NR328 Pediatric Nursing
Week4 Clinical
Simulation
Date:
Johnny Parker
1. Identify pediatric populations at risk for poisoning and list 3 agents used for
gastrointestinal decontamination. Describe how nutrition may be affected in a
child who has ingested a poison.
• Pediatric population at risk for poisoning is Infants, Toddlers, Preschoolers,
School-age.
• The agents for gastrointestinal decontamination:
▪ Activated charcoal
▪ Gastric lavage
▪ Induce vomiting
• Acetaminophen toxicity antidote is n-acetylcysteine orally
▪ Child may display lethargy and confusion.
▪ The client may report intolerance to keep food or fluids down, may
include nausea, vomiting, diarrhea, abdominal pain. Initiate NPO to
avoid risk for aspiration risk
2. What psychosocial and developmental interventions should a nurse consider about
home safety when caring for a child who has accidentally ingested toxic substances?
• Safety locks should be placed on cabinets that contain cleaners and other
chemicals
• Medications should be kept in childproof containers, away from the reach of
toddlers
• The phone number for a poison control center should be kept near the phone.
3. What assessment findings, including your ABC head to toe physical
assessment, might the nurse discover on a pediatric patient who has ingested
high levels of acetaminophen?
▪ 2-4 hours after ingestion – pallor, diaphoresis, N/V
▪ 24-36 hrs after – improving condition
▪ 36hr – 1 week (or longer) – confusion/stupor, disturbances
with coagulation, jaundice, RUQ pain
▪ Final stage – gradual recover or fatality
Medication Calculations: The healthcare provider ordered N-acetylcysteine for a pediatric
patient who ingested an excessive amount of acetaminophen.
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https://www.coursehero.com/file/65885321/Wk4-Clinical-Simulation-Questionsdocx/
, 1. The medication is ordered for 100mg/kg over sixteen hours. The patient weighs 33 lb. How
many milligrams will the nurse administer per dose? (If needed, round to the nearest tenth).
33/2.2 = 15kg. 100mg/15kg = 6.7mg
2. This dose will arrive from the pharmacy diluted in 225mL of D5W. This is to infuse
over sixteen hours. Calculate the hourly rate of infusion. 225/16 = 14 mL/hr
3. A provider has ordered D5 0.45 NS w/20 meq KCL/L as maintenance fluid for a patient who
weighs 33lbs. Using the chart below, what is the volume and rate of maintenance fluid
required in 24 hours? 33/2.2 =15kg 1000 + (50mL/15kg )= 1003 total mL every 24 hours
at a rate of 1003/24= 42ml/hr
Body Weight Amount of fluid per day
1 -10 kg 100 mL/kg
11-20 kg 1000 mL + 50mL/kg for each kg > 10 kg
>20 kg 1500 mL +20mL/kg for each kg > 20 kg
Cooper Madison
1) What are the three main phases of a seizure? Differentiate among these phases,
and list clinical assessment findings you might observe when a patient is having a
seizure.
Three Main phases of seizure & Clinical assessment findings:
I. Tonic phase 10-20 seconds
• Eyes roll upward
▪ Loss of consciousness
▪ Tonic contractions of entire body, with arms flexed and legs, head
and neck extended.
▪ Loss of swallowing reflex and increased salivation
▪ Apnea leading to cyanosis
II. Clonic phase typically 30 to 50 seconds; can last 30 min or longer
• Violent jerking movements of the body
• Trunk and extremities experience rhythmic contraction and relaxation
• Gradual slowing of movements until cessation
• Can be incontinent of urine and feces
• Can have foaming in the mouth
This study source was downloaded by 100000839739811 from CourseHero.com on 04-06-2022 02:20:30 GMT -05:00
https://www.coursehero.com/file/65885321/Wk4-Clinical-Simulation-Questionsdocx/
Week4 Clinical
Simulation
Date:
Johnny Parker
1. Identify pediatric populations at risk for poisoning and list 3 agents used for
gastrointestinal decontamination. Describe how nutrition may be affected in a
child who has ingested a poison.
• Pediatric population at risk for poisoning is Infants, Toddlers, Preschoolers,
School-age.
• The agents for gastrointestinal decontamination:
▪ Activated charcoal
▪ Gastric lavage
▪ Induce vomiting
• Acetaminophen toxicity antidote is n-acetylcysteine orally
▪ Child may display lethargy and confusion.
▪ The client may report intolerance to keep food or fluids down, may
include nausea, vomiting, diarrhea, abdominal pain. Initiate NPO to
avoid risk for aspiration risk
2. What psychosocial and developmental interventions should a nurse consider about
home safety when caring for a child who has accidentally ingested toxic substances?
• Safety locks should be placed on cabinets that contain cleaners and other
chemicals
• Medications should be kept in childproof containers, away from the reach of
toddlers
• The phone number for a poison control center should be kept near the phone.
3. What assessment findings, including your ABC head to toe physical
assessment, might the nurse discover on a pediatric patient who has ingested
high levels of acetaminophen?
▪ 2-4 hours after ingestion – pallor, diaphoresis, N/V
▪ 24-36 hrs after – improving condition
▪ 36hr – 1 week (or longer) – confusion/stupor, disturbances
with coagulation, jaundice, RUQ pain
▪ Final stage – gradual recover or fatality
Medication Calculations: The healthcare provider ordered N-acetylcysteine for a pediatric
patient who ingested an excessive amount of acetaminophen.
This study source was downloaded by 100000839739811 from CourseHero.com on 04-06-2022 02:20:30 GMT -05:00
https://www.coursehero.com/file/65885321/Wk4-Clinical-Simulation-Questionsdocx/
, 1. The medication is ordered for 100mg/kg over sixteen hours. The patient weighs 33 lb. How
many milligrams will the nurse administer per dose? (If needed, round to the nearest tenth).
33/2.2 = 15kg. 100mg/15kg = 6.7mg
2. This dose will arrive from the pharmacy diluted in 225mL of D5W. This is to infuse
over sixteen hours. Calculate the hourly rate of infusion. 225/16 = 14 mL/hr
3. A provider has ordered D5 0.45 NS w/20 meq KCL/L as maintenance fluid for a patient who
weighs 33lbs. Using the chart below, what is the volume and rate of maintenance fluid
required in 24 hours? 33/2.2 =15kg 1000 + (50mL/15kg )= 1003 total mL every 24 hours
at a rate of 1003/24= 42ml/hr
Body Weight Amount of fluid per day
1 -10 kg 100 mL/kg
11-20 kg 1000 mL + 50mL/kg for each kg > 10 kg
>20 kg 1500 mL +20mL/kg for each kg > 20 kg
Cooper Madison
1) What are the three main phases of a seizure? Differentiate among these phases,
and list clinical assessment findings you might observe when a patient is having a
seizure.
Three Main phases of seizure & Clinical assessment findings:
I. Tonic phase 10-20 seconds
• Eyes roll upward
▪ Loss of consciousness
▪ Tonic contractions of entire body, with arms flexed and legs, head
and neck extended.
▪ Loss of swallowing reflex and increased salivation
▪ Apnea leading to cyanosis
II. Clonic phase typically 30 to 50 seconds; can last 30 min or longer
• Violent jerking movements of the body
• Trunk and extremities experience rhythmic contraction and relaxation
• Gradual slowing of movements until cessation
• Can be incontinent of urine and feces
• Can have foaming in the mouth
This study source was downloaded by 100000839739811 from CourseHero.com on 04-06-2022 02:20:30 GMT -05:00
https://www.coursehero.com/file/65885321/Wk4-Clinical-Simulation-Questionsdocx/
