ATI Peds Remediation Capstone: Nursing Questions and Answers | Exams Nursing

ATI Peds Remediation Capstone

• A nurse is assessing for strabismus in a pediatric client. Identify three (3) clinical

findings noted with strabismus.

• Abnormal corneal light reflex or cover test

• Misaligned eyes

• Frowning or squinting

• Identify three (3) points to discuss with new mothers who are breastfeeding their

newborn.

• Provides complete diet for infants up to 6 months

• Solids are introduced at 4-6 months

• Weaning can be accomplished when infant shows signs of readiness and are able to

drink from a cup

• What are defined gross motor skills for a 4-year-old client who is a preschooler?

• Skips and hops on one foot

• Throws ball overhead

• Catches ball reliably

• A nurse is preparing to administer the MMR immunization to a client. What are two (2)

contraindications for this vaccine?

• Pregnancy

• Allergy to eggs, gelatin, or neomycin

• Explain how methylphenidate hydrochloride works in children who have Attention

Deficit Hyperactivity Disorder (ADHD).

• It increases dopamine and norepinephrine levels

• It helps pt to focus

• Adverse effects: insomnia, anorexia, nervousness, anemia, hyper/ hypotension

• A nurse is preparing to administer ear drops to a 2-year-old child. How should the

nurse administer this medication?

• Younger than 3 pull pinna down and straight back

• Older than 3 pull pinna up and back

• A child had tympanoplasty tubes placed and the nurse is completing discharge teaching

for the family. List three (3) important points to include in the teaching.

• Limit activities for a few days after surgery

• Notify provider when tubes come out

• Avoid getting water in ear while tubes are in place

• Identify three (3) clinical manifestations of hydrocephalus in an infant.

• High pitched cry, lethargy

• Vomiting

• Bulging fontanels and/ or widening cranial suture lines

• The nurse is caring for a client with suspected bacterial meningitis. What is a priority

action for the nurse to initiate?

• Isolate client in droplet precautions

• Decrease environmental stimuli

• Provide comfort measures

• Seizure precautions

• What is a Patent Ductus Arteriosus? Identify two (2) clinical manifestations of patent

ductus arteriosus (PDA)

• Condition in which the normal fetal circulation conduit between the pulmonary artery

and the aorta fails to close and results in increased pulmonary blood flow (lefttoright

shunt)

• Murmur (machine hum)

• Wide pulse pressure, Bounding pulses

• Name two (2) manifestations of infective endocarditis in children.

• Fever and malaise

• New murmur

• Myalgias and arthralgias

• Headache

• Diaphoresis and weight loss

• A nurse is providing education to an adolescent client with diabetes and his parents

regarding 'Sick Day Rules' while sick. What information should the nurse provide?

• Monitor blood glucose and urinary ketone levels every3 hr

• Continue to take insulin or oral antidiabetic agents. However, dosages can differ

• Encourage sugar-free, noncaffeinated liquids to prevent dehydration

• Meet carbohydrate needs by eating soft foods if possible. If not, consume liquids that

are equal to the usual carbohydrate content

• Rest

• A nurse has been assigned to care for a child with hemophilia who is experiencing

acute hemarthrosis. What are two (2) expected findings for this client? What are two

(2) nursing interventions that can be initiated for this client?

• Episodes of bleeding and excessive bleeding, easy bruising

• Joint pain and stiffness, activity intolerance

• NO IM injections- subq, avoid any skin punctures, venipuncture use heel or finger stick

if possible

• Monitor urine, stool, and nasogastric output for occult blood

• No aspirin

Partial preview of the text

Download ATI Peds Remediation Capstone: Nursing Questions and Answers and more Exams Nursing in PDF only on Docsity!

ATI Peds Remediation Capstone

• A nurse is assessing for strabismus in a pediatric client. Identify three (3) clinical

findings noted with strabismus.

• Abnormal corneal light reflex or cover test

• Misaligned eyes

• Frowning or squinting

• Identify three (3) points to discuss with new mothers who are breastfeeding their

newborn.

• Provides complete diet for infants up to 6 months

• Solids are introduced at 4-6 months

• Weaning can be accomplished when infant shows signs of readiness and are able to

drink from a cup

• What are defined gross motor skills for a 4-year-old client who is a preschooler?

