Peds Test Flashcards

Terms Definitions
Beta-thalassemia
Medical/Nursing Management

• Medical Tx:
– Chronic ____
– Sometimes ____ectomy
– ____ transplant
• Nursing Issues:
– Blood Transfusions
– ____ therapy
– Risk of infection, post-
splenectomy
– Patient/Family Edu
Beta-thalassemia
Medical/Nursing Management

• Medical Tx:
– Chronic transfusions
– Sometimes splenectomy
– Bone marrow transplant
• Nursing Issues:
– Blood Transfusions
– Chelation therapy
– Risk of infection, post-
splenectomy
– Patient/Family Education
Childhood Cancer
Treatment Modalities

• ____
(biopsy, resect, debulk)
• ____
(rapidly dividing cells)
• ____ therapy
(shrink, residual)
• ____ transplant
• ____ response modifiers
Childhood Cancer
Treatment Modalities

• Surgery
(biopsy, resect, debulk)
• Chemotherapy
(rapidly dividing cells)
• Radiation therapy
(shrink, residual)
• Bone marrow transplant
• Biologic response modifiers
Acquired Hypothyroidism
Clinical manifestations

* ____ rate of growth
* Weight ____
* ____ (bowels)
* ____ skin
* ____ or ____ hair
* ____ (energy)
* ____ intolerance
* ____ of face, eyes, hands
* ____ deep tendon
reflexes
* ____ puberty

Tx = Med: ___
Acquired Hypothyroidism
Clinical manifestations

* Decreased rate of growth
* Weight gain
* Constipation
* Dry skin
* Thinning or coarse hair
* Fatigue
* Cold intolerance
* Edema of face, eyes, hands
* Delayed deep tendon
reflexes
* Delayed puberty

Tx = Med: Levothyroxine
SCD
Medical/Nursing Management

• ____ transfusion
• PT teaching: Living with
chronic illness
• Pain Management
- Opioids: ATC, PCA,
__->__ transition
(avoid ____)
- NSAIDS (motrin)
• Adequate ____
• Adequate ____
• Support coping
SCD
Medical/Nursing Management

• Blood transfusion
• PT teaching: Living with
chronic illness
• Pain Management
- Opioids: ATC, PCA,
IV -> oral transition
(avoid meperidine)
- NSAIDS (motrin)
• Adequate oxygenation
• Adequate hydration
• Support coping
• Observe for complications
S/S Diabetes Insipidus

• Insufficient ___ Hormone
• ____ diuresis
• ____ osmolality
• ____ urine specific gravity
• ____ thirst
• ____hydration
S/S Diabetes Insipidus

• Insufficient ADH
• UNCONTROLLED diuresis
• DEC. osmolality
• DEC. urine specific gravity
• INSATIABLE thirst
• DEhydration
Atrial Septal Defect
* Pathophysiology
- Blood flow ____ to ____
- ____ congestion
* Clinical manifestations
- Symptomatic? ____
- ____ ____ failure
* Treatment
- ____ for ___ ___ failure
- ____ repair
Atrial Septal Defect
* Pathophysiology
- Blood flow LEFT to RIGHT
- PULMONARY congestion
* Clinical manifestations
- Symptomatic? SOMETIMES
ASYMPTOMATIC
- CONGESTIVE HEART failure
* Treatment
- DIURETICS for CHF
- SURGICAL repair
Etiology of Seizures

• ____pathic
• ____ Process
• ____ Imbalance
• ____ (temp)
• ____ Injury or ____ Tumor
• ____ Intoxication
• ____therapeutic Drug Levels
Etiology of Seizures

• Idiopathic
• Infectious Process
• Metabolic Imbalance
• Fever
• Brain Injury or Brain Tumor
• Drug Intoxication
• Subtherapeutic Drug Levels
MENINGITIS residual effects

• ____ness, ____ness
• ____
• Subdural ____,
____cephalus
• ____
• ____ palsy
• ____ (Meningococcal)
MENINGITIS residual effects

• Deafness, blindness
• Paralysis
• Subdural effusions,
hydrocephalus
• Seizures
• CP
• Amputation (Meningococcal)
Acute Lymphocytic Leukemia

• Proliferation of abnormal lymphoblasts, causes pancytopenia

• Presenting symptoms:
____, ____ pain,
____ (color), ____ing

• TX: 3 Treatment phases (chemo)
– Induction (4 weeks)
– Consolidation (6 months)
Acute Lymphocytic Leukemia

