You admit L.M., a 2-month-old girl with a history of hydrocephalus and ventriculoperitoneal (VP) shunt placement 1 month earlier. Her parents report that she has been more irritable than usual and for the past 3 days has fed poorly and has had emesis five or six times every day.
Explain how the placement of a VP shunt helps the patient

You admit L.M., a 2-month-old girl with a history of hydrocephalus and ventriculoperitoneal (VP) shunt placement 1 month earlier. Her parents report that she has been more irritable than usual, and for the past 3 days, she has fed poorly and has had emesis 5 or 6 times every day. You get L.M. settled on the unit and promptly perform her admission assessment.

It is determined that the VF shunt is infected and must be tempurarily removed. L.M. is taken to surgery to have a left extraventricular drain (EVD) placed. She returns to your unit in stable condition. You get her settled back into her room and perform an assessment. You note that her EVD is intact and draining CSF. The dressing is clean and dry and intact under a sterile dressing.

Medication Administration Record (MAR):

Acetaminophen $15 \mathrm{mg} / \mathrm{kg}$ PO q4-6hr prn Morphine sulfate $0.05 \mathrm{mg} / \mathrm{kg}$ IV q4hr prn Enalapril (Vasotec) $5 \mathrm{mcg} / \mathrm{kg}$ PO q24hr Cefotaxime $150 \mathrm{mg} / \mathrm{kg} /$ day IV in divided doses $\mathrm{q} 8 \mathrm{hr}$ Baclofen (Lioresal) $10 \mathrm{mg} / \mathrm{kg} /$ day P0 q8hr Ondansetron (Zofran) $0.1 \mathrm{mg} / \mathrm{kg}$ IV now

In which position should L.M. be placed immediately postoperatively unless ordered otherwise by the surgeon?

a. Flat, left side-lying b. Flat, right side-lying c. Supine, Trendelenburg d. Supine, head of bed ( $\mathrm{HOB}) 45$ degrees

The nurse is caring for a patient who is having a seizure. Which of the following measures will protect the patient and the nurse from injury? (Select all that apply.)

1. If patient is standing, attempt to get him or her back in bed.
2. With patient on floor, clear surrounding area of furniture or equipment.
3. If possible, keep patient lying supine.
4. Do not restrain patient; hold limbs loosely if they are flailing.
5. Never force apart a patient's clenched teeth.

You admit L.M., a 2-month-old girl with a history of hydrocephalus and ventriculoperitoneal (VP) shunt placement 1 month earlier. Her parents report that she has been more irritable than usual and for the past 3 days has fed poorly and has had emesis five or six times every day.
Explain the pathophysiology of hydrocephalus and cerebrospinal fluid (CSF) imbalance

S.G. returns to your unit 6 months later for her cleft palate repair (palatoplasty)
Which of these nursing interventions are appropriate as you plan her care? Select all that apply, and explain why or why not.
S.G. has a normal recovery and is being discharged. When giving her parents discharge instructions, what will you advise them concerning diet and signs and symptoms to report?

The nurse has just administered adenosine via IV push and sees the rhythm on the monitor. What is the nurse s priority intervention?

A) apply conductive gel and defibrillate the patient

B) document the findings and continue to monitor

C) administer another mg of the medication

D) begin chest compressions

S.G.'s parents are advised that S.G. will return 6 months later for the palatoplasty. They are concerned about the delay between surgeries. What will your response be?

What are some complications for hirschsprung disease?

The laboratory test results and findings of S.G.'s preoperative workup are normal, and she is scheduled for her cheiloplasty.
What will you include in your preoperative teaching to S.G.'s parents?

After K.B. has been on the unit for 6 hours, you identify the following changes in her assessment data: K.B. is difficult to arouse, but when awake she is able to identify who and where she is; PERRLA 1+ with slower reaction time than earlier; color pale, pink; skin cool and clammy; heart rate 126 beats/min, respiratory rate 28 breaths/min, temperature (oral) $99^{\circ}F$ ($37.2 ^{\circ}C$ ); Spo2 90%. The findings of the neurovascular checks of the affected extremities are unchanged.
What would you document about this incident?

How do open-angle and acute angle-closure glaucoma differ?

Write the correct answer on the line provided.
Margo Spencer was diagnosed with closed-angle glaucoma affecting her left eye. She is scheduled to have a/an _____ performed to treat this condition.

J.F., a 67-year-old woman, was involved in an auto accident and flown by emergency helicopter to your facility. She sustained a ruptured spleen, fractured pelvis, and compound fractures of the left femur. On admission (5 days ago) she underwent a splenectomy. Her pelvis was stabilized with an external fixation device 3 days ago, and, yesterday, her left femur was stabilized using balanced suspension with skeletal traction. She has a Thomas splint with a Pearson attachment on her left leg. She has 20 pounds of skeletal traction and 5 pounds applied to the balanced suspension. Her left femur is elevated off the bed at approximately 45 degrees. The lower leg is parallel to the bed and lies in a sling that the nurse adjusts on the frame, and the foot hangs freely. This morning, J.F. was transferred to your orthopedic unit for specialized care. You are the nurse assigned to care for her on the night shift.
You enter J.F.'s room for the first time. What aspects of the traction will you inspect?

J.F., a 67-year-old woman, was involved in an auto accident and flown by emergency helicopter to your facility. She sustained a ruptured spleen, fractured pelvis, and compound fractures of the left femur. On admission (5 days ago) she underwent a splenectomy. Her pelvis was stabilized with an external fixation device 3 days ago, and yesterday her left femur was stabilized using balanced suspension with skeletal traction. She has a Thomas splint with a Pearson attachment on her left leg. She has 20 pounds ( $9 \mathrm{~kg})$ of skeletal traction and 5 pounds $(2.25 \mathrm{~kg}$ ) applied to the balanced suspension. Her left femur is elevated off the bed at approximately 45 degrees. The lower leg is parallel to the bed and lies in a sling that the nurse adjusts on the frame, and the foot hangs freely. This morning, J.F. was transferred to your orthopedic unit for specialized care. You are the nurse assigned to care for her on the night shift.

You perform a neurovascular assessment and note the following findings: Left foot pale, temperature slightly cooler than right foot. Right foot color pink. Capillary refill less than 3 seconds on both sides. Edema +1 on left foot and lower leg; no edema on right leg. Dorsalis pedis palpable and equal on both feet. Sensation equal on both sides. Able to dorsiflex feet and rotate ankles freely. Rates pain in left femur as a 5 out of 10 .

You ask J.F. whether she is ready for her bath, and she responds positively. You let her bathe the parts she can reach and engage her in a conversation as you attend to the rest of her body. While performing perineal care, you notice that the folds of skin around her perineal area are reddened and excoriated.

Although J.F. is recovering nicely, she is becoming increasingly withdrawn. You enter her room and find her crying. She tells you that she is all alone here, that she misses her family terribly. You know that her son is flying into town tomorrow but will only be able to stay a few days. What can be done so that J.F. benefits from her family support system?