Exam 35: Caring for the Critically Ill Child

A nurse is removing an arterial line from a patient's radial artery.What actions by the nurse are most appropriate after the line is removed?

Family members are visiting a child who is mechanically ventilated and heavily sedated.The parents are visibly distressed.Which statement from the nurse is most appropriate?

A new nurse is caring for a child who has an arterial catheter in the radial artery.Which action by the new nurse causes the experienced nurse to intervene?

A mechanically ventilated adolescent has a RASS score of -3.The child is receiving pain medication and sedation by intravenous infusion.Which action by the nurse is the most appropriate?

A student nurse assesses a child for nonverbal signs of pain to report to the registered nurse.Which information should the student include?

A mechanically ventilated child is being assessed for extubation.Which assessment finding would cause extubation to be delayed?

The pediatric intensive care nurse understands the effects of stress on the critically ill child.Which factors increase stress in this population?

A pediatric intensive care nurse wants to practice in a way that helps reduce parents' stress while their child is in the unit.Which action by the nurse would be most helpful?

A child is being mechanically ventilated and is very agitated and fighting the ventilator despite receiving fentanyl citrate (Sublimaze)and midazolam (Versed).Which action by the nurse is the most appropriate?

The nursing manager of the pediatric intensive care unit wants to provide patients with improved sleep and rest.Which intervention would have the greatest impact on promoting rest in this environment?

A nurse is assessing patients in the pediatric intensive care unit for signs of hypoperfusion.Which assessment findings are indicative of this condition?

A child in the pediatric intensive care unit is started on cortisone.When the nurse enters the room to check his blood glucose,the parents are concerned that he is now a diabetic.Which response by the nurse is the most appropriate?

A patient in the intensive care unit has a pulmonary artery catheter for hemodynamic monitoring.On assessment,the nurse finds the patient clinically unchanged from the last assessment,but the hemodynamic data are significantly changed.Which action by the nurse is the most appropriate?

A child is brought to the emergency department with moderate respiratory distress.She has an oxygen saturation of 89% but is awake,alert,and responsive,and is clinging to the mother.The nurse is consulting about appropriate oxygen delivery devices and expresses concern about the patient retaining CO₂.Which oxygen delivery device is the most appropriate for this child?

The nurse has an order for isotonic crystalloid solution to treat a child with hypoperfusion.Which solution does the nurse choose?

A child is admitted to the pediatric intensive care unit with respiratory distress and respiratory acidosis.The child's pulse oximeter reads 98%.Which actions by the nurse are the most appropriate at this time?

A registered nurse working with a student nurse explains problems that can cause ventilator alarms.Which patient problems does the nurse include?

A child in the pediatric intensive care unit has a pulse oximeter for continuous oxygen saturation readings.Which action by the nurse is important for this patient's safety?

A child's blood pressure is 92/64 mm Hg.Therefore,the mean arterial pressure is ____________________.

The staff in the pediatric intensive care unit is preparing to intubate a 3-year-old child.To facilitate intubation by providing skeletal muscle paralysis,which drug does the nurse anticipate administering?