Open Resources for Nursing (Open RN) Tetracyclines are broad-spectrum antibiotics that are bacteriostatic, subsequently inhibiting bacterial growth. Indications: Tetracycline medications are useful for the treatment of many gram-positive and gram-negative infectious processes, yet are limited due to the significance of side effects experienced by many patients. Mechanism of Action: Tetracyclines work by penetrating the bacterial cell wall and binding to the 30S ribosome, inhibiting the protein synthesis required to make the cellular wall.[1] Special Administration Considerations: Significant side effects of tetracycline drug therapy include photosensitivity, discoloration of developing teeth and enamel hypoplasia, and renal and liver impairment.[2] Tetracyclines are contraindicated in pregnancy and for children ages 8 and under. Small amounts may be excreted in breast milk. Patient Teaching & Education: Patients should be instructed to avoid direct sunlight exposure and wear sunscreen to prevent skin sensitivities. Additionally, it is important for patients to be educated regarding potential impaired absorption of tetracycline with the use of dairy products. Patients who are on oral contraceptives should be educated that tetracyclines may impede the effectiveness of the oral contraceptive and an alternative measure of birth control should be utilized while on the antibiotic. Female patients must be aware to immediately stop tetracycline if they become pregnant. Expired tetracycline should be immediately disposed of as it can become toxic.[3] Now let’s take a closer look at the medication grid for tetracycline in Table 3.13.[4] Table 3.13 Tetracycline Medication Grid
Critical Thinking Activity 3.13aUsing the above grid information, consider the following clinical scenario question: The nurse is providing medication teaching to a parent of a six-year-old child with strep throat in a clinic setting. Due to multiple drug allergies, tetracycline was prescribed by a doctor who is new to the clinic. What is the nurse’s best response and why? Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book. Nursing care of Children ATI 2019 1. A nurse is providing teaching to the guardians of a school age child who has a seizure disorder. Which of the following factors should the nurse include as a common trigger that increases the risk of seizures? Prolonged headache Lack of sleep Decreased temperature Exposure to secondhand smoke 2. A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines. Which of the following instructions should the nurse include in the teaching? You can replace milk with nondairy sources of calcium You can drink milk on an empty stomach You should consume flavored yogurt instead of plain yogurt You might tolerate plain milk better than chocolate milk 3. A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is moderately dehydrated? Respiratory rate 28/min Weight loss 7% Capillary refill 1 second Bradycardia 4. A nurse is caring for an adolescent who is 1hr postoperative following an appendectomy. Which of the following findings should the nurse report to the provider? Muscle rigidity Heart rate 63/min Temperature 36.4 c (97.5F) Abdominal pain 5. A nurse is planning care for an 8-month-old infant who has heart failure. Which of the following actions should the nurse include in the plan of care? Place the infant in a prone position Provide less frequent higher volume feedings Repeat a digoxin dosage if the infant vomits within 1hr of administration Administer cool humidified oxygen via nasal cannula 6. A nurse is caring for a preschooler who is postoperative following a tonsillectomy. The child is now ready to resume oral intake. Which of the following dietary choices should the nurse offer the child? Chocolate milk Sugar free cherry gelatin Vanilla ice cream Lime flavored ice pop 7. A nurse is planning care for an adolescent who has sickle cell anemia. Which of the following immunizations should the nurse include in the plan? Measles mumps and rubella (MMR) Pneumococcal conjugate (PCV13) Rotavirus Respiratory syncytial virus (RSV) 8. A nurse is reviewing the medical record of school age child who has cystic fibrosis. Which of the following findings should the nurse report to the provider? (Click on the Exhibit) button for additional information about the client. There are three tabs that contain separate categories of data} Heart rate WBC count Oxygen saturation HbA1c 9. A charge nurse is planning care for an infant who has failure to thrive. Which of the following actions should the nurse include in the plan of care? Use half strength formula when feeding the infant Give the infant fruit juice between feedings Assign consistent nursing staff to care for the infant Keep the infant in a visually stimulating environment 10. A nurse is teaching the parent of school age child about bicycle safety. Which of the following instructions