Infectious/Immunologic Disorders
This process is used to provide extra protection against specific diseases or pathogens to prevent spread, to
limit contact with pathogenic organisms, to help prevent the spread of disease to other people
and to protect the patient, family, and healthcare providers
What is transmission-based precautions?
(Know which one you should use for which infectious disorder and know what PPE is required for each).
The person who works with nurses, doctors and other healthcare members to help them meet the developmental, emotional and intellectual needs of hospitalized children.
Who is a child life specialist?
What is the most effective way a pediatric community health nurse can prevent spread of disease?
What is Education?
Which of the following interventions should be included when teaching a healthy behaviors class for parents of adolescents? (Select all that apply.)
a. Adolescents do not require more than 4 hours of sleep
b. Insist on seatbelt use at all times
c. Encourage the use of hats and sun screen during sun exposure
d. Maintain the recommended immunization schedule
e. Encourage dental visits every 6 months
f. Discuss peer pressure and safety
What is ANS: B, C, D, E, F
Adolescents should always wear seatbelts. Immunizations should be obtained according to the recommended schedule. Good dental care is important. Parents should provide privacy but talk to the adolescent about peer pressures and safety. Wear proper skin protection when exposed to the sun.
Which of the following is most appropriate when administering intramuscular medication to a school-age child?
A. Inject medication as rapidly as possible.
B. Insert needle quickly, using a dart-like motion.
C. Penetrate skin immediately after cleansing site, before skin has dried.
D. Have child stand during administration.
What is B?
The needle should be inserted quickly in a dart like motion at a 90-degree angle unless contraindicated. Inject medications slowly. Allow skin preparation to dry completely before skin is penetrated. Place child in lying or sitting position.
The best approach to postoperative pain management in children is:
a. Administer medication early.
b. Withhold medication until absolutely needed.
c. Work to prevent pain.
d. Administer the maximum dosage.
What is C?
Strict airborne/droplet isolation is required for this condition.
Acyclovir will decrease the length and severity of the disease which is important for immune-compromised children
Caldryl/ Calamine lotion may be used to help with pruritis caused by this condition.
Parents should be instructed to keep the child cool and use mittens on hands and clip nails for no scratching
Remind parents not to administer aspirin due to REYE Syndrome
What is nursing care of a child with varicella (chicken pox)?
A preschooler is crying and uncooperative while trying to take her temp. What can the nurse do to elicit cooperation?
What is allow her to hold the thermometer?
A 6-year-old needs to cough and deep breathe following surgery. To accomplish this, the nurse will:
a) instruct the parents to remind the child to cough and deep breathe every 2 hours.
b) arrange for respiratory therapy to do coughing and deep breathing exercises with the child.
c) teach the young school-ager to use an incentive spirometer.
d) blow a pinwheel and bubbles with the child.
What is D?
Rear-facing car safety seat with snug harness until 2 , avoid smoke exposure, water heater in home should be at max of 120, supervise during bath time, no blankets or stuffed animals in the crib, back to sleep, avoid co-sleeping.
What is anticipatory guidance for an infant?
When is it appropriate to advocate for central line access?
What is when a patient needs access for longer than 7 days ?
A pain management teaching plan should include (select all that apply):
a. The possibility of addiction to pain medication
b. Assurance that the child will be kept pain-free
c. Telling the parents that pain medication and management is to control pain but has limitations
d. Telling the parents that they will need to force the child to take the pain medication.
e. When to notify the provider regarding pain management
What is C and E?
This infectious disorder manifested as painful swollen parotid glands, fevers, muscle aches, abdominal pain, fatigue and loss of appetite can largely be prevented with vaccination. Management includes a soft diet, rest and monitoring for signs of complications such as deafness, orchitis, meningitis, encephalitis and sterility.
What is mumps?
An adolescent remarks rather sarcastically that she feels like a "lab rat." What is the priority nursing action?
The nurse is caring for a 10-year-old child admitted for a surgical procedure the next day. The nurse takes the child to a special area in the playroom and lets the child "start" an IV on a stuffed bear. Which of the following is this action an example of?
a) Play therapy
b) Positive reinforcement
c) Therapeutic play
d) Age-related activity
What is C?
Incompatibility between history and presenting injury, injuries in various stages of healing, injuries in developmentally appropriate places.
What are physical signs of abuse?
Gather equipment before approaching child. Select hand rather than wrist or upper arm veins, utilizing scalp veins in young infants if needed, ensure adequate pain relief, allow topical anesthetic at least 45 minutes after application, use a device to trans illuminate the vein, make only two attempts to gain access, encourage parental participation, Coordinate care with child life specialist, secure line with minimal amount of tape, Protect the site from bumping, Assess site every 1-2 hours, provide comfort, pain relief and praise.
What are the principles of atraumatic care when managing IV Therapy?
Relaxation, Distraction, Humor, Imagery, Biofeedback, Thought stopping, Positive self-talk, Sucking/sucrose, Heat and cold applications, and Massage and pressure
What are non pharmacological pain management techniques?
This condition is treated with the use of pediculicides. Nurses are responsible for cautioning children against sharing combs, hats, scarves, hair ornaments for the prevention of this condition.
What is pediculosis capitis?
A 5 year old will be hospitalized for a surgical procedure. How can the nurse best ease the stress of hospitalization for this child?
a) Tell the parents to bring toys for the child from home.
b) Have another child talk with the child to be hospitalized.
c) Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.
d) There is no way to adequately prepare a child for an impending hospitalization.
What is C?
18 and 24 months
What is Ages for autism screening?
Calculate the IV fluid maintenance rate for a child weighing 16kg.
What is 54mL/hr?
10kgx100=1000mL
+ 6kgx50=300ml
1,300mL/24hr
What are 3 pain scales and at what age they should be used?