• Skips and hops on one foot

• Throws ball overhead

• Catches ball reliably

• A nurse is preparing to administer the MMR immunization to a client. What are two (2)

contraindications for this vaccine?

• Pregnancy

• Allergy to eggs, gelatin, or neomycin

• Explain how methylphenidate hydrochloride works in children who have Attention

Deficit Hyperactivity Disorder (ADHD).

• It increases dopamine and norepinephrine levels

• It helps pt to focus

• Adverse effects: insomnia, anorexia, nervousness, anemia, hyper/ hypotension

• A nurse is preparing to administer ear drops to a 2-year-old child. How should the

nurse administer this medication?

• Younger than 3 pull pinna down and straight back

• Older than 3 pull pinna up and back

• A child had tympanoplasty tubes placed and the nurse is completing discharge teaching

for the family. List three (3) important points to include in the teaching.

• Limit activities for a few days after surgery

• Notify provider when tubes come out

• Avoid getting water in ear while tubes are in place

• Identify three (3) clinical manifestations of hydrocephalus in an infant.

• High pitched cry, lethargy

• Vomiting

• Bulging fontanels and/ or widening cranial suture lines

• The nurse is caring for a client with suspected bacterial meningitis. What is a priority

action for the nurse to initiate?

• Isolate client in droplet precautions

• Decrease environmental stimuli

• Provide comfort measures

• Seizure precautions

• What is a Patent Ductus Arteriosus? Identify two (2) clinical manifestations of patent

ductus arteriosus (PDA)

• Condition in which the normal fetal circulation conduit between the pulmonary artery

and the aorta fails to close and results in increased pulmonary blood flow (lefttoright

shunt)

• Avoid getting water in ear while tubes are in place

• Identify three (3) clinical manifestations of hydrocephalus in an infant.

• High pitched cry, lethargy

• Vomiting

• Bulging fontanels and/ or widening cranial suture lines

• The nurse is caring for a client with suspected bacterial meningitis. What is a priority

action for the nurse to initiate?

• Isolate client in droplet precautions

• Decrease environmental stimuli

• Provide comfort measures

• Seizure precautions

• What is a Patent Ductus Arteriosus? Identify two (2) clinical manifestations of patent

ductus arteriosus (PDA)

• Condition in which the normal fetal circulation conduit between the pulmonary artery

and the aorta fails to close and results in increased pulmonary blood flow (lefttoright

shunt)

• Murmur (machine hum)

• Wide pulse pressure, Bounding pulses

• Name two (2) manifestations of infective endocarditis in children.

• Fever and malaise

• New murmur

• Myalgias and arthralgias

• Headache

• Diaphoresis and weight loss

• A nurse is providing education to an adolescent client with diabetes and his parents

regarding 'Sick Day Rules' while sick. What information should the nurse provide?

• Monitor blood glucose and urinary ketone levels every3 hr

• Continue to take insulin or oral antidiabetic agents. However, dosages can differ

• Encourage sugar-free, noncaffeinated liquids to prevent dehydration

• Meet carbohydrate needs by eating soft foods if possible. If not, consume liquids that

are equal to the usual carbohydrate content

• Rest

• A nurse has been assigned to care for a child with hemophilia who is experiencing

acute hemarthrosis. What are two (2) expected findings for this client? What are two

(2) nursing interventions that can be initiated for this client?

• Episodes of bleeding and excessive bleeding, easy bruising

• Joint pain and stiffness, activity intolerance

• NO IM injections- subq, avoid any skin punctures, venipuncture use heel or finger stick

if possible

• Monitor urine, stool, and nasogastric output for occult blood

• No aspirin

Helpful mnemonics for Maternal Newborn!! Cleft lip: nursing care plan (postoperative)—"CLEFT LIP" Crying, minimize Logan bow Elbow restraints Feed with Brecht feeder

Grimace Activity Respiratory effort Obstetric (maternity) history—"GTPAL" Gravida Term Preterm Abortions (SAB, TAB) Living children Oral contraceptives: Signs of potential problems—"ACHES" Abdominal pain (possible liver or gallbladder problem) Chest pain or shortness of breath (possible pulmonary embolus) Headache (possible hypertension, brain attack) Eye problems (possible hypertension or vascular accident) Severe leg pain (possible thromboembolic process) Preterm infant: Anticipated problems—"TRIES" Temperature regulation (poor) Resistance to infections (poor) Immature liver Elimination problems (necrotizing enterocolitis [NEC]) Sensory-perceptual functions (retinopathy of prematurity [ROP]) VEAL CHOP –which relates to fetal heart rate. V ariable decels => C ord compression (usually a change in mother’s position helps) E arly decels => H ead compression (decels mirror the contractions; this is not a sign of fetal problems) A ccelerations => O 2 (baby is well oxygenated–this is good) L ate decels => P lacental utero insufficiency (this is bad and means there is decreased perfusion of blood/oxygen/nutrients to the baby). Nine-point Postpartum Assessment...BUBBLEHER

B- Breasts U- Uterus B- Bladder B- Bowel function L- Lochia E- Episiotomy H- Hemorrhoids E- Emotional Status R- Respiratory System Considerations for the pregnant client Admittance of a pregnant client to a medical-surgical unit: You may have a pregnant client admitted with a diagnosis unrelated to her pregnancy and, therefore, she may be admitted to a general medical-surgical floor. A mnemonic to assist you in performing important assessment elements for these clients is FETUS.

F : Document fetal heart tones every shift. To assess fetal heart tones, use a handheld Doppler ultrasound and place it in an area corresponding to uterine height. For example, for a client who's less than 20 weeks' pregnant, the most likely area to find fetal heart tones is at the pubic hairline or the symphysis pubis. For a client whose pregnancy is more advanced, such as at 24 weeks, the fetal heart rate can most probably be heard midline between the symphysis pubis and the umbilicus. As the pregnancy advances in weeks, fetal heart tones can be heard closer to and possibly above the umbilicus.
E : Provide emotional support. Pregnant women who are experiencing unexpected medical conditions are at a high level of anxiety related to how the current medical problem may affect the fetus. You should take extra care to alleviate and reduce your client's anxiety by explaining all medications and treatments. Additionally, be prepared to listen for fetal heart tones anytime the client requests it to further reduce her worry of the fetus' well being.
T : Measure maternal temperature. Because your client's core body temperature is higher than you can detect through oral or tympanic thermometers, be alert to the presence of a fever. A high maternal temperature can lead to fetal tachycardia and distress. An order for antipyretics on admission to ensure their quick availability will be a prudent request you should make to the admitting physician.
U : Ask about uterine activity or contractions. Make it a normal part of your routine to ask about any type of uterine pain, tightening, or discomfort throughout your shift. Be aware that early contractions often present as lower back pain. Don't attribute complaints of lower back pain to the hospital bed. If your client reports any unusual activity, take care to softly palpate the lower abdomen for periods of greater than 2 minutes while conversing with her. Watch for subtle changes of facial expression while simultaneously detecting a change in uterine tone. If contractions are suspected, your client will need to be monitored with continuous fetal monitoring in the labor and delivery unit.

Remember, the hospitalized postpartum client is likely to be very emotional. Not only will she be experiencing the normal hormonal fluctuations of the postpartum period, she'll may also be distraught leaving her newborn at home and feeling that she's missing bonding time with her child. Visitation between the mother and her infant may be very limited to minimize the infant's risk of infection, but visits should be arranged if at all possible. Reference: Reeves, S. (2012). Woman’s health: Putting your nursing. Nursing Made Incredibly Easy, 5/6(2012), 20-25. Placenta Previa versus Placenta Abruptio Category Placenta Previa Abruptio Placenta Problem Low implantation of the placenta Premature separation of the placenta Incidence It occurs in approximately 5 in every 1000 pregnancies It occurs in about 10% of pregnancies and is the most common cause of perinatal death. Risk Factors

Increased parity
Advanced maternal age
Past cesarean births
Past uterine curettage
Multiple gestation
- High parity
- Advanced maternal age
- A short umbilical cord
- Chronic hypertensive disease
- Pregnancy- induced hypertension
- Direct trauma
- Vasoconstriction from cigarette use
- Thrombic conditions that lead to thrombosis such as autoimmune antibodies Bleeding Always present May or may not be present Color of blood in bleeding episodes Bright red Dark red Pain during bleeding Painless Sharp, stabbing pain
Fluid replacement

such as autoimmune antibodies Bleeding Always present May or may not be present Color of blood in bleeding episodes Bright red Dark red Pain during bleeding Painless Sharp, stabbing pain Management

