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An 18-month-old patient with Down's Syndrome has a history of mild pulmonary hypertension which requires a daily dose of Furosemide (Lasix). The mother is questioning if the new dose is correct after an adjustment at the child's last Cardiology visit. The child weighs 22 pounds and the dosing for furosemide (Lasix) for this child 2mg/kg/dose. What is the appropriate dose of Furosemide Lasix for this child?
- A. 44 mg/dose
- B. 28 mg/dose
- C. 20 mg/dose
- D. 10 mg/dose
Correct Answer: C
Rationale: The correct dose of Furosemide (Lasix) for this child is 20 mg/dose. To calculate the appropriate dose, we first convert the child's weight from pounds to kilograms (22 lbs ÷ 2.2 = 10 kg). Then, we multiply the weight by the recommended dose of 2 mg/kg (10 kg x 2 mg/kg = 20 mg/dose). This calculation ensures proper dosing based on the child's weight. Choices A, B, and D are incorrect because they do not reflect the correct dosage calculation based on the child's weight.
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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.
A 4-year-old, 44-pound Autistic patient is admitted to the ED with concerns of dehydration. He has been ordered to receive a 20ml/kg fluid bolus of normal saline over 30 minutes. At what rate would you set the IV pump?
- A. 880 ml/hour
- B. 800 ml/hour
- C. 440 ml/hour
- D. 400 ml/hour
Correct Answer: A
Rationale: The correct answer is A: 880 ml/hour. To calculate the IV pump rate, first, determine the total volume to be infused: 20 ml/kg x 44 lbs = 880 ml. Next, divide the total volume by the total time in hours: 880 ml / 1 hour = 880 ml/hour. This rate ensures the patient receives the prescribed fluid bolus over 30 minutes. Choice B is incorrect as it does not account for the specific weight of the patient. Choices C and D are incorrect as they do not follow the correct calculation based on the patient's weight.
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations of ADHD are typically so bizarre that the diagnosis is easy
- B. Manifestations of ADHD affect all aspects of the child's life but are most obvious in the classroom
- C. Manifestations of ADHD such as learning disabilities eventually disappear by adulthood
- D. Manifestations of ADHD must always be present and are required to receive a positive diagnosis
Correct Answer: B
Rationale: Correct Answer: B
Rationale: Manifestations of ADHD affect all aspects of the child's life but are most obvious in the classroom. ADHD symptoms impact academic performance, social interactions, and behavior in various settings. Children with ADHD often struggle with impulse control, hyperactivity, and inattention, leading to challenges in the classroom environment. This choice acknowledges the pervasive nature of ADHD symptoms while highlighting the prominent impact on the child's educational experience.
Summary of other choices:
A: Incorrect - Manifestations of ADHD are not necessarily bizarre, and the diagnosis is often complex due to overlapping symptoms with other conditions.
C: Incorrect - Learning disabilities and ADHD are separate conditions, and ADHD symptoms may persist into adulthood without necessarily disappearing.
D: Incorrect - While consistent manifestations are a key diagnostic criterion, ADHD symptoms can fluctuate in intensity and may still be present without being constant.
The nurse is caring for a school aged child in sickle cell crisis. Which interventions are appropriate for this patient? (Select all that apply)
- A. Application of a heating pad to the painful areas
- B. Start a Morphine PCA to provide pain relief for this patient
- C. Encourage patient to ambulate often to prevent pneumonia
- D. Hydrate patient with one-and-a-half-time maintenance fluid
Correct Answer: A,B,D
Rationale: Correct Answer: A, B, D
Rationale:
A: Application of a heating pad to the painful areas helps to relieve vaso-occlusive pain in sickle cell crisis by promoting vasodilation and increasing blood flow.
B: Starting a Morphine PCA is appropriate for pain management in sickle cell crisis as it provides controlled analgesia for the patient.
D: Hydrating the patient with one-and-a-half-time maintenance fluid helps prevent dehydration and maintain adequate blood flow, reducing the risk of vaso-occlusive episodes.
Incorrect Choices:
C: Encouraging the patient to ambulate often may not be suitable during a sickle cell crisis as it can increase the risk of pain and further complications.
E, F, G: No additional choices given, but typically options not directly related to pain management, hydration, or symptom relief would be incorrect in this scenario.
The nurse is educating parents of a sickle cell patient regarding infection prevention. Which statement best indicates the parent understands the child's risk for infection?
- A. If the child has a fever, they need to stay home from school
- B. Antibiotics should be administered sparingly to prevent resistant infections in this population
- C. Children with sickle cell disease are at risk for infection due to impaired splenic function
- D. If the child is showing signs of crisis, a cup of hot tea can prevent the red blood cells from clumping rapidly
Correct Answer: C
Rationale: The correct answer is C. Children with sickle cell disease are at risk for infection due to impaired splenic function. This is because the spleen plays a crucial role in fighting infections, and individuals with sickle cell disease often have impaired splenic function, making them more susceptible to infections.
Explanation for other choices:
A: If the child has a fever, they need to stay home from school - While it is important for sickle cell patients to avoid exposure to infections, staying home from school only when the child has a fever does not address the overall risk of infection in these patients.
B: Antibiotics should be administered sparingly to prevent resistant infections in this population - While antibiotic resistance is a concern, the statement does not specifically address the child's risk for infection due to impaired splenic function.
D: If the child is showing signs of crisis, a cup of hot tea can prevent the red blood cells from clumping rapidly - This statement is incorrect as hot tea does not prevent