ATI-Peds

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1.

Chapter 25

...

13.

2.

What is an inguinal hernia

Protrusion of
abdominal organs
through the
inguinal canal into
the scrotum

With bladder exstrophy

how should you cover the
exposed bladder

With sterile, nonadherent

dressing and prepare for
immediate surgery

14.

How do you care for

phimosis

Retract foreskin and perform a

cleansing, if prescribed, for mild
cases

15.

What is a medication that

may be useful in treating
bladder spasms

Oxybutynin

16.

After surgery to correct

structural defect how
long should a patient wait
for a tub bath

At least one week or as

prescribed

17.

What kind of therapy can

be used for toddlers and
preschoolers for
emotional support after
surgery

Play therapy

18.

What are clinical

manifestations of
epispadias

Bladder exstrophy, widened

pubic symphysis, broad/spade
like penis

19.

A nurse is caring for an

infant who has
ambiguous genitalia.
Which of the following
are appropriate actions
for the nurse to take?

Prepare for surgery, obtain a

detailed family history, refer to
genetic counseling, explain the
need for a chromosomal
analysis

20.

What are clinical

manifestations of
obstructive uropathy

Increased urine flow

Urinary tract infection
Metabolic acidosis
Inability to concentrate urine
Hydronephrosis

21.

Chapter 26

...

22.

What is acute
glomerulonephritis

The glomeruli are inflamed,

which impacts the kidneys to
filter the urine properly

23.

What is acute
poststreptococcal
glomerulonephritis

An anti-body - antigen disease

that occurs as a result of certain
strains of group A strep and is
most commonly seen in children
between the ages of two and
seven

24.

What are signs/symptoms

of acute
glomerulonephritis

Decreased urine output

Irritability
Periorbital edema
Hypertension
Anorexia
Cloudy, tea colored urine

3.

What is Chordee?

Ventral curvature
of the penis

4.

What is bladder exstrophy

Eversion of the
posterior bladder
through the
anterior bladder
wall and lower
abdominal wall

5.

6.

What is hypospadia's

What is epispadias

Urethral opening
located behind
the glands of the
penis or on the
ventral surface of
the penile shaft
Meatal opening
located on the
dorsal surface of
the penis

7.

What is phimosis

Narrowing of the
preputial opening
of the foreskin

8.

What is cryptorchidism

Undescended
testes

9.

What is Hydrocele

Fluid in the
scrotum

10.

What is varicocele

Elongation,
dilatation and
tortuosity of the
veins superior to
the testicle

11.

What is testicular torsion

Testicle hangs
free from the
vascular
structures

12.

Children become aware of and are very

interested in the genital area,
normality of genital function and
gender differences between three and
six years of age. Due to this, repair of
structural defects ideally should be
done between what ages

6 to 15 months of
age, but before
three years, to
minimize impact
on body image
and to promote
healthy
development

25.

What are laboratory test

results for acute
glomerulonephritis

Proteinuria
Hematuria
Elevated bun/creatinine
Chest x-ray (to identify
pulmonary edema, cardiac
enlargement or pleural effusion)

38.

You should
include the
parent or
caregiver in rating
the pain of a

Young child or infant

39.

What does FLACC

stand for and
what ages is this
pain scale used
for

Face, legs, activity, cry, consolability, two

months to seven years

26.

During periods of
oliguria what should
you restrict the patient
from eating

Foods high in potassium

(throughout therapy sodium and
fluid may be restricted)

27.

What is medication
therapy for acute
glomerulonephritis

Diuretics and antihypertensives

to remove accumulative fluid and
manage hypertension

40.

What ages is the

faces pain scale
used for

Three years and older

28.

What is nephrotic
syndrome

Alterations in the glomerular

membrane allow proteins,
especially albumin, to pass into
the urine, resulting in decreased
serum osmotic pressure

41.

What ages is the

oucher pain scale
used for

3 to 13 years

42.

What ages is the

numeric pain
scale used for

Ages five and older

43.

How long do you

observe behavior
for noncommunicating
children's pain
checklist ages 3 to
18 years

10 minutes

44.

