ATI CMS: Nursing Care of Children
Appropriate response to death - Preschoolers: magical thinking = thinking their thoughts
caused death, thinks that death is reversible and temporary
Assisting with administration of nasogastric enteral feeding for an infant (x2) - Position the
head of crib at 30 degree angle between feedings
Assisting with scoliosis screenings for school age children - Stand with feet together and then
bend down as if touching toes, back parallel to floor
Best food options for a child who has phenylketonuria - Child with PKU cannot digest
phenylalanine, which is present in most animal products
Caring for a child in buck's traction - This is a skin traction of the lower extremity; make sure
that knots are away from pulleys, that the leg remains extended, that weights are free-
hanging at all times, that blankets do not cover ropes and that the child cannot reach or
interfere with the mechanism
Caring for a toddler who has stomatitis - Provide oral care (since the mouth with chlorhexidine
mouthwash)
Caring for an infant following repair of a hypospadias - Avoid giving the child a tub bath until
stent has been removed, don't toilet train the child during this process, encourage fluids to
maintain hydration (DON'T limit fluids) leaving the child diaper less is uneccesary
Caring for family following unexpected death of a child - Allow the family to be in close
proximity with the child's body, to care for/dress/bathe it; do not instruct them to leave room
Checking skin turgor in a child - Best on abdomen
Converting ounces to mL - 1 oz = 30 mL
Deviation from expected growth and development for a 12 month old infant - Birth weight
should be tripled
Dietary recommendations for a child who has celiac disease (x2) - Child with celiac disease
cannot process plant protein gluten (present in wheat, barley, rye). Avoid oats b/c usually
contaminated with gluten. Rice is okay!
Dietary recommendations for child with lactose intolerance - Child needs supplementary
calcium and vitamin D intake, as the dairy products that they cannot consume are high in
calcium. Also, take lactase when consuming a dairy product.
Evaluating compliance to ferrous sulfate therapy, reinforcing teaching about liquid iron
supplements - Iron supplements are given with citrus fruit, between meals when the stomach
is most acidic for better absorption, taken with a straw to avoid teeth discoloration,
administered IM using z-track technique to prevent tissue staining. Iron supplements turn
stool to a tarry green.
,ATI CMS: Nursing Care of Children
Evaluating therapeutic effect of pancrelipase - Pancrelipase is effective if steatorrhea
resolves
Evaluating treatment of infant who has dehydration - "sodium level of 145" is within expected
range of 134-150
Evaluating understanding of home oxygen use - Make sure electrical equipment is grounded
(tubes can be long! Also no smoking!)
Expected behavior for a 7 year old female child - Spends a lot of time by herself
Expected findings of gastroesophageal reflux disease - chronic cough
Expected findings of severe dehydration - Body weight loss > 10%, extreme thirst, no tears
when crying, sunken fontanelles
Expected lab values for a child who has iron deficiency anemia - Lowered Hgb/Hct, NOT high
WBCs
Facilitating communication for a child who has hearing loss - Speak slowly, facing the patient,
avoid exaggerated movements, use facial expressions and hand gestures
Findings associated with poststreptococcal glomerulonephritis - Oliguria
Findings indicating physical abuse, manifestations of physical abuse - Laceration on side of
torso (any injuries that are not typical toddler clumsiness), symmetrical burns on lower
extremities, spiral fractures
Home care of conjunctivitis - Conjunctivitis is considered non-communicable after 24 hrs of
antibiotic treatment. Do not share towels with the infected child, as this promotes spread of
highly contagious injection
Identifying a hemolytic reaction during a transfusion, monitoring a child who is receiving a
blood transfusion - Signs and symptoms of hemolytic reaction include chills and flank pain
Identifying a toddler prior to medication administration - Ask the guardian to confirm
name/DOB
Identifying nutritional risks in an adolescent - Adolescents tend to eat a lot of junk foods high
in calories but low in other nutritional content. At risk for inadequate micronutrient nutrition.
