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A 2-month-old infant whose provider applied a Pavlik harness 1 week earlier for the treatment of developmental hip dysplasia
A nurse is reinforcing teaching with the mother of a 2-month-old infant whose provider applied a Pavlik harness 1 week earlier for the treatment of developmental hip dysplasia. Which of the following statements by the mother indicates an understanding of the teaching?
- A. I will use powders & lotion on his skin around the harness clasps.
- B. I will remove the harness daily, prior to giving the bath.
- C. I will adjust the harness straps every day.
- D. I will check my baby's skin under the straps frequently.
Correct Answer: D
Rationale: The correct answer is D: I will check my baby's skin under the straps frequently. This is because regularly checking the baby's skin under the harness straps is essential to ensure there are no signs of skin irritation or pressure sores. Failing to do so can lead to skin breakdown and complications.
Choice A is incorrect as using powders and lotions near the clasps can cause friction and increase the risk of skin irritation. Choice B is incorrect as removing the harness daily can disrupt the treatment process and should only be done as instructed by the healthcare provider. Choice C is incorrect as adjusting the harness straps without proper training can affect the effectiveness of the harness and potentially harm the baby.
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A dehydrated child who weighs 10 kg
A dehydrated child has intravenous aid therapy ordered. The child weighs 10 kg. Physician ordered Lactated Ringer's solution 40 ml/kg over 4 hours How many miles per hour will this child receive?
- A. 300ml/hour
- B. 100 mL/hour
- C. 50mL/hour
- D. 200 ml/hour
Correct Answer: B
Rationale: The correct answer is B: 100 mL/hour. To calculate the IV rate, we first multiply the weight of the child (10 kg) by the ordered rate (40 ml/kg) which gives us 400 ml over 4 hours. To convert this to ml per hour, we divide 400 ml by 4 hours, resulting in 100 ml/hour. This calculation ensures the child receives the correct amount of fluid over the specified time frame. Other choices are incorrect because they do not follow the correct calculation method or do not align with the physician's order.
A child who is to receive percussion, vibration, and postural drainage
A nurse is caring for a child who is to receive percussion, vibration, and postural drainage. Which of the following actions should the nurse take first?
- A. Instruct the client to cough
- B. Perform vibration while the client exhales slowly through the nose.
- C. Percuss the upper posterior chest.
- D. Administer albuterol by nebulizer.
Correct Answer: D
Rationale: The correct answer is D: Administer albuterol by nebulizer. This should be done first to help open up the airways and facilitate the effectiveness of the subsequent treatments. Albuterol is a bronchodilator that helps to relax the muscles in the airways, making it easier for the child to breathe. Administering albuterol before percussion, vibration, and postural drainage will help optimize the child's lung function and overall response to the respiratory therapy.
Choice A: Instruct the client to cough - This can be done after administering albuterol to help clear any loosened secretions.
Choice B: Perform vibration while the client exhales slowly through the nose - This can be done after administering albuterol to further aid in loosening and mobilizing secretions.
Choice C: Percuss the upper posterior chest - This can be done after administering albuterol to assist in clearing secretions from the lungs.
A 9-year-old child for an IV catheter insertion
A nurse is preparing a 9-year-old child for an IV catheter insertion. Which of the following actions should the nurse take first?
- A. Allow the child to see and touch IV tubing and supplies.
- B. Explain to the child's parents what role they will have during the procedure.
- C. Describe the procedure using visual aids.
- D. Ask the child what he knows about the procedure.
Correct Answer: D
Rationale: The correct answer is D, asking the child what he knows about the procedure first. This step is crucial as it helps assess the child's understanding, address any misinformation, and tailor the explanation to the child's knowledge level. It also promotes trust and cooperation. Option A may increase anxiety as seeing the supplies without understanding can be intimidating. Option B involves parents before addressing the child directly. Option C may overwhelm the child with too much information at once.
A child with pneumonia who weighs 20 lb
Primary care provider orders cefazolin (Kefrol) 30 mg/kg in two divided doses per day for a child with pneumonia. Child weighs 20 lb. If the available oral suspension is 125 mg/5ml how many mls per dose should the child receive?
- A. 5.4 mL
Correct Answer: A
Rationale: To calculate the dose, we first convert the child's weight to kg: 20 lb / 2.2 = 9.09 kg. Next, we calculate the total daily dose: 30 mg/kg * 9.09 kg = 272.7 mg/day. Since the dose is divided into 2, each dose is 272.7 mg / 2 = 136.35 mg. To find the volume needed, we divide the dose by the concentration of the suspension: 136.35 mg / 125 mg/5ml = 1.09 ml. However, the dose is divided into two, so each dose is 1.09 ml * 2 = 2.18 ml. Rounded to 1 decimal, the child should receive 2.2 ml per dose, closest to option A: 5.4 ml. Other choices are incorrect as they do not align with the calculated dose.
An infant who has spina bifida
A nurse is caring for an infant who has spina bifida. Which of the following actions should the nurse take?
- A. Place the infant in prone position.
- B. Cover the infant's lesion with a dry cloth.
- C. Feed the infant through an NG tube.
- D. Diapering over a low defect will keep the infant free from infection
Correct Answer: D
Rationale: The correct answer is D. Diapering over a low defect will keep the infant free from infection. This is because keeping the area covered with a diaper helps prevent contamination and infection. Placing the infant in prone position (choice A) is not recommended as it can put pressure on the lesion. Covering the lesion with a dry cloth (choice B) may not provide adequate protection from contamination. Feeding the infant through an NG tube (choice C) is not directly related to preventing infection at the lesion site. Therefore, the best option is to diaper over the defect to maintain hygiene and prevent infection.