,PediatricNursing-ACase-BasedApproach
, PediatricNursing-ACase-BasedApproach
Chapter1:Bronchiolitis
1. Whichinterventionisappropriatefortheinfanthospitalizedwithbronchiolitis?
a. Positiononthesidewithneckslightlyflexed.
b. Administerantibioticsasordered.
c. Restrictoralandparenteralfluidsiftachypneic.
d. Givecool,humidifiedoxygen.A
NSWER:D
Cool,humidifiedoxygenisgiventorelievedyspnea,hypoxemia,andinsensiblefluidlossfromtachypne
a.Theinfantshouldbepositionedwiththeheadandchestelevatedata30-to40-
degreeangleandtheneckslightlyextendedtomaintainanopenairwayanddecreasepressureonthediaph
ragm.Theetiologyofbronchiolitisisviral.Antibioticsaregivenonlyifthereisasecondarybacterialinfec
tion.Tachypneaincreasesinsensiblefluidloss.Iftheinfantistachypneic,fluidsaregivenparenterallyto
preventdehydration.
2. Aninfantwithbronchiolitisishospitalized.Thecausativeorganismisrespiratorysyncytialvirus(
RSV).Thenurseknowsthatachildinfectedwiththisvirusrequireswhattypeofisolation?
a. Reverseisolation
b. Airborneisolation
c. ContactPrecautions
d. StandardPrecautions
ANSWER:C
RSVistransmittedthroughdroplets.InadditiontoStandardPrecautionsandhandwashing,ContactPrec
autionsarerequired.Caregiversmustuseglovesandgownswhenenteringtheroom.Careistakennottoto
uchtheirowneyesormucousmembraneswithacontaminatedglovedhand.Childrenareplacedinapriva
teroomorinaroomwithotherchildrenwithRSVinfections.Reverseisolationfocusesonkeepingbacteri
aawayfromtheinfant.WithRSV,otherchildrenneedtobeprotectedfromexposuretothevirus.Thevirus
isnotairborne.
3. Achildhasachroniccoughanddiffusewheezingduringtheexpiratoryphaseofrespiration.Thissug
gestswhatcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. ForeignbodyintracheaA
NSWER:A
Asthmamayhavethesechronicsignsandsymptoms.Pneumoniaappearswithanacuteonset,fever,andg
eneralmalaise.Bronchiolitisisanacuteconditioncausedbyrespiratorysyncytial
, PediatricNursing-ACase-BasedApproach
virus.Foreignbodyinthetracheaoccurswithacuterespiratorydistressorfailureandmaybestridor.
4. Whichnursingdiagnosisismostappropriateforaninfantwithacutebronchiolitisduetorespirat
orysyncytialvirus(RSV)?
a. ActivityIntolerance
b. DecreasedCardiacOutput
c. Pain,Acute
d. TissuePerfusion,Ineffective(peripheral)A
NS.A
Rationale1:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyanddem
and.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusuallyassociat
edwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythisrespiratory-
diseaseprocess.
Rationale2:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyanddem
and.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusuallyassociat
edwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythisrespiratory-
diseaseprocess.
Rationale3:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyanddem
and.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusuallyassociat
edwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythisrespiratory-
diseaseprocess.
Rationale4:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyanddem
and.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusuallyassociat
edwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythisrespiratory-
diseaseprocess.
GlobalRationale:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyan
ddemand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusuallyas
sociatedwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythisrespiratory-
diseaseprocess.
Chapter2:Asthma
1. Thenurseiscaringforachildhospitalizedforstatusasthmaticus.Whichassessmentfindingsuggest
sthatthechildsconditionisworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia