pedi final quizlet practice

• These notes cover pediatric nursing topics for an exam.

Infant Assessment and Development

• Closed anterior fontanel in a 5-month-old is an abnormal finding.
• Caregivers of a 3-month-old should receive Tdap/Dtap boosters to prevent pertussis.
• A first food for a 6-month-old should be iron-fortified rice cereal mixed with formula.
• Head lag and inability to roll over at 7 months indicate a need for early intervention consultation.
• Honey and peanuts should be avoided until 1 year of age.
• Picky eating is normal for a 2-year-old.
• Colic typically resolves around 12-16 weeks.
• The "back to sleep" campaign has reduced SIDS, but may increase the risk for plagiocephaly; infants should be placed supine.
• A 12-month-old's birth weight should have tripled, not doubled.

Toddler and Preschooler Care

• Allow a 3-year-old to sit on a parent's lap during an exam to ease anxiety.
• Medications should be stored in locked cabinets to prevent accidental poisoning.
• To prevent burns, keep covers on outlets, pot handles turned to the back of the stove, and use sunscreen.
• A sibling's belief that they caused a sibling's illness, feeling neglected due to the sibling's medical needs, or feeling unfairly punished compared to the sibling may indicate the need for additional teaching and counseling.
• Following a structured routine throughout the day is an important aspect of care for an infant with nonorganic failure to thrive.
• Magical thinking is an expected behavior in preschoolers.

Adolescent Development and Care

• Breast development is usually the first sign of puberty in girls and girls stop growing about 2 years after menarche. -Morphine is the best choice for a hospitalized child receiving a patient-controlled analgesia (PCA) in the immediate postoperative period.
• A weight below the 5th percentile for height and age is a criterion for failure to thrive.
• A 4-year-old should still be in a car seat and should not be allowed to warm up food in the microwave.
• Naloxone (Narcan) should be administered by slow IV push for a patient on an intravenous opioid analgesic who becomes apneic.
• When preparing for an exam, use an eye-level position and talk quietly to ensure a positive response from a toddler.
• A child's developmental level is the most important factor when communicating with children.
• Infants gain head control before sitting unassisted, which is cephalocaudal development.
• A family with a mother, her children, and a stepfather is a blended family.
• Family-centered care includes encouraging family visitation.
• Toddlers have a short, straight ear canal and large lymph tissue which predisposes them to frequent infections.
• When a 4-year-old asks the nurse when his parents are coming, the nurse should respond with "They will come after dinner."
• Injuries are the leading cause of death during the toddler period.
• Lead-based paint is the most frequent source of acute childhood lead poisoning.
• Subdural and retinal hemorrhages in an infant without external signs of trauma may indicate shaken-baby syndrome.
• Incompatibility between the history and injury observed is probably the most important criterion on which to base the decision to report suspected child abuse.
• The growth pattern of boys at 12-years-old is typically at the 50th percentile for height and at the 75th percentile for weight on the growth chart.
• The nurse should be most concerned about a 12-year-old male with short stature and depression's self-esteem.
• A normal or slightly above normal weight is descriptive of bulimia during adolescence.
• Organic causes that may be related to enuresis should be considered first and enuresis is more common in boys than in girls.
• The family should be reassured that most problems of encopresis are resolved successfully, with some relapses during periods of stress.
• Gay and lesbian adolescents are at a particularly high risk for suicide.

Medication Administration

• For a child weighing 33lbs prescribed Augmentin 150mg every 8 hours (available 125mg/5ml), administer 6ml per dose.
• Zithromax 10mg/kg is prescribed for a 6-month-old with otitis media (available 100mg/5ml); for a child weighing 22lb, administer 5ml.
• For a temperature of 103.2 in a 4-year-old with a viral infection, avoid adult Tylenol and wrapping in blankets.
• The vastus lateralis is the appropriate site for an intramuscular injection (IM) in a 1-year-old.
• For Prednisone 12mg daily (available 15mg/5ml), administer 4ml per day.
• The nurse should correctly educate a patient to take his bronchodilating (albuterol) inhaler first. For a pneumonia patient Ceftriaxone 50 mg/kg/dose IM every 24 hrs is ordered for a 12 week old female that weighs 14 LBS, 318 mg will be administered and a 25 gauge needle will be used.
• For tamiflu is ordered for a child with influenza symptoms the dose ordered is 45 mg bid available 6mg per ml the child would receive 7.5ml each dose. For a 4 year old the doctor ordered ibuprofen 5mg/kg every 6hours for a temp above 101.2 The medication is labeled 100mg in 5ml. The child has a temp of 102.2 last dose was 8 hours ago patients weight 44 lbs. The child will receive 5ml

