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using power points and notes, also dragich's flashcards

What best describes why children have fewer respiratory tract infections as they grow older?

Repeated exposure to organisms causes increased immunity.

Cool-mist vaporizers rather than steam vaporizers are recommended in home treatment of respiratory tract infections because:

They are safer.

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include:

Avoiding use for more than 3 days.

When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to:

Give small amounts of favorite fluids frequently to prevent dehydration.

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant:

Shows signs of an earache.

It is generally recommended that a child with acute streptococcal pharyngitis can return to school:

After taking antibiotics for 24 hours.

A child is diagnosed with influenza, probably type A disease. Management includes:

Amantadine hydrochloride to reduce symptoms.

Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by:

A feeling of fullness in the ear.

Which statement is characteristic of acute otitis media (AOM)?

It is treated with a broad range of antibiotics.

An infant's parents ask the nurse about preventing otitis media (OM). What should the nurse recommend?

Avoid tobacco smoke.

Which type of croup is always considered a medical emergency?

Epiglottitis

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily that:

The mother's presence will reduce anxiety and ease child's respiratory efforts.

A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of:

Bronchitis

Skin testing for tuberculosis the Mantoux test is recommended:

Periodically for children who reside in high-prevalence regions.

The mother of a toddler yells to the nurse, ""Help! He is choking to death on his food."" The nurse determines that lifesaving measures are necessary based on:

Inability to speak

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:

Monitor pulse oximetry.

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this child's care?

Monitor arterial blood gases.

Asthma in infants is usually triggered by

A viral infection

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration this suggests?

Asthma

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop:

Slowed growth.

Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack, what is their action?

Dilate the bronchioles.

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate, the nurse should recommend?

Swimming

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)?

If it is present in a child, both parents are carriers of this defective gene.

The earliest recognizable clinical manifestation(s) of cystic fibrosis (CF) is:

Meconium ileus.

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

Sweat chloride test

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease rhDNase, his drug:

May cause voice alterations

Pancreatic enzymes are administered to the child with cystic fibrosis, nursing considerations should include:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?

Diet should be high in carbohydrates and protein.

Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible?

Carotid

Which drug is considered the most useful in treating cardiac arrest?

Epinephrine hydrochloride

The Heimlich maneuver is recommended for airway obstruction in children older than?

1 year

An appropriate nursing intervention when caring for a child with pneumonia is to?

Encourage rest.

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes (choose all that apply):

Cluster care to conserve energy. AND Administration of antibiotics.

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? Choose all that apply.

Encourage infant to drink 8 ounces of formula every 4 hours. AND Cluster care to encourage adequate rest.AND Place on noninvasive oxygen monitoring.

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which actions should the nurse include in the child's postoperative care plan? (Choose all that apply.)

Notify the surgeon if the child swallows frequently. AND Place the child on the abdomen until fully awake. AND Allow the child to have diluted juice after the procedure.

A chest x-ray film is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, ""What will the radiograph show about the heart?"" The nurse's response should be based on knowledge that the x-ray film will:

Provide a permanent record of heart size and configuration.

A complication that may occur after a cardiac catheterization is:

Cardiac arrhythmia

Josh is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:

Adapted to his level of development so that he can understand.

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is ""too wet."" The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to:

Apply direct pressure above the catheterization site.

Which defect results in increased pulmonary blood flow?

Atrial septal defect

Which structural defects constitute tetralogy of Fallot?

Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?

Congestive heart failure

A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure is:

Peripheral edema

A beneficial effect of administering digoxin (Lanoxin) is that it:

Decreases edema.

Which drug is an angiotensin-converting enzyme (ACE) inhibitor?

Captopril (Capoten)

A common sign of digoxin toxicity is:

Vomiting

The parents of a young child with congestive heart failure tell the nurse that they are ""nervous"" about giving digoxin. The nurse's response should be based on knowing that:

Parents must learn specific, important guidelines for administration of digoxin.

As part of the treatment for congestive heart failure, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in:

Potassium

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be to:

Place the child in the knee-chest position

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents strokes exists. An important objective to decrease this risk is to:

Prevent dehydration

Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on knowing that

The child needs opportunities to play with peers

When preparing a school-age child and the family for heart surgery, the nurse should consider?

Letting child hear the sounds of an electrocardiograph monitor

Seventy-two hours after cardiac surgery, a young child has a temperature of 101 degrees Fahrenheit, the nurse should?

Report findings to physician.

An important nursing consideration when suctioning a young child who has had heart surgery is to?

Administer supplemental oxygen before and after suctioning.

The nurse is caring for a child after heart surgery. What should he or she do if evidence is found of cardiac tamponade?

Immediately report this to the physician.

An important nursing consideration when chest tubes will be removed from a child is to?

Administer analgesics before procedure.