Place the woman immediately on bed rest in a side-lying position.
Weight perineal pads.
NEVER attempt a pelvic or rectal examination because it may initiate massive blood loss. - Fluid replacement - Oxygen by mask - Monitor FHR - Keep the woman in a lateral position - DO NOT perform any vaginal or pelvic examinations or give enema - Pregnancy must be terminated because the fetus cannot obtain adequate oxygen and nutrients. If birth does not seem imminent, cesarean birth is method of choice for delivery. Reference: Antipuesto, D. (2011). Difference between placenta previa and abruption placenta. Retrieved from http://nursingcrib.com/nursing-notes-reviewer/maternal-child- health/difference-between-placenta-previa-and-abruptio-placenta/ More Helpful Pharm Tips! Endocrine Agents Thyroid Hormones (hypothyroidism) Thyroid Hormones are a synthetic form of thyro xine (T4) (see the form of thyroid in this hormone). These hormones increase metabolic rate, body temperature, oxygen use, renal perfusion, blood volume, and growth processes. These medications are prescribed for clients who have low thyroid hormone production (hypothyroidism). In hypothyroidism…everything is LOOOOOWWWWWW(HYPOOOOOOOOO) Common Thyroid Medications: Levo thyro xine (Syn thro id,Levo thro id) Lio thyro nien (Cytomel) Liotrix ( Thyro lar)

somatrem(Protropin) Posterior Pituitary Hormones/Antidiuretic Hormone This medication promotes the reabsorption of water within the kidneys; causes vaso constriction due to the contraction of vascular smooth muscle. Common Posterior Pituitary Hormones/Antidiruetic Hormones: desmopressin (DDAVP, stimate) vaso pressin (Pitressin synthetic) (See the form of vaso in the drug name, for vaso constriction) Anticonvulsants The anticonvulsants are medications used for the treatment of epileptic seizures. These meds suppress the rapid and firing of neurons in the brain that start a seizure. Drugs for all types of seizures, except petit mal: CaPhe like cafe in French CA rbamazepine PHE nytoin/Phenobarbital Drugs for petit mal seizures: ValEt Val proic Acid Et hosuximide Phenytoin: adverse effects P - interactions H irsutism E nlarged gums N ystagmus Y ellow-browning of skin T eratogenicity O steomalacia I nterference with B metabolism (hence anemia) N europathies: vertigo, ataxia, headache All anti-epileptic drugs can be remembered by this mnemonic: Dr.BHAISAB's New PC. D ...Deoxy barbiturates B ...Barbiturates H ....Hydantoin

A …. Aliphatic carb acids I ....Iminostilbenes S ....Succinimides B ....Benzodiazepines (BZD's) N ....Newer drugs P ....Phenyltriazines C ...Cyclic gaba analogues Antiparkinsonian An antiparkinson , or antiparkinsonian medications are used for clients diagnosed with Parkinson’s Disease. These medications increase dopamine activity or reduce acetylcholine activity in the brain. They do not halt the progression of the disease. These medications offer symptomatic relief. Anti-Parkinsonian Drugs include: A Cat Does Like Milk! A nticholinergic Agents C OMT Inhibitors (catechol-O-methyltransferase); An enzyme involved in degrading neurotransmitters. D opamine Agonists L evodopa M AO-B Inhibitors Ophthalmic Ophthalmic medications are drugs used for the eye. These medications are typically prescribed for clients who have Glaucoma, Macular Degeneration. Other ophthalmic medications are used to treat allergic conjunctivitis, inflammatory disorders, dyes to visualize the eye, and to treat infections or viruses. Beta-Adrenergic Blocking Agents Prescribed for clients who have open-angle glaucoma. These agents decrease the production of aqueous humor. Block beta 1and beta 2 receptors. Common Beta-Adrenergic Ophthalmic Blocking Agents: beta xolos ( Bet optic ) (see the form of beta in the drug names?) See optic in Betoptic? Opthalmic medication. levo beta xolol ( Beta xon) (see the form of beta in the drug names?) levobunolol ( Beta gan) (see the form of beta in the drug name?) timolol ( Bet imol) (see the form of beta in the drug name?) Prostaglandin Analogs

