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Pediatric Study Guide Exam 1 Flashcards | StudBud
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Pediatric Study Guide Exam 1
Pediatric Study Guide Exam 1
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1
Motor vehicle injuries: select all that apply
no pillows in crib
rear facing until 2 or height recommended
should not be left in parked cars
no rear facing seat in front seat with airbags
infant only, convertible infant toddler car seats
safest area for infants/children- backseat until 12
2
Burn prevention: select all that apply
sunscreen
smoke detectors
cover outlets
crib mattress in lowest position
Do not warm fluids in microwave, temp of bath water- check with elbow
hot water heater < 120º, handles turned in, pots to back of stove
3
What nursing action should be done FIRST for low pulse ox readings?
move probe site locations
place pt supine
monitor to see if reading comes up on its own
confirm accuracy by looking for good waveform
4
Suffocation prevention: select all that apply
avoid plastic bags, no balloons
toys with small parts out of reach
lock up firearms
crib mattress fit snug, crib mobiles removed by 4-5 months old
drawstrings removed from jackets and other clothing
no pillows in crib, infants on back to sleep
5
How to check for Babinski reflex?
pat top of babys foot
pinch the pinky toe
smack bottom of infants foot
stroke outer edge of the sole of an infants foot towards toe
6
Precautions to take with children who have croup: select all that apply
prepare for intubation, never suction
protect airway, dont place anything in the mouth
do not listen to how parents explain baseline for child behavior
Droplet precautions (24 hrs after IV abx has started)
IV fluids, IV abx
humidified O2, corticosteroids
7
S/Sx of mild dehydration: select all that apply
mucous membranes -> WNL
cap refill greater than 2 seconds
weight loss of 3-5% in infants & 3-4% in children
slight thirst
anterior fontanel, pulse, BP <- WNL
dry mucous membranes
8
Kawasaki disease expected findings: select TWO
onset fever lasting 5d-2wk that is unresponsive to antipyretics
ceberal edema
strawberry tongue
fever
9
Erikson's theory of birth-1 yr old:
Trust vs. mistrust: meet their needs to build trust
autonomy vs. shame and doubt: independence, negative responses
intiative vs. guilt: energetic learners
industry vs. inferiority: skill development and knowledge to society
10
Where to perform painful procedure on a child?
in another pt room
out of their safe place and into a treatment room
in their safe place
at the play area
11
S/Sx of intussusception: select all that apply
diagnosed bu ultrasound
abd mass (SAUSAGE SHAPE)
urinary retention
vomiting, fever, tender abd, distened abd
sudden episodic abd pain, screaming w knees drawn up to chest in pain
stools mixed w/ blood and mucus that resemble jelly
12
Gross motor skills in 2-5 yr olds: select all that apply
jumps across floor and off chairs /steps using both feet
stands on one foot momentarily
takes a few steps on tiptoe
jumps 6ft into air
13
anaphylactic shock: results from hypersensitivity for foreign substance, leads to massive vasodilation and capillar leak
False
True
14
Aspiration prevention: select all that apply
do not warm fluids
age appropriate toys should be provided
clothing should be checked (loose buttons)
sharp objects out of reach
hold for feedings, do not prop bottles
small objects like grapes, coins, candy should be avoided
15
Why do toddlers have tantrums?
result when toddlers are frustrated with restrictions on independence
result when toddlers are not frustrated with restrictions on independence
16
Lab expectations of rheumatic fever: select all that apply
CRP elevation
ESR (elevated due to inflammation)
decreased potassium
blood antistreptolysin O titer (elevated or rising)
throat culture
elevated magnesium
17
Gross motor skills in 15 Months: select TWO
Walks with out help
creeps up stairs
walks with help
runs up stairs
18
Pain assessment (in general) on a child? select all that apply
loud cry
guarding
no cry
ask parents how pain meds have been working
19
Types of shock: cardiogenic & anaphylactic
False
True
20
Findings associated with meningitis for 2yrs - adolescents: select all that apply
high pitch cry
positive kernigs and babinski sign
chronic draining of the ear
stupor and coma, petechia, joint involvement
irritable, restless, progressing to drowsiness, delirium
seizures, nuchal rigidity, fever, chills, headache, vomiting
21
Safety precaution when weighing an infant
place baby on edge of scale for accurate reading
hold hand 1 in over child to make sure he does not fall off scale
place baby on scale and leave room for supplies
add extra blankets to baby if weight is too low
22
FACES pain scale used on 3-18 year olds with rating of 0-5 scale and 6 faces
False
True
23
S/Sx of epiglottis: select all that apply
tripod positioning
Drooling
stridor
tachycardia
24
Stages a hospitalized child goes through: select all that apply
Loneliness
Despair
Separation Anxiety
Detachment
Excitement
Protest
25
Ways to provide safe sleep: select all that apply
sleep in bed with parents or guardian
swaddle child until able to roll, then use sleep sack
place prone
place on back
do not add extra toys, blankets, pillows
sleep in own bed with only crib sheet
26
Gross motor skills in 2 yr olds
pulls and pushes toys
falls often
creeps up stairs
walks up and down stairs by placing feet on each step
27
Protest stage: select all that apply
agression towards others
withdrawal from others
Clinging
Screaming
28
Gross motor skills in 18 months: select all that apply
jumps in place with both feet
pulls and pushes toys
jumps across the floor
throws ball overhand
runs clumsily, falls often
throws ball underhand
29
examining ears on infants and toddlers: pull pinna down and back
True
False
30
Anaphylactic shock can occur in response to an allergy to latex, drugs, insects stings, or blood tansfusions
True
False
31
Asthma education at discharge: select all that apply
indentify triggers and avoid them, asthma action plan ready
administer meds, peak flow meter at the same time each day
learn how to recgonize astham exacerbation, reg exercise for asthma therapy
Record PEFR results daily to compare, learn how to interpret PEFR readings
infection prevention techniques, vaccines, meds to prevent bronchus spasms
educate to live life on edge and dont worry about asthmatic behavior
32
Signs/Symptoms of shock: select all that apply
breath sounds with crackles
dyspnea and hypotension
tachycardia
weak peripheral pulses
bradycardia
grunting
33
How to prevent a toddler from having a tantrum?