The most common causative agent of bacterial endocarditis is?

Streptococcus viridans.

What painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?

Osler nodes

The primary nursing intervention to prevent bacterial endocarditis is to?

Counsel parents of high-risk children about prophylactic antibiotics.

A common, serious complication of rheumatic fever is?

Cardiac valve damage

A major clinical manifestation of rheumatic fever is?

Polyarthritis

When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease?

High-density lipoproteins (HDLs).

The leading cause of death after heart transplantation is?

Rejection

One of the most frequent causes of hypovolemic shock in children is?

Blood loss

What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?

Anaphylactic shock

What occurs in septic shock?

Increased cardiac output

A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, what medication should the nurse prepare for immediate administration?

Epinephrine

Nursing interventions for the child after a cardiac catheterization include choose all that apply

Assess the affected extremity for temperature and color. AND Maintain a patent peripheral intravenous catheter until discharge.

Which clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock, choose all that apply.

Cool extremities and decreased skin turgor AND Confusion and somnolence AND Tachypnea and poor capillary refill time

An accurate description of anemia is?

Decreased oxygen-carrying capacity of blood.

Several blood tests are ordered for a preschool child with severe anemia. She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago, the nurse should explain that?

Topical application of local anesthetic can eliminate venipuncture pain.

The most appropriate nursing diagnosis for a child with anemia is?

Activity Intolerance related to generalized weakness.

What explains why iron deficiency anemia is common during toddlerhood?

Milk is a poor source of iron.

When teaching the mother of a 9-month-old infant about administering liquid iron preparations, the nurse should include that:

Adequate dosage will turn the stools a tarry green color.

What is often administered to prevent or control hemorrhage in a child with cancer?

Platelets

Which term is used to describe a child's level of consciousness when the child can be aroused with stimulation?

Obtundation

Which term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation?

Stupor

Which drug would be used to treat a child who has increased intracranial pressure (ICP) resulting from cerebral edema?

Mannitol

What is descriptive of a concussion?

It is a transient, reversible neuronal dysfunction.

Which type of fracture describes traumatic separation of cranial sutures?

Diastatic

What clinical manifestations would suggest hydrocephalus in a neonate?

Bulging fontanel and dilated scalp veins

Exophthalmos (protruding eyeballs) may occur in children with:

Hyperthyroidism

The nurse is teaching the parents of a child who is receiving propylthiouracil for the treatment of hyperthyroidism (Graves' disease). Which statement made by the parent indicates a correct understanding of the teaching?

If my child develops a sore throat and fever, I should contact the physician immediately.

What effect does immobilization have on the cardiovascular system? It causes:

Venous stasis.

True false : If an infant with nasopharyngitis shows signs of an earache, it may indicate respiratory complications and possible secondary infections.

False

True false: Acute streptococcal pharyngitis must be treated with antibiotics to prevent acute rheumatic fever.

True

What is the significance of continuous swallowing after a tonsillectomy?

There may be bleeding.

True false: Clinical symptoms and blood test are both needed to establish the diagnosis of infectious mononucleosis.

True

True false: benzocaine ear drops cannot provide topical relief for the pain of otitis media.

True

What instructions should the nurse practitionergive the parents of a child with otitis media and has a prescription foramoxicillin?

If the child has had it before and also has a severe case of AOM give in high doses (80 to 90 mg/kg/day, divided twice daily) for 10 days. For a child with mild to moderate AOM who is 6 or older, a 5 to 7 day course is accurate.

True false: eliminating tobacco smoke from the environment can help prevent otitis media.

True

Define otitis media with effusion.

Fluid in the middle ear space without symptoms of acute infection.

Define otitis externa.

Infection of the external ear resulting from normal ear flora that assume pathogenic characteristics under conditions of excessive wetness or dryness.

List the symptoms of acute otitis media.

fever and otalgia, ear pain

What disorder should you suspect if a preschooler has "froglike croaking" sound on inspiration, is agitated.

Acute epiglottis

Why would you not want to examine a child's throat that has drooling and is very sore?

They might aspirate, refer them to primary care provider immediately, and put resuscitation and suctioning equipment by the bedside.

What interventions should be done for mild croup?

cool mist

What organism is thought to cause epiglottis?

Hemophilus influenzae

Stridor is aggravated when a child with epiglottis is spine?

True

What is the value of having a parent at the bedside of a child with laryngo-tracheobronchitis?

They may comfort the child by holding them and rocking them.

What is usually the causative organism of bronchiolitis?

Human meta-pneumovirus

If a child is positive for Human Meta-pneumovirus what type of precautions should be implemented?

Use contact and standard precautions, and put child in separate rooms, may need to use droplet precautions.

What nursing interventions are necessary for a child with staphylococcal pneumonia?

