ATI Proctored PEDs, ATI Pediatrics
Proctored Exam, PEDS ATI proctored
review
Preschool-Aged Children
Body-Integrity - Answer - - Preschool-aged children are very concerned about their body
integrity
- They believe that their insides can leak our from even a small wound.
- Explains reason for their preoccupation with bandages
Preschool (3-6 Years) - Answer - - IMITATION of adults: providing a stethoscope allows
child an opportunity for THERAPEUTIC play.
- Time based on events, magical thinking, animism, centration.
- Stress = Regresion; may still be picky eaters , sleep 12 hours average, pedestrian
safety
- Keep a consistent bedtime routine
Pyloromyotomy - Answer - - Release of hypertrophied muscle around the pyloric
sphincter that causes narrowing of the pyloric canal.
- Infants will be fed shortly postoperative (with return of bowel sounds) in small, frequent
oral feeds.
- There is no incision to the gastric walls or mucosa and NPO is not required.
Cystic Fibrosis
Nutritional Care - Answer - - ↑ Protein, Carbs and minerals, to promote weight gain
- They have difficulty absorbing nutrients due to blockage of pancreatic enzymes by
thick mucus secretions in the pancreas and liver.
- Pancreatic enzymes help breakdown ingested foods so the body can metabolize
nutrients.
- Administering pancreatic enzymes BEFORE eating will enable children to metabolize
nutrients so they can be used more effectively
- Fat content doesn't need to be decreased or eliminated. They have difficulty absorbing
fat due to thick mucus in intestines and the inability of the pancreatic enzymes to reach
the duodenum.
- ↑ of fiber is NOT needed, their stools are bulky because of fat content, but they have
regular bowel movements
- C.F. patients excrete excessive salt through the skin, the child with cystic fibrosis will
likely require additional salt in their diet, especially during activities.
,- 85% O2 Sat = mild hypoxemia, as mucopurulent secretions gather in airways,
respiratory compromise worsens and oxygenation becomes impaired and ↓ in O2 Sat is
likely seen
Chemotherapy - Answer - - Low WBC count places the child at risk for infection and
isolation with monitoring of fever is priority.
↓RBC - Answer - - Quiet play and best rest, administer O2
↓ Platelet - Answer - - Protect child from injury and monitor for bleeding.
- Quiet play should be encouraged, it will lessen the R/F injury and ↓ hemorrhage
Dehydration - Answer - - Assessment, response to parenteral fluids.
the nurse should weigh the patient daily because weight is the most sensitive indicator
of hydration status in clients of all ages.
- Weight is the only measurement the reflects both measurable fluid balance changes
(I/O) and insensible fluid loss (skin and respiratory)
Koplik spots - Answer - - Maculopapular rash and fever; Rubeola
- Koplik spots: oral lesions that are characteristics of rubeola (measles). The small,
irregular spots with a blue/white center are seen on the Buccal mucosa, which is
opposite the molars, in the prodromal stage of measles.
- Koplik spots appear about 2 days before maculopapular rash appears and are
accompanied manifestations of fever, malaise, conjunctivitis, and other cold
manifestations.
- They begin to fade the second day after the rash appears. Immunity to measles is
conferred by the MMR (Measles-Mumps-Rubella) immunization that children receive @
15 months.
Rubeola - Answer - Measles; Maculopapular starts on the face and spreads downward.
It desquamates after about 3-4 days. The rash does not progress to vesicles and crusts
like the papules of chicken pox.
- cephalocaudal rash upper trunk and faceand more confluence as it spreads to the
lower areas of the body.
Varicella - Answer - Chicken Pox; Vesicles and crusts are present
- Commences with a maculopapular rash that progressess to vesicles on erythematous
bases which eventually rupture and crust over.
, Kawasaki Syndrome (Scarlet Fever) - Answer - - Strawberry tongue; sloughed off its
normal coating, exposing swollen prominent papillae.
Pertussis (whooping Cough) - Answer - Paroxysmal Cough
A1C - Answer - AKA glycosylated hemoglobin assay; is the most sensitive indication of
client compliance with the treatment regimen. The life span of RBC is about 120 days,
and glucose molecules adhere to about 4-6% of hemoglobin. Because of the longevity
of the RBC's recent changes in diet, activity or medication will not affect the results of
this test.
Skeletal Traction - Answer - The most effective means of traction, applying to a bone
with wire pins or tongs
Compartment Syndrome - Answer - Involves the compression of nerves and blood
vessels due to swelling within the enclosed space created by the fascia that separates
groups of muscles
Ventricular Septal Defect - Answer - - Murmur best heard at the lower left sternal
border; Ventricular septal wall defect between ventricles is an Acyanotic heart defect.
- Sound is transmitted in the direction of blood flow, so any back flow of blood from the
left to the right ventricle through the septal defect would be best heard in this area.
Acute Glomerulonephritis - Answer - - ASO titer will indicate if the child has had a recent
strep infection. In determining a definitive diagnosis for acute glomerulonephritis.
- Elevated RBCs is expected and the presence of hematuria
- Monitor B.P. Q4hr due to ↑HTN
HIV
Preschooler - Answer - - Immunizations contraindicated for this patient is the oral polio
- the child is susceptible to infection and must be immunized to the common
preventable childhood diseases.
- However, the oral polio vaccine contains a form of the virus that in SOME clients can
lead to an actual case of polio, this risk is increased with HIV and must receive the
injectable form of the polio immunization.
Myelomeningocele - Answer - - Hydrocephalus; is a post-operative risk because the
pathway for the cerebral spinal fluid has been altered.
