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The nurse is teaching a parent with a 2-month-old infant who has been diagnosed with colic about ways to relieve colic. Which statement by the parent indicates the need for additional teaching?
- A. I should let my infant cry for at least 30 minutes before I respond.
- B. I will swaddle my infant tightly with a soft blanket.
- C. I should massage my infants abdomen whenever possible.
- D. I will place my infant in an upright seat after feeding.
Correct Answer: A
Rationale: Because the infant has been diagnosed with colic, the parent should respond to the infant immediately or any type of interventions to relieve colic may not be effective. Also, the infant may develop a mistrust of the world if his or her needs are not met. The parent should swaddle the baby tightly with a soft blanket, massage the babys abdomen, and place the infant in an upright seat after a feeding to help relieve colic.
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A parent brings a 12-month-old infant into the emergency department and tells the nurse that the infant is allergic to peanuts and was accidentally given a cookie with peanuts in it. The infant is dyspneic, wheezing, and cyanotic. The health care provider has prescribed a dose of epinephrine to be administered. The infant weighs 24 lb. How many milligrams of epinephrine should be administered?
- A. 0.11 to 0.33 mg
- B. 0.011 to 0.3 mg
- C. 1.1 to 3.3 mg
- D. 11 to 33 mg
Correct Answer: B
Rationale: The correct dose of epinephrine to use in the emergency management of an anaphylactic reaction is 0.001 mg/kg up to a maximum of 0.3 mg, giving a range of 0.011 to 0.3 mg using a weight of 11 kg (24 lb).
Where do eczematous lesions most commonly occur in an infant?
- A. Abdomen, cheeks, and scalp
- B. Buttocks, abdomen, and scalp
- C. Back and flexor surfaces of the arms and legs
- D. Cheeks and extensor surfaces of the arms and legs
Correct Answer: D
Rationale: The lesions of atopic dermatitis are generalized in infants. They are most common on the cheeks, scalp, trunk, and extensor surfaces of the extremities. The abdomen and buttocks are not common sites of lesions. The back and flexor surfaces are not usually involved.
The nurse is examining an infant, age 10 months, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions. What is the most likely cause?
- A. Impetigo
- B. Urine and feces
- C. Candida albicans infection
- D. Infrequent diapering
Correct Answer: C
Rationale: C. albicans infection produces perianal inflammation and a maculopapular rash with satellite lesions that may cross the inguinal folds. Impetigo is a bacterial infection that spreads peripherally in sharply marginated, irregular outlines. Eruptions involving the skin in contact with the diaper but sparing the folds are likely to be caused by chemical irritation, especially urine and feces, and may be related to infrequent diapering.
The parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a constant worry. What is the nurses best action?
- A. Encourage the parent to verbalize feelings.
- B. Encourage the parent not to worry so much.
- C. Assess the parent for other signs of inadequate parenting.
- D. Reassure the parent that colic rarely lasts past age 9 months.
Correct Answer: A
Rationale: Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathetic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help alleviate the parents anxiety. The nurse should reassure the parent that he or she is not doing anything wrong. The infant with colic is experiencing spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day. Telling the parent that it will eventually go away does not help him or her through the current situation.
The nurse is interviewing the parents of a 4-month-old boy brought to the hospital emergency department. The infant is dead, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. The nurse might initially suspect his death was caused by what?
- A. Suffocation
- B. Child abuse
- C. Infantile apnea
- D. Sudden infant death syndrome (SIDS)
Correct Answer: D
Rationale: The description of how the child was found in the crib is suggestive of SIDS. The nurse is careful to tell the parents that a diagnosis cannot be confirmed until an autopsy is performed.