• Presenting symptoms:
Fever, bone pain,
pallor, bruising

• 3 Treatment phases (chemo)
– Induction (4 weeks)
– Consolidation (6 months)
– Maintenance (2 - 3years)
• For relapse, further chemo
and bone marrow transplant
NCLEX
A child with suspected bacterial
endocarditis arrives at the
emergency department. Which of the
following findings is expected during
assessment?
1. Weight gain
2. Bradycardia
3. Low-grade fever
4. Increased hemoglobin level
3. Low-grade fever
SICKLE CELL Life-threatening complications

•____-occlusive episode:
-PAIN due to ____
(acute, chronic)
–____
*S/S= severe ____ache,
____ signs
*Evaluate c transcranial
____
*Tx: ____ transfusion
q 3-4 wks
Tx: ____ therapy:
Desferoxami
SICKLE CELL Life-threatening complications

•Vaso-occlusive episode:
-Pain due to ischemia
(acute, chronic)
–Stroke
*S/S= severe headache,
neuro signs
*Evaluate c transcranial
doppler
*Tx: blood transfusion
q 3-4 wks
Tx: Chelation therapy:
Desferoxamine SC
infusion 5 nts/week
–Acute Chest Syndrome
*S/S= pneumonia-like
picture, hypoxemia, pain
*Tx= Transfusion or
exchange transfusion,
Respiratory support
  Which test distinguishes sickle cell anemia from sickle cell trait? - 1  Schick test 2  Sickledex test 3  Complete blood count (CBC) 4  Hemoglobin electrophoresis
4  Hemoglobin electrophoresis
 
 
RATIONALE: The laboratory test to distinguish sickle cell anemia from sickle cell trait is called hemoglobin electrophoresis. Neither the Schick test nor a CBC provides information related to sickle cell anemia. The Schick test determines the presence of a significant quantity of diphtheria antitoxins in the blood. The Sickledex test is used to determine whether or not the child has a general sickle cell problem. If this test is positive, hemoglobin electrophoresis is done to determine which sickle cell disorder the child has.
NCLEX
Administration of which of the following drugs
would be the most important in treating
transposition of the great arteries?
1. Digoxin
2. Diuretics
3. Antibiotics
4. Prostaglandin E1
4. Prostaglandin E1
CYANOTIC
congenital heart diseases
that cause mixed blood flow:
____
____
____
____
* Transposition of great arteries
* Total anomalous pulmonary venous return
* Truncus arteriosus
* Hypoplastic L heart syndrome
NCLEX
Which of the following signs is considered
a late sign of shock in children?
1. Tachycardia
2. Hypotension
3. Delayed capillary refill
4. Pale, cool, mottled skin
2. Hypotension
Which nursing diagnosis takes priority for a child with iron deficiency anemia? - 1  Activity intolerance related to reduced oxygen-carrying capacity of blood 2  Activity intolerance related to iron deficiency anemia 3  Ineffective tissue perfusion (ca
CORRECT     1  Activity intolerance related to reduced oxygen-carrying capacity of blood
 
RATIONALE: Activity intolerance related to reduced oxygen-carrying capacity of blood is the most appropriate nursing diagnosis. Reduced oxygen-carrying capacity of the blood in anemia decreases the energy available for normal activity. Iron deficiency anemia is a medical diagnosis; it's inappropriate in a nursing diagnosis statement. Iron deficiency anemia doesn't result in hypervolemia, which is an increase in blood volume. Skin pallor is a sign of ineffective tissue perfusion and, therefore, is a defining characteristic, not a cause
 
 
 
ACYANOTIC
congenital heart diseases
that cause ↑ Pulmonary
blood flow:
_____
_____
_____
* A/V septal defects
* Patent ductus arteriosus
* Atrioventricular canal
Patent Ductus Arteriosus
* Diagnosis
- Continuous ____ below
left ____
- Dx with ____, cardiac ___
* Treatment
- ____ for preterm only
- ____
Patent Ductus Arteriosus
* Diagnosis
- Continuous MURMUR below
left CLAVICLE
- Dx with X-RAY, cardiac
ECHO
* Treatment
- INDOMETHACIN for preterm
only
- SURGERY
Differences in Adult and Child Cancer

– Origin
– Cause
– Prevention and screening
– Metastasis at diagnosis
– Response to treatment
– Cure rate
Find answers in book
Neuroblastoma

