Toddlers A nurse bases the plan of care for a 15-month-old toddler with celiac disease on the pathophysiology of the
disorder, which is characterized by an:
Inability to metabolize gluten A parent tells a nurse at the clinic, "Each morning I offer my 24-month-old juice, and all I hear is 'No.' What should I do? I know she needs fluid!" What is the best response by the nurse?Offer the child a choice of two juices.Antibiotic prophylaxis is prescribed for a 2-year-old child with a cardiac malformation who is awaiting corrective surgery. The nurse explains to the child's parents that the antibiotic will prevent: Subacute bacterial endocarditis A nurse is teaching dietary management to the parents of a toddler who is undergoing chelation therapy to treat lead poisoning. What should be included in the discussion of the dietary plan?Ensuring adequate fluid intake A toddler who was physically abused is admitted to the pediatric unit. What behavior does the nurse expect when approaching the child?Exhibiting fear of physical contact initiated by anyone A nurse is observing two 18-month-old children playing side by side in a sandbox. Although they watch each other, neither interacts with the other. What type of play does the nurse identify?Parallel A nurse is caring for a toddler who has undergone bone marrow transplantation. What clinical finding(s) should the nurse anticipate if an infection develops?Fever and lethargy An 18-month-old toddler requires an intramuscular injection. As the nurse enters the room with the medication, the child begins to scream and flail about on the bed. The father is sitting at the child's bedside and gets up to leave. What action should the nurse take to best handle this situation?Ask the father to stay to comfort the child while the injection is being given.How should a nurse respond to parents who are concerned about separation anxiety in their 15-month-old toddler?This is an expected developmental reaction." A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and asks what to do. What is the best response by the nurse?Call the Poison Control Center.What does a nurse identify as the priority short-term goal for a toddler with dehydration caused by diarrhea?Improvement of fluid balance A mother tells her neighbor, a nurse, that her toddler has been found to have parasites (worms) and that the whole family will need to be treated. She asks the nurse what kind of worm it is. What is the most likely type of worm infestation?Pinworm (Enterobius) The mother of a 2-year-old child tells the nurse that she is concerned about her child's vision. What behavior when the child is tired leads the nurse to suspect strabismus?One eye moves inward
A nurse explains to the parents of a toddler why 2-year-old children are at risk for lead poisoning. What major risk factor does the nurse includes in the discussion?They explore the environment by touching and tasting.A nurse is assessing a toddler with plumbism (lead poisoning). Which organ system is of most concern because of the condition's irreversible effects?Nervous A 2-year-old child with previously diagnosed hemophilia is admitted to the pediatric unit for observation after a motor vehicle collision. The toddler has several bruises but no other apparent injuries. What is the nurse's specific concern regarding this child?Undetected injury The mother of a 2-year-old toddler tells the nurse that her child is frequently constipated. The nurse asks the mother how she handles the child's toileting. Which response indicates to the nurse that the mother requires further education?I schedule my child's toileting for before each meal." A toddler with hemophilia A is receiving factor VIII. The mother asks the nurse, "If my son hurts himself, I'll give him 2 children's Advil. Is that right?" How should the nurse respond?Give him Tylenol. Advil may cause bleeding." What is the priority nursing care in the immediate postoperative period for a toddler with a newly applied hip spica cast?Checking the toddler's peripheral circulation A 30-month-old boy who was transferred to a regional hospital has not seen his parents for 2 weeks. He now responds to the staff with friendliness and affection. When his mother visits he turns away from her and ignores her. What should the nurse explain to the mother?Your little boy misses you very much; give him time and he'll reach for you." A nurse is obtaining a health history from the mother of a 15-month-old toddler with celiac disease. The
nurse expects the mother to indicate that her toddler:
Has bulky, foul, frothy stools An unconscious toddler requires intermittent nasogastric feedings. When should the nurse check placement of the tube?Before each feeding The nurse notes that a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure.What is the priority nursing responsibility at this time?Protecting the child from self-injury The mother of a 2-year-old child calls her neighbor, who is a nurse, exclaiming that her child just ate some automatic dishwasher powder. What should the nurse tell the mother to do first?Call the Poison Control Center.After a prolonged period in a regional hospital far from home to which the parents were unable to travel, an 18-month-old toddler becomes depressed, withdrawn, and apathetic. Eventually the toddler begins playing with toys and relating to others, even strangers. When the parents visit, the child ignores them. The parents tell the nurse that their child has forgotten them. The nurse explains that their child's behavior: Signifies typical behavior in toddlers who are separated from their parents for prolonged periods and that their child will need special attention from them The parents of a toddler tell the nurse the family has been living in a very old building. The nurse should carefully assess the child for the irreversible effects of possible lead poisoning by focusing on the: Central nervous system
During a well-child visit the parents tell a nurse, "Our 3-year-old doesn't listen to us when we speak—he ignores us!" An auditory screening reveals that the child has a mild hearing loss. What should the nurse explain to the parents about this degree of hearing loss?Speech therapy in addition to hearing aids may be required.What is the priority nursing responsibility in the care of a young toddler after a circumcision?Watching for bleeding around the penis A 13-month-old child is undergoing lumbar puncture for confirmation of a diagnosis of bacterial meningitis. During the procedure the nurse notes that the spinal fluid is cloudy. What does this finding indicate?Increased white blood cell (WBC) count A child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the best initial action by the nurse?Placing the child on the floor The parents of a 2½-year-old child whose older sibling recently died tell a nurse in the pediatric well-child clinic that their child has started to hit them and refuses to go to bed at night. What is the best explanation the nurse can give for this behavior?This is an appropriate reaction to anxiety within the household.A nurse is reviewing how 18-month-old children with no hearing impairment usually communicate. What form of interaction does the nurse expect?Using at least six words During a nap, a 3-year-old hospitalized child wets the bed. What is the best response by the nurse?Change the child's clothes without discussing the incident.A 2-year-old toddler has hearing loss caused by recurrent otitis media. What treatment does the nurse anticipate that the practitioner will recommend?Myringotomy A nurse is conducting an assessment of a 1-year-old in the well-baby clinic. What activity does the nurse expect the infant to have accomplished?Attempting to climb stairs An 18-month-old child has received all required immunizations. What immunization should the nurse explain to a parent will be one of the vaccines required between 4 and 6 years of age?Inactivated poliovirus What foods should a nurse order for a 30-month-old toddler on a regular diet?Macaroni and cheese and Cheerios A nurse teaches the mother of a 2-year-old child who has celiac disease which foods to avoid. Which foods identified by the mother indicate that she understands the teaching?Macaroni and cheese A child with β-thalassemia (Cooley anemia) is admitted to the ambulatory care unit for a transfusion. What instruction should the nurse include in the plan of care?Protect from infections.What is an important nursing intervention in the care of a hospitalized toddler with cystic fibrosis?Performing postural drainage
A 3-year-old child with chronic lead poisoning who has not responded to succimer (Chemet) therapy must be given multiple injections of edetate calcium disodium (calcium EDTA). How should the nurse prepare the child psychologically for this treatment?Allow the child to play with a syringe, using a doll, before treatment is initiated and after each injection is administered.The parents of a toddler with newly diagnosed cystic fibrosis ask a nurse what causes the problems related to this disorder. What should the nurse consider about the primary pathologic process before responding?Mechanical obstruction of mucus-secreting glands The parent of a 2-year-old child tells a nurse at the clinic, "Whenever I go to the store, my child has a screaming tantrum because he wants a toy or candy on the shelves. How can I deal with this situation?" What is the best response by the nurse?Don't say anything—just let the tantrum play itself out." A nurse is caring for a 3-year-old child with acute laryngotracheobronchitis. The child has severe dyspnea and a temperature of 104.0º F (40.0° C) and is receiving cool mist by way of a facemask. The mother asks
why her child is not receiving warm mist. The nurse explains that cool mist:
Facilitates reduction of mucosal edema A 2½-year-old toddler is admitted with a fever of 103º F (39.4° C), stiffness of the neck, and general malaise. The diagnosis is acute bacterial meningitis. What is the priority nursing intervention for this child?Instituting droplet precautions When is the most appropriate time for the nurse to plan for chest percussion and postural drainage for a toddler with cystic fibrosis?One hour before meals A toddler has frequent temper tantrums. The parents ask a nurse how to limit this acting-out behavior. What should the nurse recommend?Ignore the tantrum whenever possible.A toddler in the pediatric intensive care unit is on a ventilator. One of the nurses asks what should be done when condensation collects in the ventilator tubing. How should the nurse manager respond?Empty the fluid and reconnect the tubing to the ventilator.The parent of a 14-month-old toddler asks the nurse how to proceed with bowel training. What is the best response by the nurse?Start by having the child sit on a potty chair.A 19-month-old boy who has been in the hospital for 2 weeks becomes increasingly withdrawn and mute.What is the most appropriate nursing action?Encouraging the parents to stay with him as much as possible A 20-month-old girl is seen for her well-child checkup. The nurse assesses the child, taking vital signs and measuring height and weight. The nurse then plots the child's growth on the growth chart that the clinic has maintained since the child's birth. What information should be shared with the health care practitioner regarding the findings on the growth chart?The child's weight has dropped from the 25th percentile to the 10th percentile in the last 6 months.A nurse is teaching parents of toddlers about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?Steroids