Rasmussen College :NUR 2513/Maternal 2513 Exam 3 Blueprint FINAL 2021/2022,100% CORRECT
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NUR 2513
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NUR 2513
Rasmussen College :NUR 2513/Maternal 2513 Exam 3 Blueprint FINAL 2021/2022
Modules:
Dosage calc
7 (Chp 34, 38, 40, 41): Interventions for hospitalized peds client, Respiratory, Cardiac Diseases/Disorders
● What are techniques for administration of ear drops (less than 2 versus older than...
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Rasmussen College :NUR 2513/Maternal 2513 Exam 3 Blueprint FINAL
2021/2022
Modules:
Dosage calc
7 (Chp 34, 38, 40, 41): Interventions for hospitalized peds client, Respiratory, Cardiac
Diseases/Disorders
● What are techniques for administration of ear drops (less than 2 versus older than 2)
Turn the child or ask the child to turn onto his or her back or use restraint as necessary. Turn the
child’s head to one side. The slant of the ear canal in children. If the child is younger than 2 years
of age, straighten the external ear canal by pulling the pinna down and back. If the child is older
than 2 years of age, pull the pinna of the ear up and back. Instill the specified number of drops
into the ear canal. Hold the child’s head in the sideways position to ensure the medication fills
the entire ear canal. Praise the child for cooperating during this difficult procedure
● What are tips for helping a child take oral medication?
Available in preparations (liquids, chewables, and meltaways). Determine the child’s ability to
swallow pills.
Use the smallest measuring device for doses of liquid medication. Use an oral medication
syringe for smaller amounts, and a medication cup for larger amounts.
Avoid measuring liquid medication in a teaspoon or tablespoon. Use rigid plastic cups instead
of paper cups for liquid medications. Avoid mixing medication with formula or putting it in a
bottle of formula because the infant might not take the entire feeding, and the medication can
alter the taste of the formula.
Hold the infant in a semi-reclining position similar to a feeding position. Hold the small child in
an upright position to prevent aspiration. Administer the medication in the side of the mouth in
small amounts. This allows the infant or child to swallow.
Only use the droppers that come with the medication for measurement. Stroke the infant under
the chin to promote swallowing while holding cheeks together. Teach the child to swallow
tablets that aren’t available in liquid form and can’t be crushed. Teach in short sessions using
verbal instruction, demonstration, and positive reinforcement. Provide atraumatic care.
Mix the medication in a small amount of sweet nonessential food (applesauce or sherbet). Offer
juice, a soft drink, or snack after administration. Add flavoring to medications as available.
Use a nipple to allow the infant to suck the medication. Reward small child with a prize or sticker
afterwards.
Administer medications via a feeding tube. Confirm placement. Use liquid formulation. Do not
add medication to the formula bag. If administering several medications, flush tubing with water
,after the administration of each medication.
● What are teaching tips for use of a metered-dose inhaler?
A metered-dose inhaler (MDI) is a handheld device that provides a route for medication
administration directly to the respiratory tract. The child inhales while depressing a trigger on
the apparatus. For successful use, children need to follow five general rules: shake the canister,
exhale deeply, activate the inhaler and place it in their mouth as they begin to inhale, take a
long slow inhalation, and then hold their breath for 5 to 10 seconds.
Caution them to take only one puff at a time, with a 1-minute wait between puffs. Coordinating
inhalation with MDI use can be difficult; therefore, use of an aerochamber (spacer) is generally
recommended to prevent deposition on the posterior pharynx. Younger children can use an MDI
attached to an aerochamber with a mask. All children using inhaled corticosteroids need an
aerochamber to prevent deposition of the medication in the mucous membranes of the mouth
and pharynx, which can contribute to the development of thrush. Instruct the child and
guardians to clean the MDI and spacer after each use and to have the child rinse out the mouth
and expectorate.
-Do not shake the device.
-Take the cover off the mouthpiece.
-Follow the directions of the manufacturer for preparing the medication (turning the wheel of the
inhaler).
-Exhale completely. Place the mouthpiece between the lips and take a deep breath through the
mouth.
-Hold breath for 5 to 10 seconds.
-Take the inhaler out of the mouth and slowly exhale through pursed lips. Resume normal
breathing.
-If more than one puff is prescribed, wait the length of time directed before administering the
second puff.
-Remove the canister and rinse the inhaler, cap, and spacer once a day with warm running water.
Dry the inhaler before reuse.
