Pediatric Health Promotion Quiz

Primary Care of Children

Collecting Data

• When collecting data from a 6-year-old child, a nurse should report a parent's statement about the child's squinting to see the board, as it may be a sign of strabismus.
• A child's loss of front teeth and occasional temper tantrums are normal at this age.

Caring for an Adolescent with a Fractured Tibia

• After applying a plaster cast, a nurse should perform a neurovascular check to check for circulation, motion, and sensation in the lower extremities.
• The nurse should elevate the client's leg to promote venous return and minimize swelling.
• The nurse should assist the client to ambulate using crutches to promote general circulation and prevent complications of immobility.

Administering Medication to a Child

• To elicit a child's cooperation when taking medication, a nurse can offer an ice pop prior to administering the medication to help numb the tongue and alleviate the bad taste.
• It is not recommended to hide medication in food or threaten the child with a shot if they don't take the medication.

Otitis Media

• A nurse should expect a child with otitis media to tug on the affected earlobe and have a loss of appetite due to pain.
• Drainage from the ear canal is not typically associated with otitis media, unless the tympanic membrane ruptures.

Hirschsprung's Disease

• The goal of surgery for Hirschsprung's disease is to create an ostomy, which relieves the obstructed area and allows the bowel to rest.
• A second surgery is usually performed at 12 to 18 months of age to repair the bowel.

Hypercalcemia

• A nurse should expect a client with hypercalcemia to have constipation, muscle hypotonicity, and bradycardia.

Toys for Hospitalized Children

• A nurse should provide toys that are appropriate for the child's age and developmental level, such as modeling clay for preschool-age children.
• Brightly-colored mobiles are suitable for very young infants, but not for preschool-age children.

Caring for an Infant with a Cleft Lip

• A nurse should apply antibiotic ointment to the suture site to prevent infection.
• The nurse should feed the infant using a syringe or bottle, or allow the infant to breastfeed, and avoid placing objects in the infant's mouth that can cause suture damage.

Cystic Fibrosis

• Clients with cystic fibrosis are at high risk for infection and should practice good hand washing techniques.
• A diet that is high in calories and protein, and unrestricted in fats and salt, is recommended for children with cystic fibrosis.
• Daycare settings should be avoided due to the high risk of exposure to illnesses.

Spinal Cord Injury

• A client with a spinal cord injury should catheterize every 4 to 6 hours, and as needed.
• Drinking plenty of water is important to prevent urinary tract infections.
• Using a suppository every 1 to 2 days to stimulate a bowel movement is appropriate.

Pyloric Stenosis

• Projectile vomiting followed by hunger in a 2-month-old infant is a sign of pyloric stenosis.
• The infant should be examined in the clinic as soon as possible by the provider.

Toys for 10-Month-Old Infants

• A nurse should suggest toys that assist the infant in developing muscles and gross motor skills, such as push-pull toys.

Postoperative Care of a Tonsillectomy

• A nurse should offer clear, cold fluids such as ice pops to help decrease swelling and pain in the operative area.
• Dairy products and acidic fluids such as cranberry juice should be avoided.

Bedtime Routine

• A nurse should suggest that a child participate in soothing activities prior to bed and establish a consistent bedtime routine.
• Allowing a child to stay up past a reasonable hour or sleeping in the parent's bed can lead to inadequate sleep and habits.

ß-Thalassemia

• A nurse should expect a child with ß-thalassemia to exhibit listlessness, decreased exercise tolerance, anorexia, and unexplained fever.
• Pallor is a common manifestation of ß-thalassemia.

Stuttering

• A nurse should suggest that a parent take time to listen attentively to a child who stutters and avoid interrupting or finishing the child's sentences.### Pediatric Care

Stuttering

• A child who stutters will stutter at any pace, slowing down does not resolve the child's disfluent speech pattern.
• Promising a reward for not stuttering is not an appropriate action, as a child is unable to control stuttering.
• Completing a child's sentences when they begin to stutter can appear as impatience and lead to further stress.

Sickle Cell Anemia

• Hydration decreases the viscosity of the blood, which helps lower the risk of sickling due to venous stasis.
• Mild activity is encouraged to maintain muscle tone and build activity tolerance.
• Postural drainage does not benefit a child with sickle cell anemia.

Safe Food Choices

• Mashed potatoes are a safe food choice for children, as they are soft and have a low risk of choking.
• Raw carrots, popcorn, and watermelon with seeds can cause choking in children younger than 4 years of age.