Watch vital signs, especially respiratory; give caution when giving fluids.

What causes a young child to have a foul smelling discharge and frequent sneezing?

a foreign body

What test should be used to monitor carbon monoxide poisoning?

ABG's and COhB

What is the primary factor responsible for possible multiple clinical signs and symptoms of cystic fibrosis?

Mechanical obstruction caused by increased viscosity of mucous gland secretions.

What is the earliest clinical manifestation of Cystic fibrosis?

Meconium ileus

What tests aid in the diagnosis of cystic fibrosis?

Sweat test, absence of pancreatic enzymes, radiography, COPD, and family hx.

Children with CF should receive aerosolized bronchodilator when?

Once or twice a day

What is DNase?

Dornase alfa, which decreases the viscosity of mucous.

What are significant side effects?

voice alterations and laryngitis

What are signs of pneumothorax in a child?

Tachypnea, tachycardia, dyspnea, pallor, and cyanosis

What are the nursing considerations with administering pancreatic enzymes to a child with CF?

Only proprietary enzymes should be given to children, generic enzymes are not considered adequate.

What measures are used for pain control after a tonysilectomy?

Ice collar, analgesics, tetrecaine lollipops or ice pops, antiemetic's

What is laryngomalcia?

A very common condition of infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction.

What is broncho-pulmonary dysplasia?

A chronicling condition that affects newborn babies who were either put on a breathing machine after birth or were born very early, prematurely.

What medications are used for broncho-pulmonary-dysplasia?

Corticosteroids, oxygen, Synagis, Palivizumab

What are indications of tubes in the ears?

Persistent ear infections

What are the complications of tonsillitis?

URI, OM

Is there scarring with Impetigo?

No scarring

What often causes cellulitis?

Strep or staph

What are some manifestations of hypoglycemia?

Weakness,dizziness, difficulty concentrating ,speaking ,focusing ,and coordianting ,seating and pallor

What is Gower's sign?

It is a characteristic way of rising from a squatting or sitting position on the floor

This disorder has Gower's sign ,waddling gait ,and lordosis. What is it?

Duchenne Muscular dystrophy

What is the first action anurs should do if achild has a hypercynotic dspell?

Place the child in a knew chest position

What is the blood flow pattern in Ventricular sepatl defect?

There is increase pulmonary blood flow because of the left to right shunt

What complication is prevented when surgery is donefor apatent ductus arteiosus?

Prevent pulmonary vascularngestion

Which of the following defects results in obstruction of blood flow---aortic stensois ,trcuspid atresia or atrial septal defect?

Aortic stensois

Pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertropophy make up what syanotic heart defect?

Tetralogy of Fallot

Does the child with congenital heart disease need the opportunity to play with others?

Yes the child needs opportunity for socialization

What refers to involuntary, rhythmic and repetitive muscular contractions, that occur usually in the ankles, wrist and the kneecap or patella, ankles are the most commonly affected?

Clonus

What are the symptoms of bacterial endocarditis?

Decreased appetite ,intermittent fevers, muscle and joints ache, does not seem like self

What is the primary nursing intervention to prevent bacterial endocarditis?

Counsel parents of high risk kids about the need for good dental health.

If a child has symptoms of bacterial endocariditis ,can they wait until a clinical appointment is arranged to see a medical provider?

No, the child needs to be seen immediately for an evaluation

How can the school nurse prevent rheumatic fever?

Refer the child with symptoms for a throat culture

What medications are used for the treatment of Kawasaki disease?

High dose Intravenous gamma globulin and salicylate therapy

Why is nursing care for a child with Kawasaki challenging?

The child is very irritable

When is selective cholesterol screening recommended for children over 2years of age?

When body mass index = 95 percentile

The mother of a young infant is worried her child is going to get meningitis. What should yo say to this mother?

Vaccinations to prevent pneumococcal and H Influenza type B are available

What are petechiae?

Pinpoint flat round red spots under the skin surface caused by intradermal hemorrhage, bleeding into the skin.

A child arrives on the floor with possible bacterial meningitis.When should the nurse start the antibiotic?

As soon as possible

When planning care for a a school age child with bacterial meningitis, What intervention should be included?

Keep environmental stimuli to a minimum

How can one reduce the incidence of Reye Syndome?

Avoid ASA for children with a viral illness

What is an important intervention for child with Syndrome of inappropriate ADH secretion?

Restrict fluids

What are the hallmark symptoms of diabetes Mellitus?

Frequent urination, polyuria , Glycosuria ,and polydipsa

What should a child with Diabetes carry when exercising?

Extra snacks

This disorder is caused by aspirochete spread by ticks?

What is Lyme disease

IS there still a" no nits policy" in most schools?

The child can remain in school with treatment done at home

What is the inappropriate voiding of urine at least twice a week?

Enuresis

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