should the nurse include in the teaching? Your child should keep the bicycle at least 3 feet from the curb while riding in the street Your child should walk the bicycle through intersections Your child’s feet should be 3 to 6 inches off the group when seated on the bicycle Your child should ride the bicycle against the flow of traffic 11. A nurse is providing discharge teaching to the parents of an infant who is at risk for sudden infant death syndrome (SIDS). Which of the following statements by the parents indicates an understanding of the teaching? I will move my baby’s stuffed animal to the corner of her crib while she sleeps I will have my baby sleep next to me in bed during the night I will dress my baby in lightweight clothing to sleep I will lay my baby on her side to sleep for naps 12. A nurse in a PACU is caring for a school age child immediately following a tonsillectomy. Which of the following actions should the nurse take? Place the Chile in aside lying position Instruct the child to drink fluids through a straw Offer the child ice cream when alert Encourage the child to deep breath and cough 13. A nurse in the emergency department is caring for an adolescent who is requesting testing for STIs. Which of the following actions is appropriate for the nurse to take? Contact the clients’ parents to obtain phone consent Obtain written consent from the client Request verbal consent from the social worker Postpone the testing until the clients’ parents are present 14. A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first? A toddler who has a partial thickness burn on his right hand and requires a dressing change A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillin An adolescent who has sickle cell anemia and slurred speech An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10 15. A nurse is assessing a 5-month-old infant. Which of the following findings should the nurse report to the provider? Unable to hold a bottle Absent grasp reflex Exhibits head lag when pulled to a sitting position Unable to roll from back to abdomen 16. A nurse is caring for a 10-month-old child was brought to the emergency department by his parents following a head injury. Which of the following actions should the nurse take first? Inspecting for fluid leaking from the ears Assess respiratory status Check pupil reactions Examine the scalp for lacerations 17. A nurse is providing teaching to the parents of an infant who is to undergo pilocarpine iontophoresis testing for cystic fibrosis. Which of the following statements should the nurse include in the teaching? A nurse will insert an IV prior to the test Your baby will need to fast for 8hours prior to the test The test will measure the amount of chloride in your baby’s sweat We will measure the amount of protein in your baby’s urine over a 24-hour period 18. A nurse is planning care for a 6-month-old infant who has bacterial meningitis. Which of the following interventions should the nurse include in the plan of care? Pad the side rails of the crib Provide frequent range of motion to the neck and shoulders Keep the television on in the room to provide background noise Place the infant in a semiprivate room 19. A nurse is caring for a school age child following the application of a cast to fractured right tibia. Which of the following actions should the nurse take first? Elevate the child leg Administer pain medication Petal the edge of the cast Teach the child about cast care 20. A nurse is preparing to administer immunizations to a 3month old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care? Provide a pacifier coated with an oral sucrose solution prior to the injections Use a 20-gauge needle for the injections Apply eutectic mixture of local anesthetics (EMLA) cream immediately before the injections Inject the immunizations into the deltoid muscle 21. A nurse is caring for an infant who has a patent ductus arteriosus. The nurse should identify that the defect is at which of the following locations of the heart? (You will find hot spots to select in the artwork below. Select only the hot that corresponds to your answer) Heart picture B 22. A nurse is providing teaching to the parents of a 2-month-old infant who has developmental dysplasia of the hip and has a prescription for a Pavlik harness. Which of the following statements by the parents indicates an understanding of the teaching? We will apply lotion to the skin under the straps We should adjust the straps daily We will place the diaper under the straps We should expect our baby to wear this harness for a weeks 23. A nurse is reviewing the medical record of a 15-month-old child who is schedule to receive the measles, mumps, and rubella (MMR) vaccine which of the following findings should the nurse identify as a contraindication for receiving this vaccine? Allergy to neomycin Family history of seizures Temperature of 37.2 C (99 F) Upper respiratory infection 2 days ago 24. A nurse is discussing coping mechanism with a parent of a 3-month-old infant. Which of the following therapeutic questions should the nurse ask the parent? What do you do when your infant is fussy? Does parenting cause you stress Is it overwhelming when your infant is having a bad day? Are you willing to take new parenting classes? 