Pediatric Application Of Skills

Question 0

When preparing a child for a procedure should the information that may produce anxiety be told first or last?

Answer 0

Last

Question 1

Should you lie to a child about a procedure to make them feel better?

Answer 1

No you should be honest

Question 2

You should emphasize ______ aspects of procedure

Answer 2

Sensory- see, feel, hear, smell

Question 3

How do you identify a child that doesn’t know their name

Answer 3

Reading Name tag

Question 4

How long do you wash hands for a routine wash

Answer 4

15 seconds

Question 5

How long do you wash your hands if they are contaminated

Answer 5

1 full minute

Question 6

Should you wave your hands to dry them?

Answer 6

No you should rub in until dry

Question 7

You should use soap and water after how many gels?

Answer 7

4

Question 8

What kind of terms should you use when preparing a child for a procedure

Answer 8

Concrete–example: saying the place on the arm that is red, puffy, and hurts instead of saying infected (abstract term)

Question 9

Should you only stress parts of the body that are involved when preparing a child for a procedure

Answer 9

No, you should stress parts of the body that are involved and parts that are not involved

Question 10

Should you avoid medical terms with children

Answer 10

No use both concrete and medical terms….remember the doctors may use medical terms so you don’t want to avoid them

Question 11

Is crying and being mad okay?

Answer 11

Yes! Allow expression of feelings. Biting and kicking are not ok

Question 12

The child was awful during a procedure–how should you respond after

Answer 12

Praise the child after no matter how he/she behaved..this may be hard to do but it works because you are setting up positive for the next procedure

Question 13

A child is on bed rest what kind of bath should the child get

Answer 13

Bed bath

Question 14

Maximum water temperature for child and elderly for shower/bath/bed bath

Answer 14

100-105

Question 15

Maximum water temperature for adults needing shower/bath/bed bath

Answer 15

110

Children and elderly 100-105

Question 16

Should you assume the parent will give the child the bath?

Answer 16

No!! But it is ok if they want to do it just give them equipment and support as you help them

Question 17

Naps are common in children less than ___ years of age

Answer 17

5

Question 18

What should you remember when taking a child’s weight

Answer 18

Same time, same clothes, same scale

Question 19

Are children allowed to run in hospital

Answer 19

No

Question 20

Should infant sleep on back or belly

Answer 20

BACK!

Back to sleep

Question 21

When should children be in a crib?

Answer 21

Under 3

Question 22

When should children be in a bed

Answer 22

Over 3

Question 23

If a kid gets out of bed do you put the side rails down

Answer 23

No. Side rails are up if a kid is in or out of bed

Question 24

What is the most difficult vital sign to get

Answer 24

Respirations

Question 25

How do you get respirations in a baby

Answer 25

Watch abdomen or stethoscope on back. You want to leave them in parents arms if that's where they are

Question 26

What may you see with toileting in kids

Answer 26

You may see Regression in kids

Question 27

Should you go in room and say "I'm going to take your vital signs"