Remember BAD POCC for key points or side effects of Opthalmic Medications: B -Blurred vision A -Angle closure glaucoma (medications are used for this kind of glaucoma) D -Dry eyes P -Photophobia O -Ocular pressure (used to treat OP from glaucoma) C -Can Cause systemic effects C -Ciliary muscle constriction

ATI Peds Remediation Capstone: Nursing Questions and Answers, Exams of Nursing

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Download ATI Peds Remediation Capstone: Nursing Questions and Answers and more Exams Nursing in PDF only on Docsity!

ATI Peds Remediation Capstone

• A nurse is assessing for strabismus in a pediatric client. Identify three (3) clinical

findings noted with strabismus.

• Abnormal corneal light reflex or cover test

• Misaligned eyes

• Frowning or squinting

• Identify three (3) points to discuss with new mothers who are breastfeeding their

newborn.

• Provides complete diet for infants up to 6 months

• Solids are introduced at 4-6 months

• Weaning can be accomplished when infant shows signs of readiness and are able to

drink from a cup

• What are defined gross motor skills for a 4-year-old client who is a preschooler?

• Skips and hops on one foot

• Throws ball overhead

• Catches ball reliably

• A nurse is preparing to administer the MMR immunization to a client. What are two (2)

contraindications for this vaccine?

• Pregnancy

• Allergy to eggs, gelatin, or neomycin

• Explain how methylphenidate hydrochloride works in children who have Attention

Deficit Hyperactivity Disorder (ADHD).

• It increases dopamine and norepinephrine levels

• It helps pt to focus

• Adverse effects: insomnia, anorexia, nervousness, anemia, hyper/ hypotension

• A nurse is preparing to administer ear drops to a 2-year-old child. How should the

nurse administer this medication?

• Younger than 3 pull pinna down and straight back

• Older than 3 pull pinna up and back

• A child had tympanoplasty tubes placed and the nurse is completing discharge teaching

for the family. List three (3) important points to include in the teaching.

• Limit activities for a few days after surgery

• Notify provider when tubes come out

• Avoid getting water in ear while tubes are in place

• Identify three (3) clinical manifestations of hydrocephalus in an infant.

• High pitched cry, lethargy

• Vomiting

• Bulging fontanels and/ or widening cranial suture lines

• The nurse is caring for a client with suspected bacterial meningitis. What is a priority

action for the nurse to initiate?

• Isolate client in droplet precautions

• Decrease environmental stimuli

• Provide comfort measures

• Seizure precautions

• What is a Patent Ductus Arteriosus? Identify two (2) clinical manifestations of patent

ductus arteriosus (PDA)

• Condition in which the normal fetal circulation conduit between the pulmonary artery

and the aorta fails to close and results in increased pulmonary blood flow (lefttoright

shunt)

• Avoid getting water in ear while tubes are in place

• Identify three (3) clinical manifestations of hydrocephalus in an infant.

• High pitched cry, lethargy

• Vomiting

• Bulging fontanels and/ or widening cranial suture lines

• The nurse is caring for a client with suspected bacterial meningitis. What is a priority

action for the nurse to initiate?

• Isolate client in droplet precautions

• Decrease environmental stimuli

• Provide comfort measures

• Seizure precautions

• What is a Patent Ductus Arteriosus? Identify two (2) clinical manifestations of patent

ductus arteriosus (PDA)

• Condition in which the normal fetal circulation conduit between the pulmonary artery

and the aorta fails to close and results in increased pulmonary blood flow (lefttoright

shunt)

• Murmur (machine hum)

• Wide pulse pressure, Bounding pulses

• Name two (2) manifestations of infective endocarditis in children.

• Fever and malaise

• New murmur

• Myalgias and arthralgias

• Headache

• Diaphoresis and weight loss

• A nurse is providing education to an adolescent client with diabetes and his parents

regarding 'Sick Day Rules' while sick. What information should the nurse provide?