Peds GI
The nurse palpates a small, firm mass resembling an olive in the infant's right upper abdomen.
Pyloric Stenosis
The nurse teaches the parent of a child with mild croup to use this type of air to help decrease airway inflammation.
What is cool, humidified air?
These children are particularly vulnerable to severe RSV infection.
Who are infants younger than 6 months and children who are premature, immunocompromised, or have chronic heart/lung conditions?
A child with OM develops pain, redness, and swelling behind the affected ear. The nurse suspects this complication.
What is mastoiditis?
This type of conjunctivitis is most associated with purulent discharge and crusting.
What is bacterial conjuctivitis
A child inherits only one sickle cell gene. What condition does the child have?
What is sickle cell trait?
Hemophilia is inherited through this pattern.
What is X-linked recessive inheritance? What is X-linked recessive inheritance?
Acute rheumatic fever typically develops how long after an inadequately treated streptococcal infection?
What is 2–6 weeks?
Repeated vomiting of gastric acid places this infant at risk for this acid-base imbalance.
What is metabolic alkalosis?
The nurse should NOT do this to the throat of a child suspected of having epiglottitis.
What is insert a tongue depressor or inspect the throat?
This medication has historically been used as monthly IM prophylaxis during RSV season for certain high-risk children.
What is palivizumab?
A child with OM suddenly develops drainage from the ear and reports that the severe ear pain has improved. What should the nurse suspect?
What is tympanic membrane perforation?
Important:
Drainage + sudden relief of pressure/pain = possible perforation.
Viral conjunctivitis is usually treated with what?
Viral conjunctivitis is generally self-limiting and treated with supportive/symptomatic care.
Why does SCD cause chronic anemia?
A. The bone marrow stops producing RBCs
B. Sickled RBCs have a shortened lifespan and are destroyed prematurely
C. The kidneys excrete RBCs
D. Plasma volume increases
What is B?
Rationale:
Normal RBCs live about 120 days, while sickled cells have a much shorter lifespan, resulting in increased hemolysis.
Hemophilia A results from deficiency of which clotting factor?
What is Factor VIII?
The autoimmune response in ARF can cause inflammation of the joints, skin, brain, and especially this cardiac structure.
What is the heart, particularly the mitral valve?
A dehydrated infant with pyloric stenosis is scheduled for pyloromyotomy. What must the nurse prioritize before surgery?
What is correcting fluid and electrolyte imbalances?
The nurse is caring for four pediatric clients. Which finding requires immediate intervention?
A. Barking cough
B. Mild sore throat
C. Frequent swallowing after tonsillectomy
D. Child with croup drinking fluids
C
The nurse assesses four children with RSV. Which child should the nurse assess first?
A. Infant with rhinorrhea and mild cough
B. Infant with decreased appetite
C. Infant with wheezing and occasional cough
D. Infant with cyanosis and apneic spells
What is D—the infant with cyanosis and apneic spells?
This antibiotic is commonly prescribed for bacterial otitis media.
What is amoxicillin?
This medication class may be used for allergic conjunctivitis.
What are antihistamines?
This is the most common reason children with SCD are hospitalized.
What is a vaso-occlusive crisis (VOC)?
Hemophilia B results from deficiency of which clotting factor?
What is Factor IX?
A 4-year-old has:
What condition should the nurse suspect?
What is Kawasaki disease?
A child with Hirschsprung disease develops fever, explosive diarrhea, abdominal distention, and signs of systemic illness. The nurse should suspect this serious complication.
What is enterocolitis?
Hirschsprung + fever + abdominal distention + diarrhea = enterocolitis emergency.
A 4-year-old suddenly develops respiratory distress, drooling, dysphagia, a muffled voice, and tripod positioning. The parents report that the child is having difficulty breathing.
What is the nurse's priority action?
What is protect the airway and prepare for emergency intubation?
The nurse offers an infant with RSV smaller amounts of food or fluids more frequently to accomplish these goals.
What are conserve energy and prevent dehydration/aspiration?
The nurse is teaching a parent how to administer ear drops to a 2-year-old. Which direction should the parent pull the pinna?
What is down and back?
When cleaning discharge from an infected eye, the nurse wipes in which direction?
What is from the inner canthus toward the outer canthus?
Name three common triggers of a vaso-occlusive crisis.
What are dehydration, hypoxia, and infection?
A mother is a carrier of an X-linked recessive hemophilia gene. The father does not have hemophilia. Which child has the greatest risk of having hemophilia?
A. Daughter
B. Son
C. All daughters
D. All children
A son receives his X chromosome from his mother and Y chromosome from his father. If he receives the affected X, he can have hemophilia.
A child with Kawasaki disease has completed IVIG therapy. The parent asks when the child can receive MMR and varicella vaccines.
Delay live vaccines for approximately 11 months after IVIG,
The nurse assesses for this complication after severe intestinal inflammation or obstruction because it can lead to shock.
What is bowel perforation?
Put these nursing actions in the correct order for suspected epiglottitis:
What is 2 → 4 → 3 → 1?
Think:
CALM → UPRIGHT → NOTIFY → AIRWAY EQUIPMENT
The nurse is caring for an infant with RSV. Which intervention should occur before feeding?
What is C—suction the nares?
Why?
Clearing secretions makes it easier for the infant to breathe and feed.
A parent calls and says, "My child's ear tube fell out. Should I take my child to the emergency department?"
What is no—the tube is expected to fall out spontaneously and this is not normally an emergency?
Rationale:
Tympanostomy tubes commonly fall out spontaneously, often within about 2 years, depending on the tube and clinical circumstances.
Place these nursing actions in the best order when caring for a child with eye discharge:
What is 1 → 2 → 3 → 4?
The nurse receives report on four children with SCD:
A. 10-year-old with severe leg pain, dry mucous membranes, and decreased urine output
B. 8-year-old with fatigue and mild jaundice
C. 12-year-old with an erection lasting 5 hours
D. 9-year-old with cough, fever, chest pain, and oxygen saturation of 89%
Who should the nurse assess FIRST?
the child with cough, fever, chest pain, and SpO₂ 89%.
Why?
This presentation strongly suggests acute chest syndrome, a life-threatening complication involving the lungs.
A child with hemophilia develops a swollen, warm, painful knee. Which actions should the nurse take?
☐ A. Rest the extremity
☐ B. Apply ice
☐ C. Massage the knee
☐ D. Elevate the extremity
☐ E. Encourage vigorous ROM
☐ F. Apply compression as appropriate
A, B, D, F
Think:
R = Rest
I = Ice
C = Compression
E = Elevation
The nurse is caring for four children with Kawasaki disease. Which child should be assessed FIRST?
A. Child with cracked lips and peeling skin
B. Child with persistent irritability
C. Child with sudden pallor, vomiting, and abdominal pain
D. Child with cervical lymphadenopathy
What is C?
Why?
These may represent a subtle myocardial infarction, which is potentially life-threatening.