ATI PN NURSING CARE OF THE CHILDREN FOCUSED REVIEW 2020/2021 (GUIDE A)

1.Most communicable diseases can be prevented with immunizations. Antibiotics and antitoxins reduce serious complications. Immunizations are a form of primary prevention. Secondary prevention includes the control of the spread of the disease to others. Conjunctivitis, which is also known as pink eye, is spread by direct contact. Incubation will depend on the infection. Pertussis, which is also known as whooping cough, is spread through direct contact, droplet, and indirect contact with freshly contaminated objects. The incubation period will be between 6 and 20 days, usually around 7-10. At 2 hours of age, temperature is approximately 99° F (37.2° C). The temperature stabilizes at 98.6° F (37° C) by about 4 hours of age. Temperature should be obtained from a newborn or infant less than 1 month old using the axillary route. Rectal temperatures are contraindicated in newborns less than 1 month old because the rectal mucosa is fragile, and there is an increased risk of rectal perforation from the thermometer. Oral temperatures are contraindicated in children younger than 5 years old. Oral temperatures are also contraindicated in children who are receiving oxygen, have had recent trauma to the oral mucosa, or have an altered level of consciousness 2.The nurse is taking a blood pressure on a child. What are some nursing considerations when doing the procedure? Suggested Nursing Care of Children Learning Activity: Vital Signs in the Pediatric Population • Allow the child to role play using equipment • Use the extremity as baseline to determine trends • Explain each step of the examination to the child using age appropriate language 3.The nurse is planning activities for toddlers who are hospitalized. What activities would be appropriate for this age group? Identify three (3) appropriate activities. Suggested Nursing Care of Children Learning Activity: Hospitalization and Illness • Large piece puzzles • Finger painting • Playing with blocks 4.A nurse in the emergency department suspects that a child who was admitted for burns of hands and arms may have been abused. What are some findings that may indicate abuse or maltreatment? Suggested Nursing Care of Children Learning Activity: Child Abuse • Inconsistencies between the parent/caregiver’s report and the child’s injuries • Inconsistency between nature of injury and developmental level of the child • Repeated injuries requiring emergency treatment • Inappropriate responses from the parents or child 5.A nurse caring for a child with an acute infectious gastrointestinal disorder is concerned about possible dehydration. Provide five (5) clinical manifestations associated with dehydration. Suggested Nursing Care of Children Learning Activity: Gastrointestinal Disorders • Dry, pale skin, cool lips, dry mucous membranes, decreased skin turgor, diminished urinary output, concentrated urine, excessive thirst, rapid pulse, irritability, restlessness, alteration in level of consciousness 6.A nurse is reinforcing education to the parents of a 4-month-old infant regarding introduction of solid food. What guidelines should be followed? • New foods should be introduced one at a time, over a 5 – 7 day period, to observe for indications of allergy or intolerance, which can include fussiness, rash, vomiting, diarrhea, and constipation. • Indicators for readiness include interest in solid foods, voluntary control of the head and trunk, and disappearance of the extrusion reflex. • Iron-fortified cereal is typically introduced first due to its high iron content. 7.The nurse is caring for a client who is diagnosed with Nephrotic Syndrome. What four (4) nursing interventions would the nurse do when providing nursing care to this client? • Provide rest. Use cluster care as much as possible. • Monitor I&O. • Weigh diapers of infants and toddlers. • Monitor urine for protein. • Monitor vital signs. • Monitor daily weights; weigh the child on the same scale with the same amount of clothing. • Monitor edema and abdominal girth daily. • Inspect skin for areas of breakdown • Encourage nutritional intake. 8.The nurse is evaluating the effectiveness of sleep teaching to a group of parents. Identify two things that the parents have done at home to promote effective sleep patterns in their preschooler. • Maintaining a regular bedtime routine • Eliminate naps during the day • Allow child to express feelings of fear or anxiety 9.A nurse is caring for a client with asthma who is prescribed Albuterol, a beta2-adrenergic agonist. Identify two (2) adverse effects of this medication therapy. Suggested Nursing Care of Children Learning Activity: Asthma • Watch the child for tremors and tachycardia when taking albuterol. • Also look for dizziness, nausea, and chest pain,palpitations,muscleaches and nervousness. 10.A nurse is reinforcing discharge instructions to the parents of a child with asthma who is being treated with the Leukotrene Modifier, Montelukast. What should be included in the teaching plan regarding Montelukast?very effective in airway inflammation reduction as indicated by reduction of fractional exhaled nitric oxide a marker of inflammation. • Encourage the child to drink plenty of fluids to promote hydration. • Instruct the child and family to watch for redness, sores, or white patches in the mouth, and report them to the provider. • Instruct the family to follow prescription for medication administration (dosage, tapering off medication, length of time to take). • Educate on need of taking once daily in the evening 11.The nurse is caring for a preschool aged child. The provider has ordered a diagnostic test for this client. Wh interventions should the nurse provide to this client about teaching the child about the diagnostic test? Suggested Nursing Care of Children Learning Activity: Hospitalization and Illness • Explain procedures using simple, clear language. • Avoid medical jargon and terms that can be misinterpreted. • Encourage the child to express feelings. • Validate the child’s fears and concerns. • Provide toys that allow for emotional expression, such as a pounding board to release feelings of protest. 12.A nurse is caring for a client who experiences a tonic-clonic seizure. What are the expected findings for this type of seizure? Suggested Nursing Care of Children Learning Activity: Seizures Onset without warning. Tonic phase (10 to 30 seconds) • Eyes roll upward • Loss of consciousness • Tonic contraction of entire body, with arms flexed and legs, head, and neck extended • Mouth snaps shut and tongue can be bitten • Thoracic and abdominal muscles contract • Possible piercing cry • Increased salivation • Flushing • Blood pressure and heart rate increases • Loss of swallowing reflex • Apnea leading to cyanosis Clonic phase (30 to 50 seconds) • Violent jerking movements of the body • Trunk and extremities experience rhythmic contraction and relaxation • Can having foaming in the mouth • Can be incontinent of urine and feces ..................................................................................CONTINUED