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

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

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?

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

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. 

Highlight the conditions requiring immediate follow-up in the “follow-up” category.

Assessment:

Weight:15.9 kg

Height: 41 in

Heart rate: 122 beats per minute

Blood pressure: 96/44

Child is anxious, looks thin, and has dry lips and dry mucous membranes. Upon neck palpation the child has several enlarged cervical lymph nodes and has a “sweet odor to her breath, The remainder of the examination is within normal limits.

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

What nursing action is appropriate to take when an infant with a congenital heart defect has increased respiratory rate, is sweating, and is not feeding well?

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

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)

Which intervention should be included in the plan of care for an infant with the nursing diagnosis Fluid Volume Excess related to 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)