Pediatric Nursing- A Case-Based Approach
pc pc pc pc
,Pediatric Nursing- A Case-Based Approach
pc pc pc pc
, Pediatric Nursing- A Case-Based Approach pc pc pc pc
Chapter 1: Bronchiolitis pc p c
1. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
pc pc pc pc pc pc pc pc pc
a. Position on the side with neck slightly flexed. pc pc pc pc pc pc pc
b. Administer antibiotics as ordered. pc pc pc
c. Restrict oral and parenteral fluids if tachypneic.
pc pc pc pc pc pc
d. Give cool, humidified oxygen. pc pc pc
ANSWER: D
pc pc
Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss fro
pc pc pc pc pc pc pc pc pc pc pc pc pc
m tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
degree angle and the neck slightly extended to maintain an open airway and decrease pressure
pc pc pc pc pc pc pc pc pc pc pc pc pc pc p
on the diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is
c pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
a secondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is tachy
pc pc pc pc pc pc pc pc pc pc pc pc pc
pneic, fluids are given parenterally to prevent dehydration.
pc pc pc pc pc pc pc
2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytia
pc pc pc pc pc pc pc pc pc pc pc
l virus (RSV). The nurse knows that a child infected with this virus requires what type of i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
solation?
a. Reverse isolation pc
b. Airborne isolation pc
c. Contact Precautions pc
d. Standard Precautions pc p
ANSWER: C
c pc
RSV is transmitted through droplets. In addition to Standard Precautions and hand washing, C
pc pc pc pc pc pc pc pc pc pc pc pc pc
ontact Precautions are required. Caregivers must use gloves and gowns when entering the roo
pc pc pc pc pc pc pc pc pc pc pc pc pc
m. Care is taken not to touch their own eyes or mucous membranes with a contaminated glov
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ed hand. Children are placed in a private room or in a room with other children with RSV inf
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ections. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other ch
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ildren need to be protected from exposure to the virus. The virus is not airborne.
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiratio
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
n. This suggests what condition?
pc pc pc pc
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign body in trachea pc pc pc p
ANSWER: A
c pc
Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset, f
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
pc pc pc pc pc pc pc pc pc pc pc pc
, Pediatric Nursing- A Case-Based Approach pc pc pc pc
virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stri
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
dor.
4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due t
pc pc pc pc pc pc pc pc pc pc pc pc pc
o respiratory syncytial virus (RSV)?
pc pc pc pc
a. Activity Intolerance pc
b. Decreased Cardiac Output pc pc
c. Pain, Acute pc
d. Tissue Perfusion, Ineffective (peripheral)
pc pc pc
ANS. A
pc pc
Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc p
cand demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
s not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc p
cand demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
s not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc p
cand demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
s not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen s
pc pc pc pc pc pc pc pc pc pc pc pc pc
upply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. P
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affec
pc pc pc pc pc pc pc pc pc pc pc pc pc
ted by this respiratory-disease process.
pc pc pc pc
Chapter 2: Asthma pc pc
1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment findin
pc pc pc pc pc pc pc pc pc pc pc pc pc
g suggests that the childs condition is worsening?
pc pc pc pc pc pc pc
a. Hypoventilation
b. Thirst
c. Bradycardia
pc pc pc pc
,Pediatric Nursing- A Case-Based Approach
pc pc pc pc
, Pediatric Nursing- A Case-Based Approach pc pc pc pc
Chapter 1: Bronchiolitis pc p c
1. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
pc pc pc pc pc pc pc pc pc
a. Position on the side with neck slightly flexed. pc pc pc pc pc pc pc
b. Administer antibiotics as ordered. pc pc pc
c. Restrict oral and parenteral fluids if tachypneic.
pc pc pc pc pc pc
d. Give cool, humidified oxygen. pc pc pc
ANSWER: D
pc pc
Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss fro
pc pc pc pc pc pc pc pc pc pc pc pc pc
m tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
degree angle and the neck slightly extended to maintain an open airway and decrease pressure
pc pc pc pc pc pc pc pc pc pc pc pc pc pc p
on the diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is
c pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
a secondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is tachy
pc pc pc pc pc pc pc pc pc pc pc pc pc
pneic, fluids are given parenterally to prevent dehydration.
pc pc pc pc pc pc pc
2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytia
pc pc pc pc pc pc pc pc pc pc pc
l virus (RSV). The nurse knows that a child infected with this virus requires what type of i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
solation?
a. Reverse isolation pc
b. Airborne isolation pc
c. Contact Precautions pc
d. Standard Precautions pc p
ANSWER: C
c pc
RSV is transmitted through droplets. In addition to Standard Precautions and hand washing, C
pc pc pc pc pc pc pc pc pc pc pc pc pc
ontact Precautions are required. Caregivers must use gloves and gowns when entering the roo
pc pc pc pc pc pc pc pc pc pc pc pc pc
m. Care is taken not to touch their own eyes or mucous membranes with a contaminated glov
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ed hand. Children are placed in a private room or in a room with other children with RSV inf
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ections. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other ch
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ildren need to be protected from exposure to the virus. The virus is not airborne.
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiratio
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
n. This suggests what condition?
pc pc pc pc
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign body in trachea pc pc pc p
ANSWER: A
c pc
Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset, f
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
pc pc pc pc pc pc pc pc pc pc pc pc
, Pediatric Nursing- A Case-Based Approach pc pc pc pc
virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stri
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
dor.
4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due t
pc pc pc pc pc pc pc pc pc pc pc pc pc
o respiratory syncytial virus (RSV)?
pc pc pc pc
a. Activity Intolerance pc
b. Decreased Cardiac Output pc pc
c. Pain, Acute pc
d. Tissue Perfusion, Ineffective (peripheral)
pc pc pc
ANS. A
pc pc
Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc p
cand demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
s not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc p
cand demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
s not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain
pc pc pc pc pc pc pc pc pc pc pc pc pc pc pc
is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply
pc pc pc pc pc pc pc pc pc pc pc pc pc p
cand demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain i
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
s not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected
pc pc pc pc pc pc pc pc pc pc pc pc pc
by this respiratory-disease process.
pc pc pc
Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen s
pc pc pc pc pc pc pc pc pc pc pc pc pc
upply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. P
pc pc pc pc pc pc pc pc pc pc pc pc pc pc
ain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affec
pc pc pc pc pc pc pc pc pc pc pc pc pc
ted by this respiratory-disease process.
pc pc pc pc
Chapter 2: Asthma pc pc
1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment findin
pc pc pc pc pc pc pc pc pc pc pc pc pc
g suggests that the childs condition is worsening?
pc pc pc pc pc pc pc
a. Hypoventilation
b. Thirst
c. Bradycardia
