CAPSTONE - PEDS QUESTIONS WITH ANSWERS. COMPLETE

1. ADHD
∆ Identify two (2) adverse effects of METHYLPHENIDATE HYDROCHLORIDE (RITALIN) in
the school aged child.
≜ Insomnia
≜ Loss of appetite or anorexia
∆ EPA
≜ Produces CNS and Respiratory stimulation with weak sympathomimetic activity
2. ALBUTEROL
» The nurse is educating an adolescent about the use of ALBUTEROL for asthma. What
information should the nurse include in this teaching?
»  It is used for acute exacerbations, and Prevention of exercised-induced asthma

3. ANTIDIABETIC AGENTS
» Contraindications
 Renal disease or renal dysfunction
 Alcoholism, metabolic acidosis, hepatic disease
 Hypoglycemia
 Cross allergy if pt is allergic to sulfonamide Abx
 Class III or IV heart failure, liver or kidney disease
4. ANTIPYRETIC
∆ What antipyretic drugs can safely be administered to a child who is febrile?
≜ ASPIRIN can be safely administered during febrile stage

5. BREASTFEEDING
» Client Education
 For growth and development the newborn needs 2.25 to 4g/kg of protein per day.
 Mothers are encouraged to breastfeed their newborns for the first 12 months of life.
 Newborns who are formula fed should receive iron fortified newborn formula until 12 months of age.
6. BLOOD TRANSFUSION
» ACUTE HEMOLYTIC REACTION - Expected findings:
 Mild or life-threatening
 Symptoms:
≜ Chills
≜ Fever
≜ Low-back pain
≜ Tachycardia
≜ Flushing
≜ Hypotension
≜ Chest tightening or pain
≜ Tachypnea
≜ Nausea
≜ Anxiety
≜ Hemoglobinuria
7. CLEFT LIP/PALATE REPAIR
» Post-op Interventions
 Change position frequently to facilitate breathing & place on abdomen in immediate post-op period
 Maintain IV fluids until infant able to eat & drink
 Monitor packing for bleeding (usually removed in 2-3 days)
 Avoid placing objects in infant’s mouth in post-op
 Elbow restraints may be needed to used to prevent injuring repair
∆ A nurse is caring for an infant ff a CLEFT LIP AND PALATE REPAIR. Which of the ff actions should the nurse take in the
post-operative period? Administer analgesics - The nurse should keep the infant pain-free to decrease crying and stress
on the repair.
≜ Pacifiers should be avoided during the post-operative period.
≜ Hard toys should be avoided because the infant may bring them to the mouth and damage the incision site.
≜ Avoid placing objects into the infant's mouth following a cleft lip and palate repair.
8. EPIGLOTTITIS
» Expected findings
 Severe sore throat, dysphagia, fever.

, » Nursing Interventions
 O2 therapy, Abx, bronchodilators, IV fluids for dehydration
9. EPILEPTIC MEDICATIONS (Seizure medications)
» Client Education
 Seizure meds should be taken at the same time everyday.
 Teach the child and parents about the adverse effects of the medications
 The dosage of the medication can be increased as the child grows.
10. GER
∆ When feeding a client who has GASTROESOPHAGEAL REFLUX (GER), in which position
should the client be placed in and why?
≜  Position with head elevated at 30 degrees for 1hr after meals to prevent nausea from
occurring.

11. GLOMERULONEPHRITIS – Intervention; Dietary Recommendations
» Monitor I&O
» Monitor daily weights – weigh the child on the same scale with the same amount of clothing daily.
» Encourage adequate nutritional intake
» Possible restriction of sodium and fluids
» Restrict foods high in potassium during periods of oliguria
» Provide small, frequent meals of favorite foods due to a decrease in appetite
» Avoid added salt and salty foods such as chips.
» Manage fluid restrictions as prescribed.
» Fluids can be restricted during periods of edema and HTN
∆ A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take?
Check the child's blood pressure every 4 hours
∆ A nurse is caring for a school-age child who has glomerulonephritis. The child has decreased urinary output, a blood
pressure of 160/78 mmHg, and is receiving hydralazine. Which of the following lunch choices should the nurse
recommend? 3 oz grilled chicken, 1 cup of pear slices, and 120 ml (4oz) of apple juice
12. GROUP-B HEMOLYTIC STREPTOCOCCI (GABHS)
» Manifestation(s):
 Mouth odor/breathing
 Snoring & nasal qualities in voice
 Fever
» Intervention(s):
 Therapeutic procedure of Tonsillectomy
 s/p tonsillectomy
≜ Place in side-side lying position or abdomen
≜ Elevate HOB when child fully awake
≜ Assess for bleeding (i.e. frequent swallowing, clearing throat, restlessness, bright red emesis, tachycardia, pallor)
≜ Monitor for difficulty breathing
≜ Provide ice collar & offer ice chips or sips of water
≜ Clear liquid diet after return of gag reflex and avoid use of red-colored liquids, citrus juice, & milk0based foods
initially
» Discharge teaching
 Teach parents to administer the Abx for the full course of treatment
 Administer IV Abx as prescribed
≜ Penicillin PO to control the acute local manifestation and is administered for at least 10 days; Amoxicillin q1d; IM
penicillin G benzathine is also appropriate; Erythromycin PO for children allergic to penicillin; Administer
antipyretics for fever; Clarithromycin, azithromycin, clindamycin, oral cephalosporins and amoxicillin with clavulanic
acid are also effective.
13. HEAD INJURY, CLOSED-HEAD INJURY
» Clinical Manifestation(s):
 Changes in VS
 Altered mental status
 Increase ICP
 Alteration in pupillary response
 Posturing
 Bradycardia
 Decreased motor & sensory responses