NURSING CARE OF CHILDREN ATI CORRECT ANSWERS 2023

NURSING CARE OF CHILDREN ATI CORRECT ANSWERS 2023 Findings for adolescent who has Anorexia Nervosa - ANSWERS--◯ Subjective Data ■ History and physical assessment findings may reveal vague reports (anorexia, headache, fatigue). Dehydration: Oral rehydration is attempted first for mild and moderate cases of dehydration. - ANSWERS--☐ Mild: 50 mL/kg rehydration fluid every 4 to 6 hr Moderate: 100 mL/kg rehydration fluid every 4 to 6 hr Replacement of diarrhea losses with 10 mL/kg each stool Dehydration: Monitor parenteral fluid therapy as prescribed - ANSWERS--☐ Implemented when a child is unable to drink enough oral fluids to correct fluid losses, and those who have severe dehydration or continued vomiting. Isotonic solution at 20 mL/kg IV bolus with possible repeat for isotonic and hypotonic dehydration. Hypertonic dehydration - Rapid fluid replacement is contraindicated because of the risk of cerebral edema. Administer maintenance IV fluids as prescribed. Avoid potassium replacement until kidney function is verified. Iron Deficiency Anemia: Dietary sources of iron - ANSWERS--☐ Infants - iron-fortified cereals and formula Older children - dried beans and lentils; peanut butter; green, leafy vegetables; iron-fortified breads and flour; poultry; and red meat Nutritional Needs of Infants who have Heart Failure - ANSWERS--Encourage the child to eat foods high in potassium, such as bran cereals, potatoes, tomatoes, bananas, melons, oranges, and orange juice. Planning Care for an Infant who has Heart Failure - ANSWERS--● Nursing Care ◯ General Interventions ■ Remain calm when providing care. ■ Keep the child well-hydrated. ■ Conserve the child's energy by providing frequent rest periods; clustering care; providing small, frequent meals; bathing PRN; and keeping crying to a minimum in cyanotic children. ■ Perform daily weight and I&O to monitor fluid status and nutritional status. ■ Monitor heart rate, blood pressure, serum electrolytes, and renal function for complications. ■ Provide support and resources for parents to promote developmental growth in the child. ■ Monitor family coping and provide support. ■ Administer prescribed medications. ■ Maintain fluid and electrolyte balance. Administer potassium supplements if prescribed. These might not be indicated if the child is concurrently taking an ACE inhibitor. Maintain sodium and fluid restrictions if prescribed. Planning Care for an Infant who has Heart Failure: Decrease workload of the heart - ANSWERS--☐ Maintain bed rest. Position the infant in a car seat or hold at a 45° angle. Keep safety restraints low and loose on the abdomen. Allow the child to sleep with several pillows and encourage a semi-Fowler's or Fowler's position while awake. Planning Care for an Infant who has Heart Failure: Provide for adequate nutrition. - ANSWERS--☐ Plan to feed the infant using a feeding schedule of every 3 hr. The infant should be rested, which occurs soon after awakening. Use a soft preemie nipple or a regular nipple with a slit to provide an enlarged opening. Hold the infant in a semi-upright position. Allow the infant to rest during feedings, taking approximately 30 min to complete the feeding Gavage feed the infant if he is unable to consume enough formula or breast milk. Increase caloric density of formula gradually from 20 to 30 kcal/oz. Encourage mothers who are breastfeeding to alternate feedings with high-density formula or fortified breast milk. Planning Care for an Infant who has Heart Failure: Increase tissue oxygenation. - ANSWERS--☐ Provide cool, humidified oxygen via an oxygen hood (or tent), mask, or nasal cannula. Suction the airway as indicated. Monitor oxygen saturation every 2 to 4 hr. Evaluating Understanding of Diabetes Mellitus Dietary Management - ANSWERS--◯ Provide nutritional guidelines. ■ Read labels for nutritional value. ■ Meal planning is based on the requirements of growth and development of the child. ■ Plan meals to achieve appropriate timing of food intake, activity, onset, and peak of insulin. Calories and food composition should be similar each day. ■ Eat at regular intervals and do not skip meals. ■ Count grams of carbohydrates consumed. ■ Recognize that 15 g of carbohydrates are equal to 1 carbohydrate exchange. ■ Avoid high-fat and high-sugar/high-carbohydrate food items. ■ Use artificial sweeteners in moderation ■ Children active with team sports will require a snack 30 min prior to activity. ■ Encourage sugar-free, non-caffeinated liquids to prevent dehydration. ■ Meet carbohydrate needs by eating soft foods if possible. If