Nokea
The nurse manager on a pediatric floor is reviewing national sentinel event alerts and preparing recommendations for the unit. Which strategy would help reduce pediatric medication errors? Select all that apply.
- A. Eliminate the pediatric satellite pharmacy.
- B. Increase the steps in the medication administration procedure.
- C. Utilize only oral syringes to administer oral medication.
- D. Limit the size of I.V. fluid bags that can be hung on small children.
- E. Reduce the available concentrations or dose strengths to the minimum.
Correct Answer: C,D,E
Rationale: Oral syringes ensure accurate dosing, smaller IV bags prevent fluid overload, and fewer concentrations reduce dosing errors.
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A 4-year-old has been scheduled for a cardiac catheterization. To help prepare the family the nurse should:
- A. Advise the family to bring the child to the hospital the night before.
- B. Explain that the child will need a large bandage after the procedure.
- C. Discourage bringing favorite toys that might become associated with pain.
- D. Explain that the child may get up as soon as the vital signs are stable.
Correct Answer: B
Rationale: The catheter insertion site will be covered with a bandage. This is important for preschool children to know as they are very concerned about bodily harm. Preparing the child the night before, bringing favorite toys, and explaining activity restrictions are also important but not the primary focus of this choice.
When preparing the teaching plan for the mother of a child with asthma, which of the following should the nurse include as signs to alert the mother that her child is having an asthma attack?
- A. Secretion of thin, copious mucus.
- B. Tight, productive cough.
- C. Wheezing on expiration.
- D. Temperature of 99.4°F (37.4°C).
Correct Answer: C
Rationale: Wheezing on expiration is a hallmark sign of an asthma attack, indicating airway narrowing. The mother should be taught to recognize this to initiate prompt treatment.
In an initial screening for lead poisoning, a 2-year-old child is found to have a lead level of 12 mcg/dL. The nurse should:
- A. Arrange a follow-up appointment in 6 months.
- B. Initiate chelation therapy.
- C. Refer to a neurologist.
- D. Test siblings for lead exposure.
Correct Answer: A
Rationale: A lead level of 12 mcg/dL requires follow-up in 3-6 months per CDC guidelines. Chelation is for levels >45 mcg/dL, neurology referral is premature, and sibling testing depends on shared exposure risk.
After surgery to repair a tracheoesophageal fistula, an infant receives gastrostomy tube feedings. After feeding the infant by this method, the nurse positions the infant with the head elevated for approximately 30 minutes, primarily to help accomplish which of the following?
- A. Promote intestinal peristalsis.
- B. Prevent regurgitation of formula.
- C. Relieve pressure on the surgical site.
- D. Associate eating with a pleasurable experience.
Correct Answer: B
Rationale: Head elevation reduces the risk of formula reflux, protecting the surgical site and airway.
After insertion of bilateral tympanostomy tubes in a toddler, which of the following instructions should the nurse include in the child's discharge plan for the parents?
- A. Insert ear plugs into the canals when the child bathes.
- B. Blow the nose forcibly during a cold.
- C. Administer the prescribed antibiotic while the tubes are in place.
- D. Disregard any drainage from the ear after 1 week.
Correct Answer: C
Rationale: Administering prescribed antibiotics as directed is crucial to prevent infection after tympanostomy tube insertion. Ear plugs are not typically recommended, as they can introduce bacteria. Forcibly blowing the nose can disrupt the tubes, and any drainage after 1 week should be reported, not disregarded.