Pediatrics Exam 5 with Complete Solution

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see? - ANSWER Peeling hands and feet; fever A parent brings an infant in for poor feeding and listlessness. Which ...

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see? - ANSWER Peeling hands and feet; fever A parent brings an infant in for poor feeding and listlessness. Which assessment data would most likely indicate a coarctation of the aorta? - ANSWER Pulses weaker in lower extremities compared to upper extremities When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding? - ANSWER The liver size increases in right-sided heart failure. A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia? - ANSWER Increased RBC A parent is asking for more information about their infant's patent ductus arteriosus (PDA). What would be included in the education? - ANSWER This is caused by an opening that usually closes by 1 week of age. The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? - ANSWER "Children who have this diagnosis may have had strep throat." At 3 years of age, a child has a cardiac catheterization. After the procedure, which interventions would be most important? - ANSWER Taking pedal pulses for the first 4 hours The nurse has administered oral penicillin as ordered for prophylaxis of endocarditis. The nurse instructs the parents to immediately report which reaction? - ANSWER Wheezing The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would the nurse expect to be prescribed? - ANSWER Digoxin The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? - ANSWER "The feeling of the heart skipping a beat is common." After assessing a child, the nurse suspects coarctation of the aorta based on a finding of: - ANSWER femoral pulse weaker than brachial pulse After a cardiac catheterization, the nurse monitors the child's fluid balance closely based on the understanding that: - ANSWER the contrast material used has a diuretic effect. A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result would be most important for the nurse to monitor? - ANSWER Serum potassium level A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? - ANSWER "We can stop the penicillin when her symptoms disappear." A 6-year-old girl is diagnosed with pulmonary stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother? - ANSWER Insertion of a catheter with an uninflated balloon tip into the affected valve, followed by inflation of the balloon to break up adhesions The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond? - ANSWER "It's great you are providing nutritious meals, but smaller frequent meals will tire your child less and promote weight gain." The nurse is caring for a 7-year-old who is being discharged following surgery with a Gore® Helex device to repair an atrial septal defect. The parents of the child demonstrate understanding of the procedure with which statements? Select all that apply. - ANSWER -"We will be sure to not allow our child to ride a bicycle for at least 2 weeks." -"We will be sure to monitor our child for any signs of infection and notify the doctor if we notice any." -"We know how important our child's medications are so we will write out a schedule to be sure medications are taken as prescribed." A nurse is preparing to administer a prescribed dose of digoxin to an 6-month-old infant. After assessing the infant's apical pulse, the nurse decides to withhold the dose and notify the health care provider. The nurse bases this decision on which apical pulse rate? - ANSWER 80 beats/min A 5-year-old child has undergone a cardiac catheterization and is being prepared for discharge home with the parents. The nurse is teaching the parents how to care for the child at home. The nurse determines that the teaching is successful based on which statement(s) by the parents? Select all that apply. - ANSWER -"After several days, we do not need to keep any dressing on the site." -"If we notice any drainage or bleeding at the site, we will call the health care provider." -"If our child has pain, we can give acetaminophen or ibuprofen." The nurse is caring for a hosptialized infant with a diagnosis of tetralogy of Fallot, awaiting surgical intervention. Which assessement finding would the nurse expect? - ANSWER The child has periods of cyanosis and decreased pulse oxyimetery readings A nurse is caring for an infant who just had open-heart surgery and the parents are asking why there are wires coming out of the infant's chest. What is the best response by the nurse? - ANSWER These wires are connected to the heart and will detect if your infant's heart gets out of rhythm. A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention? - ANSWER Notify the doctor immediately. A school nurse finds a 10-year-old's blood pressure is over the 95th percentile. The nurse advises the parent to seek medical attention for the child. What outcome would the nurse expect? - ANSWER The child will need the blood pressure checked two more times. When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover? - ANSWER Polycythemia The nurse is caring for a 6-year-old with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority? - ANSWER Place the child in a knee-to-chest position. The nurse is assessing an infant for peripheral edema. Based on the nurse's knowledge, the nurse would expect edema to occur in which area first? - ANSWER Face The nurse is assessing the heart rate of a healthy 6-month-old. In which range should the nurse expect the infant's heart rate? - ANSWER 90 to 160 bpm A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child? - ANSWER Lower extremities Which nursing diagnosis will the nurse indicate as priority for the child following cardiac surgery for tetralogy of Fallot? - ANSWER Risk for ineffective cardiopulmonary tissue perfusion The nurse is caring for a child admitted to the hospital for a cardiac catheterization. Upon return from the cardiac catheterization, which nursing action is priority? - ANSWER Assess the dressing at the insertion site.