Peds Respiratory

Name 3 educational points for parents to prevent SIDS.

The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed? Select all that apply.

• “I will rinse my mouth with water after using the inhaler and then spit out the water.” 

• “I will gargle after using the inhaler and then swallow.”

• “I will clean the plastic inhaler casing weekly by removing the canister and then washing the casing in warm soapy water. I will then let it dry before reassembling.” 

• “I will use this inhaler for asthma attacks.”

• “I will use a peak flow meter to measure my response to therapy.”

A 5-month-old infant with RSV bronchiolitis is in respiratory distress. The baby has copious secretions, increased work of breathing, cyanosis, and a respiratory rate of 78. What is the most appropriate initial nursing intervention?

• Attempt to calm the infant by placing him in his mother’s lap and offering him a bottle.

• Alert the physician or nurse practitioner to the situation and ask for an order for a stat chest x-ray.

• Suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure.

• Bring the emergency equipment to the room and begin bag-valve-mask ventilation.

A 4-year-old child comes in with the parents describing a loss of appetite, the child rolling their head from side-to-side, difficulty sleeping, and tugging of the ears. Which statements indicate a need for further teaching from the parents upon discharge? Select all that apply.

• “We will make sure to administer decongestants as instructed on the bottle”

• “We will have our child wear earplugs while swimming or showering”

• “We will avoid others who are sick with respiratory infections”

• “We should not be applying warm or cold compresses to the ear”

When evaluating a patient’s use of a metered-dose inhaler (MDI), the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time?

• Notify the doctor that the patient is unable to use the MDI. 

• Obtain an order for a peak flow meter.

• Obtain an order for a spacer device.

• Ask the prescriber if the medication can be given orally.

Name the appropriate age groups for the following pain scales: FACES, CRIES, FLACC, Objective, & Numeric.

Which of the following would the nurse not expect to find in an 18-month-old? Select all that apply.

• Standing on tiptoes

• Pedaling a tricycle

• Climbing stairs with assistance

• Carrying a large toy while walking

Which of the following statements are true regarding a post-tonsillectomy pediatric patient? Select all that apply. 

• Child should be in a side-lying or prone position until awake.

• Signs of continuous swallowing should be assessed immediately.

• A patient can have citrus juices if through a straw.

• Ice collars should be avoided due to pressure on the esophagus.

• Turn, cough, and deep breathing exercises should be performed as soon as possible.

The pediatric nurse is planning quiet activities for hospitalized 18-month-olds. Which of the following would be an appropriate activity for this age group?

• Painting by number

• Putting shapes into appropriate holes

• Stacking blocks

• Using crayons to color in a coloring book

• Playing a hand-held video game

The nurse is providing atraumatic care to children in a hospital setting. Which of the following are principles of this philosophy of care? Select all answers that apply.

• Avoid or reduce painful procedures

• Avoid or reduce physical distress

• Minimize parent–child interactions

• Provide child-centered care

• Minimize child control