Identifying risk factors for physical abuse - A child with ADHD, a child who was born
prematurely
Identifying risk factors for Urinary Tract Infection - Constipation (bowel movements every 4-5
days), urinary stasis, episode/hypospadias
Identifying splenic sequestration in a child who has sickle cell anemia - Spleen (and liver) will
be enlarged during this phase, the child must avoid activities that have a risk of abdominal
trau,a
,ATI CMS: Nursing Care of Children
Identifying therapeutic effect of digoxin, findings to report for a child who is receiving digoxin,
identifying digoxin toxicity - Therapeutic effect: increased cardiac output, "my baby is
breathing easier than she used to." Findings to report: anorexia, n/v, infant HR < 90, child HR <
70, vision changes, hypokalemia potentiates digoxin toxicity
Inserting an indwelling urinary catheter - "Apply 2% lidocaine lubricant to the urethral
meatus." (make sure of the sizing of the equipment used, it should be smaller in use with a
child. Also, this procedure must be sterile to prevent UTIs)
Interventions for mild hypoglycemia - Administer 15 grams of carbohydrates (usually 4 oz of
juice or soda) then recheck the blood glucose after 15 mins. Follow up with a more complex
carbohydrate, such as toast or crackers
Interventions to promote sleep for a toddler - Provide a consistent bedtime routine, "favorite
stuffed animal"
Isolation precautions for bacterial meningitis - Droplet precautions
Lab findings to report for an adolescent experiencing sickle cell crisis - A very low Hgb (6 for
example)
Lab value to report for a child who is taking Prednisone - Hypernatremia (also hyperglycemia,
hypokalemia, neutropenia)
Lab values requiring additional evaluation - Low platelet count (<150,000), low HCT/HGB (<12,
<31%)
Lab values to report for Wilm's Tumor - Antineoplastic medication regimen - report low CBC
Manifestations of pertussis - dry cough
Medications to administer for acute exacerbations of asthma - albuterol/levabuterol = the only
rescue/quick acting bronchodilators
Monitoring an adolescent who has asthma for improvement in condition - Looking for the
respiratory rate to return to normal (no tachypnea). Also no wheezing
Monitoring for allergic reactions to contrast dye - Urticaria (itching)
Monitoring urine protein for a child who has nephrotic syndrome - "A decrease in urine protein
indicates that the treatment has been effective."
Nursing actions for physical abuse - Report it to authorities
Nutritional needs of the child who has acute postreptococcal glomerulonephritis - Sodium
restrictions (they are puffy and edematous and sodium follows water; limit it)
Observing for an anaphylactic reaction - Hives is the earliest manifestation (then wheezing,
angioedema - hypotension is a late sign)
, ATI CMS: Nursing Care of Children
Obtaining a peak expiratory flow rate - Patient takes 3 tries and BEST attempt is recorded (not
the average). Have the patient stand during the procedure
Obtaining an infant's heart rate - Apical pulse 60s
Period of communicability for varicella - Contagious until 6 days after the lesions appear, if
they have crusted
Planning care following cleft palate repair - Place the child side-lying
Planning to administer a nasogastric enteral feeding - Always confirm placement first (with
pH- you cannot just auscultate to confirm placement) then aspirate contents
Precautions for Tonic-Clonic Seizures - Do not restrain child, move furniture away from the
child, pad the side rails of the bed to minimize injury, keep a suction set at the bedside, do not
insert anything into the child's mouth, loosen clothing around the child's neck
Priority finding for a toddler following a tonsillectomy - Frequent swallowing or clearing of the
throat = bleeding
Priority findings to report with skeletal traction - Skeletal traction consists of force applied
directly to bones through pins. Increased crusting or purulent drainage, along with other signs
of infection, should be reported to provider.
Priority intervention during a lumbar puncture - Immediately after the procedure, maintain the
child in their side lying position to prevent injury to the spinal nerves.
