A pediatric client is admitted to the hospital unconscious. The client has a history of type 1 diabetes, and according to the clients mother, has been to two birthday parties in the last few days and has resisted taking the prescribed insulin. At school the client had two more pieces of birthday cake and some ice cream at a class birthday party. What is the likely reason for this client's unconscious state?

A three-year-old, is admitted to the pediatric medical unit with acute kawasaki disease. What signs and symptoms are you most likely to note as you do your intake assessment?

Samatha, age 4, has a glucose level of 329mg/dl. She is eating the following for lunch: grilled chicken, juice(15g carb), mashed potatoes (30g carb), applesauce (15g carb). Her insulin order is as follows: 

1. Provide insulin coverage for meals at 1 unit novolog/1 carbohydrate exchange (15g carb=1 carb exchange) and,
2. Provide insulin correction for blood glucose level based on scale:

Up to 249mg/dl: no correction

250-299 mg/dl: 0.5 unit novolog 300-349 mg/dl: 1 unit novolog

350-399 mg/dl: 1.5 unit novolog

How much total insulin should Samantha receive?

Phase 1

A 10-week-old is brought to the emergency department with three days of rhinorrhea, congestion, and cough. He is presenting with mild intercostal retractions, congested cough, HR: 178, RR: 65 breaths/min, his capillary refill is >4 seconds, O2 Sat: 92% on RA, T- 99.2 F, wheezing is heard bilaterally, & mother feels the infant needs help breathing. Unable to stay latched to breast. Restless and has head bobbing. Mother at bedside.

Select and highlight the assessment findings that require follow up.

Phase 1

A 10-week-old is brought to the emergency department with three days of rhinorrhea, congestion, and cough. He is presenting with mild intercostal retractions, congested cough, HR: 178, RR: 65 breaths/min, his capillary refill is >4 seconds, O2 Sat: 92% on RA, T- 99.2 F, wheezing is heard bilaterally, & mother feels the infant needs help breathing. Unable to stay latched to breast. Restless and has head bobbing. Mother at bedside.

Medical History

Up to date with vaccine

No known allergies

Born at 39 weeks

American academy of pediatrics states taht breastfeeding should be avoided for children with congenital heart disease because it requires less energy to suck from a bottle than the breast.

Which strategy is appropriate when feeding the infant with congestive heart failure?

Phase 3:

A 10-week-old is brought to the emergency department with three days of rhinorrhea, congestion, and cough. He is presenting with mild intercostal retractions, congested cough, HR: 178, RR: 65 breaths/min, his capillary refill is >4 seconds, O2 Sat: 92% on RA, T- 99.2 F, wheezing is heard bilaterally, & mother feels the infant needs help breathing. Unable to stay latched to breast. Restless and has head bobbing. Mother at bedside.

After implementing the appropriate nursing interventions, the nurse assesses the infant. For each assessment finding listed, place the finding in the appropriate category based on whether the nursing and collaborative intervention was effective (helped to meet expected outcome), ineffective (did not help to meet expected outcomes), or unrelated (not related to the expected outcome)

Phase 2:

A 10-week-old is brought to the emergency department with three days of rhinorrhea, congestion, and cough. He is presenting with mild intercostal retractions, congested cough, HR: 178, RR: 65 breaths/min, his capillary refill is >4 seconds, O2 Sat: 92% on RA, T- 99.2 F, wheezing is heard bilaterally, & mother feels the infant needs help breathing. Unable to stay latched to breast. Restless and has head bobbing. Mother at bedside.

Place each nursing action for the infant’s care during hospitalization into one of the 3 categories: indicated (appropriate or necessary), contraindicated (could be harmful), or non-essential (makes no difference or not necessary)

You are discussing prevention of infective endocarditis with parents of a child with a complex congenital heart defect. A critical teaching point to emphasize includes:

While caring for an 18 month old male with a diagnosis of kawasaki disease, which of the following would be an indication of deterioration?

A 5-year-old child with asthma is ordered albuterol. The nurse know that the primary action of albuterol is to: