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CAPSTONE - PEDS QUESTIONS WITH ANSWERS. COMPLETE.1. ADHD ∆ Identify two (2) adverse effects of METHYLPHENIDATE HYDROCHLORIDE ( RITALIN ) in the school aged child. ≜ Insomnia ≜ Loss of appeti... te or anorexia ∆ EPA ≜ Produces CNS and Respiratory stimulation with weak sympathomimetic activity 2. ALBUTEROL » The nurse is educating an adolescent about the use of ALBUTEROL for asthma. What information should the nurse include in this teaching? »  It is used for acute exacerbations, and Prevention of exercised-induced asthma 3. ANTIDIABETIC AGENTS » Contraindications  Renal disease or renal dysfunction  Alcoholism, metabolic acidosis, hepatic disease  Hypoglycemia  Cross allergy if pt is allergic to sulfonamide Abx  Class III or IV heart failure, liver or kidney disease 4. ANTIPYRETIC ∆ What antipyretic drugs can safely be administered to a child who is febrile? ≜ ASPIRIN can be safely administered during febrile stage 5. BREASTFEEDING » Client Education  For growth and development the newborn needs 2.25 to 4g/kg of protein per day.  Mothers are encouraged to breastfeed their newborns for the first 12 months of life.  Newborns who are formula fed should receive iron fortified newborn formula until 12 months of age. 6. BLOOD TRANSFUSION » ACUTE HEMOLYTIC REACTION - Expected findings:  Mild or life-threatening  Symptoms: ≜ Chills ≜ Fever ≜ Low-back pain ≜ Tachycardia ≜ Flushing ≜ Hypotension ≜ Chest tightening or pain ≜ Tachypnea ≜ Nausea ≜ Anxiety ≜ Hemoglobinuria 7. CLEFT LIP/PALATE REPAIR » Post-op Interventions  Change position frequently to facilitate breathing & place on abdomen in immediate post-op period  Maintain IV fluids until infant able to eat & drink  Monitor packing for bleeding (usually removed in 2-3 days)  Avoid placing objects in infant’s mouth in post-op  Elbow restraints may be needed to used to prevent injuring repair ∆ A nurse is caring for an infant ff a CLEFT LIP AND PALATE REPAIR. Which of the ff actions should the nurse take in the post-operative period? Administer analgesics - The nurse should keep the infant pain-free to decrease crying and stress on the repair. ≜ Pacifiers should be avoided during the post-operative period. ≜ Hard toys should be avoided because the infant may bring them to the mouth and damage the incision site. ≜ Avoid placing objects into the infant's mouth following a cleft lip and palate repair. 8. EPIGLOTTITIS » Expected findings  Severe sore throat, dysphagia, fever. » Nursing Interventions  O2 therapy, Abx, bronchodilators, IV fluids for dehydration 9. EPILEPTIC MEDICATIONS (Seizure medications) » Client Education  Seizure meds should be taken at the same time everyday.  Teach the child and parents about the adverse effects of the medications  The dosage of the medication can be increased as the child grows. 10. GER ∆ When feeding a client who has GASTROESOPHAGEAL REFLUX (GER), in which position should the client be placed in and why? ≜  Position with head elevated at 30 degrees for 1hr after meals to prevent nausea from occurring. 11. GLOMERULONEPHRITIS – Intervention; Dietary Recommendations » Monitor I&O » Monitor daily weights – weigh the child on the same scale with the same amount of clothing daily. » Encourage adequate nutritional intake » Possible restriction of sodium and fluids » Restrict foods high in potassium during periods of oliguria » Provide small, frequent meals of favorite foods due to a decrease in appetite » Avoid added salt and salty foods such as chips. » Manage fluid restrictions as prescribed. » Fluids can be restricted during periods of edema and HTN ∆ A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take? Check the child's blood pressure every 4 hours ∆ A nurse is caring for a school-age child who has glomerulonephritis. The child has decreased urinary output, a blood pressure of 160/78 mmHg, and is receiving hydralazine. Which of the following lunch choices should the nurse recommend? 3 oz grilled chicken, 1 cup of pear slices, and 120 ml (4oz) of apple juice 12. GROUP-B HEMOLYTIC STREPTOCOCCI (GABHS) » Manifestation(s):  Mouth odor/breathing  Snoring & nasal qualities in voice  Fever » Intervention(s):  Therapeutic procedure of Tonsillectomy  s/p tonsillectomy ≜ Place in side-side lying position or abdomen ≜ Elevate HOB when child fully awake ≜ Assess for bleeding (i.e. frequent swallowing, clearing throat, restlessness, bright red emesis, tachycardia, pallor) ≜ Monitor for difficulty breathing ≜ Provide ice collar & offer ice chips or sips of water ≜ Clear liquid diet after return of gag reflex and avoid use of red-colored liquids, citrus juice, & milk0based foods initially » Discharge teaching  Teach parents to administer the Abx for the full course of treatment  Administer IV Abx as prescribed ≜ Penicillin PO to control the acute local manifestation and is administered for at least 10 days; Amoxicillin q1d; IM penicillin G benzathine is also appropriate; Erythromycin PO for children allergic to penicillin; Administer antipyretics for fever; Clarithromycin, azithromycin, clindamycin, oral cephalosporins and amoxicillin with clavulanic acid are also effective. 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