Answer 27

No! Use different words than take

Question 28

What is the order you should get vital signs

Answer 28

``` Respirations Pulse Blood pressure Temperature **least invasive to most invasive ```

Question 29

When do you use apical pulse

Answer 29

Up to 2 years

Question 30

When do you do blood pressure on a child

Answer 30

Often not until 3 years or older

Question 31

Cuff should cover ____ of upper arm in a child

Answer 31

2/3

Question 32

What should you do if you are unable to ascultate look pressure

Answer 32

Dinamap (electronic) or Doppler

Question 33

What kind of numbers does the Doppler give you

Answer 33

Only gives you top number. Example: 90/D

Question 34

Focus on disease that are transmitted by large droplets expelled in the air and travel 3-6 feet from the patient

Answer 34

Droplet precautions

Question 35

Focus on diseases that are transmitted by smaller droplets, which remain in the air for longer periods of time

Answer 35

Airborne precautions

Question 36

Used for direct and indirect contact with patients and their environment

Answer 36

Contact precautions

Question 37

Who are standard precautions used for?

Answer 37

All patients!

Question 38

What type of precautions would be used with influenza

Answer 38

Droplet precautions

Question 39

What is required with airborne precautions

Answer 39

Private room, negative-pressure airflow, N95 respirator

Question 40

When do you take axillary temperatures

Answer 40

Babies less than 1 month

Question 41

How do you straighten ear canal in children under 2

Answer 41

Down and back

Question 42

Why is tympanic temperature inaccurate at times

Answer 42

When a child has a ear infection

Question 43

When is a oral temperature taken

Answer 43

5 years and older; must be able to cooperate

Question 44

When is a rectal temperature used

Answer 44

Young children and very ill

Question 45

How is a rectal temperature taken

Answer 45

Be gentle, insert 1/2-1 inch, hold onto it at all times

Question 46

How do you get a specimen in a diapered child

Answer 46

Urine collection bag"U-bag", sitting up position, do not push fluids, check every 20 minutes

Question 47

If you have to use restraints in a emergency how long do you have to get a doctors order

Answer 47

Written order within 1 hour

Question 48

How often should you check restraints

Answer 48

Check after 15 minutes and then every hour

Question 49

Is there a time when you should restrain all 4 limbs?

Answer 49

Never!

Question 50

When opening a child tray what should you do

Answer 50

Open away from the child

Question 51

What is the best position for a child after feeding

Answer 51

Right side with support

Question 52

If you weigh a diaper 1gram = how much fluid

Answer 52

1 ml

Question 53

Is a NG or PEG more permanent

Answer 53

PEG

Question 54

What does a continuous tube feeding mean

Answer 54

Slow drip of liquid feed

Question 55

What is a "Bolus" or Intermittent feeding

Answer 55

A volume of feeding all in one feeding

Question 56

What is the difference between Bolus and intermittent feedings

Answer 56

They are the same thing

Question 57

What type of tubes can be used for Bolus or intermittent feedings

Answer 57

Tubes in stomach: NG or PEG

Question 58

What types of tubes can be used for Continuous tube feedings

Answer 58

Usually placed in intestinal: Dobhoff, NI

Question 59

Why use continuous tube feeding

Answer 59

Tubes placed in intestines so less risk of aspiration

Question 60

Why use Bolus or Intermittent tube feedings

Answer 60

More like how we normally eat

Question 61

When are orogastric tubes used

Answer 61

For babies

Question 62

How can oro/nasogastric tubes be placed

Answer 62

Continually or intermittently

Question 63

Landmarks for NG in child over 1

Answer 63

Nose to ear to xiphoid process

Question 64

Landmarks for NG tube in child under 1

Answer 64

Nose to ear to between belly button and xiphoid process

Question 65

What is the #1 indicator when placing NG to tell if patient is ok/not ok

Answer 65

Respiratory symptoms Okay- gagging Not okay- coughing

Question 66

Is gagging when placing NG okay?

Answer 66

Yes

Question 67

Is coughing when placing a NG okay?

Answer 67

No! Take out immediately, in lungs

Question 68

What do gastric contents look like? Lung content?

Answer 68

Gastric- green, tan, brown | Lungs- clear, mucus

Question 69

What is the only absolute verification of NG placement

Answer 69

X-Ray

Question 70

How should you do ongoing placement checks of NG

Answer 70

Assess respiratory status, examine external mark, withdraw contents and inspect( only when in stomach, not in intestines!!)

Question 71

How do you do ongoing placement checks of a NI tube

Answer 71

Assess respiratory status | Examine external mark

Question 72

What do you not do to verify ongoing placement of NI tube

Answer 72

Withdraw gastric contents. You do not do because there is no residual so you will harm them

Question 73

How and when do you check residual in Bolus Feed

Answer 73

Check before each feeding: if volume of residual is more than 1/2 of previous feed you should feed it back and hold feed and call the doctor

Question 74

What do you do with Bolus feeding if residual is less than 1/2 of previous feed

Answer 74

You can feed

Question 75

Why do you put back feedings when you check residual even if it is more than 1/2 of previous feeding

Answer 75

Because it is full in nutrients and full of fluids and electrolytes

Question 76

How do you check stomach residual in Continuous Feedings

Answer 76

Check every 4-6 hours, if volume of residual is more than 2 hours stop feeding and call the doctor

Question 77

What do you do if the residual is more than 2 hours in a continuous feed into stomach

Answer 77

Stop feeding and call the doctor

Question 78

What are general feeding rules

Answer 78

Go slow, golf the child, give a pacifier, during/after elevate head and place on right side

Question 79

How many people are needed to change Velcro ties

Answer 79

2 people

Question 80

How long should you wait to change Velcro ties

Answer 80

Only change after 96 hours

Question 81

What kind of trach tubes do children usually have

Answer 81

1 piece trach tubes

Question 82

What kind of trach tubes do older children have

Answer 82

2 piece trach tubes, disposable or non-disposable inner cannulas

Question 83

What type of gauze is used for trach bib

Answer 83

Hydrocell gauze

Question 84

How long do you do suctioning in children

Answer 84

5-10 seconds