ATI_RN Pediatric Nursing 2023 at at Baton Rouge Community College

A nurse is preparing to administer ampicillin 50 mg/kg/day divided equally every 6 hr to a child who weighs 30 kg (66 lb). Available is ampicillin oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest whole number.)

A nurse is caring for an infant who has heart failure and is receiving digoxin. Which of the following findings indicates a positive response to the medication?

A nurse is providing discharge teaching to the parent of a 5-year-old child who has sickle cell anemia and was admitted for a vaso-occlusive crisis. Which of the following instructions should the nurse include in the teaching?

A nurse is caring for a 5-year-old child who has nephrotic syndrome. Which of the following findings should indicate to the nurse that treatment has been effective?

A nurse is caring for an adolescent who has acute glomerulonephritis. Which of the following actions should the nurse take?

A nurse is performing an assessment for a 5-year-old child who has celiac disease. Which of the following findings should the nurse expect?

A nurse is caring for a child who is postoperative following surgical correction of tetralogy of Fallot. Which of the following findings should the nurse identify as an indication of heart failure?

A nurse is admitting an 8-year-old child to the pediatric unit.

Nurses' Notes

Day 1, 1020:

Child is a direct admit from a pediatric clinic and is accompanied by their guardian. Guardian reports that child has been sick for about 2 days with fever and chills and appears to be more irritable. Approximately 2 weeks ago, guardian reports that their child had an upper respiratory infection that was managed with over-the-counter medications. Guardian also reports that child has no prior medical conditions and has received all recommended scheduled immunizations.

1030:

Child reports nausea and headache and rates the pain as 7 on a scale of 0 to 10. Lethargic and responsive to verbal stimuli. Agitation and irritability noted. Nuchal rigidity noted. Pupils equal, round, and reactive to light. Mucous membranes pink dry, and sticky. Cervical lymph slightly enlarged. Respirations irregular. No accessory muscle use noted. Breath sounds clear anterior posterior bilaterally. Heart rhythm regular without murmurs. Radial and pedal pulses 1+ bilateral. Capillary refill seconds. Abdomen flat and non-distended. Bowel sounds ac in all 4 quadrants. Extremities are warm and dry to touch

Flow Sheet

Day 1, 1030:

Temperature 38.7° C (101.7° F)

Heart rate 114/min

Respiratory rate 26/min

Blood pressure 114/80 mm Hg

SpO2 97% on room air

Height 122 cm (48 in)

Weight 29 kg (64 lb)

Diagnostic Results

Day 1, 1040:

Potassium 3.8 mEq/L (3.4 to 4.7 mEq/L)

Hemoglobin 9.5 g/dL (10 to 15.5 g/dL)

Hematocrit 30% (32% to 44%)

RBC count 4.2 x 106/pL (4.0 to 5.5 x 106/pL)

WBC count 14,000 mm3 (5,000 to 10,000 mm3)

Platelets 350,000/mm3 (150,000 to 400,000/mm3)

Glucose 90 mg/dL (< 200 mg/dL)

Blood cultures pending

Provider Prescriptions

Day 1, 1020:

Admit directly to pediatric unit.

Keep child NPO.

Obtain comprehensive metabolic panel and blood cultures

STAT.

Vital signs every 30 min, then every hr x 4, then every 4 hr.

A nurse is reviewing the child's electronic medical record (EMR). Which of the following findings should the nurse identify as requiring immediate follow-up?

Select the 5 findings that require immediate follow-up.

A nurse is caring for a 6-week-old infant.

History and Physical

Infant was full-term at birth. Birth weight was 3.5 kg (7.7 lb). Infant is not gaining weight as expected. One week ago at outpatient visit, weight was 3.6 kg (7.9 lb). Parent reports for past 2 days infant is breathing faster during feedings and does not finish feedings. Parent also reports

decreased appetite and puffiness around the infant's eyes. Parent states that the last wet diaper was about 10 hr ago. Infant admitted for diagnostic evaluation, failure to thrive, and

nutritional/fluid support.

Vital Signs

Admission:

Temperature 37.7° C (99.9° F)

Heart rate 174/min while sleeping

Respiratory rate 72/min while sleeping

Blood pressure in right upper extremity 60/39 mm Hg

Oxygen saturation 90%

Assessment

Admission:

Respirations: Tachypneic with moderate retractions and nasal flaring. Upon auscultation, crackles heard in all lung fields. No nasal drainage noted. Dry cough noted periodically.

Skin: Pallor, scalp is diaphoretic, lower extremities are cool to touch.

Cardiac: Tachycardic, regular rhythm, no murmur is heard. Peripheral pulses are full and bounding in the upper extremities and weak bilateral pedal pulses are noted.

Fluids: Mucous membranes are slightly dry and pink. Skin turgor is slightly decreased. Capillary refill is 3 seconds. Noted periorbital edema and nonpitting edema of feet. Anterior fontanel is soft and slightly depressed. Diaper remains dry.

Abdomen: Soft, full, round, bowel sounds are present and active.

Laboratory Results

Admission:

[ Chest x-ray: mild left ventricular hypertrophy is noted. Increased pulmonary vascular markings are noted in all lobes.

What condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.