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NSG 207 EXAM III 2025 VERIFIED PEDS QUESTIONS AND ANSWERS GRADED A+, Exams of Nursing

NSG 207 EXAM III 2025 VERIFIED PEDS QUESTIONS AND ANSWERS GRADED A+ When informed consent must be obtained before any invasive procedure The most common cause of intestinal obstruction intussusception Why do children <2 require special evaluation for intracranial regulation they are unable to respond to directions Age range for intussusception 5 months to 3 years how neuro information of infants is obtained through observation of spontaneous and elicited reflex responses

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2024/2025

Available from 03/11/2025

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NSG 207
NSG 207 EXAM III 2025 VERIFIED PEDS
QUESTIONS AND ANSWERS GRADED A+
When informed consent must be obtained
before any invasive procedure
The most common cause of intestinal obstruction
intussusception
Why do children <2 require special evaluation for intracranial regulation
they are unable to respond to directions
Age range for intussusception
5 months to 3 years
how neuro information of infants is obtained
through observation of spontaneous and elicited reflex responses
what informed consent should obtain
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NSG 207 EXAM III 2025 VERIFIED PEDS

QUESTIONS AND ANSWERS GRADED A+

When informed consent must be obtained

before any invasive procedure

The most common cause of intestinal obstruction

intussusception

Why do children <2 require special evaluation for intracranial regulation

they are unable to respond to directions

Age range for intussusception

5 months to 3 years

how neuro information of infants is obtained

through observation of spontaneous and elicited reflex responses

what informed consent should obtain

sufficient information to make an informed health care decision, expected outcome, potential risks, benefits, and alternatives

2 conditions to obtain valid consent

person must be capable of giving consent (age of majority and considered competent). person must receive the information necessary to make an intelligent decision. person must act voluntarily

intussusception

intestinal obstruction. unknown etiology. occurs when a proximal segment of the bowel invaginates into the distal segment. pulls the mesentery with it more common in males than females. potentially life threatening

what the reflexes are replaced by as an infant matures

purposeful movement

how many times consent must be obtained

for each invasive procedure - one universal consent is not sufficient

what intussusception results in

venous and lymphatic obstruction. ischemia. blood and mucous leak into the intestine

classic symptoms of intussusception

currant jelly-like stools

what parents or legal guardians have full responsibility for

the care of their minor children. they are required to give informed consent

clinical manifestations of intisussecption

sudden acute abdominal pain. child screaming and drawing the knees toward the chest. child appearing comfortable during intervals between episodes of pain. vomiting (bilious). lethargy. passage of red, currant jelly-like stools (stool mixed with blood and mucous). tender, distended abdomen. palpable sausage-shaped mass in the upper right quadrant. empty lower right quadrant (Dance sign). eventual fever, prostration, and other signs of peritonitis

anatomy and physiology differences in neurological assessment of children with intracranial abnormalities

head size, cranial bones, fontanels, suture lines

eligibility for giving informed consent for married parents

usually only 1 needs to give consent

therapeutic management of intussusception

radiologist-guided pneumoenema (air enema) with or without water-soluble contrast. ultrasound- guided hydrostatic (saline) enema. surgery if these are unsuccessful

what the neurological assessment consists of

baseline neurologic information, observation, health history, developmental milestones, physical assessment (fontanels for infant), family history

eligibility for giving informed consent for divorced parents

consent needs to come from the parent who has legal custody

advantage of ultrasound-guided hydrostatic (saline) enema

no ionizing radiation is needed

the earliest indicator of IICP

LOC - deterioration or improvement

nursing assessment for intracranial regulation

vital signs, skin, eye, motor function, posturing, reflexes

recurrence of intussusception

what surgery for intussusception involves

manually reducing the invagination. resection of any nonviable intestine

may cause an increase or decrease in temperature

hypothalamic involvement

child maltreatment

a broad term that includes intentional physical abuse or neglect, emotional abuse or neglect, and sexual abuse of children

pre-procedural care management for intussusception

NPO status, routine lab testing (CBC, UA), signed parental consent, pre-anesthetic sedation

what the skin is examined for in pediatrics

signs of trauma

estimated children who were victims of child maltreatment by CPS in 2010

794,

pre-procedural care management of intussusception for the child with signs of electrolyte imbalance, hemorrhage, or peritonitis

replacement IV fluids, blood transfusion, NGT placement and attachment to suction

what the eyes are checked for in intracranial regulation

if the pupils are "fixed and dilated"

specific reflexes to check for intracranial regulation

Moro and Tonic neck

CPS

child protective services

what the nurse is to monitor before intussusception surgery/procedure

all stools

percentage of physical abuse of confirmed child maltreatment cases

17.6%

nephrotic syndrome

a glomerular disease whose clinical state is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia (not fully understood), edema

causes of altered levels of consciousness

trauma, infection, poisoning, VP shunt malfunction, seizures, tumors

clinical manifestations of altered levels of consciousness

restlessness, fussy, pupil changes, irritability, posturing, increased ICP

percentage of psychological maltreatment / emotional abuse of confirmed child maltreatment cases

8.1%

types of nephrotic syndrome

primary, secondary, and congenital

primary types of nephrotic syndrome

idiopathic nephrosis, childhood nephrosis, minimal-change nephrotic syndrome (MCNS)

early signs of increased ICP in infants

tense, bulging fontanel. separated cranial sutures. macewen (cracked-pot) sign. irritability and restlessness. drowsiness. increased sleeping. high-pitched cry. increased fronto-occipital circumference. distended scalp veins. poor feeding. crying when disturbed. setting-sun sign

the most common form of child maltreatment

child neglect

neglect

the failure of a parent/guardian to provide for the child's basic needs and adequate level of care

