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Exam 4 Flashcards

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1
Q

What symptoms should a nurse be observing for a toddler that is being evaluated for SIADH

A

Fluid retention
Hyponatremia

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2
Q

What are some manifestations a nurse should expect to see on a child with acquired hypothyroidism

A

Intolerance to cold
Constipation
Fatigue

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3
Q

What clinical manifestations occur in a child with ADH deficiency

A

Hypotension

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4
Q

How will a nurse know if desmopressin is working

A

Lower urine output

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5
Q

What should the nurse do if DKA is expected in a child?

A

Check blood sugar with fingerstick
Give insulin via IV
Give bolus of isotonic fluid

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6
Q

What should the nurse teach the parent and a child with Addison’s disease that they should take?

A

Corticosteroids

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7
Q

Give an example of a blood gas that would be seen with DKA

A

Metabolic acidosis
pH is under 7.35.
HCO3 is under 22

Example: pH 7.30, PCO2 40, HC03 20

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8
Q

What is it called when a blood sugar drops at 2am for a child with type 1 diabetes?

A

Somogyi effect

High blood sugar in am

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9
Q

What can a nurse see with diabetes insipidus?

A

Low (decreased) urine specific gravity

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10
Q

What remark said by a parent of a child with hyperparathyroidism that the nurse would see they need more teaching

A

Eat yogurt daily

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11
Q

How would you teach a 4 year old child about injections for their diabetes mellitus?

A

Demonstrate on a doll with Needleless syringes

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12
Q

What would you recommend to an adolescent who has type one diabetes

A

Annual flu shot

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13
Q

What might be a statement made by a parent that they understand about diabetes mellitus

A

Child will be shaky when hypoglycemic

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14
Q

What should the nurse include in the teaching of type one diabetes do a school-age child?

A

Check ketones in urine

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15
Q

What instructions should the nurse provide for a child who is taking Ferris sulfate?

A

Take with OJ

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16
Q

What diet should a child avoid with iron deficiency anemia?

A

Foods with milk

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17
Q

What instructions should the nurse include in the teaching in a discharge planning of a child who has sickle cell anemia after an acute crisis episode?

A

Offer fluid several times a day

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18
Q

What should the nurse include in the plan of care for a child who has sickle cell anemia?

A

Observe for hypokalemia

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19
Q

How will someone act when they have a blood sugar of 280

A

Lethargic

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20
Q

Things to know about leukemia, sickle cell, anemia, and hemophilia

A

Temperature, Bruising, Platelets,
VIII, WBC count, Pain, Petechiae

Sickle cell:
Pain, SOB, fatigue, pallor, jaundice, cold hands and feet, dizzy, headache, swollen joints, hematuria, elevated WBC, decreased Hgb,

Hemophilia:
Bleeding disorder with prolonged clot time, deficiency in factor VIII (type A), deficiency in factor IX (type B), lack of con willebrand, joint pain and stiffness, impaired motility, bruising, headache, slurred speech, decreased LOC,prolonged aptt, platelets and prothrombin time are within expected ranges, while blood clotting g some is within expected or prolonged

Leukemia:
Low grade fever, pallor, increases bruising, petechiae, listlessness, enlarged liver, lymph nodes and joints, pain (abdominal, leg, joint), constipation, headache, vomiting and anorexia, unsteady hate, hematuria, mouth ulcers, enlarged kidney and testies, ICP, anemia, low platelets, neutropenia (low neutrophils), leukemia. Blasts( immature WBC),

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21
Q

Cranial radiation

A

Nonessential, essential, contraindicated

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22
Q

What type of insulin should a nurse treat a child with diabetic keto acidosis with

