Nursing Care of Children Remediation:
Complete an ATI Focused Review® and send a detailed summary (2-3 sentences each) of 4 concepts that you learned
... [Show More] from the focused review to me in the messaging system.
Most communicable diseases can be prevented with immunizations. Antibiotics and antitoxins reduce serious complications. Immunizations are a form of primary prevention. Secondary prevention includes the control of the spread of the disease to others.
Conjunctivitis, which is also known as pink eye, is spread by direct contact. Incubation will depend on the infection. Pertussis, which is also known as whooping cough, is spread through direct contact, droplet, and indirect contact with freshly contaminated objects. The incubation period will be between 6 and 20 days, usually around 7-10.
At 2 hours of age, temperature is approximately 99° F (37.2° C). The temperature stabilizes at 98.6° F (37° C) by about 4 hours of age. Temperature should be obtained from a newborn or infant less than 1 month old using the axillary route. Rectal temperatures are contraindicated in newborns less than 1 month old because the rectal mucosa is fragile, and there is an increased risk of rectal perforation from the thermometer.
Oral temperatures are contraindicated in children younger than 5 years old. Oral temperatures are also contraindicated in children who are receiving oxygen, have had recent trauma to the oral mucosa, or have an altered level of consciousness
2. Answer the following questions and review the suggested learning activities. Send me your answers here.
The nurse is taking a blood pressure on a child. What are some nursing considerations when doing the procedure?
The nurse is planning activities for toddlers who are hospitalized. What activities would be appropriate for
this age group? Identify three (3) appropriate activities.
A nurse in the emergency department suspects that a child who was admitted for burns of hands and arms may have been abused. What are some findings that may indicate abuse or maltreatment?
A nurse caring for a child with an acute infectious gastrointestinal disorder is concerned about possible dehydration. Provide five (5) clinical manifestations associated with dehydration.
A nurse is reinforcing education to the parents of a 4-month-old infant regarding introduction of solid food. What guidelines should be followed?
The nurse is caring for a client who is diagnosed with Nephrotic Syndrome. What four (4) nursing interventions would the nurse do when providing nursing care to this client?
The nurse is evaluating the effectiveness of sleep teaching to a group of parents. Identify two things that the parents have done at home to promote effective sleep patterns in their preschooler.
A nurse is caring for a client with asthma who is prescribed Albuterol, a beta2-adrenergic agonist. Identify two (2) adverse effects of this medication therapy.
A nurse is reinforcing discharge instructions to the parents of a child with asthma who is being treated with the Leukotrene Modifier, Montelukast. What should be included in the teaching plan regarding Montelukast?
The nurse is caring for a preschool aged child. The provider has ordered a diagnostic test for this client. Wh interventions should the nurse provide to this client about teaching the child about the diagnostic test?
A nurse is caring for a client who experiences a tonic-clonic seizure. What are the expected findings for thi type of seizure?
The nurse is caring for a client who has Diabetes Mellitus. Identify two (2) nursing interventions the nurse would complete to treat hypoglycemia in the preschool age child.
The nurse is caring for a client in the postoperative period following a cleft palate. What five (5) nursing interventions should the nurse provide to this client during this period?
A nurse is reinforcing discharge instructions to the parents of a child who is being discharged following a head injury. What statement by the parent indicates need for further instruction?
" I will notify the provider if I notice increased irritability, headache, nausea, or vomiting." "I will make sure my child wears a helmet when riding a bike even in our yard."
" I will be cautious about bright lights, straining, and coughing which can increase ICP."
" I understand that diplopia is a common side effect and will go away after a full recovery."
“I understand that diplopia is a common side effect and will go away after a full recovery."
A pediatric client is choking. Identify five (5) signs of choking in a child.
• Universal sign of choking- hands around the neck
• Cyanosis
• Dyspnea
• Inability to speak
• Weak, ineffective cough
• High pitched sounds or no sound
What does a pain rating of 6 on the FLACC scale mean?
• FLACC stands for Face, Legs, Activity, Crying, and Consolability
• 4-6 is moderate pain
A parent of a 2-year-old client complains that their child is a picky eater. Discuss the nutritional requiremen of a toddler.
Suggested Nursing Care of Children Learning Activity: Developmental Stages and Transitions
• Toddlers begin developing taste preferences and are generally picky eaters who repeatedly request their favorite foods.
• Toddlers should consume 24 to 28 oz milk per day, and can switch from drinking whole milk to low fat milk after 2 years of age.
• Juice consumption should be limited to 4 to 6 oz per day.
• Trans fatty acids and saturated fats should be avoided.
• Diet should include 1 cup of fruit daily.
• Food serving size should be 1 tbsp for each year of age, or ¼ to ⅓ of an adult portion.
• Regular meal times and nutritious snacks best meet nutrient needs.
• Snacks or desserts that are high in sugar, fat, or sodium should be avoided.
• Foods that are potential choking hazards should be avoided.
• Adult supervision should always be provided during snack and mealtimes.
• Foods should be cut into bite-size pieces to make them easier to swallow and to prevent choking.