• From neural crest cells:
– brain, adrenal medulla,
pelvis, mediastinum,
sympathetic ganglia
• S/S: caused by ____
on adjacent structures,
____
• Dx: scans, lab tests
(depending on location),
biopsy
• Staging: based o
Neuroblastoma

• From neural crest cells:
– brain, adrenal medulla,
pelvis, mediastinum,
sympathetic ganglia
• S/S: caused by compression
on adjacent structures,
metastases
• Dx: scans, lab tests
(depending on location),
biopsy
• Staging: based on age,
markers present,
histology, extent of
spread (62% have mets)
• Treatment: surgical
removal, intensive chemo,
radiation (stage III), BMT
A 6-year-old child is diagnosed with iron deficiency anemia. Which nursing diagnosis is most appropriate? - 1  Activity intolerance 2  Imbalanced nutrition: Less than body requirements 3  Ineffective tissue perfusion (peripheral) 4  Impaired parenting
CORRECT     2  Imbalanced nutrition: Less than body requirements
 
 
  RATIONALE: Iron deficiency anemia is the most common anemia of infancy and childhood, resulting from inadequate dietary intake of iron. Because this child's condition stems from nutritional deficiencies, Imbalanced nutrition: Less than body requirements is the most appropriate nursing diagnosis. Activity intolerance, Ineffective tissue perfusion (peripheral),  and Impaired parenting may or may not be appropriate for this specific child, but they don't target the health care needs of a child with iron deficiency anemia as precisely
 
 
4.    Nursing considerations related to the administration of oxygen in an infant include which of the following?
 
A.    Discontinue during feedings so child can be held.B.    Assess infant to determine how much oxygen should be given.C.  
3. The nurse's responsibility is to ensure that the appropriate oxygen concentration is delivered uninterrupted.
1. Oxygen delivery needs to be continued as ordered. Most children receiving oxygen will need the supplemental oxygen during the increased energy expenditure of eating.2. Ongoing assessment of the infant's respiratory status and oxygen saturation are necessary. Oxygen is a medication, and the amount is prescribed by the practitioner. 4. Oxygen should not blow directly on the infant. Cold air applied to the face can result in the diving reflex, which causes bradycardia and shunting of blood from the periphery to central circulation. Text reference: p. 1287
Which of the following procedures uses high-frequency sound waves obtained by a transducer to produce an image of cardiac structures?

A.    EchocardiographyB.    ElectrophysiologyC.    ElectrocardiographyD.    Cardiac catheterization
1. Echocardiography uses high-frequency sound waves. The child must lie completely still. With the improvements in technology, diagnosis can sometimes be made without cardiac catheterization.
2. Electrophysiology is an invasive procedure in which catheters with electrodes are used to record the impulses of the heart directly from the conduction system. 3. Electrocardiography is a tracing of the electrical path of the depolarization action of myocardial cells.4. This is an invasive procedure in which a catheter is threaded into the heart. Text reference: 1442
S/S of Hydrocephalus

• Assess: ____ circ, ____
fontanel, ____ sutures
• Same S/S as ICP
– ____ache, ____ing,
____edema, ____
(musc), ____ity,
____argy, ____-pitched
“neuro” cry, ____sion,
____s, ____ nerve
dysfunction
• ____ ventr
Hydrocephalus
• Assess: HEAD circ, BULGING
fontanel, SEPARATED sutures
• Same S/S as ICP
– HEADache, VOMITing,
PAPILLedema, ATAXIA
(musc), IRRITABILity,
LETHargy, HIGH-pitched
“neuro” cry, CONFUsion,
SEIZUREs, CRANIAL nerve
dysfunction
• ENLARGED ventricles on
CT/MRI
Where are Wilms tumors (nephroblastomas) located?
A.    BoneB.    BrainC.    KidneyD.    Lymphatic system
3. Wilms tumor, or nephroblastoma, is the most common intraabdominal and kidney tumor of childhood.
1, 2, and 4. Wilms tumors are encapsulated and are located in the abdomen. Text reference: 1599
Nursing considerations related to the administration of chemotherapeutic drugs include which of the following?
A.    Anaphylaxis cannot occur, since the drugs are considered toxic to normal cells.B.    Infiltration will not occur unless superficial
3. Chemotherapeutic agents can be extremely damaging to cells. Nurses experienced with the administration of vesicant drugs should be responsible for giving these drugs and be prepared to treat extravasations if necessary.
1. Anaphylaxis is a possibility with some chemotherapeutic and immunologic agents.2. Infiltration and extravasations are always a risk, especially with peripheral veins.4. Gloves are worn to protect the nurse when handling the drugs, and the hands should be thoroughly washed afterward. Text reference: 1568
An appropriate nursing intervention when caring for a child with pneumonia is which of the following?

