Assessment and Intervention

Question 1

what things should you consider when obtaining a consent for someone younger than 21 (2)

Answer 1

parent or legal guardian will sign consent

any one who takes the child to the hospital can give consent

Question 2

what can help the child develop coping skills

Answer 2

imagery
distraction
relaxation

Question 3

when allowing the child handle objects that will be used in their care, what does this help do

Answer 3

helps to develop familiarity with the objects and helps reduce the threat often associated with their use

Question 4

what can “play” be used to do

Answer 4

express feelings, teach, reach a therapeutic goal (child give shot to doll), have fun

Question 5

when should you tell the child their are getting a procedure

Answer 5

the younger the child the closer to the procedure

Question 6

what should we do for the parents who DO want to stay with the child

Answer 6

give them a job to do

Question 7

what should we do for the parents who DONT want to be present with child

Answer 7

tell them how long it will take, and where they need to wait

also we need to respect their choice

Question 8

where can the procedure take place and how should it go

Answer 8

treatment room
playroom
should be organization and confident

Question 9

after the procedure what should be done

Answer 9

praise the child
reward the child
allow child to talk about what happened
return to see the child shortly after procedure

Question 10

what should be done to measure recumbent length for birth-2 years

Answer 10

hold head in midline
push knees flat and fully extended
mark paper and measure between marks

Question 11

when measuring height or stature in children older than 2 years of age what should be done

Answer 11

standing up they should be touching in 3 points against wall or measuring device

Question 12

who are platform scales used for

Answer 12

infants and very young children (weigh infants nude)

Question 13

in failure to thrive babies what may ftt be a result of

Answer 13

physical problems
psychosocial issues
poverty
health beliefs
family stress
feeding issues

Question 14

what percentile do the ftt babies fall on

Answer 14

weight less than 5th percentile

Question 15

what should you ask the parent of an ftt baby

Answer 15

diet history
parent height
physical
assessment of meal time rituals, behaviors
take a look at parent child interaction
(R?O lead toxicity, anemia, ova and parasites

Question 16

what is the nursing care management with an ftt baby

Answer 16

provide positive feedings
doc childs behavior and parent child interaction during feeding
provide primary core of nurses
introduce new foods slowly

Question 17

when assessing the pt what should you do first (atraumatic care)

Answer 17

1st= respirations
2nd= heart rate
last= blood pressure and temp

Question 18

what is best practice when obtaining a pulse

Answer 18

apical pulse for 1 full minute

Question 19

if a child is in-between blood pressure cuff sizes what should the nurse do

Answer 19

choose the bigger one

Question 20

what blood pressure location is least invasive

Answer 20

dorsalis pedis artery because its farther from the core

Question 21

what factors affect body temp

Answer 21

active exercise
stress
crying
environment

Question 22

what is the first thing that should be given to a child with fever

Answer 22

antipyretics

Question 23

when can you start interventions related to fever

Answer 23

an hour after antipyretics are given

Question 24

what things can be done after antipyretics have not sufficiently lowered the temp of child

Answer 24

minimal clothing
increasing air circulation
applying cool, moist compresses (do not use if causes shivering)

Question 25

caused by prolonged and repetitive contact with an irritant or combination or irritants

Answer 25

diaper dermatitis "diaper rash"

Question 26

white patches on the tongue, palate, and inner aspects of the cheeks that do not scrape off

Answer 26

oral candidiasis (thrush)

Question 27

when will thrush start going away

Answer 27

may take 2 months to resolve but in the meantime it may spread

Question 28

if a child has thrush what should be given 4 times a day

Answer 28

nystatin

Question 29

what is important to know about administering nystatin

Answer 29

give after feeding so it doesn't get washed down swab over surface of oral mucosa and tongue swallow remainder

Question 30

if the child with thrush is breastfed who should be treated

Answer 30

both mother and baby

Question 31

how should bottles, nipples and pacifiers be cleaned if the child has thrush

Answer 31

boil for 20 minutes (spores are resistant to heat)