A

Regular via IV

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23
Q

What other patient can be placed with a child who has leukemia

A

A Child on neutropenic precautions

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24
Q

What should a patient be placed on who has low platelet count

A

Bleeding precautions

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25
What should the nurse do first before administering insulin- when does the parent need further teaching?
When they say they should aspirate before giving insulin
26
What should a nurse tell the parents of a child with iron deficiency anemia and what should a child have checked routinely
you want to observe them daily and monitor blood for several weeks
27
Priority question, who should the nurse see first
10 year old with sickle cell, anemia and severe chest pain
28
What will the client who has hemophilia “A” receive before a wisdom tooth extraction?
Recumbent packed RBCs
29
What should the client be doing if the client has Addison’s disease?
Daily weight
30
What is Addison’s disease caused by?
Lack of production of aldosterone by adrenal glands
31
What are some warning signs of cancer?
Non healing sores Change in bowl patterns Change in borders of moles Nagging cough
32
What should the nurse expect if an adolescent is shaky, has difficulty speaking, and a blood level of 55?
Tachycardia
33
What not to do if a parent finds an abdominal mass
Do not palpitate
34
What food should be encouraged to eat if a toddler has iron deficiency anemia?
Tunafish
35
What food should the nurse provide teaching on that prevents protein energy malnutrition?
Tuna Cottage cheese Omelettes Milkshakes Everything but strawberry banana smoothie
36
What dietary changes should a client make if she is receiving chemotherapy
Do not drink fluids an hour before treatment
37
What should the nurse be teaching about aplastic anemia?
Low bone marrow production of RBCs
38
What communication therapy should the nurse provide for an adolescent with metastatic osteocarcinoma?
Tell me more about what you were thinking-continue the conversation
39
What teaching should the nurse provide for a client who has testicular cancer
Risk factors: 15 to 35 years Close relatives with it
40
What should the nurse provide the client after radiation treatment?
Hydrating lotion
41
What is consistent with leukocytosis?
Fever
42
What should be included in the teaching for a client with neutropenia because of radiation therapy?
Bottled water is a good choice
43
What should the nurse observe for a client who is being treated for lung cancer?
Signs of infection
44
What should the nurse do if a 17-year-old refuses treatment for a relapse of leukemia
Notify the provider
45
What should the nurse include in the care plan for a client who has leukemia and a platelet count of 130,000?
Limit IM injections
46
What lab values it should be expected Following a hematologic event (the client who has a cute leukemia, and received an aggressive chemotherapy treatment 10 days ago)
Low platelets, leukocytes and erythrocytes
47
What should the nurse monitor for the client who has myelosuppression after receiving chemotherapy
Bleeding gums
48
What manifestations will a client have after experiencing severe nausea and vomiting after a course of chemotherapy
Metabolic alkalosis
49
What interventions should the nurse include in the plan of care for a client who has immunosuppression following chemotherapy?
Limit the number of healthcare workers in the room and visitors
50
What should the nurse include in the diet of a client who is taking chemotherapy and losing weight?
-Top fruit with yogurt -Add cream to soup -Use milk instead of water in recipes -Dip meat in eggs and bread crumbs before cooking
51
What should the nurse recommend regarding food for an older client who has WBC count of 2000 after three rounds of chemo?
Nothing raw Serve cooked fruits
52
What is a finding that the nurse should report to the provider as a possible sign of malignancy
Check the borders of bowls Irregular borders are a sign
53
Which lab value should give the nurse the best indication of the client’s renal function who has systemic lupus erythematous (SLE)
serum creatine
54
What should the nurse expect to see of a client who has a systemic lupus?
Butterfly rash Which is a red rash across the nose and cheeks
55
What is the highest priority for a nurse to report to the provider for a client who has lupus (SLE)?
Peripheral edema
56
What discharge teaching for a client who has a Lupus (SLE) should the nurse provide
Use mild protein shampoo
57
What should the nurse monitor on a client with a platelet count of 9000?
Monitor for bleeding
58
What will happen if the nurse does not administer diphenhydramine prior to a transfusion of RBC
Stop allergic reaction (urticaria)
59
What is a manifestation of an allergic reaction?
Pruritus with amoxicillin
60
What lab value is the nurse looking for a client who reports anorexia and is experiencing malnutrition?
Albumin will be altered
61
What should the nurse expect from a patient who is malnourished
Low mental status
62
What should the nurse seeing a client who has HIV infection Dementia and has progressed to AIDS
Night sweats
63
What lab value as a priority for a client who has HIV
CD4 T cell count 180
64
What should the nurse monitor for a client who has HIV infection and is prescribed zidovudine as part of anti-retroviral therapy
Aplastic anemia
65
What test confirms HIV?
Western blot
66
What should the nurse expect in a client who has failure to thrive?
Not gaining weight
67
What should be part of the background component when using SBAR tool regarding “failure to thrive”?
-Current weight -How much formula they were given -They should gain 0.2 K each week
68
What discharge teaching to the nurse provide for a child with juvenile idiopathic arthritis
Prednisone every other day
69
What should the nurse teach a child who has eczema?
Use topical corticosteroids
70
NGN: leukemia
Risk factors: Childhood, male, FHx, Down syndrome Findings: Low fever, pallor, increase bruising, petechiae, listlessness, or larger liver lymph nodes and joints, abdominal leg and joint pain, constipation, headache, vomiting, anorexia, instead gate, hematuria, mouth ulcers, enlarged kidney and testicles, ICP Lab test: CBC, anemia, thrombocytopenia, neutropenia, leukemia blasts, blood smear Diagnostic: Bone marrow aspiration or biopsy. Topical anesthetic (45 mins - 1 hr before), conscious sedation, position based on site(iliac crest is most common), apply pressure to site 5-10 mins, pressure dressing, assess VS, monitors for bleeding first 24 hours CSF analysis: Lumbar puncture, Emily bladder, sterile, topical anesthetic (1 hr prior), side laying with keens to chest and back arched, can sedate, monitor VS and for bleeding, flat position for 39 minutes, can causes headache, drink water if it does. Meds: Chemo, corticosteroids, methotrexate. Antiemetics Adverse effects: Mucosal ulcer Skin break down Neuropathy Pain Loss of appetite Hemorrhage cystitis Alopecia Therapeutic procedures: Radiation Hematopoietic stem cell transplant
71
NGN: AIDS

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