Priority interventions during a vaso-occlusive crisis - Oxygen first (ABCs) then encourage fluid
intake
Proper removal of PPE - Gloves, goggles, gown, and mask
Recognizing clinical manifestations of Hemophilia A - Disabling joint pain -> hemarthrosis
Recognizing early manifestations of increased inter cranial pressure - Early sign: increased
irritability, infant: irritability, high pitched cry, bulging fontanelles; late signs: CS respirations,
abnormal posturing, fixed and dilated pupils are emergency (but not the earliest sign)
Recognizing manifestations of hypocalcemia - Hypotension
Recommended immunizations for an adolescent - Usually HPV, Tdap, or meningococcal
vaccine
Reinforcing Dietary Teaching for a Child who is recovering from Glomerulnephritis - Pick
lowest sodium option: apples
Reinforcing home safety instructions with the parents of a toddler - "I will place a screen in
front of the fireplace." Medications go in LOCKED cabinets, toy box with lightweight lid
Appropriate response to death - Preschoolers: magical thinking = thinking their thoughts
caused death, thinks that death is reversible and temporary
Assisting with administration of nasogastric enteral feeding for an infant (x2) - Position the
head of crib at 30 degree angle between feedings
Assisting with scoliosis screenings for school age children - Stand with feet together and then
bend down as if touching toes, back parallel to floor
Best food options for a child who has phenylketonuria - Child with PKU cannot digest
phenylalanine, which is present in most animal products
Caring for a child in buck's traction - This is a skin traction of the lower extremity; make sure
that knots are away from pulleys, that the leg remains extended, that weights are free-
hanging at all times, that blankets do not cover ropes and that the child cannot reach or
interfere with the mechanism
Caring for a toddler who has stomatitis - Provide oral care (since the mouth with chlorhexidine
mouthwash)
Caring for an infant following repair of a hypospadias - Avoid giving the child a tub bath until
stent has been removed, don't toilet train the child during this process, encourage fluids to
maintain hydration (DON'T limit fluids) leaving the child diaper less is uneccesary
Caring for family following unexpected death of a child - Allow the family to be in close
proximity with the child's body, to care for/dress/bathe it; do not instruct them to leave room
Checking skin turgor in a child - Best on abdomen
Converting ounces to mL - 1 oz = 30 mL
Deviation from expected growth and development for a 12 month old infant - Birth weight
should be tripled
Dietary recommendations for a child who has celiac disease (x2) - Child with celiac disease
cannot process plant protein gluten (present in wheat, barley, rye). Avoid oats b/c usually
contaminated with gluten. Rice is okay!
Dietary recommendations for child with lactose intolerance - Child needs supplementary
calcium and vitamin D intake, as the dairy products that they cannot consume are high in
calcium. Also, take lactase when consuming a dairy product.
Evaluating compliance to ferrous sulfate therapy, reinforcing teaching about liquid iron
supplements - Iron supplements are given with citrus fruit, between meals when the stomach
is most acidic for better absorption, taken with a straw to avoid teeth discoloration,
administered IM using z-track technique to prevent tissue staining. Iron supplements turn
stool to a tarry green.
,ATI CMS: Nursing Care of Children
Evaluating therapeutic effect of pancrelipase - Pancrelipase is effective if steatorrhea
resolves
Evaluating treatment of infant who has dehydration - "sodium level of 145" is within expected
range of 134-150
Evaluating understanding of home oxygen use - Make sure electrical equipment is grounded
(tubes can be long! Also no smoking!)
Expected behavior for a 7 year old female child - Spends a lot of time by herself
Expected findings of gastroesophageal reflux disease - chronic cough
Expected findings of severe dehydration - Body weight loss > 10%, extreme thirst, no tears
when crying, sunken fontanelles
Expected lab values for a child who has iron deficiency anemia - Lowered Hgb/Hct, NOT high
WBCs
Facilitating communication for a child who has hearing loss - Speak slowly, facing the patient,
avoid exaggerated movements, use facial expressions and hand gestures
Findings associated with poststreptococcal glomerulonephritis - Oliguria
Findings indicating physical abuse, manifestations of physical abuse - Laceration on side of
torso (any injuries that are not typical toddler clumsiness), symmetrical burns on lower
extremities, spiral fractures
Home care of conjunctivitis - Conjunctivitis is considered non-communicable after 24 hrs of
antibiotic treatment. Do not share towels with the infected child, as this promotes spread of
highly contagious injection
Identifying a hemolytic reaction during a transfusion, monitoring a child who is receiving a
blood transfusion - Signs and symptoms of hemolytic reaction include chills and flank pain
Identifying a toddler prior to medication administration - Ask the guardian to confirm
name/DOB
Identifying nutritional risks in an adolescent - Adolescents tend to eat a lot of junk foods high
in calories but low in other nutritional content. At risk for inadequate micronutrient nutrition.
