Medical Notes for Mothers With Child Getting Ready for Home

The child is on the medical unit getting ready to go home.  The nurse is now reviewing the mother's note on treating hypoglycemia for errors.  What corrections should the nurse make to the mom's notes?
If blood sugar below 70, administer 15 grams of carbohydrate.
Wait 15 minutes and retest
If still less than 70 repeat the 15 grams of carbohydrate
Recheck blood glucose in 15 minutes
When blood glucose is at 80 give a snack if the next meal is over 30 minutes away
When treating hypoglycemia, the 15-15 rule should be followed. The rule is only recommended when the blood sugar is below 70 but more than 55mg/dl. The mother should give 15grams of carbohydrate, wait for 15 minutes and test again. If the sugar levels are still low (within this range), the mother should repeat the process until it hits the targeted range (above 70mg/dl). After this, the mother should give the child a nutritious meal or snack to ensure the sugar levels do not fall low again. In severe cases such as when the sugars are below 55mg/dl, the mother should rush the child to hospital where injectable glucagon will be administered. Therefore, the mother’s notes are correct and the nurse should only add more necessary details and reassurance.
The seven-year-old is in the provider's office for a follow up visit two months later.  Mom is a single mom who works as a nurse full time at a local hospital.  The seven year old is doing well.  Mom looks tired and wishes she could  get away a little for time with family and friends.  What part of the resiliency wheel is Mom missing?
Clear and consistent boundaries
Prosocial bonding
High expectations
Life skills
The mother’s sign of fatigue is an indication that she is being overwhelmed by the new activities/adjustments surrounding their daily life. She needs to establish a balance on how to tackle these issues and having her normal daily routine back. She is missing the clear and consistent boundaries in her daily activities.
In Two hours the nurse notes the O2 sat monitor is beeping and checks on the infant. Her assessment reveals:
T 101 P180 and RR 70 with substernal and intercostal retractions.  The infant is extremely lethargic and the lung sounds on both sides are diminished in the bases.  The nurses next action is:
Notify the provider to request an increase O2 delivery
Notify respiratory therapy to initiate albuterol via nebulizer
Arrange for a transfer to PICU
Activate rapid response team
Respiratory distress syndrome and pneumonias are the most common reasons infants are admitted to the PICU, oxygen therapy is the first line action in management therefore the first course of action would be to notify the provider to request an increase in O2 delivery.
Match the cardiac disorder on the left to the potential resulting condition on the right
1.Kawasaki Disease
2.Ventral septal defect      
3. Tetralology of Fallot
match
a.cardiac coronary artery aneurism  
b.  Discrepancy in BP and pulses between upper and lower body     
 c. Pulmonary artery hypertension           
d.  Polycythemia and stroke   
Kawasaki Disease- Cardiac coronary artery aneurism
Ventral septal defect- pulmonary artery hypertension
Tetralogy of Fallot- polycythemia and stroke       
The nurse receives the following report on these four children with cardiac disease.  Which patient would the nurse check FIRST?
A five-year-old with Kawasaki disease who has a temperture of 102.6
An 18 month old with coarctation of the aorta whose capillary refill is slower in his lower extremities than his upper extremities.
A two year old with Tetralogy of Fallot who has crackles audbile throughout both lungs
A three year old with rheumatic heart disaease who is crying R/T severe knee pain
Based on the severity and the possible life-threatening implications, most of these conditions do not require emergency intervention, checking on the three-year-old with rheumatic heart disease would be appropriate to check if the child’s pain can be managed.
The parents ask the school nurse to provide information to their provider about the child's response to the methylphenidate.  The interaction between the nurse and the provider is what part of the child's ecosystem?
Group of answer choices
macrosystem
microsystem
mesosystem
exosystem
mesosystem- the child directly interacts with the two environments, both the healthcare provider’s environment and the school. These are the child’s micro systems. The interaction between these two systems forms his/her mesosystem (Bouchard & Smith, 2017).
The patient states that she had been using her albuterol inhaler two or three times a day over the last week in addition to using it prior to exercise.  The nurse's best response to the adolescent is:
That's too much albuterol.
We need to contact your provider to alter your treatment plan
It's not unusual for cross country runners to need extra albuterol during training
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