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Century Pediatric Nursing 21st
A 9-month-old child has been treated after a choking incident. Which advice does the nurse give to the parents to prevent further incidents? Select all that apply. A "Never leave your child unattended." B "Your child is too young to be allowed to eat solid food." C "Make sure all cabinets, drawers, and containers are childproof." D "Marbles and LEGOs are not appropriate toys for children at that age." E "Allowing your child to crawl on the floor increases the risk for injury." - โโA, C, D Crawling infants may explore their environments through taste and touch. They tend to put everything in their mouths. Therefore, the nurse should advise the parents to always keep a watch on their child and never leave their child unattended. Children at 9 months of age will begin to be able to pull themselves up to standing positions, potentially giving them access to cabinets, drawers, and containers that they were unable to access before. Therefore, the parents need to thoroughly childproof the home. The parents should be warned about providing small, colorful toys or leaving small objects on the floor because the child will be attracted to such objects and may attempt to swallow them, which may result in choking. The child is 8 months old. By this age, solid foods are permitted. The child should be allowed to play and crawl on the floor, as this is helpful for the development of the child's gross motor skills.
The nurse is assessing a school-age child. The child stays with a parent who is recently divorced and has a meager income. The child does not like to mingle with other students at school. The child's performance is poor in studies and is cruel toward pets at home. Which factors in the child could most likely lead to pediatric social illness? Select all that apply. A Poverty B Pet cruelty C Single parent D Going to school Behavior with others - โโB Pediatric social illness is a new morbidity in children. It refers to "the behavior, social, and educational problems that the children face". Poor socioeconomic status is a social problem. Animal cruelty is a behavioral problem. Problem within the family is a social problem Failure at school is an educational problem, and behavior with other children is also a behavioral problem. Any of these could cause pediatric social illness. Going to school does not cause social illness. It helps the child to gain knowledge, learn moral values, and to lead a successful life. The nurse is caring for a patient who is on long-term catheterization. According to the National Quality Forum, what should the nurse assess in this patient? A Oxygen saturation using arterial or venous blood B Monitoring of respiratory rate while in a sitting position C Signs and symptoms of a urinary tract infection
distress in the child. Preventive measures such as vaccination for preventing tetanus are not an intervention included in a traumatic care. The parent of a newborn child asks the nurse the importance of breastfeeding. What should the nurse tell the parent? Select all that apply. A Breast milk is not rich in micronutrients. B Breast milk is not recommended for infants with fever. C Enzymes in breast milk are helpful in the digestion of milk. D Immunoglobulins in milk can prevent infections and diseases. E Breastfeeding can decrease infant mortality and morbidity. - โโC, D, E Breast milk contains enzymes that are helpful in the digestion of milk and improve the bioavailability of all nutrients in the milk. Immunoglobulins in milk give immunity against infections and allergies. Hence, breastfeeding can decrease infant mortality and morbidity. Breast milk is rich in micronutrients. Breast milk has immunologic properties, so it can be given to the infants with fever. The nurse has to follow a method of problem identification and problem solving. Arrange the steps of the nursing process model in an appropriate order. A.Planning B Evaluation
C Diagnosis D Assessment E Implementation - โโD, C, The five-step nursing process model is assessment, diagnosis, planning, implementation, and evaluation. The first step is assessment in which the nurse collects, and analyzes subjective and objective data of the patient. This step is very crucial in determining the Client Needs. The second step is the formulation of the nursing diagnosis. In this phase, the nurse interprets and makes decisions about the acquired data. The third step is planning wherein the nurse develops a care plan and establishes the desired outcomes in the patient. This care plan also includes the interventions that would help the patient to achieve the desired outcomes. The fourth step is implementation in which the interventions that have been listed in the care plan are carried out in a systematic manner. Evaluation is the last step of nursing process which establishes the efficacy of the interventions provided to the patient. The nurse finds that a child spends several hours each day playing video games and lives in a home environment with limited access to safe playgrounds and parks. What health risks does the nurse expect based on these findings? Select all that apply. A Tooth decay B Hypertension C Diabetes
included in the diet. During adolescence, children tend to make food choices for sociability and the first 3 years of life are crucial in establishing eating habits of children. Cholesterol is present only in animal products such as meat, milk, and eggs but not present in plant products. The role of the pediatric nurse is influenced by trends in health care. The greatest trend in health care is: A primary focus on treatment of disease or disability. B national health care planning on a distributive or episodic basis. C accountability to professional codes and international standards. D shift of focus to prevention of illness and maintenance of health. - โโD Prevention is the current focus of health care, one in which nursing plays a major role. Traditionally, treating disease or disability is the role of the physician. National health care planning is not a major trend. Accountability to professional codes is an established responsibility, not a trend. The nurse is teaching a pregnant woman to eat a nutritious diet and to attend regular antenatal health check-ups for the assessment of fetal well- being. The primary purpose of this nursing intervention is to reduce the neonatal mortality rate due to: A birth weight less than 2.5g. B gestational diabetes in mother. C birth weight of more than 3.5 g. D febrile convulsions in neonate - โโA