What are some

atraumatic and
pharmacologic
measures

45.

What kind of
injections are not
recommended for
pain control in
children

IM

46.

Intranasal
medications are
not
recommended for
children younger
than

18

47.

Fentanyl patch
can be used for
children over the
age of

12

48.

Chapter 11

...

What are
signs/symptoms of
nephrotic syndrome

Weight gain
Periorbital edema
Ascites
Decreased frothy urine
Proteinuria 2+
Few RBCs in the urine

How would the

bloodwork look in a
patient that has
nephrotic syndrome

Hypoalbuminemia
Hyperlipidemia
Hemoconcentration
Hyponatremia
Hi GFR

31.

When is a kidney biopsy

indicated

Only if nephrotic syndrome is

unresponsive to steroid therapy

32.

How do you treat

nephrotic syndrome

With steroid therapy, diuretics

and possibly albumin

33.

If a patient cannot
tolerate prednisone or
has repeated relapses of
MCNS what should you
administer

Cyclophosphamide

What are common

infections seen in
children with nephrotic
syndrome due to
steroid therapy

Pneumonia
Peritonitis
Cellulitis

35.

Chapter 9

...

36.

What are some

expressions of pain in an
infant

Eyes tightly closed, mouth open in

a squarish shape and eyebrows
lowered in drawn together

Self-report for pain is

used for children over
the age of

Four

29.

30.

34.

37.

49.

50.

Current stage of
development as it
relates to death
chart

Chapter 2

52.

Expected
temperatures for
children chart

54.

Examples of
expected ranges
of blood pressure
by age and gender
chart

56.

Erect head
posture is
expected in
infants after
blank months of
age

Four

57.

Lymph nodes
should be
nonpalpable but
if they are
palpable what
should they be
like

Small, nontender and mobile

58.

When does the

posterior
fontanelle usually
close

6 to 8 weeks of age

59.

When does the

anterior
fontanelle you
some close

12 to 18 months

60.

What tests are

used to check
visual acuity of
children who are
unable to read
letters or
numbers

E or HOTV test

61.

Palpebral is pink
and bulbar is
blank

Transparent

62.

How many teeth

should infant
have by age one

6 to 8

63.

When children
are younger than
seven what kind
of breathing is
seen

More abdominal movement is seen

during respirations

64.

Where is S1 and S2
best heard

S1 is heard best at the apex and S2 at

the base

What are physical

manifestations of
death

51.

53.

55.

...

Expected pulse
rates and
respirations for
children

What should the

blood pressure of
an infant be

65-80/40-50

65.

Infant reflexes
expected findings
and age chart

66.

Chapter 13

67.

What are things

you should do
during a seizure

78.

What is an
apparent life
threatening event

Sudden event where the infant exhibits

apnea, changing color, change in muscle
tone and choking

79.

What are risk

factors for ALTE

Respiratory infections
Urinary tract infections
Gastroesophageal reflux
Seizure

80.

What are
diagnostic
procedures for an
ALTE

PH study
ECG
EEG
MRI
Sleep study

81.

What are risk

factors for sudden
infant death
syndrome

82.

What are things

that patients can
do to reduce the
risk of SIDS

83.

What are the

stages of
acetaminophen
poisoning

84.

What are the

stages of
supplemental
iron poisoning

...

68.

What is a
hemispherectomy

Removal of one hemisphere of the brain

69.

What is a corpus
callosotomy

Separation of the two hemispheres in

the brain

70.

What is
diphtheria

A respiratory illness causing difficulty

breathing

71.

Chapter 42

...

72.

How is apnea
defined in
pediatrics

This cessation of respirations for more

than 20 seconds

73.

If an infant has an
obstructed airway
what should you
do

Use a combination of back blows and

chest thrusts

74.

If children and
adolescents have
an obstructed
airway what
should you do

Use abdominal thrusts

75.

How should you

place a child
recovering from
an airway
obstruction

Side lying position with legs bent at the

knees for stability

76.

What is a
submersion injury

A near drowning incident in which the

child has survived for 24 hours after

77.

