Pediatrics: Administering Medications

With otic installations for children under 3 years of age, the nurse should:

A. Pull the pinna gently down and back.
B. Pull the pinna gently up and back.
C. Pull the pinna gently down and forward.
D. Pull the pinna gently up and forward.

Answer: A. After administering ear drops, the child should remain with their head to the side with the affected ear up (to maximize contact with the external canal and reach the eardrum).

True or False

Usually 1ml is the maxiumum volume that should be administered in a single site to infants and children. TRUE.

After administering eye drops, the nurse should:

A. Encourage the child to leave their eyes open.
B. Encourage the child to keep their eyes closed briefly.
C. Encourage the child to look in all directions with eyes closed.
D. Both B & C

Answer: D. When the child closes their eyes briefly and looks in all directions, it maximizes the contact and distribution of the medication.

True or False

Since children's skin is more permeable, there is an increased risk for medication absorption and resultant systemic effects. TRUE.

Special Diets

A client with gastroesophageal reflux disease (GERD) should:

A. Decrease protein.
B. Increase protein and avoid alcohol.
C. Decrease protein and restrict spicy foods.
D. Increase protein and increase fatty foods.

Answer: B. Clients with GERD should avoid strong stimulants of acid secretion (such as alcohol), increase protein and avoid foods that reduce LES competence (such as fatty foods, tomato-based foods and onions).

The diet for a client with cystine stones should be low in:

A. Purine
B. Phosphorus
C. Calcium
D. Protein

Answer: D.

A client with hyperthyroidism should have a diet which is:

A. High in protein and vitamin C
B. High in purine and vitamin B
C. High in protein and vitamin B
D. High and protein and vitamin D

Answer: C. Clients with hyperthyroidism should have a high calorie diet, which is high in protein and vitamin B.

Happy New Year!

I want to wish all of you a happy new year. I pray that this will be a successful year for all of our Entralink students. May this year bring you new focus, a fresh perspective, and the confidence to pass the NCLEX. My thoughts and prayers are with you all.

Ann

Hypertrophic Cardiomyopathy

A disease in which the heart muscle has thickened, making it harder to pump blood. Hypertrophic cardiomyopathy is often asymmetrical, meaning one part of the heart is thicker than the other parts. It is usually inherited genetically.

Causes
It is believed to be caused by defects with the genes that control heart muscle growth.

Symptoms
Symptoms can include: chest pain, light-headedness, dizziness, sudden fainting, abnormal heart rhythms, and shortness of breath, especially following activity. In some cases, clients do not experience symptoms and may not even realize they have the condition. The first symptom of hypertrophic cardiomyopathy among many young patients is sudden death, caused by arrhythmias.

Tests
Tests used to diagnose heart muscle thickness, problems with blood flow, or leaky heart valves may include: ECG, echocardiography with Doppler ultrasound, chest x-ray and cardiac catherization.

Treatment
Treatment can include beta blockers, implanted pacemakers or surgery.

TRUE or FALSE
In people over age 60, hypertrophic cardiomyopathy is often associated with mild hypertension . TRUE

Hypertrophic cardiomyopathy is a major cause of death in young athletes who seem completely healthy but die during heavy exercise.

Sample Questions

A client is diagnosed with Nephrotic Syndrome. The nurse knows that the diet for this client would include a:

A. Decrease in both potassium and sodium
B. Decrease in protein and increase in potassium
C. Decrease in sodium and increase in protein
D. Decrease in protein and increase in sodium

Answer: C .

A nurse is caring for a client who has recently been diagnosed with COPD and fibromyalgia. Which of the following tasks could the nurse delegate to the nursing assistant?

A. Transferring the client to the shower.
B. Educating the client on monitoring fatigue
C. Ambulating the client for the first time.
D. Taking the client's breath sounds

Answer: A. Nursing assistants should be competent on all transfers.

A 36 year-old client with a complaint of dizziness has an order for Morphine via. IV. Which of the following should the nurse should do first?

A. Recommend that the on-call physician assess the client.
B. Check the resuls of the client’s chest x-ray.
C. Perform a neurological screen on the client.
D. Retake vitals including blood pressure.

Answer: D. Dizziness can be a sign of hypotension, that may be a contraindication with Morphine.