Preschool-Aged Children
Body-Integrity - CORRECT ANSWER - Preschool-aged children are very concerned
about their body integrity
- They believe that
... [Show More] their insides can leak our from even a small wound.
- Explains reason for their preoccupation with bandages
Preschool (3-6 Years) - CORRECT ANSWER - IMITATION of adults: providing a
stethoscope allows child an opportunity for THERAPEUTIC play.
- Time based on events, magical thinking, animism, centration.
- Stress = Regresion; may still be picky eaters , sleep 12 hours average, pedestrian
safety
- Keep a consistent bedtime routine
Pyloromyotomy - CORRECT ANSWER - Release of hypertrophied muscle around the
pyloric sphincter that causes narrowing of the pyloric canal.
- Infants will be fed shortly postoperative (with return of bowel sounds) in small, frequent
oral feeds.
- There is no incision to the gastric walls or mucosa and NPO is not required.
Cystic Fibrosis
Nutritional Care - CORRECT ANSWER - ↑ Protein, Carbs and minerals, to promote
weight gain
- They have difficulty absorbing nutrients due to blockage of pancreatic enzymes by
thick mucus secretions in the pancreas and liver.
- Pancreatic enzymes help breakdown ingested foods so the body can metabolize
nutrients.
- Administering pancreatic enzymes BEFORE eating will enable children to metabolize
nutrients so they can be used more effectively
- Fat content doesn't need to be decreased or eliminated. They have difficulty absorbing
fat due to thick mucus in intestines and the inability of the pancreatic enzymes to reach
the duodenum.
- ↑ of fiber is NOT needed, their stools are bulky because of fat content, but they have
regular bowel movements
- C.F. patients excrete excessive salt through the skin, the child with cystic fibrosis will
likely require additional salt in their diet, especially during activities.
- 85% O2 Sat = mild hypoxemia, as mucopurulent secretions gather in airways,
respiratory compromise worsens and oxygenation becomes impaired and ↓ in O2 Sat is
likely seen
Chemotherapy - CORRECT ANSWER - Low WBC count places the child at risk for
infection and isolation with monitoring of fever is priority.
ATI Proctored PEDs, ATI Pediatrics
Proctored Exam, PEDS ATI proctored
review
↓RBC - CORRECT ANSWER - Quiet play and best rest, administer O2
↓ Platelet - CORRECT ANSWER - Protect child from injury and monitor for bleeding.
- Quiet play should be encouraged, it will lessen the R/F injury and ↓ hemorrhage
Dehydration - CORRECT ANSWER - Assessment, response to parenteral fluids.
the nurse should weigh the patient daily because weight is the most sensitive indicator
of hydration status in clients of all ages.
- Weight is the only measurement the reflects both measurable fluid balance changes
(I/O) and insensible fluid loss (skin and respiratory)
Koplik spots - CORRECT ANSWER - Maculopapular rash and fever; Rubeola
- Koplik spots: oral lesions that are characteristics of rubeola (measles). The small,
irregular spots with a blue/white center are seen on the Buccal mucosa, which is
opposite the molars, in the prodromal stage of measles.
- Koplik spots appear about 2 days before maculopapular rash appears and are
accompanied manifestations of fever, malaise, conjunctivitis, and other cold
manifestations.
- They begin to fade the second day after the rash appears. Immunity to measles is
conferred by the MMR (Measles-Mumps-Rubella) immunization that children receive @
15 months.
Rubeola - CORRECT ANSWER Measles; Maculopapular starts on the face and
spreads downward. It desquamates after about 3-4 days. The rash does not progress to
vesicles and crusts like the papules of chicken pox.
- cephalocaudal rash upper trunk and faceand more confluence as it spreads to the
lower areas of the body.
Varicella - CORRECT ANSWER Chicken Pox; Vesicles and crusts are present
- Commences with a maculopapular rash that progressess to vesicles on erythematous
bases which eventually rupture and crust over.
Kawasaki Syndrome (Scarlet Fever) - CORRECT ANSWER - Strawberry tongue;
sloughed off its normal coating, exposing swollen prominent papillae.
Pertussis (whooping Cough) - CORRECT ANSWER Paroxysmal Cough
A1C - CORRECT ANSWER AKA glycosylated hemoglobin assay; is the most sensitive
indication of client compliance with the treatment regimen. The life span of RBC is about
120 days, and glucose molecules adhere to about 4-6% of hemoglobin. Because of the
longevity of the RBC's recent changes in diet, activity or medication will not affect the
results of this test.
ATI Proctored PEDs, ATI Pediatrics
Proctored Exam, PEDS ATI proctored
review
Skeletal Traction - CORRECT ANSWER The most effective means of traction,
applying to a bone with wire pins or tongs
Compartment Syndrome - CORRECT ANSWER Involves the compression of nerves
and blood vessels due to swelling within the enclosed space created by the fascia that
separates groups of muscles
Ventricular Septal Defect - CORRECT ANSWER - Murmur best heard at the lower left
sternal border; Ventricular septal wall defect between ventricles is an Acyanotic heart
defect.
- Sound is transmitted in the direction of blood flow, so any back flow of blood from the
left to the right ventricle through the septal defect would be best heard in this area.
Acute Glomerulonephritis - CORRECT ANSWER - ASO titer will indicate if the child
has had a recent strep infection. In determining a definitive diagnosis for acute
glomerulonephritis.
- Elevated RBCs is expected and the presence of hematuria
- Monitor B.P. Q4hr due to ↑HTN
HIV
Preschooler - CORRECT ANSWER - Immunizations contraindicated for this patient is
the oral polio
- the child is susceptible to infection and must be immunized to the common
preventable childhood diseases.
- However, the oral polio vaccine contains a form of the virus that in SOME clients can
lead to an actual case of polio, this risk is increased with HIV and must receive the
injectable form of the polio immunization.
Myelomeningocele - CORRECT ANSWER - Hydrocephalus; is a post-operative risk
because the pathway for the cerebral spinal fluid has been altered.
- Infants --> Measure the head circumference Qshift.
- children with NTDs usually produce too much cerebral spinal fluid and once the sac is
removed, there is nowhere for this additional CSF to accumulate except in the ventricles
of the brain.
Epiglottitis - CORRECT ANSWER D/O caused by inflammation and it has been
decreased since the inclusion of the HiB vaccine; it is common in children between 2-6.
Cardiac Catheterization - CORRECT ANSWER - Any bleeding from the entry site of
the cardiac cath. could indicate potential hemorrhage. [Show Less]