GU
Describe how you would obtain a UA/UC from a diapered 9 month old boy.
1. Cleanse the peri-area 2.Apply UBag device then put on diaper, 3. Once urine is in bag, remove bag. 4. Snip corner and allow urine to drain into specimen cup.
List 4 symptoms of infant dehydration
Sunken eyes, no tears, lethargy/listless, decreased urine output, depressed fontanel, poor skin turgor, weight loss, RR and Pulse weak and rapid, pale/cool skin
A child is found to have seizures where he stares off in the distance, that last 4 seconds, and occur 10 times per day. What are these called?
You just admitted a 2 y.o. to the inpatient unit following a diagnosis of Wilm's Tumor. What priority precaution do you need to take in caring for this child pre-operatively?
Do not palpate abdomen
List 3 signs of hypoglycemia.
Cold and clammy skin, headache, hunger, lightheaded/dizzy, shaky, irritability, difficulty thinking/confusion, slurred speech, blurred vision, loss of consciousness, seizure
Provide education to an adolescent female about preventing UTI reoccurrence.
Wiping habits; Retract foreskin of male; Keep underwear dry; Stay hydrated, Encourage freq voiding, Avoid constipation and straining, Cotton underwear, Wiping Habits, Avoid bubble baths, Empty bladder completely, void after Intercourse
You are an ED nurse, and a 5 y.o. child presents with signs of intussception. Name 3 of these signs.
Intermittent mod/severe abd pains; draw legs up to chest, bloody mucus stool, vomiting, exhaustion, fever
You are caring for a neonate (age 1 month) who has a temperature of 102. What is your main concern, or possible diagnosis of this infant?
Meningitis
You are caring for a 3 y.o. s/p appendectomy who also has classic hemophilia. You note that he has increased sanguineous drainage from one of his lap sites. You know you need to administer his prn dose of what medication?
Recombinant Factor VIII (will accept "Factor 8")
Your 9 y.o. patient with T1DM is ready to eat dinner. Her BS is 302, carb ratio 20:1, and she is going to eat 60 carbs. What type and How much insulin will you give? Sliding Scale: 100-200 = 0 units; 201-250 = 1 unit; 251-300 = 2 unit; 301-350 = 3 unit
6 units of rapid-acting insulin
You are an ER nurse admitting a 7 y.o. male with suspected testicular torsion. What does your nursing care look like?
Prepare for surgery (start IV access, NPO); call MD; admin pain meds
You are a RN caring for a child s/p cleft palate repair. List 4 interventions that protect the surgical site.
IV pain meds and tongue suture in place 1st 24 hrs; no straws, spoons, or suction catheters; axillary temp; No hard foods x 2 wks, elbow restraints, oral pain meds
Explain how a ventriculo-peritoneal shunt works - and what condition is it used to treat?
A catheter lodged in the ventricles of the brain drain excess CSF through the tube, into the peritoneum where it is reabsorbed by the body. This is used for hydrocephalus.
The lowest point of the WBC count dropping following round of chemotherapy. This is when the child is the most at risk for infections because immunocompromised. Begins 7-12 days after chemo, lasts for 7-10 days.
What is the goal of HIV Antiretroviral therapy (ART)?
Goal is to maximally suppress viral replication to non-detectable levels for as long as possible
You are an ER nurse caring for an 11 year old's; when reviewing the chart you note LABS: Potassium 6.3, Sodium 128, Creatinine 2.1, BUN 22. VITALS: 98.9 F, BP 130/88, HR 98. Based upon this information what do you think the patient has?
Acute Renal Failure
You are caring for a newborn, who is 6 hrs old - you note the infant appears hungry; during an observed feeding you note the infant has copious salivation, is coughing and gagging, and has developed abdominal distention. What do you think is going on and what is your priority intervention?
Tracheo-esophageal Fistula - Make NPO, elevate HOB
Explain in general WHEN and HOW a child with epilepsy should stop taking anti-epileptic medications.
After 2 years seizure free, use a gradual taper; do not stop during puberty. If reoccurrence, restart meds.
You are admitting a 13 y.o. with sickle cell for an acute crisis. What do treatment do you expect the orders to state?
IVF, PCA, Oxygen
List 2 live vaccines - and answer when are the contraindicated?
When a person is immunocompromised they should not receive a live vaccine, such as MMR, Rotavirus, Varicella, Nasal flu, oral polio, or yellow fever.
Name 2 pharmacologic treatments for Nephrotic Syndrome
Prednisone & furosemide (diuretics)
will also accept albumin infusion
Correct any fluid/electrolyte imbalances; insert NG for decompression and emptying of stomach contents; make NPO.
List four LATE signs of increased ICP in a child.
Bradycardia, decreased motor and sens response, change in pupil size and reactivity, posturing, cheyne-stokes, papilledema, decr LOC
You are working at an outpatient clinic, and a child is presenting with signs of leukemia. A CBC is ordered, what do you expect to see on this differential?
Leukemic Blast cells. Decreased RBC count (Hgb/Hct) and thrombocytopenia. Increased WBC count.
A 12 year old child is presenting with a goiter and exopthalamos. When you get the lab results back what lab value do you expect to be elevated?
FT4 (or Free T3, thyroxine)