PEDS Practice: Ch. 29 Nursing Care
During a Pediatric Emergency
A 12-year-old boy has broken his arm and is showing signs and symptoms of shock.
Which action should the nurse take first? - correct answer Establish a suitable IV site.
The goal of treating shock is to restore circulating blood volume. This requires that
vascular access be obtained to administer fluids and vasoactive drugs. Hyperventilation
is reserved for temporary treatment of severe intracranial pressure. Analgesics should
not be administered prior to neurologic and cardiovascular examination being
performed. Chelation therapy is a treatment for metallic poisoning.
The nurse is providing support to the parents of a 10-year-old boy receiving emergency
care. The boy is their foster child. Which comment will be most effective? - correct
answer "Hold your child's hand while this is going on."
The atmosphere during an emergency can be chaotic and overstimulating. Keep the
parents or other family with the child whenever possible. Involve the parents in the
child's care; tell the parents in concrete terms what they can do to support the child
(e.g., hold the child's hand and talk quietly to him or her). Attempt to talk quietly and
soothingly and provide comfort measures. Involving parents in the care helps them to
cope. Tell them in concrete terms what they can do to help. Talking about hypovolemia
may be too technical. When in doubt, simplify. Many professional organizations, such as
the Emergency Nurses Association and the American Heart Association, support giving
parents the option to be present during resuscitation efforts. Any caregiver with a
parental role should remain with the child when possible.
The nurse is preparing an in-service program on pediatric cardiopulmonary
resuscitation. The nurse would include a discussion that cardiopulmonary arrest in
infants and children is most likely the result of: - correct answer respiratory failure.
Cardiopulmonary arrest in infants and children typically results from disorders that lead
to respiratory failure and shock. In adults, the most common causes of cardiopulmonary
arrest are lethal arrhythmias secondary to heart disease. Although neurologic trauma
can lead to respiratory failure, it alone is not the most likely factor.
Assessment of a child reveals a tension pneumothorax. The nurse would prepare the
child for: - correct answer needle thoracotomy.
A needle thoracotomy is indicated for tension pneumothorax to relieve the air collected
in the space. Intubation is indicated for apnea and in situations in which the airway
cannot be maintained. Suctioning would be indicated for excessive airway secretions
that influence airway patency. Defibrillation is used to stimulate or alter the heart's
electrical rhythm.
A young client in the intensive care unit is in a coma after a severe head injury. The
primary nurse is teaching a nursing student how to assess the client's level of
, PEDS Practice: Ch. 29 Nursing Care
During a Pediatric Emergency
consciousness using a coma scale. What type of scale could be used for this purpose?
- correct answer Glasgow scale
The Glasgow Coma Scale is used to grade comas according to level of consciousness.
The Apgar score is assigned immediately after delivery to determine how the infant
tolerated the birth. Wong-Baker FACES and the visual analogue scales are used to rate
pain.
The child's physician requests that the nurse should notify her if the child's urine output
is less than 1 mL/kg of body weight each hour. The child weighs 56 lb (25.46 kg).
Calculate the minimum amount of urine output the child should produce each hour.
Record your answer using a whole number. - correct answer 25
Urine output should be calculated using weight in kilograms. 25.46 kg x 1 mL/kg = 25.46
mL/hour The child must produce 25 mL/hour
When assessing a client in an emergency situation, to guide the assessment the nurse
should be aware that most pediatric cardio-pulmonary arrests stem from what cause? -
correct answer Airway and breathing problems
Most pediatric arrests are related primarily to airway and breathing, and usually only
secondarily to the heart. This information guides the nurse to always assess the airway
first in case of an emergency involving cardiopulmonary arrest.
The nurse is caring for a child brought to the emergency room by the babysitter. The
babysitter reports the child was playing and acting "fine" but started to be "sick and get
worse" all of a sudden after lunch. The babysitter denies any obvious reason or situation
leading to the child's decline. What would the nurse further assess for? - correct answer
Ingestion of a toxin
When an otherwise healthy child suddenly deteriorates without a known cause, the
nurse should suspect a toxic ingestion. A near drowning, cardiac arrhythmia, or
traumatic injury would manifest with specific assessment findings.
The nurse is performing CPR on a child who is a victim of a near-drowning experience.
How should the nurse open the child's airway to provide breaths? - correct answer Jaw-
thrust maneuver
Cervical spine precautions should be used in any child suffering trauma or near
drowning. The proper way to open the airway in a child in this case is the jaw thrust
method. The head tilt-chin lift procedure is used in clients without cervical spine injuries.
The two hands encircling method is the method for performing compressions on an
infant during two-person CPR. There is no such method as the tongue thrust.