● What’s important to know about the newborn/infant nose and breathing? What
assessments are important? p. 932
Infants are obligate nose breathers. They cannot coordinate mouth breathing, so they become
disturbed when the nose is temporarily blocked to check for patency; do this only momentarily
to avoid discomfort. Most newborns have milia (i.e., small white papules) on the surface of the
nose, which are of no consequence and disappear without treatment.
,Observe the nose for flaring of the nostrils (a sign of a need for oxygen). Using an otoscope
light, observe the mucous membrane of the nose for color—it should be pink; pale suggests
allergies, and redness suggests infection. Note and describe any discharge. Document the septum
is in the midline because a displaced septa such as those that occur after facial injuries can
interfere with respiration and make nasal intubation in emergencies difficult. Gently press one
nostril closed and ask the child to inhale. Repeat on the opposite side to ensure both sides of the
nose are patent; that is, no choanal atresia or membrane obstructing the posterior nares exists.
Sinuses do not fully develop until about 6 years.
● What are signs of dehydration? (see below)
-Mild
WEIGHT LOSS 3% to 5% in infants, 3% to 4% in children
MANIFESTATIONS: Behavior, mucous membranes, anterior fontanel, pulse, and blood
pressure within expected findings, Capillary refill greater than 2 seconds, Possible slight thirst
-Moderate
WEIGHT LOSS 6% to 9% in infants, 6% to 8% in children
MANIFESTATIONS: Capillary refill between 2 and 4 seconds, Possible thirst and irritability,
Pulse slightly increased with normal to orthostatic blood pressure, Dry mucous membranes and
decreased tears and skin turgor, Slight tachypnea, Normal to sunken anterior fontanel on
infants
-Severe
WEIGHT LOSS Greater than 10% in infants, 10% in children
MANIFESTATIONS: Capillary refill greater than 4 seconds, Tachycardia present, and
orthostatic blood pressure can progress to shock,Extreme thirst, Very dry mucous membranes
and tented skin, Hyperpnea, No tearing with sunken eyeballs, Sunken anterior fontanel
● What are interventions for mild/moderate versus severe
dehydration from gastroenteritis? pp. 1062-1063;
https://www.aafp.org/afp/2009/1001/p692.html
NURSING ACTIONS
-Oral rehydration is attempted first for mild and
moderate cases of dehydration. Mild: 50 mL/kg
rehydration fluid within 4 hr
Moderate: 100 mL/kg rehydration fluid
within 4 hr Replacement of diarrhea
losses with 10 mL/kg each stool
, -Administer parenteral fluid therapy as prescribed. Initiate when a child is unable to drink enough
oral fluids to correct fluid losses, and those with severe dehydration or continued vomiting.
-Isotonic solution at 20 mL/kg IV bolus with possible repeat for isotonic and hypotonic
dehydration. Hypertonic dehydration: rapid fluid replacement is contraindicated because of the
risk of cerebral edema. Administer maintenance IV fluids as prescribed. Avoid potassium
replacement until kidney function is verified.
-Assess capillary refill. Assess vital signs. Monitor weight. Maintain accurate I&O.
● What are therapeutic interventions to manage croup (bronchiolitis)?
Cool moist air combined with a corticosteroid, such as dexamethasone, or racemic epinephrine,
given by nebulizer, usually reduces inflammation and produces effective bronchodilation to open
the airway. The provider may prescribe dexamethasone for home administration but racemic
epinephrine needs to be administered in a healthcare setting.
● What are symptoms of streptococcal pharyngitis and complications/risks?
Group A β-hemolytic streptococcus is the organism most frequently involved in bacterial
pharyngitis in children, particularly those between the ages of 5 and 15 years. Onset is abrupt
and characterized by pharyngitis, headache, fever and abdominal pain. Tonsils and pharynx
can be inflamed and covered with exudate, usually appears by second day of illness.
Streptococcal infections are generally more severe and present more suddenly than viral
infections. The back of the throat and palatine tonsils are usually markedly erythematous
(bright red); the tonsils are enlarged, and there may be a white exudate in the tonsillar crypts.
Petechiae may be present on the palate. A child typically appears ill, with a fever, sore throat,
headache, stomach ache, and difficulty swallowing. Other respiratory symptoms are generally
absent, such as cough, congestion, rhinorrhea, or conjunctivitis. A rapid antigen test and/or
throat culture should be done to confirm the presence of the Streptococcus bacteria. These
findings may vary depending on the child’s age and make it difficult to distinguish it from a
viral illness. Some children may develop a sandpaper-like rash (scarlatiniform rash) on the
body.
Although rare, streptococcal infections can lead to acute rheumatic fever and glomerulonephritis
if not treated.
● What are post-
tonsillectomy nursing cares?
POSTOPERATIVE NURSING
ACTIONS
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