Phase 1

A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. 

Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided.

While assessing the child the nurse recognizes that

______

,

_____

, and

____

are signs of

_____

, a possible diagnosis. The nurse anticipates the provider will order the following tests,

_____

and

_____

to help confirm or rule out the diagnosis

Phase 1

A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. 

Phase 2

The primary care office does not have a glucometer available, so the provider orders a urinalysis dip stick test. The urinalysis shows a glucose of over 500mg/dl with blood, leukocytes, and ketones.  The results are shared with the grandparents along with the potential diagnosis and complications. The child’s grandparents are visibly upset and start asking the nurse questions about their grandchild.

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)

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.

Which nursing actions (interventions) are indicated for infant’s care at this time? (select all that apply)

Children with a history of Respiratory syncytial virus (RSV) infection are at an increase risk of developing asthma later in life.

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.

Choose the most likely options for the information missing from the statements below by choosing from the corresponding list. 

Based on the infant’s assessment data, the nurse determines that the infant’s abnormal vital sign findings are most likely due to

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. What is the nurse’s primary rationale for this action?

Phase 1

A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. 

Phase 2

The primary care office does not have a glucometer available, so the provider orders a urinalysis dip stick test. The urinalysis shows a glucose of over 500mg/dl with blood, leukocytes, and ketones.  The results are shared with the grandparents along with the potential diagnosis and complications. The child’s grandparents are visibly upset and start asking the nurse questions about their grandchild.

Below are several responses the nurse can make to the child’s grandparents. Drag and drop the nurse’s responses to the child’s grandparents to either ‘therapeutic” or “nontherapeutic” based on how you would best categorize the responses.

Which congenital heart disease causes cyanosis when not repaired? (select all that apply)

Aspirin is a part of the treatment for children with Kawasaki disease.

Which type of respiratory condition is always considered an emergency?

The nurse is teaching parents about administering digoxin. What instructions should the nurse tell the parents?