Pediatrics

Recent sore throat

A child is weak and lethargic, has headaches, has no appetite, and has dark, cloudy urine. The nurse suspects acute poststreptococcal glomerulonephritis (APSGN). Which question would the nurse ask the mother?

• Diagnosis confirmed with Atistreptolysin O Titer, urinalysis, or blood chemistry

Hemophilia A

S/S of this condition include:

• Nosebleeds

• Hematuria

• Painful and swollen joints

• Easy bruising

Patency of NG tube

Which nursing intervention would the nurse provide a 3-week-old infant immediately after surgery for esophageal atresia?

Diaphragmatic hernia

This condition in newborns requires gastric decompression via NG tube to minimize intra-abdominal pressure

Running

One big activity that is contraindicated in kids with asthma is…

Down Syndrome

S/S of this include:

• Flat, occiput and broad nose

• Small, misshapen, low-set ears

• Protruding tongue

Hirschsprung Disease

This is diagnosed via rectal biopsy

• Affects the nerves of the large intestine

Sweat Test and Chest X-ray

Cystic Fibrosis is diagnosed via…

Two hours after feedings

Which schedule (in relation to feedings) would the nurse implement for a 3-month-old infant with cystic fibrosis who is to receive clapping, percussion, and postural drainage every 4 hours?

Before development of faulty speech patterns

The mother of an 18-month-old child with a cleft palate asks the nurse why the pediatrician has recommended that closure of the palate be performed before the child is 2 years old. How would the nurse respond?

Level of consciousness hourly

Priority assessment for a child with bacterial meningitis

Injury to suture line

Why is it taught to parents not to brush the child’s teeth immediately following a palate surgery?

Sitting up

The anterior fontanelle should not be bulging in babies when they are doing this…

• Indicates increased ICP (mannitol?)

Seizures

Interventions include:

• Nothing in the mouth

• Stay with pt, protect from hitting head on objects

• Monitor time, movements, and LOC

Cranial apertures or sinuses

Most common route of transmission for bacterial meningitis

Cystic Fibrosis

A common early sign of this condition is a meconium ileus

Hearing loss

If a 6-month-old is startled by a loud noise but does not turn in the direction of the sound, what does this indicate?

Humidified cool air and adequate hydration

What two things are a priority for infants with RSV?

Abdominal swelling

Which clinical manifestation would we expect in a child with Wilms tumor?

Erb Palsy

Nerve injury to the brachial plexus that occurs during birth

Immediately

How soon does a myringotomy provide relief?

Mongolian Spots

Medical condition characterized by the appearance of irregular, deep-blue pigmented spots on the gluteal regions upon birth

Rubber-tipped syringe

What would a nurse provide to an infant after a cleft lip repair?

Fluid Retention

Periorbital edema, smoky urine, and headaches are indicative of this in acute poststreptococcal glomerulonephritis

Pain management (then oxygenate)

In a sickle cell crisis, what takes priority?

Monitor for intracranial pressure

Which nursing intervention would be implemented for an infant in the first 24 hours after surgery to replace a ventriculoperitoneal shunt for hydrocephalus?

Daily weights

What is the best method to use to assess an infant’s response to oral rehydration therapy?

Depressed anterior fontanelle

This is a clinical sign of fluid volume deficiency in infants

High fluid intake

The main teaching with polycythemia vera is…

Polycythemia Vera

Condition of high concentrations of erythrocytes, leukocytes, and platelets, leading to high blood viscosity and risk for thrombus formation and HTN

Red Reflex

An absence of this in newborns is indicative of congenital cataracts

Vitamin K

This is prepared for newborns because their intestinal tracts do not synthesize it for several days after birth

9 months

Developmental milestones include:

• Push-pull toys

• Sits steadily without support

• Responds to simple commands

Interference from maternal antibodies

Main reason for why the immunization schedule doesn’t begin until 2 months? (minus Hep B)

Murmur at left sternal border

Which physical examination finding is indicative of a VSD?

4 months

When does the rooting reflex disappear in infants?

Visual clarity

Infants with acquired herpes simplex are at risk for problems regarding…

Rubella

Infants are at risk for contracting deafness and cardiac anomalies in the first trimester is a mother has contracted…

Bacterial meningitis

S/S include:

• Neck stiffness

• Kernig Sign (can’t extend legs while supine)

• Brudzinski’s Sign (flexion of the hips when the neck is flexed from a lying position)

• Severe headache

• Decreased LOC

• Photophobia

Kernig Sign

Clinical sign that is indicative of meningitis

• Hamstring muscles spasm during leg extension (inability to extend the leg when lying supine)

Babinski Reflex

Reflex of toes fanning out in reaction to foot stimulation

Chvostek Sign

Facial twitching in response to low calcium

Trousseau’s Sign

Hand/wrist spasm in response to low calcium

Sodium Lactate (forms bicarb to increase pH)

An infant undergoes surgery for the repair of a myelomeningocele and develops metabolic acidosis, accompanied by decreased urine output. Which medication would the nurse anticipate providing teaching for?

Acknowledge child’s feelings

Most appropriate strategy in cases of giving shots to children

Toxicity

What are infants at higher risk for due to having thinner skin in relation to transdermal med administrations?

