Pediatric Nursing Flashcards

Which complication is of greatest concern when a child has a tracheostomy?

Answer: Accidental decannulation (tube dislodgement)

Accidental decannulation is life-threatening because the child cannot breathe without the tracheostomy tube (or cannot breathe adequately). A replacement tube of the same size and a size smaller must always be at the bedside. This is the highest-priority safety concern.

A child with asthma is using their SABA (salbutamol) inhaler more than 2 times per week. What does this indicate?

Answer: Poorly controlled asthma requiring step-up therapy assessment

SABA use more than 2 days per week (excluding pre-exercise use) indicates poorly controlled or persistent asthma. Per GINA guidelines, this is a trigger for reassessment and possible step-up in controller therapy (e.g., adding or increasing ICS).

What is the first action when a nurse discovers a child has aspirated a small object and is now silent and cyanotic?

Answer: Perform 5 back blows and 5 chest thrusts (for child under 1 year) or abdominal thrusts (Heimlich) for child over 1 year

A silent, cyanotic child has a complete airway obstruction. For infants 1 year: abdominal thrusts (Heimlich). Blind finger sweeps are contraindicated as they may push the object further.

A nurse is caring for a premature infant in an incubator. What is the purpose of the incubator?

Answer: Maintain thermoregulation and reduce insensible water loss

Premature infants lack adequate subcutaneous fat and brown fat reserves for thermoregulation. Incubators maintain a neutral thermal environment (NTE), reducing metabolic oxygen demand and insensible water loss. Temperature control is critical for survival.

A child with rheumatic fever develops carditis. Which medication is most important in preventing further cardiac damage?

Answer: Prophylactic penicillin to prevent recurrent group A streptococcal infection

Rheumatic heart disease results from repeated streptococcal infections triggering autoimmune cardiac damage. Long-term prophylactic penicillin (up to age 21 or for life with significant heart disease) prevents recurrent strep infections and further cardiac damage.

What is the recommended temperature and route for assessment in an infant under 2 years?

Answer: Rectal temperature; normal range 36.6–38.0°C

Rectal temperature is the most accurate measurement in infants and young children (under 2 years). Normal rectal temperature is 36.6–38.0°C (97.9–100.4°F). Oral temperature is unreliable in this age group. Axillary is used as a screening tool only.