Birth weight of less than 2,500 grams or 5.5 pounds in considered low birth weight (LBW). LBW is associated with higher neonatal mortality rate in the United States when compared with other countries. The lower the birth weight, the higher the mortality rate. Birth weight of the neonates born to uncontrolled diabetic mother can be high. The mortality rate of neonates born with a birth weight of more than 3.5 g is lower than that of neonates born with LBW. Febrile convulsions seldom cause death in neonates. Test-Taking Tip: Key words or phrases in the stem of the question such as first, primary, early, or best are important. Similarly, words such as only, always, never, and all in the alternatives are frequently evidence of a wrong response. As in life, no real absolutes exist in nursing; however, every rule has its exceptions, SO answer with care. The number of deaths of children in community are 24, 86, 100, and 200 respectively for the children under the age of 4 weeks, 4 months, 28 weeks, and 8 months per 2,000 live births. What is the neonatal mortality rate? Record your answer using whole number. _____/1,000 live births - โโ 12 Neonatal mortality rate is the number of deaths during the first 28 days of life per 1,000 live births. In this case, death rate of children under 4 weeks (28 days) in this community is 24/2,000 live births so this it is equal to 12/1,000 live births. The nurse who works in a pediatric ward wants to explore his/her own ability to develop a therapeutic relationship with children and their families. The nurse does a self-assessment to evaluate the caregiving style by using an assessment questionnaire. In the questionnaire the nurse answers "yes"
Neonate refers to a baby who is younger than 28 days of age. The number of deaths younger than 28 days, or 4 weeks, was 30. Therefore, neonatal mortality rate = number of deaths younger than 28 days (4 weeks) / number of live births or 30 / 3000 = 10 / 1000. Nurses play an important role in current issues and trends in health care. What is a current trend in pediatric nursing and health care today? A The patient is the unit of care for the health care provider. B Discharge planning begins when the physician writes the order. C Health promotion resources enable children to achieve their full potential. D The focus of pediatric health care is trending toward acute hospital care. - โโC Health promotion provides opportunities to reduce differences in current health status among members of different groups and provides a better chance to achieve the fullest health potential. The patient and family is the unit of care for the health care provider. Discharge planning begins when the patient is admitted. The focus of pediatric health care is trending away from acute hospital settings. The signs and symptoms in a nursing diagnosis describe:
A projected changes in an individual's health status, clinical conditions, or behavior. B an individual's response to health pattern deficits in the child, family, or community. C a cluster of cues and/or defining characteristics that are derived from patient assessment and indicate actual health problems. D physiologic, situational, and maturational factors that cause the problem or influence its development. - โโC Identifying characteristics derived from patient assessment is the third part of the nursing diagnosis , the signs and symptoms. Projected changes in health status are the outcomes or goals that are established. An individual's response to health pattern deficits is the definition of the problem statement, the first component of the nursing diagnosis. The factors that cause the problem or influence its development is the definition of etiology, the second component of the nursing diagnosis. The pediatric nurse has recorded the birth weight, head circumference, axillary temperature, and crown to rump length of a newborn baby. What does the nurse consider while assessing the risk for mortality in this infant? A Measure head circumference on alternate weeks. B Use the birth weight for the assessment of infant mortality rate. C Prefer rectal temperature to axillary temperature in the new born. D Crown to rump length is the best indicator of infant mortality rate - โโB
E Meeting the mother outside of the hospital to discuss the child - โโA, B, C, E Giving toys, clothes, food, and other items to the patient; working overtime to take care of a particular patient; calling the hospital or patient's home frequently to inquire about the patient's health; and meeting the patient or family outside of the hospital indicate that the nurse is overinvolved with the child and the family. Thus, such actions should be avoided to develop a good nurse-patient relationship. Asking if the mother is involved in the child's care indicates that the nurse is concerned about the patient and the family. It indicates a therapeutic relationship between the nurse and the child and family. The pediatric nurse works efficiently in providing nursing care to an acutely ill child. After discharge, parents of the child ask the nurse to visit their home for dinner. What should the nurse do? A Accept it; otherwise it may adversely affect the good relationship. B Tell them to schedule it later as it is a busy day in hospital. C Reject it courteously and thank them for the invitation. D Ask them to invite other staff who were involved in the care as well.