- Infants --> Measure the head circumference Qshift.
Proctored Exam, PEDS ATI proctored
review
Preschool-Aged Children
Body-Integrity - Answer - - Preschool-aged children are very concerned about their body
integrity
- They believe that their insides can leak our from even a small wound.
- Explains reason for their preoccupation with bandages
Preschool (3-6 Years) - Answer - - IMITATION of adults: providing a stethoscope allows
child an opportunity for THERAPEUTIC play.
- Time based on events, magical thinking, animism, centration.
- Stress = Regresion; may still be picky eaters , sleep 12 hours average, pedestrian
safety
- Keep a consistent bedtime routine
Pyloromyotomy - Answer - - Release of hypertrophied muscle around the pyloric
sphincter that causes narrowing of the pyloric canal.
- Infants will be fed shortly postoperative (with return of bowel sounds) in small, frequent
oral feeds.
- There is no incision to the gastric walls or mucosa and NPO is not required.
Cystic Fibrosis
Nutritional Care - Answer - - ↑ Protein, Carbs and minerals, to promote weight gain
- They have difficulty absorbing nutrients due to blockage of pancreatic enzymes by
thick mucus secretions in the pancreas and liver.
- Pancreatic enzymes help breakdown ingested foods so the body can metabolize
nutrients.
- Administering pancreatic enzymes BEFORE eating will enable children to metabolize
nutrients so they can be used more effectively
- Fat content doesn't need to be decreased or eliminated. They have difficulty absorbing
fat due to thick mucus in intestines and the inability of the pancreatic enzymes to reach
the duodenum.
- ↑ of fiber is NOT needed, their stools are bulky because of fat content, but they have
regular bowel movements
- C.F. patients excrete excessive salt through the skin, the child with cystic fibrosis will
likely require additional salt in their diet, especially during activities.
,- 85% O2 Sat = mild hypoxemia, as mucopurulent secretions gather in airways,
respiratory compromise worsens and oxygenation becomes impaired and ↓ in O2 Sat is
likely seen
Chemotherapy - Answer - - Low WBC count places the child at risk for infection and
isolation with monitoring of fever is priority.
↓RBC - Answer - - Quiet play and best rest, administer O2
↓ Platelet - Answer - - Protect child from injury and monitor for bleeding.
- Quiet play should be encouraged, it will lessen the R/F injury and ↓ hemorrhage
Dehydration - Answer - - Assessment, response to parenteral fluids.
the nurse should weigh the patient daily because weight is the most sensitive indicator
of hydration status in clients of all ages.
- Weight is the only measurement the reflects both measurable fluid balance changes
(I/O) and insensible fluid loss (skin and respiratory)
Koplik spots - Answer - - Maculopapular rash and fever; Rubeola
- Koplik spots: oral lesions that are characteristics of rubeola (measles). The small,
irregular spots with a blue/white center are seen on the Buccal mucosa, which is
opposite the molars, in the prodromal stage of measles.
- Koplik spots appear about 2 days before maculopapular rash appears and are
accompanied manifestations of fever, malaise, conjunctivitis, and other cold
manifestations.
- They begin to fade the second day after the rash appears. Immunity to measles is
conferred by the MMR (Measles-Mumps-Rubella) immunization that children receive @
15 months.
Rubeola - Answer - Measles; Maculopapular starts on the face and spreads downward.
It desquamates after about 3-4 days. The rash does not progress to vesicles and crusts
like the papules of chicken pox.
- cephalocaudal rash upper trunk and faceand more confluence as it spreads to the
lower areas of the body.
Varicella - Answer - Chicken Pox; Vesicles and crusts are present
- Commences with a maculopapular rash that progressess to vesicles on erythematous
bases which eventually rupture and crust over.
, Kawasaki Syndrome (Scarlet Fever) - Answer - - Strawberry tongue; sloughed off its
normal coating, exposing swollen prominent papillae.
Pertussis (whooping Cough) - Answer - Paroxysmal Cough
A1C - Answer - AKA glycosylated hemoglobin assay; is the most sensitive indication of
client compliance with the treatment regimen. The life span of RBC is about 120 days,
and glucose molecules adhere to about 4-6% of hemoglobin. Because of the longevity
of the RBC's recent changes in diet, activity or medication will not affect the results of
this test.
Skeletal Traction - Answer - The most effective means of traction, applying to a bone
with wire pins or tongs
Compartment Syndrome - Answer - Involves the compression of nerves and blood
vessels due to swelling within the enclosed space created by the fascia that separates
groups of muscles
Ventricular Septal Defect - Answer - - Murmur best heard at the lower left sternal
border; Ventricular septal wall defect between ventricles is an Acyanotic heart defect.
- Sound is transmitted in the direction of blood flow, so any back flow of blood from the
left to the right ventricle through the septal defect would be best heard in this area.
Acute Glomerulonephritis - Answer - - ASO titer will indicate if the child has had a recent
strep infection. In determining a definitive diagnosis for acute glomerulonephritis.
- Elevated RBCs is expected and the presence of hematuria
- Monitor B.P. Q4hr due to ↑HTN
HIV
Preschooler - Answer - - Immunizations contraindicated for this patient is the oral polio
- the child is susceptible to infection and must be immunized to the common
preventable childhood diseases.
- However, the oral polio vaccine contains a form of the virus that in SOME clients can
lead to an actual case of polio, this risk is increased with HIV and must receive the
injectable form of the polio immunization.
Myelomeningocele - Answer - - Hydrocephalus; is a post-operative risk because the
pathway for the cerebral spinal fluid has been altered.
- Infants --> Measure the head circumference Qshift.
