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