What would be a
good laboratory
test for a
drowning patient

ABGs

85.

What are
manifestations of
lead poisoning

86.

What is the
intervention used
for
acetaminophen

87.

What is the
interventions
used for aspirin

88.

N-acetylcysteine (Mucomyst) given orally

Interventions for
other specific
substances chart

89.

What is early signs

of respiratory
distress

Tachypnea, tachycardia, diaphoresis,

dyspnea, restlessness, retractions

90.

Chapter 27

...

91.

What are some

risk factors for
fractures other
than normal
playing

Obesity and poor nutrition

92.

What are some of

the different
types of fractures

93.

What is
emergency
nursing care at
the time of injury

94.

How long should

you elevate the
cast above the
heart to prevent
swelling

During the first 24 to 48 hours

95.

How does a cast

feel when it is first
applied

Warm

96.

What should you

instruct the
patient to do
after it cast has
been removed

Soak the extremity in warm water and

then apply lotion

97.

Skin traction uses

a pulling force
that is applied by
weights. Using
tape and straps
applied to the
skin along with
boots and/or
cuffs, weights are
attached by a
rope to the
extremity. What
are examples of
skin traction

Buck, Russell, Byrant traction

Skeletal traction
uses a
continuous
pulling force
that is applied
directly to the
skeletal
structure and/or
specific bone. A
pin or rod is
inserted through
or into the bone.
What does
skeletal traction
allow a patient
to do without
interfering with
the pull of the
traction and it
decreases
complications
associated with
immobility and
traction

Change positions

99.

What does
balanced
suspension
traction do

Suspends the leg in a flexed position

with the hip and hamstring muscles
relaxed

100.

What should you

have attached to
the vest with a
halo traction
just in case CPR
is necessary

A wrench

101.

How should you

make the bed for
a patient that
has a traction

From head to toe

102.

What are clinical

manifestations
of compartment
syndrome

98.

103.

What are clinical

manifestations
of osteomyelitis

104.

What kind of
traction has the
patients butt
raised off the bed

Bryant

105.

Chapter 23

...

106.

When is repair of
a cleft lip usually
done

Typically done between 2 to 3 months.

Infant should be at least 10 weeks old,
weigh 10 pounds and hemoglobin 10

107.

When is repair of
a cleft palate
usually done

6 to 12 months

108.

For isolated cleft

lip you should
encourage
breast-feeding,
use a wide-based
nipple for
bottlefeeding
and squeeze

The infants cheeks together during

feeding to decrease the gap

109.

For CP or CL/CP
you should
position the
infant upright
while cradling
the head during
feeding, use a
specialized
bottle with a
one-way valve
and a specially
cut nipple, burp
the infant
frequently and

Syringe feeding it may be necessary for

the infant who is unsuccessful with other
methods

110.

What are things

you should avoid
giving an infant
after a CL/CP
repair

Nipple or pacifier and hard toys

111.

How should you

position the
patient
immediately after a
cleft lip repair

Upright, car seat position, on their back

or on their side in the immediate
postoperative period to maintain the
integrity of the repair. Also apply elbow
restraints to keep the infant from
injuring the repair site

112.

How should you

position the
patient
immediately after a
cleft palate repair

Change the infants position frequently

to facilitate breathing. The infant may be
placed on the abdomen in the
immediate post operative period

What should you

avoid placing in an
infants mouth after
cleft palate repair

Tongue depressor or pacifier. Really

anything. Also elbow restraints may be
needed for 4 to 6 weeks after

114.

What are three

complications of
CL/CP

Ear infections, speech problems, dental

problems

115.

Risk factors for GER

include
prematurity,
bronchopulmonary
dysplasia,
neurological
impairments,
asthma, cystic
fibrosis, cerebral
palsy, scoliosis.
Risk factors for
GERD include

Neurological impairments, hiatal hernia,

esophageal atresia, morbid obesity

116.

What are
complications of
GER and GERD

Recurrent pneumonia, weight loss and

failure to thrive

117.

What is
hypertrophic
pyloric stenosis

Thickening of the pyloric sphincter which

creates an obstruction and usually
occurs within the first five weeks of life

118.

