Exam 1: Practice Pediatric Disorders

B. Administer IV immunoglobulin (IVIG)

Rationale: Fever >5 days + strawberry tongue, immediately think Kawasaki disease. Treatment for Kawasaki disease includes IVIG and high dose aspirin to prevent coronary artery aneurysm.

A 3-year-old is brought to the emergency department with a fever for 6 days, bilateral conjunctivitis, swollen hands and feet, cracked lips, and a strawberry tongue. Which intervention is the priority?

A. Start broad-spectrum antibiotics

B. Administer IV immunoglobulin (IVIG)

C. Place the child on droplet precautions

D. Encourage oral fluids only

sausage-shaped

Other S/S of Intussusception: currant, jelly-like stool; knees to chest

The hallmark abdominal finding of intussusception is a __________ mass.

air (or contrast) enema

Rationale: The air enema often diagnoses and corrects the telescoped bowel at the same time. If unsuccessful or perforation is suspected → surgery.

The first-line treatment for uncomplicated intussusception is an ________ enema.

• Enlarged head

• Bulging fontanel

• Vomiting

• Increased ICP

What are the hallmark signs of hydrocephalus?

ventriculoperitoneal (VP) shunt

A ________ is a surgically implanted medical device used to treat hydrocephalus by draining excess cerebrospinal fluid (CSF) from the brain's ventricles into the abdominal cavity, where the body absorbs it.

B. Give 15 g carbohydrate

Rationale: “Cold and Clammy need some Candy” — hypoglycemia — give carbs to increase BG level

A child is pale, sweaty, shaky, and confused. What should the nurse do FIRST?

A. Give insulin

B. Give 15 g carbohydrate

C. Encourage exercise

D. Restrict fluids

airway patency

The #1 nursing priority for a patient with cystic fibrosis is ________.

• Salty skin

• Thick mucus

• Poor growth

• Frequent lung infections

What are the S/S of cystic fibrosis?

• Chest physiotherapy

• Pancreatic enzymes

• High-calorie diet

What are the treatment priorities for cystic fibrosis?

low-phenylalanine

Remember: People with PKU lack the enzyme required to process phenylalanine, an amino acid found in most protein foods, so it is important to limit protein intake to prevent brain damage.

Children with PKU require a lifelong __________ diet.

C. Nasal Flaring

Signs of Resp Distress: retractions, nasal flaring, grunting, cyanosis, tripoding

Which finding is MOST concerning in a child with respiratory distress?

A. Mild cough

B. Sneezing

C. Nasal Flaring

D. Clear nasal drainage

bull’s-eye (erythema migrans)

Rationale: A classic sign of Lyme disease is a red circular rash around the bite with an outer, halo-like ring surrounding it.

A child with Lyme disease classically develops a __________ rash.

Antibiotics

• doxycycline for adults + older children

• amoxicillin or cefuroxime for young children + pregnant / breast-feeding mothers

What is the treatment for Lyme disease?

B. Child who received aspirin during influenza

Think: viral illness + aspirin = increased ICP

Which child should the nurse suspect has Reye syndrome?

A. Child with asthma using albuterol

B. Child who received aspirin during influenza

C. Child with strep throat

D. Child with otitis media

• Hot + Dry (Hot + Dry sugar High)

• Polydipsia

• Polyuria

What are the S/S of hyperglycemia?

insulin and fluids

Hyperglycemia is treated with ________ and ________.

DKA

The priority when caring for a patient experiencing hyperglycemia is to prevent ________.

C. Strict hand hygiene

Rationale:

• ANC below 500 = severe neutropenia.

• Risk is infection.

• Hand hygiene is the most effective intervention

A child receiving chemotherapy has an absolute neutrophil count (ANC) of 250/mm³. Which nursing intervention is the priority?

A. Fresh flowers in the room

B. Encourage raw fruits and vegetables

C. Strict hand hygiene

D. Rectal temperatures every shift

tea-colored / cola-colored

The classic urine finding in poststreptococcal glomerulonephritis is ________ urine.

A. BP 146/90

Rationale: Hypertension is a serious complication of PSGN because damaged kidneys retain sodium and water. Severe hypertension can lead to seizures or heart failure.

Which assessment finding is most concerning in a child with poststreptococcal glomerulonephritis?

A. BP 146/90

B. Mild sore throat

C. Temperature 99°F

D. Heart rate 96

B. Galactosemia

A newborn develops jaundice, vomiting, poor feeding, and cataracts after beginning formula. Which disorder should the nurse suspect?