- โโC The nurse is not supposed to develop personal relationships with the children and families during the care and after the discharge. Therefore, the nurse has to courteously reject such invitations that may lead to personnel relationships. Even if the nurse is busy, the nurse should not accept invitations for lunch, dinners, or other parties, or ask the families to invite other medical staff. This shows unprofessional behavior.
The pediatric nurse is working on a project to contribute to research and evidence-based practice. What should the nurse do when caring for patients of different age groups? Arrange the following steps in the correct order. A Develop a care plan. B Evaluate the effectiveness of intervention C Collect information. D Identify specific questions. - โโ, B The responses of the nurse to health and illness have to be followed in an order. The nurse has to identify specific questions to collect appropriate information and develop a care plan to implement. Identification of specific questions to be asked to the patient would help to formulate a clear and precise assessment plan. Collection of subjective and objective information of the patient would be helpful in determining the needs of the patient. Developing a care plan of the patient would help in establish the desired outcomes and the interventions required to achieve those outcomes. Finally, the nurse should evaluate the effectiveness of the intervention to determine if the care plan designed for the patient was successful. Test-Taking Tip: In this Question Type, you are asked to prioritize (put in order) the options presented. For example, you might be asked the steps of
time with the patient indicates that the nurse is overinvolved with the patient. Allowing a parent to stay with the child at all times is not part of atraumatic care. In 2010, there were 2000 live births in an area with a population of 20 million. There were 10 deaths among infants younger than 27 days old, 20 deaths among children ages 0 to 6 months, and 40 deaths among children younger than 1 year of age (includes all subcategories of deaths under 1 year). What is the infant mortality rate (IMR)? Record your answer using a whole number. _____________ per 1000 live births. - โโ 20 The infant mortality rate is the number of deaths during the first year of life per 1000 live births. The number of deaths of infants younger than 1 year of age was 40. Thus, IMR = number of deaths under 1 year / number of live births or 40 / 2000 = 20 / 1000. The nurse is evaluating the quality of evidence of research found in the field of infectious diseases in infants. The nurse found unusually strong evidence from unbiased observational studies. What grade should be given to this research according to the GRADE criteria? 1 Low 2 High
Very low 4 Moderate - โโ 4 The GRADE criteria are used for grading the evidence of research by nurses. According to this, if evidence is found to be unusually strong from unbiased observational studies, it should be graded as moderate. Low grade is given to the evidence with at least one critical outcome from the observation studies. High grade is given to the studies with exceptionally strong evidence from unbiased observational studies and very low grade is given to studies with at least one critical outcome from very indirect evidence. What important information should the nurse include when teaching the parents of an adolescent about nutrition? 1 Adolescents are usually mature enough to make healthy food choices. 2 Resources are available to assist lower income families to obtain enough protein. 3 Behavior problems in this age group are not related to nutritional deficiencies. 4
pulmonary edema. - โโ 1 One of the major disadvantages of long-term ventilator care is ventilator- associated pneumonia. The nurse has to assess the patient for ventilator- associated pneumonia or for the early detection of respiratory complications due to ventilators. Lung cancer is not associated with ventilator support. Cystic fibrosis is due to defect in chromosome number 7. Pulmonary edema is not the main concern associated with ventilators in the ICU. The nurse is leading an educational program for parents of 5- to 9-year-old children. Which topic should the nurse include in the teaching plan to prevent childhood mortality in children of this age? 1 Suicide 2 Being overweight 3 Heart diseases 4 Unintentional injuries - โโ 4 Unintentional injuries and accidents are the leading cause of death in children ages 5 to 9 because this age group have the ability to run and climb and may experience falls, burns, and collisions. Therefore, the nurse
should focus mainly on reducing the risk of accidents. Suicide is not a significant cause of mortality in children under the age of 10. Being overweight is a significant problem in childhood, but not the leading cause of deaths in the 5-9 age group. Heart diseases are the most significant causes of mortality in children ages 1-4 years and 15-19 years. The senior nurse instructed the student nurse to check the website, www.ndvh.org. Information about which topic will the student nurse find on this website? 1 Domestic violence 2 Malnourishment 3 Infant mortality rate 4 Hospital administration - โโ 1 In USA, www.ndvh.org is the official website of the National Domestic Violence Hotline. Pediatric nurses can find valuable information on this website related to the signs of exposure to violence in children. This website also provides nonviolent problem-solving strategies, counseling, and referrals for children who are the victims of domestic abuse. Information about malnourishment, infant mortality rates, and hospital administration is not available at this website.
