CAPSTONE - PEDS PREASSESSMENT, QUESTIONS AND ANSWERS. LATEST

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CAPSTONE - PEDS PREASSESSMENT, QUESTIONS AND ANSWERS. LATEST.A nurse is reviewing the history and physicality of an adolescent client who has conduct disorder. Which of the following is an expected fi... nding? Suspended from school several times in the past year - Conduct disorder is an impulse-control disorder which includes a long-term pattern of violating the rights of others and performing violent or hostile acts. ◦ Death of client's father two months ago Risk factors for conduct disorder include harsh discipline with inconsistent parenting or growing up in an institutional environment. Death of the client's father two months ago could trigger a stress/trauma disorder, such as acute stress disorder, but does not put the client at risk for conduct disorder. ◦ Experiences frequent facial tics A client who has Tourette's disorder often experiences facial and verbal tics and other motor difficulties. ◦ Adheres strictly to routines A client who has autism spectrum disorder experiences difficulty with communication and interaction with others, might also become fixated with certain objects, and adheres strictly to routines. A nurse is planning care for a 6yo child who has bacterial meningitis. Which of the following interventions is UNNECESSARY in the client PoC? Measure head circumference every shift. - The head circumference of a 6-year-old can't increase since the fontanels and sutures have been closed since the child was 18 months old. Therefore, it is unnecessary to measure the child's head circumference. ◦ Place the client in a semi-Fowler's position. A semi-Fowler's position, with the head of bed elevated to between 30° and 45°, will help to reduce edema in the brain. ◦ Admit the client to a private room. Isolation for the first 24 hr is indicated for a client who has bacterial meningitis due to the highly contagious nature of some types of bacterial meningitis. Decreasing the environmental stimuli is also an important action in the care of a client who has meningitis. ◦ Implement seizure precautions. Seizure precautions are appropriate because the child has an increased risk for seizure activity. The meningitis itself and corresponding brain edema and meningeal irritation can result in seizure activity. Meningitis typically causes a very high fever, which increases the risk of febrile seizure. A nurse is teaching the parents of a child who has ADHD about methylphenidate. Which of the following statements should the nurse include in the teaching? "Restrict your child's intake of caffeine while she is taking this medication." - The nurse should instruct the parents that the child should avoid caffeine while taking methylphenidate as it increases the stimulating effects of the medication. Caffeine can also lead to irritability in the child. ◦ "Administer the medication at bedtime." The nurse should instruct the parents to administer methylphenidate no later than 1600. Early morning dosing is often recommended to enhance the child's ability to focus during school hours. Administration late in the day can cause the child to experience insomnia. ◦ "Your child might gain weight while taking this medication." The nurse should instruct the parents that their child might lose weight while taking methylphenidate. This medication is a stimulant and increases metabolism while suppressing the appetite. ◦ "This medication might increase the amount of saliva your child produces." The nurse should inform the parents that dry mouth is a common adverse effect of methylphenidate. Other common adverse effects include restlessness, insomnia, weight loss, and tachycardia. A nurse is caring for a 6mo client who has sudden abdominal pain, vomiting, distended abdomen and red current jelly-like stools. The nurse should know that these are signs for which of the following. Manifestations of appendicitis include: Abdominal pain; generalized pain that typically begins at the peri-umbilical area and localizes to the right lower quadrant (pain may be most intense at McBurney’s point, located about halfway between the anterior superior iliac crest and the umbilicus.); pain that increases with movement; rigid abdomen; Fever, tachycardia, possible vomiting, constipation and/or diarrhea, anorexia, pallor, lethargy, and/or irritability ◦ Hernia The manifestations presented indicate intussusception not a hernia. Intussusception Intussusception is the telescoping of the intestine over itself. This usually occurs in infants and young children up to 5 years of age, but it is most common between 5 and 9 months of age. Manifestations include: • Normal comfort interrupted by periods of sudden and acute pain • Palpable, sausage-shaped mass in the right upper quadrant of the abdomen and/or a tender, distended abdomen • Stools that are mixed with blood and mucus that resemble the consistency of red currant jelly Pyloric stenosis Manifestations of pyloric stenosis include: ◦ Vomiting that often occurs 30 to 60 min after a meal and becomes projectile as obstruction worsens ◦ Constant hunger ◦ Olive-shaped mass in the right upper quadrant of the abdomen and possible peristaltic wave that moves from left to right when lying supine [Show More]

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