During a Pediatric Emergency
A 12-year-old boy has broken his arm and is showing signs and symptoms of shock.
Which action should the nurse take first? - correct answer Establish a suitable IV site.
The goal of treating shock is to restore circulating blood volume. This requires that
vascular access be obtained to administer fluids and vasoactive drugs. Hyperventilation
is reserved for temporary treatment of severe intracranial pressure. Analgesics should
not be administered prior to neurologic and cardiovascular examination being
performed. Chelation therapy is a treatment for metallic poisoning.
The nurse is providing support to the parents of a 10-year-old boy receiving emergency
care. The boy is their foster child. Which comment will be most effective? - correct
answer "Hold your child's hand while this is going on."
The atmosphere during an emergency can be chaotic and overstimulating. Keep the
parents or other family with the child whenever possible. Involve the parents in the
child's care; tell the parents in concrete terms what they can do to support the child
(e.g., hold the child's hand and talk quietly to him or her). Attempt to talk quietly and
soothingly and provide comfort measures. Involving parents in the care helps them to
cope. Tell them in concrete terms what they can do to help. Talking about hypovolemia
may be too technical. When in doubt, simplify. Many professional organizations, such as
the Emergency Nurses Association and the American Heart Association, support giving
parents the option to be present during resuscitation efforts. Any caregiver with a
parental role should remain with the child when possible.
The nurse is preparing an in-service program on pediatric cardiopulmonary
resuscitation. The nurse would include a discussion that cardiopulmonary arrest in
infants and children is most likely the result of: - correct answer respiratory failure.
Cardiopulmonary arrest in infants and children typically results from disorders that lead
to respiratory failure and shock. In adults, the most common causes of cardiopulmonary
arrest are lethal arrhythmias secondary to heart disease. Although neurologic trauma
can lead to respiratory failure, it alone is not the most likely factor.
Assessment of a child reveals a tension pneumothorax. The nurse would prepare the
child for: - correct answer needle thoracotomy.
A needle thoracotomy is indicated for tension pneumothorax to relieve the air collected
in the space. Intubation is indicated for apnea and in situations in which the airway
cannot be maintained. Suctioning would be indicated for excessive airway secretions
that influence airway patency. Defibrillation is used to stimulate or alter the heart's
electrical rhythm.
A young client in the intensive care unit is in a coma after a severe head injury. The
primary nurse is teaching a nursing student how to assess the client's level of
, PEDS Practice: Ch. 29 Nursing Care
During a Pediatric Emergency
consciousness using a coma scale. What type of scale could be used for this purpose?
- correct answer Glasgow scale
The Glasgow Coma Scale is used to grade comas according to level of consciousness.
The Apgar score is assigned immediately after delivery to determine how the infant
tolerated the birth. Wong-Baker FACES and the visual analogue scales are used to rate
pain.
The child's physician requests that the nurse should notify her if the child's urine output
is less than 1 mL/kg of body weight each hour. The child weighs 56 lb (25.46 kg).
Calculate the minimum amount of urine output the child should produce each hour.
Record your answer using a whole number. - correct answer 25
Urine output should be calculated using weight in kilograms. 25.46 kg x 1 mL/kg = 25.46
mL/hour The child must produce 25 mL/hour
When assessing a client in an emergency situation, to guide the assessment the nurse
should be aware that most pediatric cardio-pulmonary arrests stem from what cause? -
correct answer Airway and breathing problems
Most pediatric arrests are related primarily to airway and breathing, and usually only
secondarily to the heart. This information guides the nurse to always assess the airway
first in case of an emergency involving cardiopulmonary arrest.
The nurse is caring for a child brought to the emergency room by the babysitter. The
babysitter reports the child was playing and acting "fine" but started to be "sick and get
worse" all of a sudden after lunch. The babysitter denies any obvious reason or situation
leading to the child's decline. What would the nurse further assess for? - correct answer
Ingestion of a toxin
When an otherwise healthy child suddenly deteriorates without a known cause, the
nurse should suspect a toxic ingestion. A near drowning, cardiac arrhythmia, or
traumatic injury would manifest with specific assessment findings.
The nurse is performing CPR on a child who is a victim of a near-drowning experience.
How should the nurse open the child's airway to provide breaths? - correct answer Jaw-
thrust maneuver
Cervical spine precautions should be used in any child suffering trauma or near
drowning. The proper way to open the airway in a child in this case is the jaw thrust
method. The head tilt-chin lift procedure is used in clients without cervical spine injuries.
The two hands encircling method is the method for performing compressions on an
infant during two-person CPR. There is no such method as the tongue thrust.