MCNS

minimal change nephrotic syndrome

the early signs of increased ICP in infants to focus on

irritability and restlessness. high-pitched cry. poor feeding

types of child neglect

physical, emotional

labs (blood sugar, electrolytes, BUN, creatinine, toxicology, ammonia level, CBC, blood cultures), EEG, LP, CT, MRI

emotional neglect

lack of affection, attention, and emotional nurturance. failure to meet the child's needs for affection, attention, and emotional nurturance

congenital form of nephrotic syndrome

inherited as an autosomal recessive disorder

physical abuse

deliberate infliction of physical/bodily injury on a child, usually by the child's caregiver

pathophysiology of nephrotic syndrome

the cause is unknown/not completely understood. thought to be immune-mediated, metabolic, biochemical, physiochemical. a disturbance in the basement membrane of the glomeruli causes increased permeability to proteins, especially albumin, leading to hyperalbuminuria, which reduces serum albumin resulting in hypoalbuminemia, decreasing colloidal osmotic pressure in the capillaries and causing fluid to accumulate as fluid shifts from the plasma to the interstitial space and body cavities (edema and ascites). this leads to a decrease in the vascular fluid volume, leading to hypovolemia, stimulating the release of ADH, aldosterone, and RAS. there will be tubular reabsorption of sodium and water in an attempt to increase the intravascular volume. there will also be an increase in serum lipids, cholesterol, and triglycerides

lumbar puncture

a spinal needle is inserted usually between the 3rd and 4th lumbar vertebrae

universally accepted definition of what constitutes as major and minor physical abuse

does not exist

age for nephrotic syndrome

between 2-7 years old

nursing considerations for intracranial regulation

maintain airway, perform routine care, provide adequate nutrition, provide skin care, perform ROM activities, provide sensory stimulation, provide family support and education

SBS

shaken baby syndrome

common gender with nephrotic syndrome

twice as likely to be male

number of children with shaken baby syndrome / traumatic brain injury in the US

1200-1400/year

percentage of children with shaken baby syndrome / traumatic injury that die

25-30%

what there is not in nephrotic syndrome

hematuria or hypertension

acquired hydrocephalus

infection vs trauma

what happens in shaken baby syndrome / traumatic brain injury

babies have a large head-to-body ratio, weak neck muscles, and a large amount of water in the brain. violent shaking causes the brain to rotate in the skull, resulting in shearing head injury

hallmark of nephrotic syndrome

proteinuria: >3+ on urine dipstick

communicating / non-obstructive hydrocephalus

impaired absorption. congenital malformation vs acquired due to trauma, postinfectious meningitis, intraventricular hemorrhage

prevention of shaken baby syndrome / traumatic brain injury

teach caregivers about crying. techniques on how to cope with inconsolable crying. educate (National Center on Shaken Baby Syndrome, The Period of Purple Crying)

clinical manifestations of nephrotic syndrome

weight gain. facial edema/puffiness of face (especially around the eyes, apparent on arising in the morning, subsides during the day). abdominal swelling/ascites. pleural effusion. labial or scrotal swelling. edema of intestinal mucosa possibly causing diarrhea, anorexia, poor intestinal absorption. ankle or leg swelling. irritability. easily fatigued. lethargic. blood pressure normal or slightly decreased. susceptibility to infection. urine alterations (decreased volume, frothy)

noncommunicating / obstructive hydrocephalus

due to an obstruction: infection, ventricular hemorrhage, tumor, structural deformity

early signs / clinical manifestations of hydrocephalus in infants

increased head circumference, bulging fontanels, irritability or lethargy, dilated scalp veins

medication management for nephrotic syndrome

steroids (first line therapy) give over several weeks - prednisone 2 mg/kg with response seen within 14-21 days. diuretics for severe edema offer temporary relief. 25% albumin for severe edema. antibiotics for infections

general signs / clinical manifestations of hydrocephalus in infants

difficulty swallowing or feeding. cardiopulmonary depression. shrill, high-pitched cry

resists soothing in PURPLE

your baby may not stop crying no matter what you try

nursing care management for nephrotic syndrome

monitoring for fluid retention (strict I&O, daily weight, measurement of abdominal girth). assessment of skin for edema. monitoring vital signs to detect early sign of infection process. monitoring urine for protein (albumin) and specific gravity. monitoring the child for infection and prevention of infection (keep warm and dry, keep away from others who may have an infection). encourage the child to eat as loss of appetite is common; consult dietician; restricted salt diet. support the family and teach the family the signs of relapse

clinical manifestations of hydrocephalus in children

headache. irritability, lethargy. altered level of consciousness. personality changes. alterations in motor development. signs of ICP

what the neurological assessment for hydrocephalus includes

head circumference that is increasing in the growth chart

what to teach parents with nephrotic syndrome

to test the urine of albumin. how to administer medications. general care. avoiding infections. the child should attend school

pain-like face in PURPLE

a crying baby may look like they are in pain, even when they are not

AGN

acute glomerulonephritis

what to do for serial head measurements

mark the location of the tape measure

long lasting in PURPLE

crying can last as much as 5 horus a day or more