What are
signs/symptoms of
hypertrophic
pyloric stenosis

113.

119.

What is nursing
care following
surgery for
hypertrophic
pyloric stenosis

120.

What is
Hirschsprung
disease

A structural anomaly of the G.I. tract that

results in decreased motility and
mechanical obstruction

121.

What are
signs/symptoms
of Hirschsprung
disease in a
newborn

Failure to pass meconium within 24 to 48

hours after birth
Episodes of vomiting bile
Refusal to eat
Abdominal distention

122.

What are
signs/symptoms
of Hirschsprung
disease in an
infant and older
child

123.

What should the

diet be in a
patient that has
Hirschsprung
disease

High-protein, high calorie, low fiber diet

124.

What are three

complications of
Hirschsprung
disease

Enterocolitis
Anal stricture
Incontinence

125.

What is
intussusception

One part of the intestine telescopes into

another part. Most common in children
between three months and three years

126.

What is a risk
factor for
intussusception

Cystic fibrosis

127.

What is
treatment for
intussusception

Air enema or surgery in reoccurring

cases

128.

When a patient
has appendicitis
what are two
things you
should avoid

Heat to the abdomen and

enemas/laxatives

129.

What is the most

common
complication of
appendicitis

Peritonitis

130.

Chapter 28

...

131.

How is club foot

treated

Through a series of casting starting

shortly after birth and continuing until
correction is accomplished

What are two

disorders that
clubfoot can
occur with

Cerebral palsy and spina bifida

132.

133.

What are
symptoms an
infant has
developmental
dysplasia of the
hip

Limited hip abduction

Asymmetry of gluteal and thigh folds
Positive ortolani and Barlow test
Shortening of the femur

141.

What are
symptoms that a
child has
developmental
hip dysplasia

Positive Trendelenburg sign

One leg shorter than the other
Walking on toes on 1 foot
Walk with a limp

142.

Treatment for
newborn to six
months for
dysplasia of the
hip is the Pavlik
harness. What
should you
know about this
harness?

Maintain harness placement for 12

weeks
Check straps every 1 to 2 weeks for
adjustment (teach family not to do this)
Perform neurovascular and skin
integrity checks

143.

When adduction
contracture is
present a bryant
traction may be
used what angle
should the hips
be flexed at and
where should
the Butt be

90, butt raised off the bed

144.

How should you

handle spica cast

With palm of the hand until dry

145.

What is
osteogenesis
imperfecta

Heterogeneous, autosomal dominant

disorder of the bones resulting in
fractures and deformity

146.

What are
signs/symptoms
of osteogenesis
imperfecta

147.

Treatment for
osteogenesis
imperfecta is
supportive.
Medications
such as blank
may be
administered to
increase bone
density

What are the

different types of
clubfoot

134.

What are three

surgical
interventions for
clubfoot

Osteotomy-removing part of the bone

Fusion-fusing two bones together
Tendon lengthening or shortening

135.

What is leg calve

perthes disease

Aseptic necrosis of the femoral head

which can be unilateral or bilateral

136.

LCPD can occur

from trauma or
coagulation
defects. Signs
and symptoms
can include
intermittent
painless limp,
hip stiffness,
Limited ROM and

Thigh pain
Shortening of the affected leg
Muscle wasting

137.

What is
treatment for
LCPD

NSAIDs, rest and nonweightbearing

treatments such as traction or abduction
brace, in some cases surgery may be
needed

138.

What kind of
diagnostic test is
used for LCPD

Radiographs

What is
subluxation

Incomplete dislocation of the hip

139.

140.

Pamidronate

148.

Complications of
osteogenesis
imperfecta include
hearing loss,
permit deformities
and disuse
osteoporosis. How
can you prevent
disuse
osteoporosis

Limit time in casts and encourage activity

155.

Fungal
infection/causative
agent clinical
manifestations
chart

149.

The Cobb
technique is used
to determine the
degree of curvature
with a patient that
has scoliosis. What
does the Risser
scale do

Determine the skeletal maturity

156.