Respiratory Conditions

• Increased wheezing and mild retractions in an 8.1kg 4-month-old with RSV would be MOST effective with administering albuterol by nebulization.
• "avoidance of known triggers is the best way to prevent attacks." is the nurse's BEST advice for exposure to tobacco smoke at a friend's home"
• Adults caring for children should receive a booster vaccine for pertussis and Pertussis may lead to permanent lung problems.
• For stridor associated with croup in a 20 month-old, the nurse anticipates a STAT order from the physician for racemic epinephrine (Vaponephrine)
• Concerning manifestations for a 3 month old infant diagnosed with respiratory syncytial virus (RSV) is expiratory wheezing than decreased air movement and respiratory grunting
• barking cough and stridor distinguishes croup from other respiratory disorders.
• Respiratory rate of 62 alerts the nurse to EARLY signs of increasing distress in a 5 month old infant.
• The nurse would notify the most experienced provider for intubation for a child with epiglottitis that is worsening.
• For a recent tonsillectomy patient, excessive swallowing and spitting up bright red blood is a concerning finding.
• PH 7.21 laboratory result would be the most important piece of information regarding respiratory status.
• Grunting is a physical sign indicating respiratory failure in a child with RSV.
• The nurse would advise a mother with a child that has a barky cough to take the child outside to the cool air.
• Respiratory airways of infants and young children are more narrow so they are easily obstructed and The metabolic rate and oxygen consumption of infants and young children are faster than older children is accurate information about the respiratory systems of infants and young children.
• "For a tympanic temperature, pull the pinna down and back before inserting the probe into the ear." is the most accurate information about when teaching the parents of an 8-month-old child with bronchiolitis how to take their child's temperature.
• After discharge for a patient diagnosed with Asthma the nurse reviews all the following to prevent exacerbation that includes get yearly flu shot, Keep rescue inhalers available at all times and Remove molds and dust mites from the home.
• A 7 month old stops breathing her HR is 80 the nurse should administer 100% oxygen by bag valve mask.

Emergency Care

• A rigid body indicates pain in an infant after blood draw.
• For a child in cardiac arrest, if IV access is not possible, intraosseous needle access is the next step.
• A respiratory rate of 30 breaths per minute is a normal finding in a 12-month-old and should be documented.
• For a mom that states "she is very tired and that the baby cries she is afraid she is "going to lose it", a nurse best response would be to place the baby in the crib let her cry and call a family member or friend to help care for the baby.
• A BP 76/48 in a 8 year old that has a 3 day history of vomiting and diarrhea and is difficult to arouse is classified as hypotension.

Miscellaneous

• Maintain a structured routine and keep stimulation to a minimum ,should plan priority intervention when caring for the child with autism spectrum disorder (ASD).
• A child that is complaining of abdominal pain,and rebound tenderness, increased WBC's and left shift The nurse knows the patient presents with Appendicitis.
• Bananas, rice ,applesauce and toast is the recommened diet for a child with gastroenteritis after clear liquids
• Weight loss, Tachycardia and Poor skin turgur are accurate physical assessment findings for an infant with dehydration.
• The nurse responds by stating Spontaneous closure usually occurs 3-4 (most by 1yr.) a mom that wants to know what will be done for a Umbilical Hernia that is seen in a 2 month old boy
• wash and sterilize nipples and pacifiers The child has yeast infection oral nystatin will be used should be included when answering a mom on how is this treated for her 4 week old infant that is not feeding well and when examined there is white coating in the oral in the mouth.
• Umbilical Hernia The source used to classify sexual development of an child is Tanner Staging
• Place child in a private room if a 12 month old child being sent up from the Emergency Room with a fever and cough for 2 days suspects influenza which is following best practice.
• Rigid body is an observation nurses determine that a infant has pain after drawing blood

Cardiac Conditions

• Prostaglandin E. drug is used to maintain the patency of the patent ductus arteriosus in infants with transposition of the great vessels
• surgical removal of affected section of bowel Therapeutic management treatment is implemented for children with Hirschsprung disease.
• A child's color becomes blue and respiratory rate increases to 44 bpm places the child in knee-to-chest position a child diagnosed with tetralogy of fallot
• A 6-month old client with ventralseptal defect is receiving digitalis the nurse would notify the doctor in a heart rate of 60 bpm.
• The nurse would elevate the head but give nothing by mouth when caring for a neonate with a suspected tracheoesophageal fistula.
• Intussusception is the name of one segment of bowel within another.
• Rotavirus the pathogen that frequently causes acute diarrhea in very young children if they are not immunized
• The Principal mode of transmission for hepatitis B is infected body fluids Hepatitis B can be prevented by HBV vaccine.
• Feed baby more often is a suggestion minimize reflux when caring for a 4-month-old infant has gastroesophageal reflux (GERD) but is thriving without other complications.

Malformations

• "Affects 1 in 800. More common in boys. Etiology: hereditary, environmental " should be included when a student nurse asked about the condition the nurse responds with newborn diagnosed with a cleft lip.
• The student nurse would respond N oral temps and Maintain patent airway. Lung assessment before/after feeding when asked Nursing Care Post-Op Cleft lip. Anal dimpling may be presen and Meconium may appear from perianal fistula or in urine should be included in the case study to new grads about a patient the with a Anorectal Malformations.
• "She can eat anything but wheat bread" indicates further education would need to be teached to a mom about diet restriction for her daughter diagnosed with Celiac Disease
• A 19 year old just delivered a baby in the Emergency room. She stated that she did not know she was pregnant and did not receive prenatal care.The child is cyanotic ,sunken abdomen and bowel sounds are heard in the chest.The nurse is concerned the child may have Diaphragmatic Hernia
• Failure to pass meconium within the first 24 hours after birth may indicate Hirschsprung disease

Tetralogy of Fallot

• Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy congenital heart defects the nurse is conducting a staff in-service Cardiac valve damage is a common, serious complication of rheumatic fever. The nurse should plan Organize nursing activities to allow for uninterrupted sleep to decrease cardiac demands infant with congestive heart disease (CHD).