HESI PEDIATRICS PRACTICE 2019 | HESI PED’S PRACTICE

HESI PED’S PRACTICE • Child received chemotherapy last week and now has a reduced neutrophil count highest priority for this child is  Risk for infection. • Postural drainage for a child w/ Cystic fibrosis is most effective when performed after nebulization and before meals or at least 1 hr. after eating to prevent N/V. • The mother reports taking a lot of aspirin during her pregnancy, her 6 month old should be assessed for Reaction to loud noises --to assess for Ototoxicity which diminishes hearing and tinnitus and vertigo. • Nurse caring for a restrained child after surgery Remove one restraint at a time to and provide ROM exercises. • Order of taking V.S of a 4-month old Respirations, Heart Rate and then rectal temperature. • Closure of VSD’s prevents oxygenated blood from being shunted from LV to RV.  Prevent the return of oxygenated blood to the lungs. • A Child w/ Asthma  expect intercostal retractions during inspiration. (results from effort to draw in air into restricted airways) • CDC MMR vaccine should be given no sooner than 12 months of age, and ideally between 12~15 months of age. • The most definitive measure of improved nutrition in an infant is by obtaining the child’s Daily weight. • Projectile vomiting, which contributes to metabolic acidosis, is a classic sign of Pyloric Stenosis. • Steatorrhea Fatty, foul smelling stools that float on water (common in children w/ Cystic Fibrosis). • 3 week old infant Neonates w/ VSD fatigue quickly during feeding and ingest inadequate amounts. Monitor infant for weight gain, and should have at least 6 wet diapers daily. A one month old—should ingest 2~4 ounces formula per feeding and progress to about 30 ounces per day by 4 months of age. Due to fatigue the infant should rest but be fed at least every 2 hrs to ensure adequate intake. A softer preemie nipple or a nipple w/ larger opening helps to reduce the sucking effort and energy expenditure, allowing the infant to eat more w/ less effort. • Surgery is being delayed in an infant w/ undescended testes A trial of (HCG) Human chorionic gonadotrophic hormone may aid in testicular decent. • The preschooler’s major stressor concern is for his body integrity, he fears that his “insides will leak out.” • School- aged children strive for independence and productivity (Erickson’s Industry vs. Inferiority) and enjoy individual and group activities related to real life situations such as playing follow-the-leader. • Discipline guidelines Parental control should be consistent. (clear, reasonable and consistent) • Children aged 3 to 6yrs are in Erickson’s “Initiative vs. Guilt” stage, characterized by vigorous, intrusive behavior, enterprise and strong imagination. At this age, Children need to retain a sense of initiative without impinging on the rights and privileges of others. • A 4 year old is able to use a happy/sad face pain scale to indicate level of pain. • 5-yr old child w/ Diabetes, nurse should plan to teach first Process of glucose testing. (It can be helpful if it is presented as a game for them.) • Parents of a 3 week old infant report that child eats well but vomits after each feeding Most Important information for the nurse to get Is a Description of vomiting episodes in the past 24 hours. • Hirschsprung’s disease is a mechanical obstruction caused by inadequate motility in part of the intestines. The condition results from failure of the ganglion cells to migrate craniocaudally along the GI track during gestation. The lack of peristalsis in the affected bowel segment causes constipation and small diameter Ribbon like and brown colored stools. • Outcome of learning is best demonstrated when a client not only verbalizes understanding but can also provide return demonstration. • Nystatin (Myacostatin) Antifungal drug effective in treating thrush, an oral fungal infection. • The best approach for a toddler is to ignore the attention seeking behavior.