ATI Pediatrics Proctored Exam

ATI Pediatrics Proctored Exam hand preference Ans- all kids normally show hand preference by 1 year old plaster casts Ans- -heavy -not water resistant -dry in 10-72 hrs fiberglass casts Ans- -light weight -water resistant -dry in 15-20 min types of traction Ans- Skin traction: -Buck -Bryant -Russell Skeletal traction Halo traction -cervical traction care for traction Ans- -assess pin sites -ensure hardware is tight -ensure bed is in correct position -ensure weights do not touch floor Halo: ensure wrench is readily available surgical intervention for scoliosis Ans- -realign (2 rods on either side of spine) -internal fixation -fusion The child is prescribed lanoxin (Digoxin) 75 mcg PO qd. The pharmacy supplies lanoxin (Digoxin) 0.05mg scored tablets. How many tablets will the nurse administer? Record your answer using one decimal place. Ans- 1.5 tablets The physician orders the patient a 10-mL/kg normal saline bolus to infuse over 2 hours. The child weighs 36 kg. Calculate the infusion rate in mL/hr. Ans- 180 mL/hr What happens to the voice during epiglottitis? Ans- it becomes hoarse Leukotreine modifiers Ans- -Blocks leukotriene receptors or synthesis of leukotrienes (Singulair) -Side effects: headache, nausea, abdominal pain, increase infections if over age 55, depression, suicidal, aggression -Generally well tolerated. -Monitor for improvement in symptoms Cromolyn (Intal) and nedocomil (Tilade) Ans- -Anti-inflammatory agents that inhibit release of histamine, leukotrienes, -Prevention or maintenance drugs -Administered by inhalation, onset of action in 2-4 weeks -Side effects: cough, headache, throat irritation, GI upset Long acting beta-adrenergics Ans- -Salmeterol (Serevent) -used twice daily -Added to anti-inflammatory therapy -Not for acute symptoms due to onset of action in 20 minutes with peak in 3-4 hours Lortab Ans- tylenol with hydrocodone dornase alpha Ans- decreases viscosity of secretions (thins mucous) for CF patients tobramycin Ans- aerosolized antibiotics used for CF Norwood procedure Ans- -Treats hypoplastic left heart -3 stages -done shortly after birth -Right ventricle is converted: connects aorta to right ventricle -Between step 1&2 is highest risk for death -bi-directional Glenn operation (stage 2, under 6 mo. old) -superior vena cava redirected to lungs -Fontan operation (1.5-3 yrs old) -inferior vena cava redirected to lungs Heart transplant is another option Biot's respirations Ans- periods of apnea alternating with 2 or 3 shallow breaths Cheyne-Stokes respirations Ans- periods of apnea alternating with periods of hyperventilation What gauge needle should be used when administering an immunization to a toddler? Ans- 24 gauge sodium normal range Ans- 135-145 Recommended play activities for infant, toddler, preschool, and school age children Ans- Infant: play pat-a-cake Toddler: push-pull toy Preschool: play dress-up School age: create a scrapbook protecting against SIDS Ans- -supine to sleep -empty bed: firm mattress only -breastfeeding -use of pacifier while sleeping manifestations of pneumonia in infants Ans- nasal flaring increased WBCs diarrhea abdominal distention steps to take during a tonic-clonic seizure Ans- **FIRST: assist child to side-lying position on the floor then... -apply O2 mask -clear immediate area -loosen restrictive clothing A nurse is preparing to administer ibuprofen f5 mg/kg q6h PRN for temps above 38 degrees F to an infant who weights 17.6 lb. The infant has a temp of 38.4. Available is ibuprofen liquid 100 mg/5 mL. How many mL should the nurse administer to the infant per dose? Round to nearest whole number. Ans- 2 mL What is an indication of IICP in a child with a concussion? Ans- forceful vomiting What is an expected finding of endocarditis? Ans- headache What is an expected finding in a school-age child with glomerulonephritis? Ans- brown colored urine McBurney's point Ans- -lower right abdomen -pain in appendicitis teaching to parents of child with juvenile idiopathic arthritis Ans- -exercise large joints regularly -encourage child to perform independent self-care -provide a firm mattress for sleeping -discourage daytime naps because stiffness can occur quickly Celiac disease expected findings Ans- -steatorrhea -distended abdomen -weight loss What type of vomiting is common with pyloric stenosis? Ans- projectile vomiting management of tinea pedis Ans- -avoid wearing plastic shoes -wear sandals as much as possible What is used to treat scabies lesions? Ans- permethrin 5% cream For what disease should non-washable items be sealed in a plastic bag for 14 days? Ans- pediculosis manifestation of pertussis Ans- dry hacking cough manifestation of acute streptococcal pharyngitis Ans- inflamed throat with exudate manifestation of bacterial conjunctivitis Ans- purulent eye drainage Koplik spots Ans- rubeola (measles securing an infant's car seat Ans- lower anchors and tethers (the LATCH child safety system) when this is available the seatbelt does not have to be used Where should the car seat harness in rear-facing car seat be positioned? Ans- at or just below the infant's shoulders At what angle should an infant's car seat be placed? Ans- 45 degree angle 1. Who should the FACES pain rating scale be used for? 2. Who should the numeric pain rating scale be used for? 3. Who should the CRIES pain assessment scale be used for? 4. Who should the non communicating children's pain checklist be used for? Ans- 1) 3+ yrs old 2) 5+ yrs old 3) infants 4) pediatric clients with cognitive impairments Diabetes insipidus lab values Ans- -dilute urine/low specific gravity -high sodium -normal blood glucose -polyuria (excessive urine output) minimal change nephrotic syndrome management Ans- -dietary fluid restriction -low sodium diet -corticosteroids How often should a child with asthma get pulmonary function tests? Ans- every 12-24 months lumbar puncture nursing care Ans- -apply topical analgesic to the lumbar site 60 min prior to procedure -place in prone position or flat in bed for up to 12 hours to prevent post procedural spinal headache -encourage to drink extra fluids to replace CSF care for a partial-thickness burn Ans- -wash the affected area with mild soap & water -apply antibiotic ointment to the affected area