TEST BANK Pediatric Nursing, A Case- Based Approach, 1st Edition By Tagher Knapp

TEST BANK Pediatric Nursing, A Case- Based Approach, 1st Edition By Tagher Knapp Chapter 1: Bronchiolitis 1. Which intervention is appropriate for the infant hospitalized with bronchiolitis? a. Position on the side with ...

TEST BANK Pediatric Nursing, A Case- Based Approach, 1st Edition By Tagher Knapp Chapter 1: Bronchiolitis 1. Which intervention is appropriate for the infant hospitalized with bronchiolitis? a. Position on the side with neck slightly flexed. b. Administer antibiotics as ordered. c. Restrict oral and parenteral fluids if tachypneic. d. Give cool, humidified oxygen. ANS: D Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree angle and the neck slightly extended to maintain an open airway and decrease pressure on the diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a secondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is tachypneic, fluids are givenparenterally to prevent dehydration. 2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus(RSV). The nurse knows that a child infected with this virus requires what type of isolation? a. Reverse isolation b. Airborne isolation Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp c. Contact Precautions d. Standard Precautions ANS: C RSV is transmitted through droplets. In addition to Standard Precautions and hand washing, Contact Precautions are required. Caregivers must use gloves and gowns when entering the room. Care is taken not to touch their own eyes or mucous membranes with a contaminated gloved hand. Children are placed in a private room or in a room with other children with RSV infections. Reverse isolation Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp focuses on keeping bacteria away from the infant. With RSV, other children need to be protected fromexposure to the virus. The virus is not airborne. 3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. Thissuggests what condition? a. Asthma b. Pneumonia c. Bronchiolitis d. Foreign body in trachea ANS: A Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset,fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stridor. 4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due torespiratory syncytial virus (RSV)? a. Activity Intolerance b. Decreased Cardiac Output c. Pain, Acute d. Tissue Perfusion, Ineffective (peripheral) ANS. A Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this respiratorydisease process. Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this respiratorydisease process. Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this respiratorydisease process. Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not usuallyassociated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this respiratorydisease process. Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen supply anddemand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this respiratorydisease process. Chapter 2: Asthma 1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment findingsuggests that the childs condition is worsening? a. Hypoventilation b. Thirst Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp c. Bradycardia d. Clubbing ANS: A The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability, and increased heart and respiratory rate. As the child tires from the increased work of breathing hypoventilation occurs leading to increased carbon dioxide levels. The nurse would be alert for signs of Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sign of hypoxia; tachycardia is. Clubbing develops over a period of months in response to hypoxia. The presence of clubbing does not indicate the childs condition is worsening. 2. Whichc findingc is c expectedc whenc assessingc ac childc hospitalizedc for c asthma? a. Inspiratoryc stridor b. Harsh, c barkycough c. Wheezing d. Rhinorrheac ANS: c C Wheezingc is c ac classicc manifestationc of c asthma. c Inspiratoryc stridor c is c ac clinical c manifestationc of c croup. c Ac harsh, c barkyc coughc is c characteristicc of c croup. c Rhinorrheac is c not c associatedc withc asthma. 3. Ac childc has c hadc coldc symptoms c for c morec thanc 2c weeks, c ac headache, c nasal c congestionc withc purulent c nasal c drainage, c facial c tenderness, c andc ac coughc that c increases c duringc sleep. c Thec nursec recognizes c thesec symptoms c arec characteristicc of c whichc respiratoryc condition? a. Allergicc rhinitis Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp b. Bronchitis c. Asthma d. Sinusitis c ANS: c D Sinusitis c is c characterizedc byc signs c andc symptoms c of c acoldc thatc doc not c improvec after c 14c days, c a Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp low-gradec fever, c nasal c congestionc andc purulent c nasal c discharge, c headache, c tenderness, c ac feelingc of c fullness c over c thec affectedc sinuses, c halitosis, c andc ac coughc that c increases c whenc thec childc is c lyingc down. c Theclassicc symptoms c of c allergicc rhinitis c arec wateryc rhinorrhea, c itchyc nose, c eyes, c ears, c andc palate, c andc sneezing. c Symptoms c occur c as c longc as c thec childc is c exposedc toc thec allergen. c Bronchitis c is c characterizedc byc ac gradual c onset c of c rhinitis c andc ac coughc that c is c initiallyc nonproductivec but c mayc changec toc ac loosec cough. c Thec manifestations c of c asthmac mayc vary, c withc wheezingc beingc ac classicc sign. c Thec symptoms c presentedc inc thec questionc doc not c suggest c asthma. 4. What c is c ac commonc trigger c for c asthmac attacks c inc children? a. Febrilec episodes b. Dehydration c. Exercise d. Seizures c ANS: c C Exercisec is c onec of c thec most c commonc triggers c for c asthmac attacks, c particularlyc inc school-agec children. c Febrilec episodes c arec consistent c withc other c problems, c for c example, c seizures. c Dehydrationc occurs c as c ac result c of c diarrhea; c it c does c not c trigger c asthmac attacks. c Viral c infections c arec triggers c for c asthma. c Seizurescanc result c fromc ac too-rapidc intravenous c infusionc of c theophyllineac therapyc for c asthma. 5. Thec practitioner c changes c thec medications c for c thec childc withc asthmac toc salmeterol c (Serevent). c Thec mother c asks c thec nursec what c this c drugc will c do. c Thec nursec explains c that c salmeterol c (Serevent) c is c usedc toc treat c asthmac becausec thec drugc produces c whichc characteristic? Pediatric Nursing, A Case-Based Approach, 1st Edition By Tagher Knapp 1. Decreases c inflammation 2. Decreases c mucous c production 3. Controls c allergicc rhinitis 4. Dilates c thec bronchiolesc Correct c Answer: c 4