Question 32

when should the posterior fontanel be closed

Answer 32

by 2 months of age

Question 33

when should the anterior fontanel be closed

Answer 33

by 12-18 months of age

Question 34

what is know as the red reflex

Answer 34

fundus

Question 35

when should the child have binocular vision

Answer 35

4 months

Question 36

one eye does not fixate correspondingly

Answer 36

strabismus

Question 37

lazy eye, brain started turning off and eventually that eye will become blind

Answer 37

amblyopia

Question 38

when looking at the ear what is important

Answer 38

the top of ear is aligned with outer corner of eye

Question 39

low set ears usually indicate

Answer 39

autism

Question 40

why are children more prone to ear infections

Answer 40

because they have wide open flat lying eustachian tubes and that is great for bacteria to get into

Question 41

for access to canal of a child less than 3 years what should you do

Answer 41

pull pinna down and back

Question 42

for access to canal of child older than 3 years what should you do

Answer 42

pull pinna up and back

Question 43

what is it called when the chest bones are sunken in

Answer 43

excavatum

Question 44

what is it called when the chest bones are sticking out

Answer 44

carinatum

Question 45

where can you check the pulse rate on a child

Answer 45

less than 7= fourth intercostal | greater than 7= fifth intercostal

Question 46

what is a normal finding when listening to a childs heart

Answer 46

sinus arrhythmia

Question 47

what are 6 signs of respiratory failure

Answer 47

``` nasal flaring retractions cyanosis asthma (wheezing) grunting crackles ```

Question 48

if pt is nearing respiratory failure what mask will be most beneficial

Answer 48

non rebreather

Question 49

what 5 things should be done when suctioning a trach

Answer 49

- suction should be 1/2 diameter of tube - humidify before and after procedure with 100% O2 - < 5 seconds down and for infants and <10 for children - rest 30-60 sec between - always monitor pulse ox during procedure

Question 50

what fluid is preferred for an enema

Answer 50

isotonic fluid (DO NOT GIVE tap water)

Question 51

1Gm of wet diaper weight=

Answer 51

1mL of urine

Question 52

what is the minimum acceptable urine output formula for an infant (birth-2)

Answer 52

1mL/kg/hr

Question 53

what is the minimum acceptable urine output for a child (2 and greater)

Answer 53

0.5mL/kg/hr

Question 54

how often should you assess IV site

Answer 54

every 1-2 hrs

Question 55

for implanted ports how often are they heparinized

Answer 55

once a month or after an infusion

Question 56

for broviac (tunneled catheter) how often are they heparinized

Answer 56

daily

Question 57

what should pediatric "rate to be infused" be set

Answer 57

for 2 hours of fluid and attend to IV alarms promptly because their iv sites can clot and or infiltrate really fast

Question 58

what are the 8 s/s of a hemolytic reaction (after administration of blood products)

Answer 58

``` sudden severe HA chills fever shaking N/V chest tightness flank pain if there is a reaction turn off blood, maintain IV of NS ```

Question 59

when using an oral syringe for oral medications where should it be placed

Answer 59

to side of tongue so it goes back of mouth and give slowly (NEVER mix medication in milk bottle or formula because they may not finish it)

Question 60

for a baby, what amount can you inject into one muscle

Answer 60

no more than 0.5- may need to split into two injects if volume is too much

Question 61

for a small child, what amount can you inject into one muscle

Answer 61

1 mL is appropriate

Question 62

for children, what amount can you inject into one muscle

Answer 62

never inject more than 2mL into their muscle

Question 63

can painful injections be mixed with lidocaine

Answer 63

yes but there has to be an order

Question 64

what is the preferred method of IM administration for infants and children

Answer 64

vastus lateralus (90 degree angle)

Question 65

for a deltoid what volume should you never exceed

Answer 65

1 mL of fluid

Question 66

what are the scared points of children before surgery

Answer 66

taking off their gown, taking off underwear, giving up their transitional item