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Exam (elaborations)

NR328 Pediatric Nursing Week4 Clinical Simulation Questions 2022

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Johnny Parker 1. Identify pediatric populations at risk for poisoning and list 3 agents used for gastrointestinal decontamination. Describe how nutrition may be affected in a child who has ingested a poison.  Pediatric population at risk for poisoning is Infants, Toddlers, Preschoolers, School-age.  The agents for gastrointestinal decontamination:  Activated charcoal  Gastric lavage  Induce vomiting  Acetaminophen toxicity antidote is n-acetylcysteine orally  Child may display lethargy and confusion.  The client may report intolerance to keep food or fluids down, may include nausea, vomiting, diarrhea, abdominal pain. Initiate NPO to avoid risk for aspiration risk 2. What psychosocial and developmental interventions should a nurse consider about home safety when caring for a child who has accidentally ingested toxic substances?  Safety locks should be placed on cabinets that contain cleaners and other chemicals  Medications should be kept in childproof containers, away from the reach of toddlers  The phone number for a poison control center should be kept near the phone. 3. What assessment findings, including your ABC head to toe physical assessment, might the nurse discover on a pediatric patient who has ingested high levels of acetaminophen?  2-4 hours after ingestion – pallor, diaphoresis, N/V  24-36 hrs after – improving condition  36hr – 1 week (or longer) – confusion/stupor, disturbances with coagulation, jaundice, RUQ pain  Final stage – gradual recover or fatality Medication Calculations: The healthcare provider ordered N-acetylcysteine for a pediatric patient who ingested an excessive amount of acetaminophen. This study source was downloaded by from CourseH on :12:14 GMT -05:00 This study resource was shared via CourseH 1. The medication is ordered for 100mg/kg over sixteen hours. The patient weighs 33 lb. How many milligrams will the nurse administer per dose? (If needed, round to the nearest tenth). 33/2.2 = 15kg. 100mg/15kg = 6.7mg 2. This dose will arrive from the pharmacy diluted in 225mL of D5W. This i

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March 30, 2021
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This istudy isource iwas idownloaded iby i100000820845637 ifrom iCourseHero.com ion i03-30-2021 i01:12:14 iGMT i-05:00
https://www.coursehero.com/file/65885321/Wk4-Clinical-Simulation-Questionsdocx/ i i i i i i iNAME
NR328 iPediatric iNursing iWeek4 iClinical iSimulation
iDATE
Johnny i Parker 1.Identify ipediatric ipopulations iat irisk ifor ipoisoning iand ilist i3 iagents iused ifor igastrointestinal idecontamination. iDescribe ihow inutrition imay ibe iaffected iin ia ichild iwho ihas iingested ia ipoison.
•Pediatric ipopulation iat irisk ifor ipoisoning iis iInfants, iToddlers, iPreschoolers,
School-age.
•The iagents ifor igastrointestinal idecontamination:
▪Activated icharcoal
▪Gastric ilavage
▪Induce ivomiting
•Acetaminophen itoxicity iantidote iis in-acetylcysteine iorally
▪Child imay idisplay ilethargy iand iconfusion.
▪The iclient imay ireport iintolerance ito ikeep ifood ior ifluids idown, imay
iinclude inausea, ivomiting, idiarrhea, iabdominal ipain. iInitiate iNPO ito
iavoid irisk ifor iaspiration irisk
2.What ipsychosocial iand idevelopmental iinterventions ishould ia inurse iconsider iabout ihome isafety iwhen icaring ifor ia ichild iwho ihas iaccidentally iingested itoxic isubstances?
•Safety ilocks ishould ibe iplaced ion icabinets ithat icontain icleaners iand iother
chemicals
•Medications ishould ibe ikept iin ichildproof icontainers, iaway ifrom ithe ireach iof itoddlers
•The iphone inumber ifor ia ipoison icontrol icenter ishould ibe ikept inear ithe iphone.
3.What iassessment ifindings, iincluding iyour iABC ihead ito itoe iphysical iassessment, imight ithe inurse idiscover ion ia ipediatric ipatient iwho ihas iingested ihigh ilevels iof iacetaminophen?
▪2-4 ihours iafter iingestion i– ipallor, idiaphoresis, iN/V
▪24-36 ihrs iafter i– iimproving icondition
▪36hr i– i1 iweek i(or ilonger) i– iconfusion/stupor, idisturbances iwith icoagulation, ijaundice, iRUQ ipain
▪Final istage i– igradual irecover ior ifatality
Medication iCalculations: iThe ihealthcare iprovider iordered iN-acetylcysteine ifor ia ipediatric ipatient iwho iingested ian iexcessive iamount iof iacetaminophen. https://www.coursehero.com/file/65885321/Wk4-Clinical-Simulation-Questionsdocx/This istudy isource iwas idownloaded iby i100000820845637 ifrom iCourseHero.com ion i03-30-2021 i01:12:14 iGMT i-05:001.The imedication iis iordered ifor i100mg/kg iover isixteen ihours. iThe ipatient iweighs i33 ilb. iHow
imany imilligrams iwill ithe inurse iadminister iper idose? i(If ineeded, iround ito ithe inearest itenth).
i33/2.2 i= i15kg.100mg/15kg i= i6.7mg
2.This idose iwill iarrive ifrom ithe ipharmacy idiluted iin i225mL iof iD5W. iThis iis ito iinfuse iover isixteen ihours. iCalculate ithe ihourly irate iof iinfusion. i225/16 i= i14 imL/hr
3.A iprovider ihas iordered iD5 i0.45 iNS iw/20 imeq iKCL/L ias imaintenance ifluid ifor ia ipatient iwho iweighs i33lbs. iUsing ithe ichart ibelow, iwhat iis ithe ivolume iand irate iof imaintenance ifluid irequired iin i24 ihours? i33/2.2 i=15kg1000 i+ i(50mL/15kg i)= i1003 itotal imL ievery i24 ihours iat ia irate iof i1003/24= i42ml/hr
Body iWeight Amount iof ifluid iper iday
1 i-10 ikg 100 imL/kg
11-20 ikg 1000 imL i+ i50mL/kg ifor ieach ikg i> i10 ikg
>20 ikg 1500 imL i+20mL/kg ifor ieach ikg i> i20 ikg
Cooper iMadison
1)What iare ithe ithree imain iphases iof ia iseizure? iDifferentiate iamong ithese iphases, iand ilist iclinical iassessment ifindings iyou imight iobserve iwhen ia ipatient iis ihaving ia iseizure.
Three iMain iphases iof iseizure i& iClinical iassessment ifindings:
I.Tonic iphase i10-20 iseconds
•Eyes iroll iupward
▪Loss iof iconsciousness
▪Tonic icontractions iof ientire ibody, iwith iarms iflexed iand ilegs, ihead iand ineck iextended.
▪Loss iof iswallowing ireflex iand iincreased isalivation
▪Apnea ileading ito icyanosis
II.Clonic iphase itypically i30 ito i50 iseconds; ican ilast i30 imin ior ilonger
•Violent ijerking imovements iof ithe ibody
•Trunk iand iextremities iexperience irhythmic icontraction iand irelaxation
•Gradual islowing iof imovements iuntil icessation
•Can ibe iincontinent iof iurine iand ifeces
•Can ihave ifoaming iin ithe imouth

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