A.    Avoid placing child on affected side.B.    Cluster care to conserve energy.C.    Place in Trendelenburg position.D.    Administer an
2. Encouraging rest by clustering care and promoting a quiet environment is the best intervention for a child with pneumonia.
1. Lying on the affected side may promote comfort by splinting the chest and reducing pleural rubbing. The child should be positioned with the unaffected side up to promote maximum expansion.3. Children should be placed in a semierect position or position of comfort.4. Antitussives are usually not indicated. Text reference: p. 1340
3.    Which of the following blood oxygenation tests is the photometric measurement of oxygen saturation?
 
A.    Oximetry B.    Capnography C.    Arterial puncture D.    Transcutaneous oxygen and carbon dioxide monitoring
1. Oximetry provides continuous noninvasive measurements of hemoglobin saturation. Photometric measurements are used to determine the oxygen saturation.2. Capnography measures carbon dioxide during inhalation and exhalation.3. Arterial puncture is the sampling method to obtain blood for gas analysis.4. This provides a continuous and reliable trend of arterial oxygen and carbon dioxide. Text reference: p. 1282
The school nurse is discussing prevention of acquired immunodeficiency syndrome with some adolescents. Which of the following is appropriate to include?
A.    Virus is easily transmitted.B.    It is only transmitted through blood.C.    Condoms s
4. Human immunodeficiency virus is spread through blood and body fluids. Intravenous needles that have been used should not be shared. They may be contaminated with the virus.
1. The virus is not easily transmitted. It requires direct contact with blood or body fluids on a nonintact skin surface.2. Body fluids may also transmit the virus.3. Condoms should be used for both heterosexual and homosexual sex. Text reference: 1550
  A 7-year-old with hemophilia A has been treated with factor VIII after a baseball injury to his arm. The nurse tells the parents that they can give the child which medication for pain? - 1  Aspirin 2  Indomethacin (Indocin) 3  Ibuprofen (Advil) 4 
CORRECT     3  Ibuprofen (Advil)
 
 
RATIONALE: Ibuprofen in the form of Advil, Motrin, or Nuprin is safe to administer to children with hemophilia A. Nonsteroidal anti-inflammatory drugs, such as aspirin, indomethacin, and etodolac, shouldn't be used because they inhibit platelet function and can cause increased bleeding.
Lymphoma

• From lymphoid and
hematopoietic systems

NON-HODGKINs Lymphoma
– Peak 7-11 years
S/S: Depend on location
(mediastinal mass,
pleural effusion,
lymphadenopathy)
– Pain, edema, generalized
– Often advanced at dx
• With mediasti
Lymphoma

• From lymphoid and
hematopoietic systems

NON-HODGKINs Lymphoma
– Peak 7-11 years
S/S: Depend on location
(mediastinal mass,
pleural effusion,
lymphadenopathy)
– Pain, edema, generalized
– Often advanced at dx
• With mediastinal mass,
risk of respiratory
distress and superior vena
cava syndrome
• Treatment with multi-agent
chemotherapy
• High risk of tumor lysis
syndrome
TX for Elevated ICP (slide#1)

• 1st: ___'s!
– Stabilize ____
- ____-____ CO2
– ____active drugs
– ____ drugs (Osmotic/Loop)
– ____osmolar therapy
with ____% saline
– Positioning: ____, HOB
___, ____/____ alignment
TX for Elevated ICP (slide#1)

• 1st: ABC’s!
– Stabilize AIRWAY
- LOW-NORMAL CO2
– VASOactive drugs
– DIURETICS (Osmotic/Loop)
– HYPERosmolar therapy
with 3% saline
– Positioning: SUPINE, HOB
UP, HEAD/NECK alignment
Seizure Types
• Partial
– ____
– ____
• Generalized
– ___-___
– A____
– A____
– A____
Seizure Types
• Partial
– Simple
– Complex
• Generalized
– Tonic-Clonic
– Absence
– Atonic
– Akinetic
Anemia (Hgb levels)

