Peds

Question 1

Edu for the parents regarding nutrition for a 2 year old toddlers

Answer 1

give the toddler 2 choices for finger foods

Question 2

What do we teach parents about sex education with preschoolers?

Answer 2

• will ask where do babies come from– ask where the child think they come from and what they already know
• only give info that is asked
• simple, direct, and honest answer

Question 3

Education for parents on nightmares

Answer 3

parents should validate the child’s fear, rather than discouraging it
“Yes, I agree, monsters are scary; it’s a good thing they aren’t real”

Question 4

What are some risk factors for suicide in adolescents? (9) select all that apply question

Answer 4

1. Depression or mental illness
2. History of suicide attempts
3. Family history of suicide
4. Poor school performance
5. Substance Abuse
6. Homosexuality
7. Giving valued possessions away
8. Incarceration
9. Loner / No friends

Question 5

Education on smoking in adolescence

Answer 5

• discuss short/long term effects, unintentional injuries/sexual encounters, school performance, dependency, society, healthy lifestyle, resisting peer pressure, confidence in one’s own judgement
• speak directly
• consider/ hear their input
• why are their reasons important
• collaborate to find a solution
• expect some noncompliance

Question 6

When doing an assessment, what are two key concepts

Answer 6

• always background info prior to physical assessment

- less invasive first

Question 7

What do you tell the parent when doing a examination on a child?

Answer 7

Newborn: Keep up running dialog with caregiver, explaining each step as you do it.
Infant: Explain each step; address child by name; perform most invasive parts last
Toddler: Introduce yourself to both child and caregiver; explain most steps to child, but all steps to adult; let child handle instruments; most invasive parts last.
Preschool: Speak to care giver before and after examination; let child decide order of examination; let them try instruments
School-age: Include child in all parts of examination with a Head-to-toe approach- genitals last. Speak to caregiver before and after
Teen: Explain confidentiality to both. Speak to them both together and separately. Head-to-toe. Genitals last.

Question 8

nursing action in alternatives for pain management

Answer 8

• before pain/ nerves starts
• “take a deep breath in and blow bubbles out” with the child
• avoid “hurt” “pain” “this will be terrible”
• use descriptive words “pinching”
• offer praise, positive reinforcement, hugs, and support for using technique

Question 9

s/s and hallmark sign of croup

Answer 9

• hallmark: barking/ seal sounding cough
• most likely developed at night suddenly and resolved in the morning (lasting 3-5 days)
• mild URI symptoms (mucus production blocking airway)
• inspiratory stridor
• suprasternal retraction

Question 10

Postoperative care for Hirsprung disease, regarding ileostomy care

Answer 10

1. Observe for fever, abdominal distention, diarrhea, explosive stools, rectal bleeding, straining.
   - If any signs are noted above call MD ASAP. Admn. IV fluids and antibiotics to prevent shock and death.
2. Provide ostomy care to prevent skin breakdown.
3. Measure stool and fluid volume
4. Consult wound care RN for newly placed stoma

Question 11

Signs and symptoms of adrenal crisis? (7)

Answer 11

1. Persistent vomiting
2. Dehydration
3. Hyponatremia
4. Hypotension
5. Hyperkalemia
6. Tachycardia
7. Shock

Question 12

post care for joint fluid aspiration

Answer 12

cold therapy to decrease swelling
pressure dressing to prevent hematoma formation or fluid re-collection
assess for infection (fever, joint pain, or edema)

Question 13

post op/ discharge teaching for cardiac cath

Answer 13

• change dressing the day after
• keep dry for few days
• inspect site for redness, irritation, swelling, drainage, bleeding
• check temp for 3 days– report over 100.4 F
• resume usual diet
• avoid baths for 3 days (shower and ; sponge bath ok)
• avoid strenuous activities for 3 days
• admin Tylenol or Motrin for pain

Question 14

What are the stages of Hodgkins disease

Answer 14

I- 1 group
II- 2+ groups on the same side of the diaphragm
III- groups of lymph nodes above and below the diaphragm
IV- metastasis to organ (liver, bone, lungs)
A- absence of systemic symptoms at dx
B- systemic symptoms present at dx (fever, night sweats, weight loss)

Question 15

What is IBS?

