Exam 1: Nursing Care for Pediatric Patients

Providing care while minimizing physical and psychological distress.

• Goal: reduce fear, anxiety, and separation

What is atraumatic care?

Encourage parental presence

What is the best intervention to reduce a hospitalized child's anxiety?

Parent separation

What is the biggest stressor for hospitalized infants?

Fear of bodily injury

What is the biggest stressor for hospitalized preschoolers?

Loss of accomplishment and productivity

What is the biggest stressor for hospitalized school-age children?

Loss of independence and privacy, as well as impaired body image

What is the biggest stressor for hospitalized adolescents?

offering choices when possible

What nursing intervention promotes autonomy in toddlers?

C. Weight in kilograms

The nurse receives an order for a pediatric medication. What should be verified FIRST?

A. Parent's understanding

B. Child's favorite drink

C. Weight in kilograms

D. Child's height

Small errors can cause significant harm due to a child's size.

Why are pediatric medication calculations high risk?

Observe

What should the nurse do before touching an infant during assessment?

Last

In pediatric assessment, should painful procedures be performed first or last?

least

When assessing a child, use the ______ invasive assessment techniques first.

They have larger tongues and smaller airway

Why are children at greater risk for airway obstruction than adults?

severe hypoxia (reduced oxygen in tissues in certain area of the body)

What does bradycardia in an infant often indicate?

Determine how illness affects daily functioning and development

What is the purpose of a functional health history?

• Nutrition

• Sleep

• Elimination

• Activity

• School performance

• Development

What areas are commonly assessed during a pediatric functional history?

B. "How many hours does your child sleep each night?"

Which question is part of a pediatric functional health history?

A. "What is your favorite color?"

B. "How many hours does your child sleep each night?"

C. "What is your blood type?"

D. "What is your occupation?"

FLACC

Which pain scale is used for infants and nonverbal children?

Face
Legs
Arms
Crying
Consolability

What does FLACC stand for?

Wong-Baker FACES Scale

Which pain scale is commonly used for preschool and school-age children?

increased head circumference and bulging fontanelle (increased ICP)

What is the hallmark finding of hydrocephalus?

increased ICP

What is the priority concern for hydrocephalus?

• monitor head circumference

• monitor fontanelles

• frequent neuro checks

• monitor VP shunt function

What are the nursing actions for a child with hydrocephalus?

B. Hydrocephalus

A 4-month-old presents with a bulging fontanel and rapidly increasing head circumference. The nurse suspects:

A. Croup

B. Hydrocephalus

C. Otitis Media

D. Kawasaki Disease

Premature closure of skull sutures

What is the hallmark findings of craniosynostosis?

Restricted brain growth and increased ICP

What is the priority concern(s) for craniosynostosis?

Monitor development and prepare child for surgical correction

What is the primary nursing action for craniosynostosis?

Aspirin

What medication is associated with Reye Syndrome?

C. "I should avoid aspirin during viral illnesses."

The nurse is teaching parents about Reye syndrome. Which statement indicates understanding?

A. "I'll give aspirin for fever."

B. "Aspirin is safe after chickenpox."

C. "I should avoid aspirin during viral illnesses."

D. "Aspirin prevents complications."

Bulls-eye shaped rash

What is the hallmark sign of Lyme’s Disease?

tick bites

Lyme Disease is commonly spread by ________.

C. Rocky Mountain Spotted Fever

A child develops a rash beginning on the wrists and ankles after a camping trip. The nurse suspects:

A. Measles

B. Lyme Disease

C. Rocky Mountain Spotted Fever

D. Scarlet Fever

Barking cough

What is the hallmark sign of croup?

airway patency

The priority concern in croup is ______.

D. Croup

A child presents with inspiratory stridor and a barking cough. Which disorder is most likely?

A. Asthma

B. Bronchiolitis

C. Pneumonia

D. Croup

Wheezing

What is the hallmark respiratory sound heard in bronchiolitis (RSV)?

adequate oxygenation

The priority concern in bronchiolitis is ______.

• Wheezing

• Cough

• Prolonged expiration

What are the hallmark findings of asthma?

C. Absent breath sounds

Which assessment finding indicates worsening asthma?

A. Mild wheezing

B. Productive cough

C. Absent breath sounds

D. Nasal congestion

greasy, fatty stools

What GI finding is commonly associated with cystic fibrosis?

pancreatic enzymes

Children with cystic fibrosis often require ______.

B. Cystic Fibrosis

A child has chronic lung infections and greasy stools. The nurse suspects:

A. Asthma

B. Cystic Fibrosis

C. Kawasaki Disease

D. Diabetes

strawberry tongue

What oral finding is classic in Kawasaki disease?

IVIG and aspirin

Kawasaki disease is treated with ________.

C. Kawasaki Disease

A child has had a fever for 6 days, conjunctivitis, and a strawberry tongue. The nurse suspects:

A. Measles

B. Scarlet Fever

C. Kawasaki Disease

D. Pneumonia

Currant, jelly stools

What stool finding is characteristic of intussusception?

sausage

A ______-shaped abdominal mass may be felt in intussusception.

• Polydipsia

• Polyuria

• Polyphagia

What are the 3 P's of diabetes?

DKA

The priority concern in pediatric diabetes is preventing ______.

• Sweating

• Tremors

• Confusion

What are common signs of hypoglycemia?

15

Mild hypoglycemia is treated with ______ grams of rapid carbohydrate.

• Bone pain

• Brusing

• Fatigue

What are the hallmark findings of leukemia?

infection prevention

The priority nursing concern in leukemia is ______.

Pancytopenia (decreased RBCs, WBCs, and Platelets)

What is the hallmark finding of aplastic anemia?

neutropenic and bleeding precautions

A child with aplastic anemia requires ______

fever

What is often the only sign of a UTI in infants?

before

A urine specimen should be obtained ________ starting antibiotics.

Tea-colored/cola-colored urine

What urine finding is classic in PSGN?

Periorbital

______ edema is commonly seen in PSGN.

serial casting

What is the primary treatment for clubfoot?

inward turning of the foot

Clubfoot is characterized by ______.

multisystem autoimmune disorder

What type of disorder is SLE?

excessive sun exposure

Children with SLE should avoid ________.

B. PKU

A newborn has a musty body odor. Which disorder should the nurse suspect?

A. Galactosemia

B. PKU

C. Autism

D. ADHD

phenylalanine

Children with PKU require a low ______ diet.

C. Galactosemia

A newborn develops vomiting and jaundice after milk feedings. The nurse suspects:

A. PKU

B. ADHD

C. Galactosemia

D. Autism

vomiting after milk ingestion

What feeding-related symptom is common in galactosemia?

milk and lactose products

children with galactosemia should avoid ______.

social communication deficits and repetitive behaviors

What are the hallmark characteristics of autism?

a consistent routine

Children with autism often benefit from ______.

• Inattention

• Hyperactivity

• Impulsivity

What three behaviors characterize ADHD?

Motor and vocal tics

What are the hallmark findings of Tourette syndrome?

supporting self-esteem and social functioning

The priority nursing concern in Tourette syndrome is ________.