McGuinness Peds tutoring Week 9

A nurse is teaching an adolescent to self-admin a corticosteroid medication using a metered-dose inhaler (MDI). Which of the following instructions should the nurse include? SATA

• shake the device prior to use

• rinse & expectorate after admin

• inhale slowly w med admin

• exhale quickly after med admin

• wait 30s between puffs

Answer explanation

MDIs require shaking for 3-4s prior to use to aerosolize the med

corticosteroids can cause an oral fungal infection, so they need to rinse and expectorate following med admin

the pt should breathe in slowly (about 3-5s) after admin med to lung

A nurse caring for a child who is receiving O2 therapy & is on a continuous O2 saturation monitor that is reading 89%. Which of the following actions should the nurse take first?

• increase O2 flow rate

• encourage child to take deep breaths

• ensure proper placement of the sensor probe

• place the child in Fowler's position

Answer explanation

1st action is to assess

This is also the least invasive

A nurse in the ED is assessing a newly-admitted infant. Which of the following findings is an early indication of hypoxemia?

• nonproductive cough

• hypoventilation

• tachypnea

• nasal stuffiness

Answer explanation

tachypnea is an early indication of hypoxemia

(remember the body is compensating)

A nurse is assessing a pt who has asthma. Which of the following are indications of deterioration in the child's resp status? SATA

• O2 sat 95%

• Wheezing

• Retraction of sternal muscles

• Warm extremities

• Nasal flaring

Answer explanation

Bronchoconstriction causes wheezing, which is an indicator of deterioration

Increased work of breathing causes retraction of the sternal muscles, which is an indicator of deterioration

Increased work of breathing causes nasal flaring which is an indicator of deterioration in a child's resp status

A nurse is teaching an adolescent about the appropriate use of his asthma meds. Which of the following meds should the nurse instruct the pt to use PRN before exercise?

• fluticasone/salmeterol

• montelukast

• prednisone

• albuterol

Answer explanation

Albuterol is a beta 2 agonist used for bronchodilation. Instruct the adolescent the med is quick-acting, should be admin prior to exercise, and is used to provide immediate relief of bronchoconstriction

A nurse is teaching a child who has asthma how to use a peak flow meter. Which of the following information should the nurse include in the teaching? SATA

• zero the meter before each use

• record the average of attempts

• perform 3 attempts

• deliver a slow, long breath into the meter

• sit in a chair w feet on the floor

Answer explanation

Zero the monitor for accurate results

3 attempts to achieve accurate results

A child w croup is administered a nebulizer racemic epinephrine tx. What is the primary reason for this tx?

• to reduce fever

• to decrease airway inflammation

• to relieve stridor

• to prevent secondary bacterial infection

Answer explanation

neb racemic episode is used to reduce airway swelling and relieve stridor in children w croup, providing rapid improvement in breathing

A nurse is caring for a child who had T1DM. Which of the following are s/s of DKA? SATA

• blood glucose of 58 mg/dL

• weight gain

• dehydration

• mental confusion

• fruity breath

Answer explanation

children w DKA experience osmotic diuresis d/t electrolyte shift (polyuria)

mental confusion d/t electrolyte shift

fruity breath d/t the body trying to compensate to eliminate ketones

A nurse is teaching a school-aged child who has DM about insulin administration. Which of the following should the nurse include in the teaching?

• "you should inject the needle at a 30 degree angle"

• "you should combine your glargine and regular insulin in the same syringe"

• "you should aspirate for blood before injecting insulin"

• "you should give 4-6 injections in one area before switching sites"

Answer explanation

4-6 injections about 1 inch apart before switching to another site

A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following home care instructions should the nurse include in the teaching? SATA

• provide extra time for completion of ADLs

• use cold compresses for joint pain

• take ibuprofen on an empty stomach

• remain home during periods of exacerbation

• perform ROM exercises

Answer explanation

providing extra time for the completion of ADLs promotes independence in the pt & provides a means to maintain mobility

ROM will assist in maintaining function of the joints