not, consume liquids that are equal to the usual carbohydrate content. Care of the Child in Traction: Traction care - ANSWERS--Traction, countertraction, and frictional force are used to align, immobilize, and reduce muscle spasms associated with certain fractures. Through the use of a forward-pulling force and a backward force, adding or removing weight controls the degree of force applied to maintain traction and alignment. The type of traction used depends on the fracture, age of the client, and associated injuries. Care of the Child in Traction: Skin traction - ANSWERS--Skin traction uses a pulling force that is applied by weights (may be used intermittently). Using tape and straps applied to the skin along with boots and/or cuffs, weights are attached by a rope to the extremity (Buck, Russell, Bryant traction). Care of the Child in Traction: Skeletal traction - ANSWERS--uses a continuous pulling force that is applied directly to the skeletal structure and/or specific bone. A pin or rod is inserted through or into the bone. Force is applied using weights attached by rope. Skeletal traction (90°/90° traction) allows the client to change positions without interfering with the pull of the traction and decreases complications associated with immobility and traction. Care of the Child in Traction: Balanced suspension traction - ANSWERS--suspends the leg in a flexed position. The hip and hamstring muscles are relaxed. Care of the Child in Traction: Halo traction - ANSWERS--uses a halo-type bar that encircles the head. Screws are inserted into the outer table of the skull. The halo is attached to either bed traction or rods that are secured to a vest worn by the client. Care of the Child in Traction: Nursing Actions - ANSWERS--☐ Maintain body alignment. Provide pharmacological and nonpharmacological interventions for the management of pain and muscle spasms. Notify the provider if the client experiences severe pain from muscle spasms that is unrelieved with medications and/or repositioning. Monitor neurovascular status. Routinely monitor the client's skin integrity and document findings. Inspect pin sites for pain, redness, swelling, drainage, or odor. Provide pin care per facility protocol. Check for changes in elimination, and maintain usual patterns of elimination. Ensure that all the hardware is tight and that the bed is in the correct position. Maintain weights so that they hang freely and the ropes are free of knots. Do not lift or remove weights unless prescribed and supervised by the provider. Ensure that the wrench to release the rods is attached to the vest when using halo traction in the event that CPR is necessary. Move the client in halo traction as a unit without applying pressure to the rods. This will prevent loosening of the pins and pain. Consult with the provider for an overbed trapeze to assist the client to move in bed. Provide range of motion and encourage activity of nonimmobilized extremities to maintain mobility and prevent contractures. Encourage deep breathing and use of incentive spirometry. Promote frequent position changing within restrictions of traction. Remove sheets from the head of the bed to the foot of the bed, and remake the bed in the same manner. Diet Recommendations for a Child who has Celiac Disease - ANSWERS--◯ Provide 24 kcal/oz. formula as prescribed. ◯ Provide high-calorie milk supplements for children. ◯ Administer multivitamin supplements including zinc and iron. ◯ Reinforce teaching to parents regarding how to mix formula properly and provide step-by-step written instructions. ◯ Limit juice to 4 oz./day. Reinforcing Teaching about Inflammatory Bowel Disease - ANSWERS--◯ Chronic diarrhea is an increase in frequency and change of consistency of stool(s) for more than 14 days. ■ It is caused by chronic conditions such as malabsorption syndrome, food allergies, or inflammatory bowel disease. Reinforcing Teaching about Low-Cholesterol Diet - ANSWERS--● High density lipoprotein (HDL) cholesterol - "good" cholesterol, having low level of cholesterol and triglycerides and high level of protein. ◯ Nursing Care/Client Education ■ Assist in screening clients at risk. ■ Instruct the client to keep a diet history for review by the dietitian. ■ Monitor the client for febrile illness 3 weeks prior to screening (illness will alter results). ■ Instruct about a diet to lower cholesterol: low fat, whole grains, fruit and vegetables. ■ Encourage use of olive oil and canola oil. ■ Assist with an exercise program (60 min per day for 5 days per week of aerobic exercise). Reinforcing Teaching about Nutrition - ANSWERS--● Nutrition ◯ Feeding alternatives ■ Breastfeeding provides a complete diet for infants during the first 6 months. ■ Iron-fortified formula is an acceptable alternative to breast milk. Cow's milk is not recommended. ■ It is recommended to begin vitamin D supplements within the first few days of life. ■ Iron supplements are recommended for infants who are being exclusively breastfed after the age of 4 months. ■ Alternative sources of fluids, such as juice or water, are not needed during the first 4 months of life. ■ After the age of 6 months, 100% fruit juice should be limited to 4 to 6 oz. per day. ◯ Solids are introduced around 4 to 6 months of age. ■ 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. ■ New foods should be introduced one at a time, over a 4- to 7-day period, to observe for signs of allergy or intolerance, which can include fussiness, rash, vomiting, diarrhea, and constipation. ■ Vegetables or fruits are started first between 6 and 8 months of age. After both have been introduced, meats can be added. ■ Citrus fruits, meat, and eggs are not started until after 6 months of age. ■ Breast milk/formula should be decreased as intake of solid foods increases, but should remain the primary source of nutrition through the first year. ■ Table foods that are cooked, chopped, and unseasoned are appropriate by 9 months of age. ■ Appropriate finger foods include ripe bananas; toast strips; graham crackers; cheese cubes; noodles; and peeled chunks of apples, pears, or peaches. ◯ Weaning can be accomplished when infants show signs of readiness, and are able to drink from a cup (sometime in the Pain Management: Guided Imagery following Surgery - ANSWERS--☐ Assist the child in an imaginary experience. Have the child describe the details. Health Promotion of Adolescents (12 to 20 Years): Communication Techniques - ANSWERS--● Cognitive Development ◯ Piaget - formal operations ■ Able to think through more than two categories of variables concurrently ■ Capable of evaluating the quality of their own thinking ■ Able to maintain attention for longer periods of time ■ Highly imaginative and idealistic ■ Increasingly capable of using formal logic to make decisions ■ Think beyond current circumstances ■ Able to understand how the actions of an individual influence others Health Promotion of Adolescents (12 to 20 Years): Socialization to Meet Developmental Needs - ANSWERS--◯ Social Development ■ Peer relationships develop. These relationships act as a support system for adolescents. ■ Best-friend relationships are more stable and longer-lasting than they were in previous years. ■ Parent-child relationships change to allow a greater sense of independence. Health Promotion of Infants (1 Month to 1 Year): Expected Growth and Development - ANSWERS--- Expected growth and development ● Physical Development ◯ The infant's posterior fontanel closes by 6 to 8 weeks of age. ◯ The infant's anterior fontanel closes by 12 to 18 months of age. ◯ Weight, height, and head circumference measurements are used to track the size of infants. ■ Weight - Infants gain approximately 150 to 210 g (about 5 to 7 oz.) per week the first 6 months of life. Birth weight is at least doubled by the age of 6 months, and tripled by the age of 12 months. ■ Height - Infants grow approximately 2.5 cm (1 in) per month the first 6 months of life. Growth occurs in spurts after the age of 6 months, and the birth length increases by 50% by the age of 12 months. ■ Head circumference - The circumference of infants' heads increases approximately 1.5 cm (0.6 in) per month for the first 6 months of life, and then approximately 0.5 cm (0.2 in) between 6 and 12 months of age. ◯ Dentition - Six to eight teeth should erupt in infants' mouths by the end of the first year of age. The first teeth typically erupt between the ages of 6 and 10 months. ■ Teething pain can be eased using cold teething rings and over-the-counter teething gels. Acetaminophen (Tylenol) or ibuprofen (Advil) is appropriate if irritability interferes with sleeping and feeding, but should not be used for more than 3 days. Ibuprofen should be used only in infants older than 6 months. ■ Clean infants' teeth using cool, wet washcloths. ■ Bottles should not be given to infants when they are falling asleep because prolonged exposure to milk or juice can cause early childhood caries. Gross to Fine Motor Skills - ANSWERS--- 1 month: › Demonstrates head lag › Has a grasp reflex - 2 months: › Lifts head off mattress when prone › Holds hands in an open position - 3 months: › Raises head and shoulders off mattress when prone › Only slight head lag › No longer has a grasp