in American society (mother, father, siblings).

A

Nuclear/Biological family

Today many nuclear families do not share the same household because of single parenthood, divorce, and remarriage

300
Q

Refers to three generations: grandparents, parents, and children.

A

extended family

301
Q

Protropin is contraindicated for a 24 year old because ___

A

further bone growth can no longer take place after epiphyseal closure

302
Q

Androgens are (male/female) hormones

A

male hormones

303
Q

What is the earliest age for the last dose of Hep B vaccine be given (recommended schedule)

A

6 months

304
Q

HPV vaccine: There are __ types of this vaccine

A

two

one is exclusively for girls

305
Q

The varicella vaccine is contraindicated in the client who is __

A

pregnant

chicken pox

306
Q

The Hib vaccine protects the client from contracting ___

A

influenza b

307
Q

Erickson: Psychosocial crisis for the School-age child

A

Industry vs Inferiority

308
Q

Tonsillectomy: Post-Op

To facilitate drainage immediately after surgery, the child is placed ___

A

partly on the side and partly on the abdomen

side lying

309
Q

Mantoux (PPD)skin test: Area of induration that measures 10 mm is interpreted as a __ result

A

positive

310
Q

The nurse would advise a mother to clear the nostrils when her infant has a cold by

A
  1. instilling a few drops of saline

2. suction secretions with bulb syringe

311
Q

___ is a primary sign of increased respiratory obstruction.

A

Restlessness

312
Q

Acute laryngotracheobronchitis: The assessment finding that would indicate the child is experiencing increased respiratory obstruction is ___

A

restlessness.

313
Q

Inhalant powders can cause ___

A

candidiasis (yeast) infection of the mouth.

314
Q

Use of a dry powder inhaler for the treatment of asthma should include the warning to RINSE THE MOUTH AFTER INHALING THE POWDER to prevent:

A

candidiasis

315
Q

Pulmonary edema appears in a child with SMOKE INHALATION INJURY ___ hours after exposure

A

6 to 72 hours

316
Q

Patent ductus arteriosus (PDA): Dyspnea occurs because blood is:

A

circulated through the lungs again

causing pulmonary circulatory congestion

317
Q

Symptoms of digoxin toxicity include (5)

A
  1. nausea
  2. vomiting
  3. anorexia
  4. irregularity in pulse rate and rhythm
  5. sudden change in pulse
318
Q

The nurse is aware that the infant born with hypoplastic left heart syndrome must acquire his or her oxygenated blood through ___

A

the patent ductus arteriosus.

319
Q

After birth, a newborn with Tracheoesophageal fistula will ____

A

vomit and choke when the first feeding is introduced.

320
Q

Meckel’s diverticulum: Development

A

a pouch forms when the vitelline duct fails to disappear.

321
Q

Antidote for Acetaminophen

A
  1. Gastric lavage

2. N-acetylcysteine (Mucomyst)

322
Q

Signs of dehydration in a child may not be evident until fluid loss has reached __

A

4%

323
Q

Zaroxolyn: Appropriate nursing considerations

A

Na+ sodium restrictions
limited ambulation
check blood sugar levels more frequently

324
Q

Because of a cardiac defect, the client has HTN. Which medication would most likely be prescribed to treat this issue?

A

trentoin

From Flashcardlet (144 decks)

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