– Mild: __ g/dl
– Moderate: __–__ g/dl
– Severe: < __ g/dl
Anemia (Hgb levels)

– Mild: 11 g/dl
– Moderate: 3 – 7 g/dl
– Severe: < 3 g/dl
NCLEX
A 2-year-old child has a known cardiac defect and is in congestive heart failure. Which assessment finding indicates to the nurse a toxic dose of digoxin?
1. Tachycardia and dysrhythmia
2. Headache and diarrhea
3. Bradycardia, nausea, and vomiting
4
3. Bradycardia, nausea, and vomiting
Syndrome of Inappropriate
ADH Secretion

- ____ H2O reabsorption
– ____ serum osmolality
– ____ serum Na (<110mEq/L)
– ____ urine osmolality

– Irritability, anorexia, nausea, cramps, lethargy, stupor, convulsions
- INC. H2O reabsorption
– DEC. serum osmolality
– DEC. serum Na (<110mEq/L)
– DEC. urine osmolality

– Irritability, anorexia, nausea, cramps, lethargy, stupor, convulsions
Monro - Kellie Hypothesis

• Once sutures have fused, the skull is
a rigid compartment filled to
capacity with
non-compressible contents:
– brain ____%
– blood ____%
– CSF ____%
• If one component increases in
volume, another component must __
Monro - Kellie Hypothesis

– brain 80%
– blood 10%
– CSF 10%

• If one component increases in volume, another component must DECREASE or ICP will
INCREASE.
Which of the following is most descriptive of the therapeutic management of osteogenic sarcoma?
A.    Intensive irradiation is the primary treatment.B.    Amputation of affected extremity is rarely necessary.C.    Treatment usually consists of s
3. Optimum treatment of osteosarcoma is surgery and chemotherapy. Surgical biopsy is followed by either limb salvage or amputation and chemotherapy.
1 and 4. Radiation and bone marrow transplantation are not part of the therapy for osteosarcoma.2. Amputation is often required when limb salvage is not possible. Text reference: 1598
Nursing interventions for the child after a cardiac catheterization would include which of the following?

A.    Allow ambulation as tolerated.B.    Monitor vital signs every 2 hours.C.    Assess the affected extremity for temperature and color
3. The involved extremity is carefully assessed for signs of complications. Pulses below the catheterization site are monitored for equality and symmetry. Temperature and color are also monitored.
1. The child is maintained on bed rest or in parent's lap for 4 to 6 hours after the procedure.2. Initially, vital signs are taken every 15 minutes.4. Pulses are checked distal to the catheterization site. Text reference: 1445
NCLEX
A nurse is giving discharge instructions to the parents of a child with Kawasaki disease. Which of the following statements shows an
understanding of the treatment plan?
1. “A regular diet can be resumed at home.”
2. “Black, tarry stools are c
3. “My child should use a soft-bristled toothbrush.”
NCLEX
A child with an atrial septal repair is entering
postoperative day 3. Which of the following
interventions would be most appropriate?
1. Give the child nothing by mouth.
2. Maintain strict bed rest.
3. Take vital signs every 8 hours.
4. Administer a
4. Administer an analgesic as needed.
Cerebral Perfusion Pressure

- blood pressure gradient
across the brain

CPP = ____–____

Keep above ____
CPP = MAP – ICP

Keep above 60
  A 17-year-old is admitted to the facility in sickle cell crisis. The nurse receives an order from the physician that she believes is in error and decides to question it. What does this order say? - 1  Restrict fluids to 800 ml/8 hours. 2  Give oxygen
CORRECT     1  Restrict fluids to 800 ml/8 hours.
 
 
  RATIONALE: The adolescent should be well-hydrated to allow sickled RBCs to move freely through the blood vessels. Dehydration leads to blood stasis and further sickling. Sickle cell anemia increases the risk of hypoxia, which also promotes sickling, so oxygen is warranted. Blood replacement may be ordered to treat anemia and reduce the viscosity of the sickled blood. Inflammation related to swollen and warm joints causes fever, which is commonly treated with acetaminophen.
The nurse is assessing a child with a cardiac problem. Extremities are cool with thready pulses, and urinary output is diminished. This is most suggestive of which of the following?

A.    Increased afterloadB.    Decreased contractilityC.    I
2. Decreased contractility is suspected if the extremities are cool with thready pulses and urinary output is diminished. Certain states are known to depress contractility (e.g., hypoxia, acidosis).
 
