post assessment pediatrics

8/18/2019 Post Assessment Pediatrics

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Post-assessment Pediatrics

A pediatric client is complaining of a sore throat and general weakness. The provider

diagnoses the client with Group A B-hemolytic streptococci (GABH!. "dentify three (#!

manifestations of GABH$ %hat are interventions and teaching points to discuss with the

caregiver(s! and child a&out treatment of GABH$Some manifestations include erythema marginatum (rash), an increase in C-reactive protein,

nontender subcutaneous nodules of bony prominences.

Interventions include encourage bed rest, administer antibiotic as prescribed, encouragenutritionally balanced meals, assess for chorea.

Some teaching points include: complete the entire course of antibiotics, keep the child hydrated,

encourage bed rest, and use arm saltater gargles.

A nurse is caring for a client with leukemia who is undergoing a &one marrow aspiration.

%hat nursing actions should &e taken pre and post procedure$

!re-procedure: "ssist the provider ith the procedure. #opical anesthetic, such as a eutectic

mi$ture of local anesthetics (%&'"), may be applied over the biopsy area min to * hr prior tothe procedure. "ssist ith positioning, it depends on the access site to be used (posterior or

anterior iliac crest is most common+ tibia can be used in infants because it is easier to access andhold the infant). " specimen is obtained by the provider.

!ostprocedure: "pply pressure to the site for to * min, then apply a pressure dressing. "ssess

vital signs freuently. &onitor for signs of bleeding and infection for hr.

A nurse is discharging a client home with the diagnosis of rheumatic fever. %hat education

should &e provided to the caregivers of a child who is &eing discharged following this

diagnosis$

!romote rest during the acute phase. !rovide information and reassurance related to the

development of chorea and its self-limiting nature. %ncourage ell-balanced meals. Seekmedical care if infection recurrence is suspected.

A nurse is preparing to administer the '' immuni)ation to a client. %hat are two (*!

contraindications for this vaccine$

!regnancy and allergy to gelatin and neomycin.

A nurse is caring for a family with a passive parenting style. %hat are some guidelines the

nurse can provide to promote accepta&le &ehavior in the children$

Set clear and realistic limits and e$pectations based on the developmental level of the child.

/alidate the child0s feelings, and offer sympathetic e$planations. !rovide role modeling and

reinforcement for appropriate behavior. 1ocus on the child0s behavior hen disciplining thechild.

"dentify five (+! nursing actions for a client who is in a hip spica cast.

!erform range of motion ith the unaffected e$tremities. !erform freuent assessment of skin

integrity, especially in the diaper area. "ssess for pain control using an age-appropriate pain tool.

Intervene as indicated. %valuate hydration status freuently. "ssess elimination status daily.


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A nurse is caring for a child with acute &urn in,uries. %hat solutions should the nurse

anticipate using during initial fluid replacement$ How much urine output is reuired for

maintain renal perfusion during this period$

1luid replacement is important during the first hr. Isotonic crystalloid solutions (.23 sodium

chloride or lactated 4inger0s solution) are used during the early stage of burn recovery. Colloid

solutions, such as albumin or synthetic plasma e$panders (5espan), may be used after the first hr of burn recovery. &aintain urine output of * to m'6kg6hr if the child eighs less than 7 kg

(88 lb). &aintain urine output of 7 m'6hr if the child eighs more than 7 kg (88 lb).

A nurse is providing education to an adolescent client with dia&etes and his parents

regarding ick /ay ules while sick. %hat information should the nurse provide$

&onitor blood glucose levels every 7 hr. Continue to take insulin or oral antidiabetic agents.

%ncourage sugar-free, non-caffeinated liuids to prevent dehydration. &eet carbohydrate needs by eating soft foods if possible. If not, consume liuids that are eual to the usual carbohydrate

content. #est urine for ketones every 7 hr. 4est. Call the health care provider if: 9lood glucose is

higher than mg6d'. 1ever higher than 7.2; C (*; 1), fever does not respond to

acetaminophen (#ylenol), or fever lasts more than * hr. !ositive ketones in the urine.


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bottom ith arm ater and gently pat dry.


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status if the client has a decreased level of consciousness. "ssess for presence of petechia or a

purpuric-type rash, hich reuires immediate medical attention.

post assessment pediatrics

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