Nokea
A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
- A. Always store insulin vials in the refrigerator
- B. Adjust insulin dosage before exercise
- C. Presence of ketones in urine indicates a need for less insulin
- D. Systematically rotate injection sites
Correct Answer: D
Rationale: Systematically rotating injection sites is crucial to prevent tissue damage and ensure optimal insulin absorption. This practice helps in preventing lipohypertrophy, a condition characterized by fat accumulation at injection sites, which can affect insulin absorption and lead to inconsistent blood glucose control. By rotating injection sites, the risk of skin and tissue damage is minimized, and insulin's effectiveness is maintained over time.
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When managing Akosua Adepa, an eight-year-old diagnosed with Asthma, the nurse will consider the following as complications EXCEPT:
- A. Cor pulmonale
- B. Respiratory arrest
- C. Respiratory distress
- D. Respiratory failure
Correct Answer: C
Rationale: When managing a pediatric patient with asthma, the nurse needs to be vigilant about potential complications. While cor pulmonale, respiratory arrest, and respiratory failure are known complications of asthma, respiratory distress is not typically considered a direct complication. Respiratory distress is more of a symptom or a sign of worsening asthma, indicating the need for immediate intervention to prevent progression to more severe complications.
When treating Baby John, who has been diagnosed with a lower respiratory infection, the selection of drugs of choice for the treatment depends primarily on:
- A. Preference of the physician
- B. Selectivity of the organism
- C. Sensitivity of the organism
- D. Tolerance of the client
Correct Answer: C
Rationale: The primary factor in selecting drugs for the treatment of a lower respiratory infection in Baby John is the sensitivity of the organism causing the infection. The choice of antibiotics should be guided by the susceptibility of the specific pathogen to ensure effective treatment and prevent resistance.
Which of the following is an indication of lower respiratory infection?
- A. Cough
- B. Fever
- C. Inability to lie supine
- D. Shortness of breath
Correct Answer: C
Rationale: Inability to lie supine is a significant indication of lower respiratory infection. This symptom often occurs due to breathing difficulties and discomfort experienced by individuals with lower respiratory infections, such as pneumonia or bronchitis. It can be caused by lung inflammation, consolidation, or fluid buildup in the lungs, making lying flat uncomfortable or difficult. Monitoring a patient's ability to lie flat can provide valuable information about the severity and progression of a lower respiratory infection.
What is the reason for Asthma in 4-year-old Mabele, as Mrs. Joyce Thomson inquires? How would you explain it?
- A. Asthma occurs due to inflammation of the respiratory tract triggered by infections.
- B. An asthmatic attack can occur when the child is exposed to certain allergens, triggering an allergic reaction in the bronchioles that causes bronchial constriction.
- C. An asthmatic attack is a response to the release of inflammatory mediators to epithelial cells, affecting the autonomic neural control of the airway.
- D. Asthma is not an inborn problem; it involves abnormal growth of the bronchial tree causing restriction.
Correct Answer: B
Rationale: Asthma in children like Mabele can be triggered by exposure to allergens, leading to an allergic reaction in the bronchioles. This reaction causes constriction of the bronchial tree, resulting in an asthmatic attack. It is essential for caregivers to identify and minimize exposure to these triggers to manage and prevent asthma episodes effectively.
Alice is rushed to the emergency department during an acute, severe prolonged asthma attack and is unresponsive to usual treatment. The condition is referred to as which of the following?
- A. Status asthmaticus
- B. Reactive airway disease
- C. Intrinsic asthma
- D. Extrinsic asthma
Correct Answer: A
Rationale: Status asthmaticus is a life-threatening condition characterized by a severe and prolonged asthma attack that does not respond to standard treatments. It requires immediate medical intervention to prevent respiratory failure and potential fatality. Reactive airway disease, intrinsic asthma, and extrinsic asthma do not specifically denote the severity and unresponsiveness to treatment seen in status asthmaticus.