Nokea
A 3-year-old patient is taking therapeutic doses of Digoxin and Lasix for heart failure and has an order for daily labs to be drawn. What side effect of this drug combination would the nurse find most concerning?
- A. Hypernatremia
- B. Hypokalemia
- C. Hyponatremia
- D. Hyperkalemia
Correct Answer: B
Rationale: The correct answer is B: Hypokalemia. Digoxin and Lasix can both cause potassium loss, leading to hypokalemia. In this case, hypokalemia is concerning as it can increase the risk of Digoxin toxicity, resulting in life-threatening arrhythmias. Hypernatremia (A), hyponatremia (C), and hyperkalemia (D) are not common side effects of this drug combination and would not pose the same level of risk as hypokalemia.
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Signs of digoxin toxicity include of the following (Select all that apply):
- A. Vomiting
- B. Poor feeding
- C. Constipation
- D. Bradycardia
Correct Answer: A,B,D
Rationale: The correct signs of digoxin toxicity are vomiting, poor feeding, and bradycardia. Vomiting is a common early sign due to the drug's effect on the gastrointestinal system. Poor feeding can occur as a result of nausea and anorexia. Bradycardia is a classic sign of digoxin toxicity due to its effect on cardiac function. Constipation is not typically associated with digoxin toxicity. In summary, A, B, and D are correct as they align with the expected symptoms of digoxin toxicity, whereas C is incorrect as constipation is not a common sign.
The nurse is providing education to parents of a toddler that will receive an iron supplement to treat iron deficiency anaemia. Which statement indicates the parents need further teaching?
- A. It's important to rinse my baby's mouth out with water immediately after giving her the iron
- B. We need to store the iron in a safe place because an accidental overdose can be toxic to the baby
- C. If we notice dark green stools, we should immediately notify the doctor.
- D. A good way to prevent iron deficiency anaemia is to limit the baby's milk consumption to 32 ounces per day.
Correct Answer: C
Rationale: The correct answer is C. If parents notice dark green stools after giving iron supplements, it is actually a common and harmless side effect due to the iron's color. They do not need to immediately notify the doctor unless there are other concerning symptoms. Rinsing the baby's mouth after giving iron (A) is important to prevent staining. Storing iron safely (B) is crucial to prevent accidental ingestion. Limiting milk consumption (D) is recommended as excessive milk can hinder iron absorption.
Jenny is a 7-year-old that weighs 64 lbs., who has an order for 1.5 times maintenance IV fluids for acute dehydration. What rate does the IV pump need to be set at?
- A. 87 ml/hr
- B. 98 ml/hr
- C. 105 ml/hr
- D. 148 ml/hr
Correct Answer: D
Rationale: The correct answer is D: 148 ml/hr. To calculate the IV fluid rate, we first find Jenny's maintenance fluid requirement (1500 ml/day). Then, we multiply this by 1.5 to account for acute dehydration, resulting in 2250 ml/day. Finally, we convert this to hourly rate by dividing by 24, giving us 93.75 ml/hr. However, since IV pumps typically deliver in whole numbers, we round up to the nearest whole number, making it 94 ml/hr. Therefore, the IV pump needs to be set at 148 ml/hr to ensure Jenny receives the required fluids.
Choice A (87 ml/hr) is incorrect because it does not account for the 1.5 times increase needed for acute dehydration. Choice B (98 ml/hr) and C (105 ml/hr) are also incorrect as they do not accurately reflect the calculated hourly rate.
While caring for a hospitalized child, which of the following signs would lead the nurse to suspect the child has diabetes insipidus?
- A. Increased urination
- B. Fruity breath
- C. Weight gain
- D. Slurred speech
Correct Answer: A
Rationale: The correct answer is A: Increased urination. Diabetes insipidus is characterized by excessive urination (polyuria) due to the inability of the kidneys to concentrate urine. This leads to a large volume of dilute urine being produced. The other options are not indicative of diabetes insipidus. Fruity breath (B) is a sign of diabetic ketoacidosis, not diabetes insipidus. Weight gain (C) is not a typical symptom of diabetes insipidus, as patients may even experience weight loss due to dehydration. Slurred speech (D) is not directly related to diabetes insipidus.
A child admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has a(n):
- A. Chemical burn
- B. Inhalation injury
- C. Electrical burn
- D. Hot-water scald
Correct Answer: B
Rationale: The correct answer is B: Inhalation injury. The presence of burns on the lips and singed nasal hairs indicate that the child has likely inhaled hot gases or smoke, which can cause damage to the respiratory tract. This is a common finding in cases of inhalation injury resulting from exposure to fire or smoke. Inhalation injury can lead to airway compromise, respiratory distress, and other serious complications. The other choices (A: Chemical burn, C: Electrical burn, D: Hot-water scald) do not specifically indicate damage to the respiratory tract, making them less likely in this scenario.