Autoimmune, heme and infectious disease review

An infant is to receive the diphtheria, tetanus, and acellular pertussis (DTaP) and inactivated polio vaccine (IPV) immunizations. The child is recovering from a cold and is afebrile. The child's sibling has cancer and is receiving chemotherapy. Which action is most appropriate?

• Give the DTaP and withhold the IPV

• Administer the DTaP and IPV

• Postpone both immunizations until the sibling is in remission.

• Withhold both immunizations until the infant is well.

The nurse implements strategies to reduce pain associated with vaccinations. Which intervention should the nurse employ?

• Use a 5/8 inch needle

• Simultaneously administer vaccines at separate sites with a second nurse.

• Aspirate to verify needle placement

• Tell the parent to breastfeed as the vaccines are administered.

A 12-month-old child is seen in the neighborhood clinic for a regular checkup. Which statement by the child's mother about the influenza vaccine reflects the need for more teaching?

• “Yearly influenza vaccinations are recommended to begin as early as 6 months of age.”

• “The Haemophilus influenzae vaccine my child has already received helps protect against some forms of the flu.”

• "My child is too young to receive the live attenuated intranasal vaccine.”

• “The first time a child receives the influenza vaccine, a second dose is recommended in 1 month.”

Nonsteroidal anti-inflammatory drugs are the first choice in treating a child with juvenile idiopathic arthritis. Which adverse effect(s) should the nurse include in the teaching plan for the parents? Select all that apply.

• weight gain

• abdominal pain

• blood in stool

• folic acid deficiency

• reduced blood clotting ability

A client, stung by a bee, is rushed to the emergency room. The client is experiencing hives and redness at the site. Upon arrival, the client states, “I feel a little lump in my throat and I am wheezing, but I'm ok!” The nurse anticipates which emergency treatment next?

• Administer oxygen 4 liters via nasal cannula.

• Administer albuterol 2 puffs stat.

• Administer an injection of epinephrine stat.

• Have the client in high Fowler’s position in the bed.

A 5-year-old child is brought to the emergency department after being stung multiple times on the face by yellow jackets. Which symptom of anaphylaxis requires priority medical intervention?

• 
  

• blood pressure of 95/50 mm Hg

• diffuse facial urticaria

• respiratory rate of 20 breaths/minute

• heart rate less than 60 beats/minute

A 4-year-old, 40-lb (18.1-kg) child is brought to the pediatrician's office. The child has upper respiratory symptoms and has had a fever for 2 days. The health care provider diagnoses a viral illness, and the parent is instructed to treat the child with rest, fluids, and antipyretics. The nurse is reviewing the orders and questions which of the following instructions?

• acetaminophen 181 mg (10 to 15 mg/kg/dose) q4h with intermittent doses of ibuprofen 181 mg (10 mg/kg/dose) q6h for temperature higher than 102.5° F (39.2° C)

• aspirin 294 mg (65 mg/kg/24 hours) q6h with intermittent doses of acetaminophen 217 mg q4h

• acetaminophen 235 mg (10 to 15 mg/kg/dose) q4h for a temperature higher than 101.4° F (39.2° C)

• acetaminophen 253 mg (10 to 15 mg/kg/dose) q4h with intermittent doses of ibuprofen 181 mg (10 mg/kg/dose) q6h for a temperature higher than 102.5° F (39.2° C)