• Toddlers should not be allowed to engage in drinking or eating during play activities or while lying down.
A client with pulmonary artery hypertension is taking Lisinopril. What foods would the nurse reinforce to th client and family to avoid while on this medication?
• Foods high in sodium
• Foods high in potassium
The nurse is caring for a 3-month-old client. Provide vital signs values that are expected for a client of this age.
Suggested Nursing Care of Children Learning Activity: Vital Signs in the Pediatric Population
• 3 months to 5 months:106 to 186/min heart rate
• 20 to 60/min (average 30 to 40/min respirations
• Females: systolic 76-105 diastolic 64-67
• Males: systolic 87-105 diastolic 63-69
• Axillary: 97.6° F (36.5° C)
Oral: 98.6° F (37° C)
Tympanic: 98.6° F (37° C)
Rectal: 99.6° F (37.6° C)
The nurse is performing a heel stick for universal newborn screening. Where should the nurse perform the heel stick? (Review the Maternal Newborn Review Module)
• The heel stick should be performed on the most medial or lateral portions of the plantar surface of th heel
A child has been brought to the clinic and is suspected to have gastroenteritis. What is the priority finding fo gastroenteritis?
Suggested Nursing Care of Children Learning Activity: Gastrointestinal Disorders
• Reporting fatigue, malaise, change in stool pattern which are usually diarrhea, watery, green, explosive, and can contain mucous or blood, poor appetite, weight loss, and abdominal cramping
• Monitor for signs of dehydration
PN Nursing Care of Children 2017 A
Nephrotic syndrome is alterations in the glomerular membrane allowing proteins, especially albumin, to pass into the urine, resulting in decreased serum osmotic pressure. It can be primary, secondary, or congenital. Some expected physical findings are weight gain over a period of days/weeks, facial/periorbital edema that decreases throughout the day, ascites, edema of lower extremities/genitalia, anorexia, diarrhea, irritability, lethargy, pallor, and decreased frothy urine.
Hypoalbuminemia is reduced serum protein and albumin. Hyperlipidemia is elevated serum lipid levels. Hemoconcentration is elevated hemoglobin, hematocrit, and platelets.
Signs of increased intracranial pressure in infants are high pitched cry, lethargy, vomiting, bulging fontanels, widening cranial suture lines, and increased head circumference. Signs of increased intracranial pressure in children are headache, vomiting, lethargy, nausea, double vision, decreased school performance of learned tasks, decreased LOC, and seizures.
When caring for client with increased intracranial pressure assist with preparation for surgery for shunt or shunt revision, use gentle movements when performing ROM exercises, minimize environmental stressors such as noise and frequent visitors. Pain should be monitored and managed. The child and parents should be informed about manifestations of shunt malfunction and hydrocephalus and when to notify the provider.
PN Nursing Care of Children 2017 B
Enteral Access Tubes: Gastroparesis, esophageal reflux, or a history of aspiration pneumonia generally requires intestinal placement. Nasogastric or nasointestinal therapy is less than 4 weeks and inserted in the nose. Gastronomy or jejunostomy therapy is longer than 4 weeks and inserted
surgically. Percutaneous endoscopic gastrostomy or jejunostomy therapy is longer than 4 weeks and inserted endoscopically. Some indications are critical illness/trauma, neurological/muscular disorders such as brain neoplasm, dementia, stroke, myopathy, and Parkinson’s disease.
Children can establish lifetime eating habits during early childhood. Toddlers begin developing taste preferences and are generally very picky eaters who will repeatedly ask for their favorite foods. Physiologic anorexia occurs, resulting in toddlers becoming fussy eaters because of decreased appetite. Toddlers should consume 24 -48 ounces of milk per day, and can switch from drinking whole milk to low fat milk after about 2 years of age.
Toddlers generally prefer finger foods because of increasing autonomy. Regular mealtimes and nutritious snacks best meet nutrient needs. Snacks and desserts that are high in sugar, fat, or sodium should be avoided.
Sharp objects should be kept out of reach. Firearms should be kept in locked boxes or cabinets. Toddlers should not be left unattended with any animals present. Toddlers should be taught about stranger safety. Toddlers should not be left unattended in bathtubs. Toilet lids should be kept closed. Toddlers should be closely supervised when near pools or any other body of water.
Board Vitals Summary
The nurse caring for the newborn with physiological jaundice knows that this problem is related to an immature liver. The best time in the menstrual cycle for a woman to perform breast self examination is the week after menstruation when her hormones are at their lowest. Before and during menstruation are times when the woman’s hormones may cause breast tissues to feel different. During the week of the cycle, a woman may experience bloating and breast tenderness which can cause breast tissue to feel different. The most visually obvious areas to assess nutrient and hydration status are skin, hair, and nails. These changes occur because the body shunts nutrients to the most important organs, including the brain and heart. Malnutrition can make the skin dry, thin, and pale. The hair becomes dry and brittle. The nails may become thin and brittle or curve like spoons, especially on the index finger or ring finger which would indicate iron deficiency. [Show Less]