1) FLACC/CRIES: up to age 3
2) Faces: 3 and up
3) Numeric scale: around 8+
This linear rash, pruritic rash requires isolation of the host and treatment of the household with prometherine lotion/
What is scabies?
A nurse is preparing a 7-year-old for abdominal computed tomography (CT) scanning with intravenous contrast. What statement would be most appropriate to explain the injection of the contrast dye to the child?
The mother of a 1-year-old patient comes to visit the child in the PICU. She sits in a chair near the child's bed but doesn't touch him. Which of the following actions by the nurse would be most appropriate?
a) Respect their privacy and leave the room.
b) Pick up the child so that the mother sees he can be touched.
c) Ask the mother if she would like to talk to the child.
d) Encourage the mother to rock the child in a rocking chair.
What is D?
Yearly scoliosis screening, vision screening,
Tdap (tetanus and diphtheria toxoids and pertussis vaccine); meningococcal vaccine (MCV4); human papillomavirus vaccine (HPV2), and yearly seasonal flu vaccine around 11-12 years old, bi-annual dental visits.
What is health promotion for school age children?
This solution should not hang for longer than 24 hours. It should be infused slowly and the rate should be increased gradually. Blood glucose levels need to be monitored frequently, catheter and site care prevents infection. To prevent hypoglycemia, hang dextrose 5-10% if this is stopped.
When administering this on a cyclical cycle, the nurse must infuse half rate at the first and last hour to prevent hyper/hypoglycemia.
What are nursing interventions for total parenteral nutrition?
Which of the following is the nurse most likely consider when preparing to educate or advocate for a pediatric patient for imaging studies?
a. Age and development
b. Intake and elimination status
c. Temperature and blood pressure
d. Height and Weight
What is A?
This condition requires the use of topical antibiotics such as mupirocin/Bactroban to treat the honey-crusted infection often caused by staphylococcus.
What is impetigo?
What type of teaching would be best for a preschooler having an invasive procedure?
The school nurse is responsible for which of the following? Select all that apply.
A. Treat individuals with chronic and acute health needs
B. Coordinate the health education programs
C. Consult with school officials to help identify and care for other persons in the school's community
D. Administer pediatric vaccinations
What is A, B and C?
**DAILY DOUBLE**
These vaccines are typically given at ages 2, 4 & 6 months of age. (Name ALL 6)
What are Hepatitis B, Rotavirus, DTaP, Hib, PCV13, IPV?
A child is preparing to undergo a lumbar puncture in the treatment room. What intervention can the nurse provide to minimize stress during the procedure?
The use of EMLA cream and parental presence are examples of what?
What are procedural pain interventions?
The nurse is teaching a group of parents at a local high school about the importance of the human papillomavirus vaccine. Which strategies by the nurse would help address concerns? Select all that apply.
A. Providing accurate and current information about the vaccine
B. Discussing the prevention of cancer as the major role of vaccine
C. Allowing parents to ask questions and express concerns about the vaccine in an open, supportive environment
D. Informing parents that they will be responsible for their children's death from a preventable cancer if they do not vaccinate
What is A, B, and C?
Name how family should be involved in each age group:
1) Infant 2) Toddler 3) Pre-school
4) School aged 5) Adolescent
1) skin on skin, breast feeding, forming attachment. Etc.
2) Provide comfort & input to HCP; sit in lap during assessment. Keep with as much as possible. Etc.
3) Provide comfort & input. Etc.
4) Kids can choose how parents are involved but do not assume. Parents will still answer most questions. Etc.
5) Provide privacy as much as possible. Involve peers. Etc.
· Temperament
· Age
· Developmental level
· Cognitive level
· Previous experience with illness or hospitalizations
· Seriousness of the diagnosis
· Parents reaction to illness or hospitalizations
· Type and amount of preparation
What are factors affecting a child's response to illness and hospitalization?
Recommended health supervision visits (under 4)
What is 6, 9, 12, 15, 18, 24 months, 3 years, 4 years?
A nurse is preparing to administer medication to a preschooler. What can the nurse do to ensure communication with the child is effective?
-Myth that children don't feel pain like adults
-Lack of pain assessment and reassessment
-Lack of understanding of how to measure pain
-Lack of knowledge of pain treatment for children
-May fear medication will cause addiction.
What are barriers to pain management?
The nurse is assessing the child with a suspected allergy. Which of the following questions should the nurse include during the assessment? Select all that apply:
A) Have you ever developed hives after being exposed to a food or substance?
B) Are you allergic to any fruit or other foods?
C) Do you ever feel short of breath after eating exercising?
D) Has your mouth ever felt itchy after eating?
E) Is there a family history of food, drug,or environmental allergies?
What is A, B, D, and E?
1. preventing/minimizing child's separation from the family members*
2. promote sense of control
3. prevent or minimize bodily injury or pain
Are examples of what concept?
The 3 ways we can promote atraumatic care?
As the pediatric triage nurse in the ED which patient requires immediate action to protect other clients in the ED from infection?
A. 2-year-old who has pediculosis capitis
B. 5-year-old who has a new pruritic rash and a possible chickenpox infection
C. 6-year-old who has a history of a Staphylococcus infection
D. 7-year old with an upper respiratory infection
What is B?
The nurse is performing a physical assessment on a 2-year-old child. Which of the following actions is most appropriate?
A. Assess respiratory rate first
B. Listen to the heart rate for 30 seconds
C. Obtain a rectal temperature
D. Palpate skin temperature first
What is A?
What should the nurse expect of a school-age child's urinary output each hour?
What is 1-2 mL/kg/hr?
Which patient will you see first? A pediatric patient with acute pain or chronic pain?
What is a patient with acute pain?