1. Increased blood pressure is indicative of higher afterload.3 and 4. These will not produce the symptoms described. Text reference: 1440
Asthma is now classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include all of the following except:

A.    Lung functionB.    Asso
2. Associated allergies are not part of the classification system used in the Guidelines for the Diagnosis and Management of Asthma.

1, 3, and 4. The clinical features that are assessed in the classification system are frequency of daytime and nighttime symptoms, frequency and severity of exacerbations, and lung function. Text reference: p. 1355
One of the goals for children with asthma is to prevent respiratory tract infection. This is because respiratory tract infection does which of the following?

A.    Increases sensitivity to allergensB.    Encourages exercise-induced asthmaC.   
4. Viral respiratory infections can exacerbate asthma, especially in young children, whose airways are mechanically smaller and more reactive than those of older children.
 
1. Respiratory infections do not affect sensitivity to allergens.2. Exercise precipitates exercise-induced asthma.3. The respiratory infection does not lessen the effectiveness of the medications. Text reference: p. 1370
NCLEX
After a pediatric client has a cardiac
cath, which intervention would the
nurse consider to be of highest
priority during the immediate
post procedure period?

1. Encourage intake of small amounts
of fluid.
2. Teach the parents signs of CHF.
3. M
4. Apply direct pressure to
entry site of 15 minutes.
CHF
* Treatment:
- ____
- Meds: ____
- Positive ____
- ____ support
* Nursing management
- 1st: ____
~ ____ assessment
~ ____ support,
____ c child
- Nursing diagnoses
~ ____ Cardiac output
~ Fluid volume ____
~ Imbalanced nutrition:
____ th
CHF
* Treatment:
- SURGERY
- Meds: DIURETICS
- Positive INOTROPES (↑CO)
- NUTRITIONAL support
* Nursing management
- 1st: ASSESSMENT
~ PHYSICAL assessment
~ FAMILY support,
INTERACTION c child
- Nursing diagnoses
~ DECREASED cardiac
output
~ Fluid volume EXCESS
~ Imbalanced nutrition:
LESS than body reqs
- OUTCOME identification
and planning
- Evaluation and family
TEACHING
  A nurse is giving an iron preparation to an 8-month-old. Which nursing intervention is most important? - 1  Mix the iron preparation in the infant's milk. 2  Mix the iron preparation in the infant's juice. 3  Always give the iron preparation behind
3  Always give the iron preparation behind the teeth.
 
 
RATIONALE: Giving the iron preparation behind the infant's teeth by using a straw or syringe will prevent staining the teeth. Never mix iron with the infant's formula or juice because drinking the mixture will stain the infant's teeth. Iron can be absorbed through the GI tract in most infants, so I.M. injections are reserved for severe cases of iron deficiency anemia when oral iron is ineffective.
A child with lymphoma is receiving extensive radiotherapy. Which of the following is the most common side effect of this treatment?
A.    MalaiseB.    SeizuresC.    NeuropathyD.    Lymphadenopathy
1. Malaise is the most common side effect of radiotherapy. For children, the fatigue may be especially distressing because it means they cannot keep up with their peers.
 
2. Seizures are unlikely because irradiation would not usually involve the cranial area for treatment of lymphoma.3. Neuropathy is a side effect of certain chemotherapeutic agents.4. Lymphadenopathy is one of the findings of lymphoma. Text reference: 1589
A nurse is teaching the parents of a 7-year-old boy with hemophilia A about health promotion strategies. Which statement by the boy's mother indicates a need for further teaching? - 1  "We don't give our son medications that contain aspirin." 2  "We've
  CORRECT     4  "Our backyard is fenced in so I let my son and his friends play outside while I do the housework."
 
 
  RATIONALE: Outside play should be supervised, and a fence won't prevent such injuries as falls or being hit with a baseball. Restricting the use of aspirin, elevating an injured area, and checking for evidence of bleeding are all correct interventions.
Chelation therapy is begun on a child with β-thalassemia major. The purpose of this therapy is to do which of the following?
A.    Treat the disease.B.    Eliminate excess iron.C.    Decrease risk of hypoxia.D.    Manage nausea and vomiting.
2. Iron overload (hemosiderosis) is a complication of the blood transfusions. Chelation therapy is necessary to minimize the development of hemosiderosis and hemochromatosis.
 
