Pediatric Gas Exchange Shadow HealthDanny Rivera- Focused Exam: Cough

Pediatric Gas Exchange Shadow HealthDanny Rivera- Focused Exam: Cough 1. Established chief complaint - ANSWER Reports cough 2. Asked about onset of cough - ANSWER Reports cough started 3 days ago 3. Asked about characteristics of cough - ANSWER Reports cough is wet Reports clear sputum with cough 4. The nurse is trying to pick a method to teach a 4-year-old with cystic fibrosis a good way to exercise her lungs. Which would be the developmentally correct strategy to help this client? - ANSWER Teach the client to blow bubbles. Explanation: A helpful exercise for the client would be to blow bubbles, a horn, or a pinwheel. This would help her exercise her lung capacity and is age-appropriate for early childhood. The other exercises are all normal activities for school-aged children. 5. What measure at home could help a child with an upper respiratory infection breathe more easily? - ANSWER Increasing room humidity Explanation: A moist environment helps prevent respiratory secretions from drying and becoming difficult to raise. 6. The nurse is caring for a 3-year-old girl who is cyanotic and breathing rapidly. Which intervention is best to relieve these symptoms? - ANSWER oxygen administration Explanation: Oxygen administration is indicated for the treatment of hypoxemia. Suctioning removes excess secretions from the airway caused by colds or flu. Saline lavage loosens mucus that may be blocking the airway so that it may be suctioned out. Saline gargles are indicated for relieving throat pain as with pharyngitis or tonsillitis. 7. If there is a foreign body in the larynx, how will the client present? - ANSWER with stridor Explanation: A foreign body can be either solid or liquid and it can lodge in the upper or lower airways. If a child has symptoms of cough, wheezing and/or stridor, it is an indication the foreign body is obstructing the upper airway. The child with a foreign body obstruction is anxious, has difficulty talking, and may be drooling. Edema of the airways may have occurred but generalized edema is not present. 8. A pediatric client is having difficulty breathing. Which nursing intervention is appropriate for this client? - ANSWER Provide oxygen as needed to maintain oxygen saturation above 93%. Explanation: The nurse would provide oxygen to increase oxygen saturation as needed for this child. A decrease in oxygen saturation will cause the child to have an increase in the work of breathing. The positioning does not promote an open airway. Having family members leave the room could increase the child's anxiety, which would worsen the respiratory status. Continuing to monitor the child provides no assistance or relief. 9. The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to: - ANSWER be at risk for respiratory distress. Explanation: If the airway becomes completely occluded due to epiglottitis, respiratory distress may lead to respiratory arrest and death. Aseptic meningitis is a complication of infectious mononucleosis, resulting in nuchal rigidity; acute otitis media resulting in ear pain is a complication of influenza; and children with pneumonia are at risk for pneumothorax. 10.A child is at risk for infection related to a respiratory disorder. What would the nurse educate the family on to prevent infection? - ANSWER Correct response: Hygiene, handwashing Explanation: The nurse should evaluate the child's and family's understanding of techniques to prevent infection (handwashing, hygiene, rest, nutrition, and avoiding sick people). The other choices are important in the care of the child but are not the best way to prevent the spread of infection. 11.Asked about activity level - ANSWER Reports typical high activity level Reports activity level low since getting sick Reports still able to run or play Reports focusing in class is difficult 12.Asked about nasal symptoms - ANSWER Reports current runny nose Denies sneezing 13.Followed up on nasal discharge - ANSWER Reports nasal discharge is clear Reports nasal discharge is thin 14.Asked about ear symptoms - ANSWER Denies ear pain Reports history of frequent ear infections Denies ear discharge Denies hearing problems 15.Asked about throat symptoms - ANSWER Reports sore throat Reports a little pain with swallowing 16.Asked about relevant medical history - ANSWER Reports frequent runny noses Reports past frequent coughs Reports past pneumonia Denies asthma diagnosis Reports immunizations as current 17.Asked about allergies - ANSWER Denies seasonal allergies Denies food allergies Denies medication allergies