NFDN 2005 CORRECT FINAL EXAMS QUESTIONS
AND ANSWERS SET A+
✔✔Developmental Intervention - ✔✔child life specialist used for children with mental
issues/frequent admissions to ensure growth and development proceed normally
- Ex: education and play programs
✔✔Preparation for Procedures in Children - ✔✔- Explain procedure in pre-school age
children and above
- Let them express their feelings
- Inform if there will be pain and how to cope
- Use language they can understand
✔✔Restraint Use - ✔✔- Restrain only if necessary
- Do not involve the parents in restraint apart from gentle holding
- Check restraints every 15 minus (PROM q1h)
✔✔Procedures Commonly Used in Children - ✔✔- EEG
- MRI
- CT
- X-Ray
- Dye Contrast
- Ultrasound
- Scope
✔✔Measuring Intake and Output - ✔✔- Keep track of how much the child drinks
- Record "breastfed" for breastfed infants
- Weigh diapers
✔✔What to do prior to anesthesia? - ✔✔- Check for loose teeth
- EN/NT tube
- Induction via mask
,✔✔Comfort Measures - ✔✔- Warm blanket
- Explain equipment
- Parents can accompany the child
- Void before surgery
- Activity in the holding area
✔✔Post Operation Measures - ✔✔- Allow parents to be present
- Describe the monitoring
- Provide pain and nausea medication
✔✔Dressing Changes - ✔✔- Allow the child to see the wound
- Educate parents regarding wound adhesives and spray-on bandages
- Provide a child with an adhesive bandage to wear after a procedure
✔✔Oxygen Administration - ✔✔- Use a set of nasal cannula or a mask
- Tape nasal cannula on in an infant or young child
- Make sure tubing is placed behind the child's back so they do not become strangled
on it
- Provide a stroller or portable tank so the child can play in the playroom, if possible
✔✔What are concerns with casts? - ✔✔- Heat
- Cast saw
✔✔Home Care - ✔✔- Early discharge à increased home care needs
- Assess family's ability to cope
- Determine if there will be additional issues arising
- Ensure education is adequate
- Arrange for follow-up with home care
- Ensure the parents know who to call if there are issues
✔✔When in life does pain begin? - ✔✔In the utero
✔✔Signs of Pain in Children - ✔✔- Crying
- Withdraw
- No movement
- Grimacing
✔✔FACES Pain Rating Scale - ✔✔tool using faces to rate pain from 1-10
- Go over pain rating scales before surgery
- Remember that pain is underestimated, underreported and undertreated
✔✔Causes of Pain in Children - ✔✔- Falls, tripping, banging their head on objects,
accidents
, - Infection
- Injury
- Anatomical abnormality
- Idiopathic/"functional" pain
✔✔What should be asked about pain? - ✔✔- PQRST - when did it start? Where does it
hurt?
- Associated symptoms - fever, vomiting, diarrhea, no bowel movements, constipation
- Activity disturbance - are they not acting like their normal self?
