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