25. A nurse is performing a cranial nerve assessment on a school age child. Which of the following findings indicates proper functioning of the child’s trigeminal nerve? The child exhibits a gag reflex when stimulated with a tongue blade The child maintains balance when standing with eyes closed The child has symmetrical jaw strength when biting down The child correctly identifies specific scenes 26. A nurse is caring for a 3-month-old infant who has a cleft of the soft palate. Which of the following actions should the nurse take? Feed the infant 177.4ml(6oz) of formula three times each day Discontinue a feeding if the infants eyes become watery Elevate the infants head to 10 angles during feeding Postpone burping the infant until after completing each feeding 27. A nurse in an emergency department is caring for a preschool -age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect? Polyuria Jaundice Hyperpyrexia Neck vein distention 28. A nurse is preparing a school age child for an invasive procedure. Which of the following actions should the nurse plan to take? Plan for 30min teaching session about the procedure Demonstrate deep breathing and counting exercises Explain the procedure to the child when they are in the playroom Use vague language to describe the procedure 29. A nurse is providing teaching to a 10-year-old child who is scheduled for an arterial cardiac catheterization. Which of the following information should the nurse include in the teaching? You will need to keep your leg straight for 8hours following the procedure You will be on bed rest for 2 days after the procedure You will have your dressing removed 12 hours after the procedure You will be on a clear liquid diet for 24hours following the procedure 30. A nurse in a provider’s office is assessing the vital signs of a 2year old child at a well child visit. Which of the following findings should the nurse report to the provider? Pulse rate 98/min Respiratory rate 26/min Blood pressure 118/74mm Hg Temperature 37.2 C (99 F) 31. A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should identify that which of the following laboratory tests can contribute to confirming this diagnosis (select all that apply) Partial thromboplastin time (PTT) C-reactive protein (CRP) Antistrepcolysin O (ASO) titer Erythrocyte sedimentation rate (ESR) Blood urea nitrogen (BUN) 32. A nurse is assessing an infant who has acute otitis media. Which of the following findings should the nurse expect? (select all that apply) Increased appetite Enlarged sub clavicular lymph node Crying Fever Restlessness 33. A nurse is planning care for a child who has osteomyelitis. Which of the following interventions should the nurse include in the plan of care? Initiate contact precaution for the child Maintain a patient intravenous catheter Encourage frequent physical activity to increase bone mass Provide a high calorie low protein diet 34. A nurse is admitting a child who has acute epiglottis. Which of the following actions should the nurse take? Initiate droplet isolation precautions Check oxygen saturation every 4 hr Assist the child into supine position Obtain a throat culture 35. A nurse is providing teaching about home care to the parent of a child who has scabies. Which of the following instructions should the nurse include in the teaching? Wash the child’s hair with shampoo containing ketoconazole Treat everyone who came into close contact with the child Soak combs and brushes in boiling water for 10 min Apply petroleum jelly to the affected areas 36. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching? Apply bactericidal ointment to lesions Administer acyclovir PO two times per day Soak hairbrushes in boiling water for 10min Seal soft toys in a plastic bag for 14 days 37. A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect? Hypothermia Ataxia Hyperactive reflexes Pinpoint pupils 38. A nurse is planning care for a school age child who was admitted from the emergency department 2hr ago. Which of the following interventions should the nurse include to promote adequate sleep for the child? Follow the child’s home sleep routine to reduce anxiety Allow the child to adjust their bedtime to promote autonomy Leave the child to adjust their bedtime to promote autonomy Leave the lights on in the child’s room to promote safety Provide the child with video games prior to bedtime to reduce stress 39. A nurse is assessing an infant who has severe dehydration due to gastroenteritis. Which of the following findings