Treatment of
bacterial infections
chart

150.

When is surgical
intervention used
for scoliosis

When there's a curvature greater than

45
157.

151.

After a patient has

surgery for
scoliosis what kind
of rolling will they
be doing

Log

Treatment of viral
infections chart

152.

Chapter 30

...

153.

Bacterial
infection/causative
agent's clinical
manifestations
chart

158.

Treatment of
fungal infections
chart

159.

Read pages 350 to

351

...

160.

What is scabies

Mites that spread by direct contact with

an infected person. Eggs mature in 21
days

161.

What is pediculosis
capitis

Head lice (lifespan of an adult is one

month and they can live up to 48 hours
without a host)

162.

What is pediculosis
corporis

Body lice (they can live in clothing for one

month and die at room temperature in 5
to 7 days)

154.

Viral
infection/causative
agents clinical
manifestations
chart

163.

Clinical
manifestations
of lice chart

164.

Treatment of
scabies and lice
chart

165.

When teaching a
parent about lice
what should you
teach them?

166.

Read through
chapter 36

...

167.

Chapter 40

...

168.

Leukemia causes
an increase in
the production
of immature
WBCs which
leads to

Infiltration of organs and tissues

169.

Leukemia is the
most common
cancer of
children. It is
more common
in boys and
Caucasians. The
peak onset is
between the ages
of

Two and five years of age

170.

Early
manifestations
of leukemia
include lowgrade fever,
pallor, increased
bruising and
petechia,
liftlessness,
enlarged
liver/lymph
nodes/joints and

171.

What are late

manifestations
and laboratory
test for leukemia

172.

Bone marrow
aspiration or
biopsy is the
most definitive
diagnostic
procedure for
leukemia. If
present, the
specimen will
show prolific
quantities of
immature he
make blast cells
and protein
markers
indicating a
specific type of
leukemia. What
are the nursing
actions for a
bone marrow
aspiration

173.

Cerebrospinal
fluid analysis
may also be used
to assess CNS
involvement
with leukemia.
What are the
nursing actions
for this
procedure?

Abdominal/leg/joint pain
Constipation
Headache
Vomiting and anorexia
Unsteady gait

174.

175.

176.

Chemotherapy
side effects and
nursing
interventions
chart

Chemotherapy
side effects and
nursing
interventions
chart 2

If a patient were to have elevated blood

pressure in the arms with bounding
pulses in the upper extremities but
decreased blood pressure and pulses in
the lower extremities what would you
suspect the patient has?

Coarctation of
the aorta

182.

What is tricuspid atresia

Complete
closure of the
tricuspid valve
that results in
mixed blood
flow

183.

What are three manifestations of

tetralogy of fallot (four defects that result
in mixed blood flow)?

Cyanosis at
birth that
progresses
over the first
year of life
Systolic
murmur
Episodes of
acute cyanosis
and hypoxia
(Blue spells)

184.

What is truncus arteriosus

Failure of
septum
formation,
resulting in a
single vessel
that comes off
of the
ventricles

185.

How long should a patient remain NPO

before cardiac catheterization

4 to 6 hours
prior to the
procedure

186.

How long should the affected extremity

be placed in the straight position to
prevent bleeding after cardiac
catheterization

4 to 8 hours

187.

When should digoxin be withheld

When the
infants pulse is
less than 90
and a child's
pulse is less
than 70

188.

What can ace inhibitors cause

Hyperkalemia

189.

What a clinical manifestations of

endocarditis

Low-grade
fever
Malaise
Decreased
appetite with
weight loss

190.

What do you administer IV to a patient

that has Kawasaki's disease

IV gamma
globulin

Therapeutic
procedures for
leukemia

When a child is at
risk for infection
from
chemotherapy
what should you
monitor

ANC

178.

What are some

complications of
myelosuppression

Hemorrhage or thrombocytopenia,
anemia

179.

How should you

treat a nosebleed

With cold and pressure

180.

Chapter 20

...

177.

181.