Providing consistent age appropriate expectations help work through tantrum
providing inconsistent expectations help work through tantrum
34
5 year olds and older can use numeric pain scale with ratings of 0-10
True
False
35
Babinski Reflex should be seen from birth to one year
True
False
36
S/Sx of moderate dehydration: select all that apply
cap refill greater than 2 secs
cap refill greater than 4 secs
thirst, irritability, HR elevated, slight tachypnea
weight loss of 6-9% in infants & 6-8% in children
BP WNL, normal or sunken anterior fontanel on infants
dry mucous membranes, decreased skin turgor and tears
37
Poisoning prevention: select all that apply
meds kept in childproof containers, away from reach
working carbon monoxide detetcor
avoid lead paint
poison control # kept near phone
safety locks on cabinets w/ cleaners, toxin/plants kept out of reach
working smoke detector
38
Risk for seizures: select all that apply
intracranial infection or hemorrhage, brain tumors or cyst
fever, cerebral edema, anoxia
toxins or drugs, lead poisoning, tetanus
safe sleep, aspiration
shigella, salmonella, metabolic conditions
hypoglycemia
39
Oucher scale is used on 3-13 year olds with pain scale of 0-5 with 6 photographs
False
True
40
Proper pain assessment scale for 4yrs and older?
FLACC
numerical scale
self report
face scale
41
Cardiac defects that decrease pulmonary blood flow: select TWO
pulmonary stenosis
tricuspid atresia
aortic stenosis
tetralogy of fallot
42
Patho of cystic fibrosis includes: Select all that apply
mucus glands that secrete an increase in thick, tenacious mucus
inherited mutated gene
leads to mechanical obstruction to organs (pancreas, lungs, liver, SI)
mucus glands that secrete thin clear liquids
43
What to do if meningitis is suspected? Select all that apply
Monitor fluid balance, UOP, Neuro status, any pain
shrug it off as nothing serious
decrease enviromental stimuli, keep family informed and comfortable
head circumference and fontanels for swelling
isolate ASAP, monitor for petechia (medical emergency), monitor VS
NPO if decreased LOC, seizure precautions
44
Adolescents are at high risk of injury because they have the "invincible" thinking
False
True
45
Despair stage: select all that apply
interacting with others
Withdrawal from others
screaming
depression
46
Common complications following a tonsillectomy: select all that apply
head bobbing
hemorrhage
dehydration
chronic infection
47
S/Sx of severe dehydration: select all that apply
extreme thirst, tented skin, no tears, oliguria or anuria
sunken eyeballs, sunken anterior fontanel
cap refill greater than 4, tachycardia, hyperpnea (rapid, deep breathing)
BP progresses to shock, extreme thirst, very dry mucous membranes
weight loss > 10% in infants & 10% in children
weight loss < 10% in infants and 15% in children
48
At 2 months old proper pain assessment will be use of the face scale
False
True
49
Actions to help chronically ill teens in the hospital to thrive: select all that apply
encourage contact with peers
include them in care plan
provide factual information
educated on intercourse
50
Defects that increase pulmonary blood flow: select all that apply
Ventricular septal defect (VSD)
Tetralogy of Fallot
Patent ductus arteriosus (PDA)
Atrial septal defect (ASD)
51
Nursing actions for rotavirus: select all that apply
monitor I&O's
start oral rehydration therapy
obtain baseline height&weight (at the same time daily)
avoid rectal temperatures
throat culture
initiate IV fluids
52
Preferred place to give IM injection on an infant is the VASTUS LATERALIS
False
True
53
Detachment stage: select all that apply
forming new relationships
interacting with strangers
happy appearence; trust is being build
withdrawal from others
54
Children who are sick with a respiratory illness stop eating b/c they can not breathe and choose to breathe over eating
True
False
55
Characteristics of cardiac defects that decrease pulmonary blood flow: select all that apply
R to L shift allowing deoxygenated blood to enter the systemic circulation
Hypercyanotic spells (blue or "tet" spells)
L to R shift allowing oxygenated blood to enter systemic circulation
obstruction of pulmonary blood flow and anatomic defect
56
Trust vs. Mistrust:Mistrust develops by lack of needs being met, or if needs are continuously met before being vocalized
True
False
57
Endocarditis: infection of lining of heart and the valves that can enter the bloodstream
False
True
58
What to expect from Babinski Reflex?
