Chapter 25: Pediatric Surgery

Chapter 25: Pediatric Surgery

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. It is important to recognize that the difference between pediatric care and adult care is not just a size issue. Major areas of distinction are the airway and pulmonary status, cardiovascular status, temperature regulation, metabolism, fluid management, and psychologic development. The most significant consideration when caring for pediatric patients that is not of concern when caring for adults is:

ANS:  B

From birth onward, the body and organs exist in a continual state of development, and multiple physiologic changes occur with age. A thorough knowledge of these differences is integral to the provision of nursing care for the pediatric patient in the OR.

REF:   Page 1085

2. Young children are predisposed to parasympathetic hypertonia (increased vagal tone), which can be induced by:

ANS:  A

Young children are predisposed to parasympathetic hypertonia (increased vagal tone), which can be induced by painful stimuli such as laryngoscopy, intubation, eye surgery, or abdominal retraction.

REF:   Page 1085

3. The immature blood-brain barrier and decreased protein binding in infants increase their sensitivity to which group of drugs?

ANS:  C

Drug distribution is different in neonates and infants compared with older children and adults because of an increased percentage of total body weight and extracellular body fluid. Infants have an immature blood-brain barrier and decreased protein binding, which results in an increased sensitivity to sedatives, opioids, and hypnotics.

REF:   Pages 1086, 1143

4. The pediatric patient is at risk for imbalanced fluid volume related to invasive surgery and accompanying blood loss. Select the outcome indicator that would best reflect that the goal of maintained fluid balance was attained.

ANS:  A

The child will maintain fluid balance as evidenced by blood pressure within expected/acceptable range, palpable peripheral pulses, moist mucous membranes, and absence of peripheral edema.

REF:   Pages 1086-1089, 1091

5. During the planning process, the perioperative nurse determines nursing interventions that will assist in meeting the appropriate goal statement of the desired nursing outcome. What nursing intervention is appropriate, when implemented, in protecting the pediatric patient from fluid volume imbalance?

ANS:  B

The following are nursing interventions directed toward protecting the patient’s fluid volume balance: maintain and protect patency of intravenous lines; review laboratory analyses for results of total blood volume; calculate estimated total blood volume using formula of 85 to 90 mL/kg of body weight if total blood volume has not been determined by laboratory tests; provide gram scales for weighing sponges discarded from operative field, weigh sponges, and report estimated loss; provide suction units with reservoirs that measure in 5- to10-mL increments; measure and record quantity of irrigating fluid used; provide appropriate amounts of intravenous fluid replacement (e.g., 250-mL containers); measure and record urinary output and output from other drainage tubes; send laboratory specimens for analysis as indicated; review results indicating fluid status.