should the nurse expect? Capillary refill of 2 seconds Increased urine output Increased respiratory rate Hypertension 40. A nurse is preparing to administer a prescribed medication to a toddler whose parent is nearby. Which of the following actions should the nurse take to identify the toddler? Check the toddlers ID band against the medical record Check the toddlers room number against their ID band Ask the parent to confirm the toddler’s identity Ask another nurse to confirm the toddlers identify 41. A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following actions should the nurse include in the plan of care? Administer oral viscous lidocaine Schedule routine oral care every 8hr Moisten the mucosa with lemon glycerin swabs Cleanse the gums with saline soaked gauze? 42. A nurse is preparing to collect a urine specimen from a female infant using a urine collection bag. Which of the following actions should the nurse take? Place a snug fitting diaper over the drainage bag Stretch perineum tant when applying the bag Apply lidocaine gel to the perineum before attaching the bag Position the opening of the bag over the urethra and the anus 43. A nurse in a pediatric clinic is providing teaching to the guardian of an infant who has a new prescription for digoxin. Which of the following manifestations should the nurse include as an indication of digoxin toxicity? Polyuria Bradycardia Jaundice Diaphoresis 44. A nurse in the emergency department is assessing a toddler who has hyperpyrexia, severe dyspnea, and is drooling, which of the following actions should the nurse take first? Administer an antibiotic to the toddler Prepare the toddler for nasotracheal intubation Obtain a blood culture from the toddler Insert an IV catheter for the toddler 45. A nurse is planning care for a child who has varicella. Which of the following interventions should the nurse plan to include? Administer aspirin for fever Assess the oral cavity for kolpik spots Provide the child with a warm blanket Initiate airborne precautions 46. A nurse is teaching home care to the parents of a preschool age child who has heart failure. Which of the following information should the nurse include in the teaching? Provide for periods of rest Weigh the child once each month Withhold digoxin if the child’s is greater than 100/min Increase the child’s oxygen flow rate until the child no longer has cyanosis 47. A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first? Set the administration race on the feeding pump Attach the feeding bag tubing to the end of the NG tube Check the pH of the gastric secretions Flush the tube with water 48. A nurse is providing teaching to the parents of a school age newly diagnosed with a seizure disorder. The nurse should teach the parents to take which of the following actions during a seizure? Minimize movement of the limbs Place the child in a prone position Insert a tongue blade between the teeth Clear the area of hard objects 49. A nurse in a provider’s office is preparing to administer immunizations to a 12-year-old client during a well child visit. Which of the following immunizations should the nurse plan to administer? Varicella Human papillomavirus (HPV) Hepatitis A Diphtheria tetanus and pertussis (DTaP) 50. A nurse is assessing a school age child who has heart failure and is taking furosemide. Which of the following findings should the nurse identify as an indication that the medication is effective? An increase in potassium levels A decrease in cardiac output An increase in venous pressure A decrease in peripheral edema 51. A nurse is teaching a group of female adolescents about healthy eating. Which of the following instructions should the nurse include in the teaching? Consume 1.500 to 1,700 calories per day Limit your sodium intake to 3000 milligrams per day Decrease your vitamin D intake once you start to menstruate Increase the amount of your dietary iron intake 52. A nurse in the emergency department is caring for a child who has a temperature of 39.1C(102.4 F) and a suspected diagnosis of bacterial meningitis. Which of the following actions should the nurse take first? Prepare the child for a lumbar puncture Administer an antipyretic to the child Implement droplet precautions for the child Dim the lights in the child’s room 53. A nurse is providing teaching to the guardians of a school age who has sickle cell disease about management of the illness. Which of the following instructions should the nurse include? Apply cold compresses to painful areas Have the child wear a surgical mask to school Limit fluids at bedtime Encourage physical activity as tolerated 54. A nurse is caring for a 5-year-old child following a tonsillectomy and adenoidectomy. Which of the following findings should the nurse identify as an indication of hemorrhage? Blood pressure 95/56 mm Hg Heart rate 54/min Continuous swallowing Flushing of the face 