Nursing Care of Children

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  1. nurse is providing teaching to parent of child with impetigo. which following instructions should the nurse include in the teaching?

    a) administer oral antiviral meds?
    b) apply 1% topical antifungal?
    c) cleanse lesions with 0.25% silver nitrate compresses?
    d) remove crust after soaking with 1:20 burow's solution?
    The bacteria that cause impetigo live right below the crust of the lesion. Therefore, the crust must be softened in order to facilitate removal and make it possible to treat the lesion topically
  2. Hydrotherapy usually involves debridement the entire process can be extremely painful.
    Children must be medicated beforehand for maximum analgesic effect during therapy
  3. Steps when a child ingest an unknown substance
    • 1. Assess by taking vital signs
    • 2. terminate exposure by assessing the oral cavity for the unknown substance
    • 3. identify the poison by calling the poison control center
    • 4. remove the posion and prevent absorption by administering activated charcoal
  4. Dry hacking cough is usually an early sign of pertussis

    Koplik spots on buccal mucosa are indicative of rubeola (measles)
    An inflamed throat with exudate is indicative of an upper airway infxn with group A B-hemolytic streptococci
  5. Demonstrating the procedures on a doll is usually appropriate for a toddler or preschooler...

    What's an appropriate method of demonstration for a school-age?
    Allow the school-age to see the equipment will give him a sense of control over the situation
  6. There is increased hepatic syntehsis of lipids during nephrotic syndrome, therefore you'll see INCREASED SERUM LIPIDS
    You will NOT see elevated creatinine clearance in nephrotic syndrome
  7. Adolescent undergoing a lumbar puncture for a diagnostic of bacterial meningitis. Expect the spinal fluid to contain which of the following?
    Increased protein
  8. Teaching parent of a preschooler diagnosed with gastroenteritis. What's the right management of diarrhea?
    Limit fruit juices since they are low in electrolytes and high in carbs and osmolarity

    BRAT diet also has little nutrients

    Water replacement does not contain necessary electrolytes either

    Regular diet is adequate, no need to increase carbs in diet.
  9. Dress up is an appropriate play activity for preschooler
    scribbling is appropriate for toddler

    pat-a-cake is appropriate for infant

    creating a sticker scrapbook is appropriate for school-age
  10. Child with hearing impaired. What's an appropriate way to communicate orally?
    Speak in short sentences
  11. School-age child with junvenile idiopathic arthritis
    Splint the child's affected joints during sleep to minimize pain and reduce flexion deformity
  12. Erythema MIGRANS is a skin manifestation that is associated with LYME DISEASE
    E. infectiosum is relatedo to HPV (aka 5th dz)

    E. marginatum is the characteristic rash seen in rheumatic fever. Rash appears as raised pink rings on the torso and inner surfaces of the extremities, appearing and disappearing several months.

    E. multiforme (range from mild and self-limiting to severe and life-threatening -- Stevens-Johnson syndrome)-- it usually starts with a papular rash, spreading to all skin surfaces except the scalp. Cause is linked to upper respiratory tract infxns and some medications (Dilantin and sulfa drugs)
  13. Mother of a toddler who has just been admitted to ped unit must leav facility to meet her other children. Which following actions should nurse suggest to mother to make transition easiest for toddler?
    Provide a security item before leaving such as blanket or fav toy will minimize fear by keeping an aspect of the environment familiar to the child
  14. A child who is supposed to receive scheduled vaccinations... mom said child is sick (running nose, occasional cough, low grade fever). What's an appropriate action?
    Give the scheduled vaccinations because it is not a contraindication
  15. Children with hypopituitarism often have a deficent secretion of growth hormone (somatotropin). The definitive tx of this condition consists of daily injections of GH
    DDAVP is tx of hyposecretion of ADH (antidiuretic hormone)

    LHRH is tx of precocious puberty to slow prepubertal growth
  16. By 7 months of age an infant should be able to transfer an object from one hand to another
    Object permanence is not developed until 9-10 months of age
  17. Type 1 diabetes adolescent

    During an illness, clients should check their urine for ketones to identify possible keotacidosis
    Before exercise, eating a stnack 30 min before is adequate
  18. The primary factor responsible for the multiorgan effects of cystic fibrosis is the mechanical obstruction caused by the production of thick, viscous mucoprotein, rather than thin, freely flowing secretions
    Children with cysitc fibrosis have large, loose stools rather than constipation
  19. The most common sites for childhood eczema are the antecubital and popliteal foassae, wrists, ankles, and feet
  20. Activities that will meet developmental needs for toddlers: puppets

    1. For preschoolers
    2. For school-age
    • 1. Large-piece puzzle
    • 2. Provide child with book of riddles
  21. Child has chicken pox. Mom asks when child can return to school.

    After your child's lesion have scabbed over
  22. A child w/ no h/o of seizure disorder just expierenced a tonic-clonic seizure. Which action should the nurse take FIRST?

    Hint: abc
    Assess child'respiration.

    Don't check for head injury even though that's assessment & safety =/
  23. A 9-month old's expected fine motor activity: banging 2 toys together

    Toddler can build a 3-block tower
    11 months can nest object inside another and be able to walk while holding onto furniture
  24. Nurse is performing a screening test for sickle cell anemia on a toddler. Which action should nurse take when performing the sickle-turbidity test?
    Perform a fingerstick
  25. Child with breakthrough pain even after pain med. Don't encourage active range of motion. Instead, massage or other methods of gentle touch should be provided to decrease level of pain
    Provide pleasant aromas should also decrease level of pain
  26. A school-age child admitted w/ partial-thickness burn. Which intervention can help increase child's self-esteem?
    Encourage child to be an active participant in self-care

    Don't point out areas of healing to the child daily because that'll make the child focus more
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Nursing Care of Children
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