Exam 35: Caring for the Critically Ill Child

A child is hospitalized with anemia and critically low hemoglobin.The health-care provider orders a blood transfusion.The parents won't sign the consent form even though they have been told that without it,their child will die.What does the pediatric intensive care nurse understand about this situation?

A nurse receives report on patients in the pediatric intensive care unit who are at risk for hypoperfusion.Which child should the nurse see first?

A 36-lb (16.4-kg)patient in the pediatric intensive care unit is started on a propofol (Diprovan)infusion.The health-care provider orders the infusion started at 410 µg/minute.Which action by the nurse is the most appropriate?

A child has a radial arterial line in place.The nurse assesses the distal fingertips as cool and pale.Which action is most appropriate based on these assessment findings?

A nurse is working with a student in the pediatric intensive care unit.The student reports that a 3-year-old patient looks very anxious,and the parents report that this behavior is not normal for her and she seems disoriented.Which action suggested by the registered nurse is the most appropriate?

A nurse is supervising a student working with hemodynamic monitors.Which action by the student requires the nurse to intervene?

A child in the pediatric intensive care unit is alert and able to eat.The child's parent asks the nurse "Why do you keep feeding my child so much? I don't want her to become fat." Which response by the nurse is the most appropriate?

A toddler is critically injured and admitted to the pediatric intensive care unit.The child is on a ventilator and is sedated.The parents explain that the child is normally very active,wants to do everything himself,and is very chatty.Which aspects of this situation would cause the greatest psychosocial impact on this child?

The nursing faculty informs a clinical group of nursing students about the detrimental effects of excessive noise exposure to patients in the pediatric intensive care unit.Which effects does the faculty member include in the discussion with the clinical group?

A nurse receives report on a patient in the pediatric intensive care unit and is told the patient is on a ventilator in SIMV mode.Which information is inconsistent with the nurse's knowledge of this type of ventilation?