A nurse is reviewing the prescriptions for a 2-year-old child who has been admitted to the pediatric unit with acute laryngotracheobronchitis (croup). What is the rationale for the prescription to administer oxygen by way of a nasal cannula?
ANS: Decreases the effort required for breathing and permits rest
Rationale: Administering oxygen by way of nasal cannula limits the energy required for breathing; this allows the child to conserve energy that can be used for fluid and nutrient intake. Congealed mucus will obstruct air passageways and increase respiratory distress. Oxygen administration does not trigger the cough reflex. Oxygen administration through a nasal cannula will have a drying effect.
Hockenberry Table27-8
The nurse is providing care to a toddler-age client of Indian descent diagnosed with lead toxicity. Which question is most appropriate for the nurse to include in the assessment process to determine the source of the lead?
ANS: “Do you use Surma for your child’s teething pain?”
Rationale: Surma, a source of lead, may be used by clients of Indian descent. Ba-Baw-San, Lozeena, and Greta are all sources of lead; however, these are used in clients of Asian, Iraqi, and Mexican descent, respectively.
The nurse is teaching the parents of a toddler-age client about food safety related to choking. Which parental statement indicates the need for further education?
“Ans: Hot dogs are safe and do not present a choking hazard for my child.”
Rationale: Large round foods, such as hot dogs, should be avoided until the toddler is able to chew effectively due to the risk for choking. Ice cream, chicken nuggets, and mashed potatoes are not identified as choking hazards for the toddler-age client.
A nursing instructor asks a nursing student about the physical changes observed in toddlers. Which statement made by the student indicates the need for further teaching?
Ans: The average toddler grows 4.2 cm each year
Rationale: An average toddler grows 6.2 cm each year. Hence, when the student says that the average growth is 4.2 cm, it indicates the need for further teaching. There is a rapid development of motor skills in children, which enables them to perform self-care activities like feeding, dressing, and toileting. Locomotion skills that develop at this age include running, jumping, standing on one foot for several seconds, and kicking a ball. An average toddler gains 5 to 7 pounds (2.3 to 3.2 kg) each year
A major developmental milestone of a toddler is the achievement of autonomy. What should the nurse instruct the parents to do to enhance their toddler’s need for autonomy?
Ans: Teach the child to accept external limits.
Rationale: Appropriate limit-setting and discipline are necessary for children to develop self-control while learning the boundaries of their abilities
After many episodes of otitis media a 3-year-old child is to undergo myringotomy and have tubes implanted surgically. What should the nurse include in the discharge preparation for this family?
Ans: Insert earplugs during the child’s bath.
Rationale: Water in the ears after myringotomy may be a source of infection. There is no reason that the child cannot be around other children, because there is no infectious process. Applying an ointment to the ear canal daily will clog the ear canal and serves no purpose. Cotton swabs may be used occasionally in the outer ear but should not be inserted into the ear.
A nurse is educating the mother of a seven-month-old child about an adequate diet plan for the child. Which statement made by the nurse should be included?
Ans: “You should supplement milk with solid food items like vegetables and fruits.”
Rationale: When the child is 6 months old, the mother should start supplementing the child’s intake of milk with solid food items to ensure a balanced diet for adequate growth. The intake of milk should be limited to 2 to 3 cups per day because the consumption of more than a quart of milk per day tends to decrease the child’s appetite for essential solid foods and results in inadequate iron intake. Serving finger foods to toddlers allows them to eat by themselves and to satisfy their need for independence and control. Small, reasonable servings allow toddlers to eat all of their meals. Children below 2 years of age should not be given low-fat or skimmed milk because the fat is important for the physical and intellectual growth of the child.
For which families should the nurse include information related to safe sleeping habits as a priority during a scheduled health maintenance visit for a toddler-age child? Select all that apply.
Ans:
Asian American
African American
Hispanic American
A 2-year-old toddler is admitted to the pediatric unit with a diagnosis of bacterial meningitis. What is the most important safety measure for the nurse to institute immediately after the child has a seizure?
Ans: Placing the child in the side-lying position
The nurse epidemiologist of a large urban hospital is called to the pediatric unit to provide information about an outbreak of diarrhea caused by Salmonella. Which common foods does the nurse suspect as the cause of the outbreak? Select all that apply.
Ans:
Hamburgers
Soft-boiled eggs
A nurse is performing health screenings of toddlers in a culturally diverse neighborhood. Which child should the nurse consider at risk for beta-thalassemia (Cooley anemia)?
Rationale: Beta-Thalassemia is common in children who are black or of Mediterranean descent (Italian, Greek, Syrian); an enlarged abdomen may be the result of hepatomegaly or splenomegaly. Pale skin is expected in children of Irish descent; children with β-thalassemia may have bronze skin as a result of hemosiderosis if the excess iron is not chelated. Defective hemoglobin leads to damaged red blood cells and a decreased hematocrit. Asian descent is not a risk factor for β-thalassemia.
Which complications should the nurse assess a toddler-age client for after receiving a gastric lavage in the treatment of an accident overdose? Select all that apply.
Ans:
Hypoxia
Aspiration
Gastric perforation
Rationale: Complications associated with gastric lavage include hypoxia, aspiration, and gastric perforation. Diarrhea and clay-colored stools are not complications associated with a gastric lavage.
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