toes curl inward
toes do not move
fingers flex
toes fan upward and out
59
Kawasaki disease: acute system vasculitis (mucocuntaneous lymph node syndrome)
False
True
60
Risk factors for down syndrome: select TWO
paternal age greater than 35
maternal age greater then 55
maternal age greater than 35
paternal age greater than 55
61
Cardiogenic shock: impaired cardiac function that leads to cardiac output decrease
False
True
62
Pain assessment for 3 years and older
FLACC scale
Face scale
numerical scale
self report
63
What should be assessed in a child with speech delays?
swallowing difficulty
being stubborn
hearing impairment
never learned letters
64
Drowning prevention: select all that apply
close bathroom doors
do not warm fluids in microwave
do not leave unattended around tub, toilet, cleaning buckets, drainage area
secure fencing around pools
65
FLACC scale includes: select all that apply
consolability
fontanel
face
cry
activity
legs
66
Non-communicating childrens pain checklist: select all that apply
used on 3 year olds and older
subcategories scale 0-3
behavior observed for 10 minutes
verbalizes pain
67
Cardiac defects that are obstructive: select all that apply
pulmonary stenosis
aortic stenosis
coarctation of aorta
clubbed fingers
68
Findings associated with meningitis in newborns: select all that apply
seizures
difficult to diagnose, vague signs
V/D, fever or hypothermia, neck is supple w/o nuchal rigidity
poor muscle tone, poor "sucking", weak cry, refusing feedings
bulging fontanel is a late sign
not present at birth, progresses within a few days
69
Bodily harm prevention: select all that apply
anchor heavy objects and furniture so they can not be overturned onto child
Sharp objects out of reach
infants should not be left unattended w/ any animals present
secure fencing around pools
70
Birth weight should be doubled by 5 months old
True
False
71
Respiratory distress symptoms: select all that apply
fast breathing(tachypnea), abnormal breathing(retraction), stridor
fast HR (tachycardia)
head bobbing
nasal flaring
slow HR (bradycardia)
tracheal tug
72
Pulse oximetry measures the amount of arterial hemoglobin
False
True
73
Pain assessment for 5 years and older
FLACC scale
numerical scale
Face scale
self report
74
Asthma risk factors: select all that apply
tobacco smoke
low birth weight
sex (girls affected more thanboys)
overweight
sex (boys affected more than girls)
family history
75
Bacterial meningitis: clear, normal glucose, negative gram stain
True
False
76
Viral meningitis: cloudy, decreased glucose, positive gram stain
True
False
77
Findings associated with meningitis in 3mo - 2yrs: select all that apply
restlessness
delirium
fever, irritability, vomiting
seizures w/ high pitched cry
bulging fontanel, nuchal rigidity, poor feeding
babinski sign and kernigs are not reliable
78
examining an ear on children greater than 3 years: pull pinna up and back
True
False
79
Nursing care for after death: select all that apply
remain w family and offer support, allow family to communicate feelings
allow family to stay with body as long as desired (no longer than 24hr)
Allow to rock, refer to patient by name
remove tubes/equipment, offer to help with post mortem care
assist with prep involving death ritual
walk pt to morgue with out providing privacy
80
Pain management regarding tonsillectomy: Select all that apply
ice chips
pain meds
ice collar
hot coffee
81
How to hold a child for a lumbar puncture?
laying on side with knees and head pulled towards each other to create "C"
reverse trendelenburg with arms crossed
prone with legs flat
supine with knees bent
82
Symptoms of bronchiolitis: select all that apply
clumsy
fever
lethargy
copious secrfetions
cyanosis
tachypnea
83
Fall prevention: select all that apply
avoid plastic bags
crib mattresses in lowest position with rails up
safety gates for stairs; top and bottom
restraints used in car seats
rear facing car seats
seats placed on ground or floor, not elevated surfaces
84
Nursing care for dying pt: select all that apply
allow for anticipated grieving
encourage independence, provide privacy, provide support
attempt to maintain a normal environment
encourage guardians to stay with child
communicate honestly and respectfully
post mortem care
85
injury prevention of all ages: select all that apply
safe sleep, suffocation
bodily harm, poisoning/substance abuse
aspiration
motor vehicle, firearms
burns
metabolic conditions
86
How a nurse (theirself) deal with dying/death of pt? Select all that apply
celebrate
express feelings/coping
develop ability for empathy
self care / go to funeral
87
How to give oral medications to an infant: select all that apply
semi reclining position
side of the mouth
stroke infant under the chin to make them swallow
blow directly into their mouth/face
88
expected recovery time post tonsillectomy is 14 days for full recovery
False
True
89
Cardogenic shock is ttypically seen after a child has had heart surgery
True
False
90
Pain assessment scale for 2 months to 7 years
self report
numerical scale
face scale
FLACC scale