Answer 15

abdominal pain relieved by defecation

onset of pain/discomfort associated with a change in frequency and/or form of stool

Question 16

Inflammatory bowel disease: Crohn’s s/s and found in?

Answer 16

• s/s: abdominal pain, diarrhea, perianal disease, enteroenteric or enterocutaneous fistula, abscess, anorexia
• found in oropharynx, esophagus, stomach

Question 17

Inflammatory bowel disease: ulcerative colitis s/s and found in?

Answer 17

• s/s: abdominal pain, bloody diarrhea, urgency, tenesmus

- found in colon (90%)

Question 18

Ostomy care for a child: (5)

Answer 18

1. Set up equipment (warm washcloth, pouch, etc)
2. Take off pouch
3. Observe skin and stoma- clean thoroughly
4. Measure stoma, marking new backing of pouch, and cut to size.
5. Apply new pouch

Question 19

cleft palate guidelines in nutrition

Answer 19

• fed with special cleft lip nipple for bottle feeding
• if unrepaired, at risk for aspiration
• burp infant to expel excessive air taken in during diff sucking
• breast tissue may create good seal
• when suture line heals post op, ordinary feeding may return
• some surgeons allow breast feeding to return immediately

Question 20

s/s of MILD dehydration

Answer 20

alert
soft/ flat fontanels
normal eyes
pink/ moist mucosa
elastic skin turgor
normal vitals and skin
may have slightly decreased output

Question 21

s/s of SEVERE dehydration

Answer 21

alert-- comatose
sunken fontanels
deeply sunken orbits
dry mucosa
tenting skin turgor
increased heart rate (may brady)
normal BP (may hypo)
cool, mottled, dusky extremities
signif decreased output

Question 22

dx labs/ values for pancreatitis

Answer 22

all levels elevated

1. serum amylase and/or lipase
2. liver profile
3. blood work (leukocytosis, may be hyperglycemia and hypocalcemia)
4. C-reactive protein

Question 23

how do you prepare for an endoscopy?

Answer 23

• bowel cleansing prior to exam
• encourage fluids to prevent dehydration
• NPO

Question 24

proper nutrition for celiac disease

Answer 24

• no gluten
• allowed: fresh fruit, veggies, milk, meat, fish, peanut butter, cold cuts, dried peas/ beans/ nuts, butter/margarine, sugar, honey, jelly/jam, plain chocolate, coconut, ground coffee, tea, soda, wine (from US)
• not allowed: wheat, oats, frozen yogurt, canned baked beans, french fries, fruit filled pies, dried fruit, commercial salad dressings, prepared soups, canned meats, creamed substances, alcohol distilled from cereals

Question 25

care of a 2 month old with acute heart failure/ CHF, in terms of nutrition (breast/bottle feeding)

Answer 25

• 150 calories/kg/day
• offer small, frequent feedings if tolerated
• continuous or intermittent gavage feedings
• infant formula 24-28 calories/ounces

Question 26

How does a child with atrial septal defect present?

Answer 26

SOB, easy fatigability, or poor growth

Question 27

How do you diagnose a child with a cardiac defect?

Answer 27

echo

Question 28

What is the function of oxygen?

Answer 28

vasodilator and decreases pulmonary vascular resistance

Question 29

nutritional education for HTN

Answer 29

restrict salt, portion sizes, decrease sugary snacks and beverages, eat healthy breakfast, increase fruits and veggies

Question 30

child vs adult abdominal assessment

Answer 30

child: inspection, auscultation, percussion, palpation
adult: inspection, auscultation, palpation, percussion

Question 31

Pros for breastfeeding post-surgery: (5)

Answer 31

Mother-child bonding.
Decreased ovulation. 
Reduced risk for cancer, diabetes, and infections.
Less likely to develop food allergies. 
Sucking builds baby's jaw muscles.

Question 32

Cons for breastfeeding post-surgery:

Answer 32

Breast discomfort
Sore nipples 
Mastitis
Engorgement
Milk Stasis
Vaginal dryness
Decreased libido