Unit 4 exam test grid

Question 1

behavior from an adolescent newly diagnosed w/ illness

Answer 1

• not always compliant w/ treatment plan because their peers don’t have to deal with this

Question 2

child abuse

Answer 2

• some young girl get UTIs but constant recurrent ones can be a sign of sexual abuse.

Question 3

illness w/ chronic limitations

Answer 3

not curable, can be maintained but may worsen.
- physical dependence/lack of autonomy and independence
- living with it being nonreversible
- as children grow, how it affects them psychosocially.
- CP , not treatable, first concern/first pt to be seen

Question 4

therapeutic nursing interventions

Answer 4

• keeping them calm
• not overwhelming them with too many things at once when they are already overwhelmed
• guided imagery
• explaining what you’re doing first, child play
• if they have child life specialists, using them

Question 5

Broselow tape

Answer 5

• any pediatric pt that is experiencing a life threatening emergency
• for when there isn’t enough time to calculate weight for weight based meds
• stretch kid out and measure them, however long they are is where they will fall under the color coded tape which can help get them life saving medications administered as soon as possible.
• child is “pink” on tape, go to pink drawer on crash cart and that will give meds for that weight estimate.

Question 6

communication w/ provider

Answer 6

preferred for doctor to put in own orders or face to face. remember to repeat back orders to provider for verbal confirmation to reduce chance of medication errors.
- give pertinent information, give allergies and current meds w/ vital signs, are vital signs abnomal

Question 7

developmental appropriateness

Answer 7

can be based on a variety of things including age, English, education, etc. If they are a small child, getting to their level but keeping it simple. Using medical terms as they get older and explaining simple.

Question 8

emotional response

Answer 8

Regression can be normal for younger children, such as a child that learned how to be potty trained suddenly starts having accidents
- separation anxiety does occur especially with babies up until about 2-3 years old, it’s normal for them to cry especially in an unknown and scary situation.

Question 9

fracture associated w/ child abuse

Answer 9

spiral —> shows twisting motion, not natural, indicates abuse

Question 10

untreated pain in the hospitalized child

Answer 10

• grimacing
• guarding
• increased bp and pulse
• crying, holding their breath —> 02 lower with less quality air exchange
• distrusting

Question 11

insulin administration

Answer 11

if you have to teach a child, allow them to do it on a doll or pretend to do it on yourself

Question 12

medical play

Answer 12

let them practice on a doll, show them a video, let them play with crutches, etc.

Question 13

minimizing stress for the pediatric patient

Answer 13

• talking to them developmentally and age appropriate
• after about age 10 you can be honest if developmentally appropriate
• if they don’t understand, show them pictures
• therapeutic communication, medical play, incorporate family such as watching mom give the medicine
• reassure parent guilt if they have to leave their child
• keeping it as homelike as possible and similar schedule, such as bedtime, sleeping with stuffed animal

Question 14

Munchausen’s syndrome

Answer 14

someone is making themselves sick, mental condition
- unnecessary tests, labs, procedures with no evidence to support complaints
- when parents step away, child may not have noticeable symptoms or seem fine

Question 15

Munchausen’s syndrome by proxy

Answer 15

parents make their children sick, mental condition for hero complex
- child could died
- abuse; needs to be reported

Question 16

negative effects of hospitalization for an infant

Answer 16

they may become preoccupied with death, won’t want to fall asleep, scared/anxious, separation anxiety if their parents have to leave
- give them a tour of the unit, introduce them to staff

Question 17

newborn airway clearance

Answer 17

bulb syringe, suction
appropriate size ambu bag that goes over their nose and face
- make sure everything is out of reach from curious children

Question 18

overwhelming caregiver burden

Answer 18

getting respite involved, seeing if others can help if they cannot take care of the child anymore, child could be in danger if not already of neglect or abuse, even if not “intentional”

Question 19

pediatric pt experiencing shock

Answer 19

child needs to be intubated, IV access with fluids infusing, get ready to use color coded resuscitation tape
- children can crash quickly and hard

Question 20

physiological integrity

Answer 20

keeping a similar setting to their home and keeping things as “normal” fr them as possible in a new and unknown setting that can be anxiety producing

Question 21

child regression

Question 22

shift safety checks

Answer 22

• medical equipment out of reach for children if unsafe
• right equipment for right patient
• beds locked in lower position with appropriate rails up

Question 23

the perception of death and dying

Question 24

therapeutic intervention with a toddler

Question 25

therapeutic relationship w/ the family

Question 26

unintentional abuse or injury

Answer 26

- if a child accidentally leaves a bruise or mark on their child; harming a child without intent to harm - may still be a cps check - can be simple mistakes like not putting cabinet locks when toddler starts exploring and they drink a cleaning product

Question 27

unresponsive child

Answer 27

check if they're breathing and for responsiveness in case they are playing, self soothing, upset, etc - if not breathing, then alert people set up code alerting staff