Thrombocytopenia

After administration of the MMR vaccine, a child develops pain, fever, and soreness. The nurse assesses the child for joint swelling and obtains a blood sample for a blood platelet count as ordered by the health care provider. Which is the most appropriate reason behind these interventions?

Reye Syndrome

Disorder characterized by metabolic encephalopathy, increased ICP, fever, impaired consciousness, and disordered liver function

• Caused by viruses like influenza or varicella and aspirin use

Tonic Neck

Reflex in which a newborn is lying supine with the head turned to the side with the legs and arms extended on the same side and flexed on the opposite

Moro Reflex

Reflex caused by a sudden change in equilibrium that causes extension and abduction of the extremities, followed by flexion and adduction

• Goes away by 4-6 months

Rear-facing in backseat

How should a car seat be placed for a newborn?

12 months

By which age should an infant have their first dental exam?

Increased protein

Which finding from cerebral spinal fluid would lead the nurse to associate with a diagnosis of bacterial meningitis?

7 months

Milestones include:

• Playing peek-a-boo

• Turning completely over

• Reaching to be picked u

• Sitting for a short time without support

Varicella

Another name for chickenpox?

Rubeola

Another name for measles?

Rubella

Another name for german measles?

Olive-sized mass in RUQ

Which manifestation of hypertrophic pyloric stenosis in an infant would the nurse expect when palpating the abdomen?

Knee-chest

An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. In which position would the nurse place the infant to relieve the cyanosis and dyspnea?

Trust

Piaget goal for birth to 18 months?

Industry

Piaget goal for 6 to 12 years?

Initiative

Piaget goal for 3 to 6 years?

Autonomy

Piaget goal for 1 to 3 years?

Shortening of a leg/uneven gluteal folds

Which finding would the nurse expect when assessing an infant with suspected developmental dysplasia of the hip?

Phenylalanine

A diet low in what is indicated for PKU?

Waterproof sunscreen, SPF 15

A girl with systemic lupus erythematosus (SLE) wants to go to the beach with her friends on the day after their junior prom. The girl asks the nurse for guidance regarding sun exposure. The nurse should provide which information to the girl?

Sudden relief of abdominal pain

Emergent sign of appendix rupture

Contaminated food/water

Primary transmission of Hep A?

Blood/blood products

Primary transmission of Hep B and C?

Bubble baths

Form of bathing that can lead to UTI’s?

Frequent swallowing

Indication of postoperative bleeding following a tonsillectomy?

Change in behavior

Early sign of increased ICP?

SIDS

Can be avoided by having the infant sleeping supine on bedding that isn’t too soft

Bronchodilators

A child who is experiencing wheezing during an acute asthma episode is brought to the emergency department by the parents. Which intervention does the nurse prepare to implement first?

With meals and snacks

When to administer pancreatic enzymes for children?

Applesauce

Best food to administer pancrealipase with?

Kawasaki Disease

S/S include:

• Peeling of fingertips

• Strawberry tongue

• Damage to vascular beds

Orange juice

Best beverage to drink when taking iron?

Black tarry stools

Normal GI finding when taking iron?

Immobilize affected joint

The mother of a child with hemophilia calls the clinic nurse and reports that her child has hit his knee on the corner of a coffee table and that the joint appears swollen. The nurse should tell the mother immediately to take which action?

Metal pins

Children with which kind of traction (insertions) are at the highest risk of osteomyelitis/infection?

Hepatitis

The nurse should contact the primary health care provider with concerns about a prescription for valproic acid for an adolescent who has a history of which disorder?

Droplet

Kind of precautions for bacterial meningitis?

EEG

A 4-month old infant boy is brought to the ED by his parents. He was been vomiting and fussy for the past 24 hours. On examination, there are circular bruises on his back. What priority assessment does the nurse anticipate?

BMI

A 6-year-old child arrives in the ED with active seizures. Which assessment is the highest priority for the nurse to obtain?

Passage of normal brown stool

What indicates a resolution of intussusception?

Through a syringe and with orange juice

Two big interventions for iron administration in children?

Doubles by 6 months, triples by 12

Weight gains for 6 and 12 months?

As non-pharmacological as possible

Pain management for peds should be…

Acetylcysteine

Nebulized agent to thin secretions?

Immediate care and surgery

Priority interventions for cyanotic cardiac issues?

• Tetralogy, Tricuspid atresia, hypoplastic heart (4 T’s)

Monitor

Priority intervention for acyanotic heart issues?

GI issues

Main s/s of digoxin toxicity for parents to learn?

Meningocele

Sac containing only meninges and spinal fluid, no neurological deficits noted

Myelomeningocele

Sac containing spinal fluid, meninges, and nerves, causing sensory and motor defects

Blood glucose and therapeutic levels

Value to check after a seizure? (to prevent recurrence)

Nephrotic Syndrome

Characterized by increased glomerular permeability to protein, causing proteinuria (frothy)

Antidiarrheals

What med to NOT give for cases of diarrhea?

Chorea

Involuntary movements of the legs, arms, and face

Low phenylalanine

Diet to follow for PKU?