Identifying risk factors for physical abuse - A child with ADHD, a child who was born
prematurely
Identifying risk factors for Urinary Tract Infection - Constipation (bowel movements every 4-5
days), urinary stasis, episode/hypospadias
Identifying splenic sequestration in a child who has sickle cell anemia - Spleen (and liver) will
be enlarged during this phase, the child must avoid activities that have a risk of abdominal
trau,a
,ATI CMS: Nursing Care of Children
Identifying therapeutic effect of digoxin, findings to report for a child who is receiving digoxin,
identifying digoxin toxicity - Therapeutic effect: increased cardiac output, "my baby is
breathing easier than she used to." Findings to report: anorexia, n/v, infant HR < 90, child HR <
70, vision changes, hypokalemia potentiates digoxin toxicity
Inserting an indwelling urinary catheter - "Apply 2% lidocaine lubricant to the urethral
meatus." (make sure of the sizing of the equipment used, it should be smaller in use with a
child. Also, this procedure must be sterile to prevent UTIs)
Interventions for mild hypoglycemia - Administer 15 grams of carbohydrates (usually 4 oz of
juice or soda) then recheck the blood glucose after 15 mins. Follow up with a more complex
carbohydrate, such as toast or crackers
Interventions to promote sleep for a toddler - Provide a consistent bedtime routine, "favorite
stuffed animal"
Isolation precautions for bacterial meningitis - Droplet precautions
Lab findings to report for an adolescent experiencing sickle cell crisis - A very low Hgb (6 for
example)
Lab value to report for a child who is taking Prednisone - Hypernatremia (also hyperglycemia,
hypokalemia, neutropenia)
Lab values requiring additional evaluation - Low platelet count (<150,000), low HCT/HGB (<12,
<31%)
Lab values to report for Wilm's Tumor - Antineoplastic medication regimen - report low CBC
Manifestations of pertussis - dry cough
Medications to administer for acute exacerbations of asthma - albuterol/levabuterol = the only
rescue/quick acting bronchodilators
Monitoring an adolescent who has asthma for improvement in condition - Looking for the
respiratory rate to return to normal (no tachypnea). Also no wheezing
Monitoring for allergic reactions to contrast dye - Urticaria (itching)
Monitoring urine protein for a child who has nephrotic syndrome - "A decrease in urine protein
indicates that the treatment has been effective."
Nursing actions for physical abuse - Report it to authorities
Nutritional needs of the child who has acute postreptococcal glomerulonephritis - Sodium
restrictions (they are puffy and edematous and sodium follows water; limit it)
Observing for an anaphylactic reaction - Hives is the earliest manifestation (then wheezing,
angioedema - hypotension is a late sign)
, ATI CMS: Nursing Care of Children
Obtaining a peak expiratory flow rate - Patient takes 3 tries and BEST attempt is recorded (not
the average). Have the patient stand during the procedure
Obtaining an infant's heart rate - Apical pulse 60s
Period of communicability for varicella - Contagious until 6 days after the lesions appear, if
they have crusted
Planning care following cleft palate repair - Place the child side-lying
Planning to administer a nasogastric enteral feeding - Always confirm placement first (with
pH- you cannot just auscultate to confirm placement) then aspirate contents
Precautions for Tonic-Clonic Seizures - Do not restrain child, move furniture away from the
child, pad the side rails of the bed to minimize injury, keep a suction set at the bedside, do not
insert anything into the child's mouth, loosen clothing around the child's neck
Priority finding for a toddler following a tonsillectomy - Frequent swallowing or clearing of the
throat = bleeding
Priority findings to report with skeletal traction - Skeletal traction consists of force applied
directly to bones through pins. Increased crusting or purulent drainage, along with other signs
of infection, should be reported to provider.
Priority intervention during a lumbar puncture - Immediately after the procedure, maintain the
child in their side lying position to prevent injury to the spinal nerves.
Priority interventions during a vaso-occlusive crisis - Oxygen first (ABCs) then encourage fluid
intake
Proper removal of PPE - Gloves, goggles, gown, and mask
Recognizing clinical manifestations of Hemophilia A - Disabling joint pain -> hemarthrosis
Recognizing early manifestations of increased inter cranial pressure - Early sign: increased
irritability, infant: irritability, high pitched cry, bulging fontanelles; late signs: CS respirations,
abnormal posturing, fixed and dilated pupils are emergency (but not the earliest sign)
Recognizing manifestations of hypocalcemia - Hypotension
Recommended immunizations for an adolescent - Usually HPV, Tdap, or meningococcal
vaccine
Reinforcing Dietary Teaching for a Child who is recovering from Glomerulnephritis - Pick
lowest sodium option: apples
Reinforcing home safety instructions with the parents of a toddler - "I will place a screen in
front of the fireplace." Medications go in LOCKED cabinets, toy box with lightweight lid