1. Blood transfusions are the primary medical management.3 and 4. Chelation therapy removes iron; it does not affect the disease process. Text reference: 1533
A 4-year-old is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations include which of the following?
A.    Encourage normal activity for as long as possible.B.    Explain the cause of the disease to the child and family.C.   
4. The family needs to learn the purpose, function, application, and care of the corrective device and the importance of compliance to achieve the desired outcome.
1. The initial therapy is rest and non?weight-bearing activity, which help reduce inflammation and restore motion.2. Legg-Calvé-Perthes is a disease of unknown etiology. A disturbance of circulation to the femoral capital epiphysis produces an ischemic aseptic necrosis of the femoral head.3. The disease is self-limiting, but the ultimate outcome depends on early and efficient therapy and the age of the child at onset. Text reference: 1779
1.    A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because it:
 
A.    Liquefies secretionsB.    Improves oxygenationC.    Promotes less labored ventilationD.    Soothes inflamed muco
4. Warm or cold mist is useful to soothe the inflamed mucous membranes. Humidification is most useful when hoarseness or laryngeal involvement occurs.
1. Normal saline nose drops should be used to liquefy secretions. The mist particles do not penetrate in sufficient amounts to accomplish this.2. There is no additional oxygen in the mist therapy commonly used for respiratory tract infections.3. The primary effect of mist is to soothe the inflamed membranes. A reduction in swelling might ease ventilatory effort, but it is not the primary purpose of the therapy. Text reference: p. 1
NCLEX
A nurse is teaching wound care to parents after cardiac surgery. Which of the following statements is most appropriate?
1. Lotions and powders are acceptable.
2. Your child can take a complete bath tomorrow.
3. Tingling, itching, and numbness are no
4. If the sterile adhesive strips over the incision
fall off, call the physician.
The nurse stops to assist a child who has been hit by a car while riding a bicycle. Someone has activated the emergency medical system. Until paramedics arrive, the nurse should consider which of the following in caring for this child who has experienced
1. The first priority is always airway, breathing, and circulation.
2. This occurs after the child's cardiopulmonary status has been addressed.3. Transport can occur by immobilizing the cervical spine. The head is maintained in a neutral position, and movement of the head or body is not allowed in any direction.4. Infants have the greatest discrepancy in body surface areas. Children old enough to ride bikes have similar body proportions to adults. Text reference: 1733
The school nurse is caring for a child with hemophilia who fell on his arm during recess. Which of the following supportive measures should the nurse do until factor replacement therapy can be instituted?
A.    Apply warm, moist compresses.B.    Ap
3. The initial response should include elevation.
1. Cold should be applied to the arm. This will aid in vasoconstriction.2. Pressure is effective in small areas, but would not work for an extremity.4. Passive range of motion is not recommended. The child can perform active range of motion after the bleeding episode has resolved. Text reference: 1539-1540
S/S of Increased ICP
in an INFANT

• ____ feeding
• ____ity
• ____-pitched cry
• ____, ____ fontanel
• ____ing
• ____ scalp veins
• ____ head circumference
S/S of Increased ICP
in an INFANT

• POOR feeding
• IRRITABILity
• HIGH-pitched cry
• TENSE, BULGING fontanel
• VOMITing
• DISTENDED scalp veins
• INCREASED head circ
NCLEX
A chld with a cyanotic heart defect is being discharged home to await surgical repair. In the discharge teaching, the nurse
instructs the parents:
1. To prevent the child from crying at all.
2. To observe the child for signs of increased intracrania
2. To observe the child for signs of increased intracranial pressure.
Nursing care of the infant and child with congestive heart failure would include which of the following?
 
A.    Force fluids appropriate to age.B.    Monitor respirations during active periods.C.    Organize activities to allow for uninterrup
3. The child needs to be well rested before feeding. The child's needs should be met as quickly as possible to minimize crying. The nurse must organize care to minimize the child's energy expenditure.
 
1. The child who has congestive heart failure has an excess of fluid.2. Monitoring vital signs is appropriate, but minimizing energy expenditure is a priority.4. The child often cannot tolerate larger feedings. Text reference: 1453
50-70% of Spina Bifida pts have an allergy to _____
50-70% of SB pts have an allergy to LATEX

Treat ALL SB pts as if they have this allergy

Found in: catheters, gloves, tubing, tape, tourniquets, glue, toys, handles, tires, balloons, elastic
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Term:
Definition:
Definition:

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