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Chapterz1:zBronchiolitis
1. Whichzinterventionziszappropriatezforzthezinfantzhospitalizedzwithzbronchiolitis?
a. Positionzonzthezsidezwithzneckzslightlyzflexed.
b. Administerzantibioticszaszordered.
c. Restrictzoralzandzparenteralzfluidszifztachypneic.
d. Givezcool,zhumidifiedzoxygen.zANS:zD
Cool,zhumidifiedzoxygenziszgivenztozrelievezdyspnea,zhypoxemia,zandzinsensiblezfluidzlosszfrom
tachypnea.zThezinfantzshouldzbezpositionedzwithzthezheadzandzchestzelevatedzatzaz30-ztoz40-
degreezanglezandzthezneckzslightlyzextendedztozmaintainzanzopenzairwayzandzdecreasezpressurezonzthez
diaphragm.zThezetiologyzofzbronchiolitisziszviral.zAntibioticszarezgivenzonlyzifzthereziszazsecondaryzbacteri
alzinfection.zTachypneazincreaseszinsensiblezfluidzloss.zIfzthezinfantzisztachypneic,zfluidszarezgivenzparent
erallyztozpreventzdehydration.
2. Anzinfantzwithzbronchiolitisziszhospitalized.zThezcausativezorganismziszrespiratoryzsyncytialzvirusz
(RSV).zTheznursezknowszthatzazchildzinfectedzwithzthiszviruszrequireszwhatztypezofzisolation?
a. Reversezisolation
b. Airbornezisolation
c. ContactzPrecautions
d. StandardzPrecautionszANS:zC
RSVzisztransmittedzthroughzdroplets.zInzadditionztozStandardzPrecautionszandzhandzwashing,
ContactzPrecautionszarezrequired.zCaregiverszmustzusezgloveszandzgownszwhenzenteringzthezroom.zCarez
isztakenznotztoztouchztheirzownzeyeszorzmucouszmembraneszwithzazcontaminatedzglovedzhand.zChildrenz
arezplacedzinzazprivatezroomzorzinzazroomzwithzotherzchildrenzwithzRSVzinfections.zReversezisolation
, PediatriczNursing,zAzCase-BasedzApproach,z1stzEditionzByzTagherzKnapp
focuseszonzkeepingzbacteriazawayzfromzthezinfant.zWithzRSV,zotherzchildrenzneedztozbezprotectedzfromz
exposureztozthezvirus.zThezviruszisznotzairborne.
3. Azchildzhaszazchroniczcoughzandzdiffusezwheezingzduringzthezexpiratoryzphasezofzrespiration.zThisz
suggestszwhatzcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. ForeignzbodyzinztracheazANS:zA
Asthmazmayzhavezthesezchroniczsignszandzsymptoms.zPneumoniazappearszwithzanzacutezonset,z
fever,zandzgeneralzmalaise.zBronchiolitisziszanzacutezconditionzcausedzbyzrespiratoryzsyncytial
virus.zForeignzbodyzinztheztracheazoccurszwithzacutezrespiratoryzdistresszorzfailurezandzmaybezstridor.
4. Whichznursingzdiagnosisziszmostzappropriatezforzanzinfantzwithzacutezbronchiolitiszdueztoz
respiratoryzsyncytialzvirusz(RSV)?
a. ActivityzIntolerance
b. DecreasedzCardiaczOutput
c. Pain,zAcute
d. TissuezPerfusion,zIneffectivez(peripheral)zANS.zA
Rationalez1:zActivityzintoleranceziszazproblemzbecausezofzthezimbalancezbetweenzoxygenzsupplyzandzde
mand.zCardiaczoutputzisznotzcompromisedzduringzanzacutezphasezofzbronchiolitis.zPainzisznotzusuallyzass
ociatedzwithzacutezbronchiolitis.zTissuezperfusionz(peripheral)zisznotzaffectedzbyzthiszrespiratory-
zdiseasezprocess.
Rationalez2:zActivityzintoleranceziszazproblemzbecausezofzthezimbalancezbetweenzoxygenzsupplyzandzde
mand.zCardiaczoutputzisznotzcompromisedzduringzanzacutezphasezofzbronchiolitis.zPainzisznotzusuallyzass
ociatedzwithzacutezbronchiolitis.zTissuezperfusionz(peripheral)zisznotzaffectedzbyzthiszrespiratory-
zdiseasezprocess.
, PediatriczNursing,zAzCase-BasedzApproach,z1stzEditionzByzTagherzKnapp
Rationalez3:zActivityzintoleranceziszazproblemzbecausezofzthezimbalancezbetweenzoxygenzsupplyzandzde
mand.zCardiaczoutputzisznotzcompromisedzduringzanzacutezphasezofzbronchiolitis.zPainzisznotzusuallyzass
ociatedzwithzacutezbronchiolitis.zTissuezperfusionz(peripheral)zisznotzaffectedzbyzthiszrespiratory-
zdiseasezprocess.
Rationalez4:zActivityzintoleranceziszazproblemzbecausezofzthezimbalancezbetweenzoxygenzsupplyzandzde
mand.zCardiaczoutputzisznotzcompromisedzduringzanzacutezphasezofzbronchiolitis.zPainzisznotzusuallyzass
ociatedzwithzacutezbronchiolitis.zTissuezperfusionz(peripheral)zisznotzaffectedzbyzthiszrespiratory-
zdiseasezprocess.
GlobalzRationale:zActivityzintoleranceziszazproblemzbecausezofzthezimbalancezbetweenzoxygenzsupplyzandz
demand.zCardiaczoutputzisznotzcompromisedzduringzanzacutezphasezofzbronchiolitis.zPainzisznotzusuallyzas
sociatedzwithzacutezbronchiolitis.zTissuezperfusionz(peripheral)zisznotzaffectedzbyzthiszrespiratory-
zdiseasezprocess.
Chapterz2:zAsthma
1. Theznurseziszcaringzforzazchildzhospitalizedzforzstatuszasthmaticus.zWhichzassessmentzfindingz
suggestszthatzthezchildszconditionziszworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. ClubbingzANS:zA
Theznursezwouldzassesszthezchildzforzsignszofzhypoxia,zincludingzrestlessness,zfatigue,zirritability,zandzincrea
sedzheartzandzrespiratoryzrate.zAszthezchildztireszfromzthezincreasedzworkzofzbreathingzhypoventilationzocc
urszleadingztozincreasedzcarbonzdioxidezlevels.zTheznursezwouldzbezalertzforzsignszof