- Pain disturbs sleep
✔✔How to provide care to children in pain? - ✔✔- Treat it
- Use distraction techniques to get mind off of pain
✔✔Drugs Used to Treat Pain - ✔✔- Ibuprofen
- Acetaminophen
- Opioids - be aware, it may kill a child if wrong dosage is given
- NO ASPRIN
- Patient-Controlled Analgesia (PCA) used for children OVER 5
✔✔Conscious Sedation - ✔✔medication to help you relax (sedative) and to block pain
(anesthetic) during a medical or dental procedure
- Can still breathe on own/full body function but consciously asleep
✔✔Safety Concerns When Using Conscious Sedation - ✔✔- Breathing (airway)
- Vital signs
✔✔Topical Anesthetics Used - ✔✔- Emla Gel for IV sites
- LET Gel for suturing
✔✔How can we teach children about side effects of pain medications (opioids)? - ✔✔-
Use non-complicated (concrete) words
· Ex: sleepy, nauseous, "might make your tummy feel not great"
✔✔Types of Non-Pharmacologic Treatments for Children - ✔✔- Guided imagery
- Thought-stopping
- Distraction
- Warm blanket
✔✔Charting Effect - ✔✔- Changes of behaviour
- Heart Rate
- Respiratory Rate
- Ask parents
AND ANSWERS SET A+
✔✔Developmental Intervention - ✔✔child life specialist used for children with mental
issues/frequent admissions to ensure growth and development proceed normally
- Ex: education and play programs
✔✔Preparation for Procedures in Children - ✔✔- Explain procedure in pre-school age
children and above
- Let them express their feelings
- Inform if there will be pain and how to cope
- Use language they can understand
✔✔Restraint Use - ✔✔- Restrain only if necessary
- Do not involve the parents in restraint apart from gentle holding
- Check restraints every 15 minus (PROM q1h)
✔✔Procedures Commonly Used in Children - ✔✔- EEG
- MRI
- CT
- X-Ray
- Dye Contrast
- Ultrasound
- Scope
✔✔Measuring Intake and Output - ✔✔- Keep track of how much the child drinks
- Record "breastfed" for breastfed infants
- Weigh diapers
✔✔What to do prior to anesthesia? - ✔✔- Check for loose teeth
- EN/NT tube
- Induction via mask
,✔✔Comfort Measures - ✔✔- Warm blanket
- Explain equipment
- Parents can accompany the child
- Void before surgery
- Activity in the holding area
✔✔Post Operation Measures - ✔✔- Allow parents to be present
- Describe the monitoring
- Provide pain and nausea medication
✔✔Dressing Changes - ✔✔- Allow the child to see the wound
- Educate parents regarding wound adhesives and spray-on bandages
- Provide a child with an adhesive bandage to wear after a procedure
✔✔Oxygen Administration - ✔✔- Use a set of nasal cannula or a mask
- Tape nasal cannula on in an infant or young child
- Make sure tubing is placed behind the child's back so they do not become strangled
on it
- Provide a stroller or portable tank so the child can play in the playroom, if possible
✔✔What are concerns with casts? - ✔✔- Heat
- Cast saw
✔✔Home Care - ✔✔- Early discharge à increased home care needs
- Assess family's ability to cope
- Determine if there will be additional issues arising
- Ensure education is adequate
- Arrange for follow-up with home care
- Ensure the parents know who to call if there are issues
✔✔When in life does pain begin? - ✔✔In the utero
✔✔Signs of Pain in Children - ✔✔- Crying
- Withdraw
- No movement
- Grimacing
✔✔FACES Pain Rating Scale - ✔✔tool using faces to rate pain from 1-10
- Go over pain rating scales before surgery
- Remember that pain is underestimated, underreported and undertreated
✔✔Causes of Pain in Children - ✔✔- Falls, tripping, banging their head on objects,
accidents
, - Infection
- Injury
- Anatomical abnormality
- Idiopathic/"functional" pain
✔✔What should be asked about pain? - ✔✔- PQRST - when did it start? Where does it
hurt?
- Associated symptoms - fever, vomiting, diarrhea, no bowel movements, constipation
- Activity disturbance - are they not acting like their normal self?
- Pain disturbs sleep
✔✔How to provide care to children in pain? - ✔✔- Treat it
- Use distraction techniques to get mind off of pain
✔✔Drugs Used to Treat Pain - ✔✔- Ibuprofen
- Acetaminophen
- Opioids - be aware, it may kill a child if wrong dosage is given
- NO ASPRIN
- Patient-Controlled Analgesia (PCA) used for children OVER 5
✔✔Conscious Sedation - ✔✔medication to help you relax (sedative) and to block pain
(anesthetic) during a medical or dental procedure
- Can still breathe on own/full body function but consciously asleep
✔✔Safety Concerns When Using Conscious Sedation - ✔✔- Breathing (airway)
- Vital signs
✔✔Topical Anesthetics Used - ✔✔- Emla Gel for IV sites
- LET Gel for suturing
✔✔How can we teach children about side effects of pain medications (opioids)? - ✔✔-
Use non-complicated (concrete) words
· Ex: sleepy, nauseous, "might make your tummy feel not great"
✔✔Types of Non-Pharmacologic Treatments for Children - ✔✔- Guided imagery
- Thought-stopping
- Distraction
- Warm blanket
✔✔Charting Effect - ✔✔- Changes of behaviour
- Heart Rate
- Respiratory Rate
- Ask parents
