Peds Capstone Review Questions and Correct Answers

Cleft palate post op care post surgery: -avoid having baby suck on nipple or pacifier -place baby laterally or on stomach to help prevent aspiration and facilitate drainage -apply restraints to prevent baby from disturbing operative site -Keep the infant pain-free to decrease crying and stress on repair -Feed w/ cups, Avoid sucking on nipple or pacifier -monitor I/O's daily -Change position frequently to facilitate breathing & place on abdomen in immediate post-op period -Maintain IV fluids until infant able to eat & drink Meningitis care -implement droplet precautions right away -maintain for at least 24 hours following initiation of abx -keep pt npo if there is a decreased LOC (r/f aspiration) -dark quiet environment (photophobia) -admx medications (abx, corticosteroids) -mx for signs of increased ICP -Position the client without a pillow, and slightly elevate the head of the bed. The client can also be positioned side-lying to reduce neck discomfort. -keep room cool -Presence of petechial or purpuric-type rash requires immediate medical attention A nurse is caring for a child with a closed head injury. What clinical manifestations would suggest deterioration in this client's condition? -changes in vital signs -altered mental status -increased intracranial pressure -alterations of pupillary response -posturing -bradycardia -decreased motor response -decreased sensory response -Cheyne-Stokes respirations -coma A child has been admitted to the emergency department with a closed head injury. Identify the lab and diagnostic tests that will be ordered. -abgs, -blood alcohol and toxicology screening, -CBC with differential -liver function tests; -cervical spine x-rays to rule out cervical spine injury, -CT and/or MRI of head and/or neck might be performed with and without contrast if indicated -measurement of ICP A child has been admitted to the emergency department with a closed head injury. What medications should the nurse anticipate the provider to prescribe and why? -Mannitol to treat cerebral edema -Antibiotics: Use r/t CSF leakage, laceration, or penetration injuries -Analgesics: Used of HA/pain management -Corticosteroids: Used to decrease cerebral edema -Antiepileptics: Used to prevent/treat seizures A nurse is assessing for strabismus in a pediatric client. Identify three (3) clinical findings noted with strabismus. -Eyes that appear crossed or an eye that seems to wander -Uncoordinated eye movements -Asymmetric corneal light reflex Misaligned eyes, Inward deviation of eye Frowning or squinting Difficulty seeing print clearly One eye closed to enable better vision Head tilted to one side Headache, dizziness Diplopia Photophobia Crossed eyes. What is a Wilm's tumor and what are manifestations of this type of cancer? a Wilm's tumor or nephroblastoma (kidney cancer) is a malignancy that occurs in the kidneys or abdomen.