A. PKU

B. Galactosemia

C. Autism

D. Tourette syndrome

lactose and galactose

Galactosemia requires lifelong avoidance of ________.

Tourette Syndrome

Motor and vocal ticks are characteristic of ________.

B. Oral antibiotics

Rationale: Bulging tympanic membrane + fever + ear pain = Acute Otitis Media.

A 2-year-old is tugging at the right ear, has a fever, and cries when lying down. Otoscopic examination reveals a bulging, opaque tympanic membrane. What is the priority treatment?

A. Oral antihistamines

B. Oral antibiotics

C. Warm compresses only

D. Ear irrigation

bulging tympanic membrane

The hallmark assessment finding of acute otitis media is a ________.

C. Otitis externa

Rationale: Pain with movement of the outer ear after swimming is classic for otitis externa (swimmer's ear). Priorities include: antibiotic ear drops + keep ear dry

A child develops ear pain after several days of swimming. The nurse notes tenderness when pulling on the pinna and redness of the ear canal. Which diagnosis is most likely?

A. Otitis media

B. Mastoiditis

C. Otitis externa

D. Meningitis

Bartonella henselae

Remember: cat-scratch disease is self-limting, so it will resolve on its own within 2-4 months.

Cat-scratch disease is caused by ________, resulting in swollen lymph nodes.

B. Rabies immune globulin and rabies vaccine

Remember: Rabies treatment must begin before symptoms develop because symptomatic rabies is almost always fatal.

A child is bitten by a raccoon while camping. The wound has been cleaned. What intervention should the nurse anticipate next?

A. Tetanus vaccine only

B. Rabies immune globulin and rabies vaccine

C. Oral antibiotics only

D. Observe the child for symptoms

tick bite

Rocky Mountain spotted fever is transmitted by a ________.

C. Surgical correction

Rationale: premature closure of the cranial sutures is known as craniosynostosis, which prevents normal skull and brain growth, leading to increased ICP. Surgical correction is needed to make room for growth.

An infant is diagnosed with premature closure of the cranial sutures. Which treatment should the nurse expect?

A. VP shunt

B. Observation only

C. Surgical correction

D. Lumbar puncture

bone marrow

Aplastic anemia is failure of the ________ to produce blood cells.

B. Infection

Rationale: Bone marrow failure leads to pancytopenia.

Greatest risks:

• Infection (low WBCs)

• Bleeding (low platelets)

A child with aplastic anemia is admitted. Which complication is the nurse most concerned about?

A. Hypertension

B. Infection

C. Hyperglycemia

D. Constipation

serial casting

The first-line treatment for congenital clubfoot is ________.

B. To allow normal limb growth and gradual correction

Parents ask why their newborn's clubfoot casts are changed every week. What is the nurse's best response?

A. To decrease pain

B. To allow normal limb growth and gradual correction

C. To prevent infection

D. To strengthen muscles

B. Cellulitis

Rationale: the hallmark S/S of cellulitis include warmth, redness, swelling, and pain. Cellulitis is typically treated with antibiotics.

A child has redness, warmth, swelling, and tenderness around a scrape on the leg. Which diagnosis is most likely?

A. Contact dermatitis

B. Cellulitis

C. Ringworm

D. Psoriasis

autoimmune

Systemic lupus erythematosus is an ________ disease

NSAIDs and corticosteroids

SLE is treated with _______ and ________.

C. ADHD

A school-age child frequently interrupts others, cannot remain seated, and is easily distracted. Which disorder is most consistent with these findings?

A. Autism

B. Tourette syndrome

C. ADHD

D. Dyslexia

impulsivity

The three hallmark characteristics of ADHD are inattention, hyperactivity, and ________.

impaired social interaction and repetitive behaviors

Children with autism commonly display ________.

B. Premature infant born at 28 weeks' gestation

Rationale: ROP primarily affects premature, low-birth-weight infants because retinal blood vessels have not fully developed. It is important that the child attends follow up eye exams with an ophthalmologist. Laser eye surgery may be needed depending on severity.

Which child is at greatest risk for developing retinopathy of prematurity?

A. Full-term infant weighing 3.8 kg

B. Premature infant born at 28 weeks' gestation

C. Toddler with otitis media

D. School-age child with diabetes

6

Most nasolacrimal duct obstructions resolve spontaneously by approximately ________ months of age.