55. A nurse is assessing a school age child’s cranial nerve function. Which of the following actions should the nurse ask the child to take when assessing the accessory nerve? Show their teeth while smiling Shrug their shoulders against mild pressure Follow a light in the six cardinal positions Move their tongue in all directions 56. A nurse in an urgent care clinic is prioritizing care for four children. Which of the following children should the nurse assess first? A preschool age child who has a muffled voice and no spontaneous cough A toddler who has nephrotic syndrome and facial edema A school age child who has diabetes mellitus and a blood glucose of 200mg/dl An adolescent who has Crohn’s disease and a recent weighs loss of 5kg (11Ib) 57. A school nurse is assessing a 7-year-old student. The nurse should identify which of the following findings as a potential indicator of physical abuse? Bruising around the wrists Front deciduous teeth missing Weight in 45th percentile Abrasions on the knees 58. A nurse is caring for an infant who receives intermittent enteral feedings through a gastrostomy tube. Which of the following actions should the nurse take when administering a feeding? (select all that apply)? Place the infant in supine position Check for residual volumes by aspirating stomach contents Heat the formula to 39C (102 F) prior to administration Instill the formula over a period of 30 to 45 min Offer the infant a pacifier during feedings 59. A nurse is caring for a 4-year-old child who has meningitis and is receiving gentamicin. Which of the following laboratory values should the nurse report to the provider? Creatinine 1.4 mg /dl Creatinine 0.3 mg/dl BUN 12 mg/dl BUN 6 mg/dl 60. A nurse is assessing a toddler who has cystic fibrosis. Which of the following findings should the nurse expect? Weight gain Visible peristalsis Rhinorrhea Steatorrhea 61. A nurse is preparing to initiate IV antibiotic therapy for a newly 12-month-old infant. Which of the following actions should the nurse plan to take? Start the IV in the infant’s foot Cover the insertion site with an opaque dressing Use a 24-gauge catheter to start the IV Change the IV site every 3 days 62. A nurse is providing teaching about the effects of sun exposure to a parent of a toddler. Which of the following responses by the parent indicates an understanding of the teaching? I should dress my child in loose weave clothing My child should remain under a beach umbrella during morning hours I should apply a 10 SPF sunscreen to my child’s entire body My child should wear a wide – brimmed hat 63. A nurse is reviewing the laboratory result of a preschooler who has gastroenteritis and notes the client’s potassium level is 3.2 mEq/L. which of the following assessment findings should the nurse expect? Hyporeflexia Oliguria Hypertension Hyperactive bowel sounds 64. A nurse is providing support to a family whose infant died from sudden infant death syndrome (SIDS). Which of the following actions should the nurse take? Avoid discussing details of the attempt to revive the infant Provide a follow up phone call 1 week following the infant’s death Discourage the parents from allowing siblings to view the body Acknowledge the family members feelings of guilt 65. A nurse is monitoring an infant who is receiving opioids for pain. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? Limb withdrawal Increased blood pressure Bradycardia Relaxed facial expression 66. A nurse is preparing to administer amoxicillin 80mg/kg/day divided into two doses daily to a 2-year-old client who weighs 10kg (22 Ib). Available is amoxicillin suspension 400mg/5ml. How many ml of amoxicillin should the nurse administer per dose? (round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero) 67. A nurse is caring for a preschooler who refuses to take a stat dose of oral diphenhydramine. Which of the following statements should the nurse make? The medication is not bad. It tastes like candy The medication will treat you want to take the medication Sometimes, when a child has to take medication, they feel sad 68. A nurse is evaluating a 4-year-old child who has cystic fibrosis and has been receiving chest physiotherapy treatments. The nurse should identify which of the following findings as an indication that the therapy has been effective? Increased expectoration Increased urine output Increased heart rate Reduce pain 69. A nurse is assessing an infant who has intussusception. Which of the following findings should the nurse expect? Board like abdomen Sausage shaped abdominal mass Increased urinary output Constipation 70. A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider? Tachypnea Rhinorrhea Coughing pharyngitis PLACE A SIMILAR OR RELATED ORDER WITH US NOW |
A nurse is providing teaching about the effects of sun exposure to a parent of a toddler
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