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1. An 18-Month-Old is discharged . 2. The route of roseola transmission is unkown, and
from the hospital after having a the disease is more commonly seen in children 6
febrile seizure secondary to exan- months to 3 years of age, so siblings do not need to
them subitum (Roseola). On dis- be isolated.
charge, the mother asks the nurse
if her 6-year-old twins will get sick.
Which teaching about the trans-
mission of roseola would be most
accurate?
1. The child should be isolated at
home until the vesicles have dried.
2. The child does not need to be
isolated from the older siblings.
3. Administer acetaminophen to
the older siblings to prevent
seizures.
4. Monitor older children for
seizure development.
2. Which would be the priority inter- 2. Varicella (Chickenpox) is highly contagious. Contact
vention for a child suspected of & Droplet respiratory precautions should be started im-
having varicella (chickenpox)? mediately because the primary source of transmission
is secretions of the respiratory tract (droplet) and also
1. Contact Precautions by contaminated objects.
2. Contact and Droplet Respiratory
Precautions?
3. Droplet respiratory precau-
tions?
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4. Universal Precautions and stan-
dard precautions.
3. Caladryl A lotion containing diphenhydramine. Should not be
applied if child has already been given benadryl
(diphenhydramine) because it can cause toxicity.
4. Which s&s would the nurse expect Ankle and knee joint pain.
with rheumatic fever?
1. Ankle and Knee Joint Pain.
2. Negative group A beta strep cul-
ture.
3. Large, red "bulls eye" - appearing
rash.
4. stiff neck with photophobia.
5. The parents of a 12-month old "You are concerned about your child receiving immu-
with HIV are concerned about him nizations. Let me explain why your child will NOT receive
receiving routine immunizations. routine immunizations today"
What will the nurse tell them about
immunizations? The nurse acknowledges a client's fears and then dis-
cusses the concerns to clarify any misconceptions. Im-
munizations and influenza vaccine are recommended
to prevent infection. Immunocompromised HIV-infect-
ed children should not receive MMR and varicella live
vaccines.
6. Nursing Assessment suspects the 1&3
newborn has cystic fibrosis. Which
interventions would the nurse be- Cystic fibrosis is an inherited autsomal trait, causing
gin. exocrien gland dysfunction. 7-10% present meconium
1. Observe frequency and nature ileus, so assessing stool frequency and consistency is
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of stools. important.
2. Provide Chest PT
3. Observe for weight gain. Assessing weight is important in newborns because
4. Assess parent's compliance with they lose up to 10% of their birth weight, and can take
fluid restrictions. 2 weeks for them to regain their birth weight.
5. Assess respiratory system fre-
Assessing the newborn's respiratory system frequently
quently.
would be monitored as frequently as other infants if
the newborn has no respiratory symptoms. Chest PT
would not be initiated in a newborn without a definitive
diagnosis.
7. Can a mother breastfeed their in- Yes. Breast milk has low amounts of phenylalanine, so
fant if they have PKU? the mother can breast as long as the infants phenylala-
nine level is monitored.
8. Vaccines given routinely at 15 Hib & DTaP
months.
9. Which priority intervention for the The newborn should receive both hepatitis B vaccine
newborn of a mother positive for and hepatitis B immune globulin within 12 hours of
hepatitis antigen? birth to prevent hepatitis B infection.
10. signs of intussusception bloody stools or "currant jelly stools", diarrhea, Large
palpable sausage shaped mass in the abdomen, ab-
dominal distention, grunting, dehydration Fever, and
pain (legs pulled towards abdomen)!
11. Flat Ribbon Stools indicate Hirschsprung Disease
12. Treatment for Intussusception Barium or air enema
13. Nursing Care for Intussusception
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Document I & O
Monitor for peritonitis & perforation
Monitor and record stools
14. Biggest complications of Intussus- Peritonitis and Perforation
ception
15. Risk factors for intussusception Cystic Fibrosis
Ages 3 months to 3 years old.
16. Complication of Mal-Rotation & Pain related to rotation of intestines around the mesen-
Valvolus teric artery can cut off circulation, leading to potential
septic intestinal necrosis.
17. Which pediatric GI disorder pre- Mal-Rotation and Valvolus
sents with green bilious vomiting?
18. GI disorders that present with Mal-Rotation/Valvolus & Intussusception.
bloody stools?
19. Obstructive GI disorders where a Mal-Rotation and Valvolus. Symptoms for these dis-
palpated sausage shaped mass is orders are similar but Mal-Rotation requires surgical
felt on the abdomen. intervention.
20. Preoperative care for Mal-Rota- Hydration, IV antibiotics, NG tube.
tion/Valvolus
21. Post-Operative Care for Intussus- Bowel sounds should return in four hours, progressive
ception diet, hydration.
22. Priority nursing diagnosis for in- Acute Pain!
tussusception
23.
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