What are three

things that you
should teach a
patient at discharge
for Kawasaki's
disease

Encourage passive ROM exercises in the 204.

bathtub
Avoid live immunizations for 11 months
Notify the provider of any fever

Children that
have surgery at
an early age are
at a high risk for
developing what

Latex allergies

205.

192.

Chapter 36

...

193.

How is Epstein bar

virus/mononucleosis
transmitted

Saliva

What is a
common
complication of
down syndrome

Respiratory infections (so you should

rinse the child's mouth with water after
feeding)

206.

194.

How is erythema
infectiosum (fifth
disease)/parvovirus B
19 transmitted

Droplet/blood

What is nursing
care for a patient
has juvenile
idiopathic
arthritis

195.

How is mumps
transmitted

Direct contact, droplet and contaminated

surfaces

196.

How is pertussis and

rubella transmitted

Direct contact and droplet

197.

How is rubeola
transmitted

Direct contact, droplet and can survive

two hours on surfaces

198.

How is varicella
transmitted

Direct contact, droplet, from a person

with shingles (airborne precautions)

199.

What might swollen

salivary gland
indicate

Mumps

200.

What might swollen

lymph glands and
splenomegaly
indicate

Mononucleosis

201.

Chapter 29

...

202.

Differences between
spastic, dyskinetic,
and ataxic cerebral
palsy

191.

203.

What you do
preoperatively for a
patient that has
myelomeningcele

207.

What should you

encourage the
patient with
juvenile
idiopathic
arthritis to get
on a regular basis

208.

The different
types of
muscular
dystrophy

209.

A nurse is caring
for a child who
has cerebral
palsy. What two
medications
with the nurse
administered to
treat painful
muscle spasms?

Baclofen and diazepam

Chapter 12

...

What are some

symptoms of
meningitis

Photophobia
Nausea
Irritability
Headache
Nuchal rigidity (unless it is a newborn)

1. Place infant any warmer, without

clothing
2. Apply a sterile, moist, nonadherent
210.
dressing with NS on the sack changing it
every two hours
211.
3. Place infant in the prone position with
hips flexed, legs abducted
4. Administer IV antibiotics as prescribed

Regular eye exams

What would the

CSF analysis of
bacterial
meningitis look
like

Cloudy color
Elevated WBC
Elevated protein
Decreased glucose
Positive Gram stain

213.

What would the

CSF analysis of
viral meningitis
look like

Clear color
Slightly elevated WBC
Normal or slightly elevated protein
Normal glucose
Negative Gram stain

214.

What is the
definitive
diagnostic test
for meningitis

Lumbar puncture

212.

215.

What is not
indicated for
viral meningitis

Antibiotics and corticosteroids

217.

When should
children receive
the Hib and PCV
vaccines

Two, four and six months of age, then

again between 12 and 15 months

What is three
ways to diagnose
r syndrome

Laboratory tests, liver biopsy and

lumbar puncture (to rule out meningitis)

Reye syndrome
primarily affects
the liver and
brain causing

Liver dysfunction and cerebral edema

220.

Chapter 3

...

221.

When does an
infants posterior
and anterior
fontanelle close

Posterior: 6 to 8 weeks
Anterior: 12 to 18 months

222.

What is the
minimum age in
infant should be
to use ibuprofen

Six months

223.

When does
separation
anxiety begin

Around 4 to 8 months

219.

When does
stranger fear
become evident

225.

What is the
immunization
schedule for
children one
year and younger

226.

At what
temperature
should the hot
water
thermostat be
set at for infants

49C or below (120F)

227.

How long should

infants and
toddlers remain
in a rear facing
car seat

Until the age of two or the height

recommended by the manufacturer

228.

What is a
medication you
would not want
to give to an
infant that has
botulism

Gentamicin

229.

What is normal
peak expiratory
flow rate

80 to 100%

230.

How long is the

incubation
period for
measles

10 to 20 days

231.

What is the
longest you
should suction a
child
tracheostomy
prevent hypoxia

No more than five seconds

232.

What helps to
prevent
recurrences of
rheumatic fever

Monthly injections of penicillin

Nursing care for

the patient that
has meningitis

216.

218.

224.

Between six and eight months of age