ATI Proctored PEDs, ATI Pediatrics Proctored Exam, PEDS ATI proctored review

ATI Proctored PEDs, ATI Pediatrics Proctored Exam, PEDS ATI proctored review Preschool-Aged Children Body-Integrity - CORRECT ANSWER - Preschool-aged children are very concerned about their body integrity - They believe that their insides can leak our from even a small wound. - Explains reason for their preoccupation with bandages Preschool (3-6 Years) - CORRECT ANSWER - IMITATION of adults: providing a stethoscope allows child an opportunity for THERAPEUTIC play. - Time based on events, magical thinking, animism, centration. - Stress = Regresion; may still be picky eaters , sleep 12 hours average, pedestrian safety - Keep a consistent bedtime routine Pyloromyotomy - CORRECT ANSWER - Release of hypertrophied muscle around the pyloric sphincter that causes narrowing of the pyloric canal. - Infants will be fed shortly postoperative (with return of bowel sounds) in small, frequent oral feeds. - There is no incision to the gastric walls or mucosa and NPO is not required. Cystic Fibrosis Nutritional Care - CORRECT ANSWER - ↑ Protein, Carbs and minerals, to promote weight gain - They have difficulty absorbing nutrients due to blockage of pancreatic enzymes by thick mucus secretions in the pancreas and liver. - Pancreatic enzymes help breakdown ingested foods so the body can metabolize nutrients. - Administering pancreatic enzymes BEFORE eating will enable children to metabolize nutrients so they can be used more effectively - Fat content doesn't need to be decreased or eliminated. They have difficulty absorbing fat due to thick mucus in intestines and the inability of the pancreatic enzymes to reach the duodenum. - ↑ of fiber is NOT needed, their stools are bulky because of fat content, but they have regular bowel movements - C.F. patients excrete excessive salt through the skin, the child with cystic fibrosis will likely require additional salt in their diet, especially during activities. - 85% O2 Sat = mild hypoxemia, as mucopurulent secretions gather in airways, respiratory compromise worsens and oxygenation becomes impaired and ↓ in O2 Sat is likely seen Chemotherapy - CORRECT ANSWER - Low WBC count places the child at risk for infection and isolation with monitoring of fever is priority. ↓RBC - CORRECT ANSWER - Quiet play and best rest, administer O2 ↓ Platelet - CORRECT ANSWER - Protect child from injury and monitor for bleeding. - Quiet play should be encouraged, it will lessen the R/F injury and ↓ hemorrhage Dehydration - CORRECT ANSWER - Assessment, response to parenteral fluids. the nurse should weigh the patient daily because weight is the most sensitive indicator of hydration status in clients of all ages. - Weight is the only measurement the reflects both measurable fluid balance changes (I/O) and insensible fluid loss (skin and respiratory) Koplik spots - CORRECT ANSWER - Maculopapular rash and fever; Rubeola - Koplik spots: oral lesions that are characteristics of rubeola (measles). The small, irregular spots with a blue/white center are seen on the Buccal mucosa, which is opposite the molars, in the prodromal stage of measles. - Koplik spots appear about 2 days before maculopapular rash appears and are accompanied manifestations of fever, malaise, conjunctivitis, and other cold manifestations. - They begin to fade the second day after the rash appears. Immunity to measles is conferred by the MMR (Measles-Mumps-Rubella) immunization that children receive @ 15 months. Rubeola - CORRECT ANSWER Measles; Maculopapular starts on the face and spreads downward. It desquamates after about 3-4 days. The rash does not progress to vesicles and crusts like the papules of chicken pox. - cephalocaudal rash upper trunk and faceand more confluence as it spreads to the lower areas of the body. Varicella - CORRECT ANSWER Chicken Pox; Vesicles and crusts are present - Commences with a maculopapular rash that progressess to vesicles on erythematous bases which eventually rupture and crust over. Kawasaki Syndrome (Scarlet Fever) - CORRECT ANSWER - Strawberry tongue; sloughed off its normal coating, exposing swollen prominent papillae. Pertussis (whooping Cough) - CORRECT ANSWER Paroxysmal Cough A1C - CORRECT ANSWER AKA glycosylated hemoglobin assay; is the most sensitive indication of client compliance with the treatment regimen. The life span of RBC is about 120 days, and glucose molecules adhere to about 4-6% of hemoglobin. Because of the longevity of the RBC's recent changes in diet, activity or medication will not affect the results of this test. Skeletal Traction - CORRECT ANSWER The most effective means of traction, applying to a bone with wire pins or tongs Compartment Syndrome - CORRECT ANSWER Involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles Ventricular Septal Defect - CORRECT ANSWER - Murmur best heard at the lower left sternal border; Ventricular septal wall defect between ventricles is an Acyanotic heart defect. - Sound is transmitted in the direction of blood flow, so any back flow of blood from the left to the right ventricle through the septal defect would be best heard in this area. Acute Glomerulonephritis - CORRECT ANSWER - ASO titer will indicate if the child has had a recent strep infection. In determining a definitive diagnosis for acute glomerulonephritis. - Elevated RBCs is expected and the presence of hematuria - Monitor B.P. Q4hr due to ↑HTN HIV Preschooler - CORRECT ANSWER - Immunizations contraindicated for this patient is the oral polio - the child is susceptible to infection and must be immunized to the common preventable childhood diseases. - However, the oral polio vaccine contains a form of the virus that in SOME clients can lead to an actual case of polio, this risk is increased with HIV and must receive the injectable form of the polio immunization. Myelomeningocele - CORRECT ANSWER - Hydrocephalus; is a post-operative risk because the pathway for the cerebral spinal fluid has been altered. - Infants --> Measure the head circumference Qshift. - children with NTDs usually produce too much cerebral spinal fluid and once the sac is removed, there is nowhere for this additional CSF to accumulate except in the ventricles of the brain. Epiglottitis - CORRECT ANSWER D/O caused by inflammation and it has been decreased since the inclusion of the HiB vaccine; it is common in children between 2-6. Cardiac Catheterization - CORRECT ANSWER - Any bleeding from the entry site of the cardiac cath. could indicate potential hemorrhage. Cleft Palate - CORRECT ANSWER - Child post-op should use a cup to avoid injury to the incision line postoperative, therefore, no objects should be inserted into the child's mouth . A cup allows the child to sip without placing anything in his mouth. Intussusception - CORRECT ANSWER - Diagnosed with a barium enema, which may also correct the condition; the telescoping of the bowel may be reduced by the hydrostatic pressure of the barium enema. Nephrotic Syndrome Prednisone - CORRECT ANSWER - In nephrotic syndrome it acts on the body to decrease the excretion of protein, and thus helps flush fluids back to their normal spaces. - Extra fluid is excreted in the urine and decreases edema that can be measured in weight loss. Spinal Fusion - CORRECT ANSWER - Log rolling Q2hr promotes good pulmonary, gastrointestinal and genitourinary functioning. It also allows the nurse the opportunity to assess the clients lengthy posterior spinal dressing for drainage or bleeding. - Pt. doesn't ambulate until fusion stabilizes about 4-5 days post-op, elevated HOB @ 2-3 days post-op Milwaukee brace - CORRECT ANSWE