ATI Pediatrics Proctored Exam

hand preference

all kids normally show hand preference by 1 year old

plaster casts

-heavy
-not water resistant
-dry in 10-72 hrs

fiberglass casts

-light weight
-water resistant
-dry in 15-20 min

types of traction

Skin traction:
-Buck
-Bryant
-Russell
Skeletal traction
Halo traction
-cervical traction

care for traction

-assess pin sites
-ensure hardware is tight
-ensure bed is in correct position
-ensure weights do not touch floor
Halo: ensure wrench is readily available

surgical intervention for scoliosis

-realign (2 rods on either side of spine)
-internal fixation
-fusion

The child is prescribed lanoxin (Digoxin) 75 mcg PO qd. The pharmacy supplies lanoxin (Digoxin) 0.05mg scored tablets. How many tablets will the nurse administer? Record your answer using one decimal place.

1.5 tablets

The physician orders the patient a 10-mL/kg normal saline bolus to infuse over 2 hours. The child weighs 36 kg. Calculate the infusion rate in mL/hr.

180 mL/hr

What happens to the voice during epiglottitis?

it becomes hoarse

Leukotreine modifiers

-Blocks leukotriene receptors or synthesis of leukotrienes (Singulair)
-Side effects: headache, nausea, abdominal pain, increase infections if over age 55, depression, suicidal, aggression
-Generally well tolerated.
-Monitor for improvement in symptoms

Cromolyn (Intal) and nedocomil (Tilade)

-Anti-inflammatory agents that inhibit release of histamine, leukotrienes,
-Prevention or maintenance drugs
-Administered by inhalation, onset of action in 2-4 weeks
-Side effects: cough, headache, throat irritation, GI upset

Long acting beta-adrenergics

-Salmeterol (Serevent) -used twice daily
-Added to anti-inflammatory therapy
-Not for acute symptoms due to onset of action in 20 minutes with peak in 3-4 hours

Lortab

tylenol with hydrocodone

dornase alpha

decreases viscosity of secretions (thins mucous) for CF patients

tobramycin

aerosolized antibiotics used for CF

Norwood procedure

-Treats hypoplastic left heart
-3 stages
-done shortly after birth
-Right ventricle is converted: connects aorta to right ventricle
-Between step 1&2 is highest risk for death
-bi-directional Glenn operation (stage 2, under 6 mo. old)
-superior vena cava

Biot's respirations

periods of apnea alternating with 2 or 3 shallow breaths

Cheyne-Stokes respirations

periods of apnea alternating with periods of hyperventilation

What gauge needle should be used when administering an immunization to a toddler?

24 gauge

sodium normal range

135-145

Recommended play activities for infant, toddler, preschool, and school age children

Infant: play pat-a-cake
Toddler: push-pull toy
Preschool: play dress-up
School age: create a scrapbook

protecting against SIDS

-supine to sleep
-empty bed: firm mattress only
-breastfeeding
-use of pacifier while sleeping

manifestations of pneumonia in infants

nasal flaring
increased WBCs
diarrhea
abdominal distention

steps to take during a tonic-clonic seizure

**FIRST: assist child to side-lying position on the floor
then...
-apply O2 mask
-clear immediate area
-loosen restrictive clothing

A nurse is preparing to administer ibuprofen f5 mg/kg q6h PRN for temps above 38 degrees F to an infant who weights 17.6 lb. The infant has a temp of 38.4. Available is ibuprofen liquid 100 mg/5 mL. How many mL should the nurse administer to the infant pe

2 mL

What is an indication of IICP in a child with a concussion?

forceful vomiting

What is an expected finding of endocarditis?

headache

What is an expected finding in a school-age child with glomerulonephritis?

brown colored urine

McBurney's point

-lower right abdomen
-pain in appendicitis

teaching to parents of child with juvenile idiopathic arthritis

-exercise large joints regularly
-encourage child to perform independent self-care
-provide a firm mattress for sleeping
-discourage daytime naps because stiffness can occur quickly

Celiac disease expected findings

-steatorrhea
-distended abdomen
-weight loss

What type of vomiting is common with pyloric stenosis?

projectile vomiting

management of tinea pedis

-avoid wearing plastic shoes
-wear sandals as much as possible

What is used to treat scabies lesions?

permethrin 5% cream

For what disease should non-washable items be sealed in a plastic bag for 14 days?

pediculosis

manifestation of pertussis

dry hacking cough

manifestation of acute streptococcal pharyngitis

inflamed throat with exudate

manifestation of bacterial conjunctivitis

purulent eye drainage

Koplik spots

rubeola (measles

securing an infant's car seat

lower anchors and tethers (the LATCH child safety system)
when this is available the seatbelt does not have to be used

Where should the car seat harness in rear-facing car seat be positioned?

at or just below the infant's shoulders

At what angle should an infant's car seat be placed?

45 degree angle

1. Who should the FACES pain rating scale be used for?
2. Who should the numeric pain rating scale be used for?
3. Who should the CRIES pain assessment scale be used for?
4. Who should the non communicating children's pain checklist be used for?

1) 3+ yrs old
2) 5+ yrs old
3) infants
4) pediatric clients with cognitive impairments

Diabetes insipidus lab values

-dilute urine/low specific gravity
-high sodium
-normal blood glucose
-polyuria (excessive urine output)

minimal change nephrotic syndrome management

-dietary fluid restriction
-low sodium diet
-corticosteroids

How often should a child with asthma get pulmonary function tests?

every 12-24 months

lumbar puncture nursing care

-apply topical analgesic to the lumbar site 60 min prior to procedure
-place in prone position or flat in bed for up to 12 hours to prevent post procedural spinal headache
-encourage to drink extra fluids to replace CSF

care for a partial-thickness burn

-wash the affected area with mild soap & water
-apply antibiotic ointment to the affected area

For what type of burn would you insert and NG tube?

a major burn - to empty the contents of the stomach & maintain decompression

CF diet

-well-balanced
-high in protein & calories
-unrestricted fat
-ensure adequate fluid intake

Can a child with celiac disease eat malt?

no, it has gluten in it

What should be done after administering PO suspension digoxin?

brush the child's teeth

manifestations of digoxin toxicity

nausea, vomiting, decreased appetite

age of controlling impulsive feelings

school age

age of understanding right from wrong

preschool

begins to express likes and dislikes

toddler