Postoperative Care

• Lethargy is a priority finding in a child who has undergone a ventriculoperitoneal shunt, as it can indicate a decreased level of consciousness or increasing intracranial pressure.
• The child should lie flat on the unaffected side to avoid pressure on the shunt valve.
• A urine output of 50 mL in 2 hours indicates adequate renal function.

Bedwetting

• Regression of toilet training is an expected behavior in children who are hospitalized, and they will regain bladder control when their health improves.

Cast Care

• The nurse should perform neurovascular checks of the affected extremity first, as the greatest risk to the client is injury from impaired circulation due to constriction.

Laryngotracheobronchitis

• The nurse should monitor for increased stridor, restlessness, and heart rate to detect an impending airway obstruction.

Vaccine Administration

• The MMR vaccine is given in two doses, with the first dose administered at 12 to 15 months of age and the second dose typically given prior to school entry at 4 to 6 years of age.

Pyloric Stenosis

• A client with pyloric stenosis exhibits metabolic alkalosis, projectile vomiting, and muscle wasting and weight loss.
• The nurse should expect to find projectile vomiting, which is usually mild at first, but becomes more forceful.

Temper Tantrums

• The parent should ignore the toddler's attention-seeking behavior, so the child realizes that expressing themselves in this way is not an effective way to communicate.

Lumbar Puncture

• The nurse should position the toddler on his side in a fetal position with his knees curled to his abdomen and his chin tucked to his chest.

IV Catheter Insertion

• The nurse should first ask the child what they know about the procedure to determine how to better direct the remaining preparations.

Toxic Shock Syndrome

• TSS is commonly associated with the use of highly absorbent tampons.

Pediculosis Capitis

• Firmly attached white particles on the hair (eggs or nits) are a definitive indication of pediculosis capitis.### Otitis Media
• Causes of otitis media are viral or bacterial in nature, not related to hydration status or earwax.
• Allergies to common irritants like smoke can cause congestion and chronic otitis media.

Opportunistic Infections

• Candidiasis (oral thrush) is an opportunistic infection that can occur in children with compromised immune systems, such as those with AIDS.
• Candidiasis is often the initial opportunistic infection noted in children with AIDS.

Disseminated Intravascular Coagulation

• In a child with disseminated intravascular coagulation, the nurse should apply an ice pack to the bridge of the nose to decrease bleeding and improve clot formation.
• The child should sit up and tilt their head forward to reduce blood pressure in the nasal vessels and prevent blood from entering the nasopharynx.

Postoperative Care

• To encourage a child to take deep breaths after abdominal surgery, the nurse should engage the child in play, such as blowing cotton balls across the table.
• The nurse should not make punitive remarks or threaten the child, as this can create anxiety and delay recovery.

Dehydration

• In a child with dehydration, the nurse should identify hypokalemia (potassium level < 3.4 mEq/L) as a priority, as it can lead to cardiac dysrhythmias or cardiac arrest.

Communication with Hearing-Impaired Children

• When communicating with a hearing-impaired child, the nurse should speak slowly, face the child, and avoid speaking loudly, as this can distort sounds.

Sickle Cell Crisis

• In a child with a sickle cell crisis, the nurse should manage pain with opioids, maintain hydration, and avoid restricting fluids or encouraging exercise.
• Blood transfusions may be necessary to treat anemia and decrease the viscosity of the blood.

Ventriculoperitoneal Shunt

• After a ventriculoperitoneal shunt, the nurse should place the child flat on the nonoperative side to prevent pressure on the shunt valve.

Adolescent Development

• During an annual health screening, the nurse should explore concerns about peer relationships, as developing a peer group is critical to adolescent development and self-esteem.

Terminal Illness

• In a terminally ill adolescent who refuses treatment, the nurse should facilitate a discussion between the parent and the adolescent to resolve their differences in opinion regarding treatment.

Tetralogy of Fallot

• In an infant with Tetralogy of Fallot, fatigue is caused by inadequate oxygenation for supporting energy metabolism.

Psychosocial Development

• In a 10-year-old child, a desire to perform well in school indicates a sense of accomplishment and meets the psychosocial development expectations of a school-age child.

Dehydration and IV Therapy

• To monitor an infant's response to IV therapy, the nurse should weigh the infant at the same time every day, as weight is the most sensitive indicator of hydration status.

Vaccination

• The nurse should question the administration of a diphtheria, tetanus, and pertussis (DTaP) vaccine if the child has a high fever (e.g., 40.5°C or 104.9°F) after the last DTaP vaccine.