Nokea
What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning?
- A. Maintain bed rest.
- B. Maintain isolation precautions.
- C. Keep an accurate record of intake and output.
- D. Institute measures to prevent skeletal fracture.
Correct Answer: C
Rationale: The iron chelates are excreted though the kidneys. Adequate hydration is essential. Periodic measurement of renal function is done. Bed rest is not necessary. Often the chelation therapy is done on an outpatient basis. Chelation therapy is not infectious or dangerous. Isolation is not indicated. Skeletal weakness does not result from high levels of lead.
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What is a significant secondary prevention nursing activity for lead poisoning?
- A. Chelation therapy
- B. Screening children for blood lead levels
- C. Removing lead-based paint from older homes
- D. Questioning parents about ethnic remedies containing lead
Correct Answer: B
Rationale: Screening children for lead poisoning is an important secondary prevention activity. Screening does not prevent the initial exposure of the child to lead. It can lead to identification and treatment of children who are exposed. Chelation therapy is treatment, not prevention. Removing lead-based paints from older homes before children are affected is primary prevention. Questioning parents about ethnic remedies containing lead is part of the assessment to determine the potential source of lead.
A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child?
- A. Monitoring the parents whenever they are with the child
- B. Reassuring the parents that the cause of the disorder will be found
- C. Teaching the parents how to obtain necessary specimens
- D. Supporting the parents as they cope with diagnosis of a chronic illness
Correct Answer: A
Rationale: MSBP refers to an illness that one person fabricates or induces in another. The child must be continuously observed for development of symptoms to determine the cause. MSBP is caused by an individual harming the child for the purpose of gaining attention. Nursing staff should obtain all specimens for analyzing. This minimizes the possibility of the abuser contaminating the sample. The child must be supported through the diagnosis of MSBP. The abuser must be identified and the child protected from that individual.
A child with diazepam (Valium) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?
- A. Succimer (Chemet)
- B. EDTA (Versenate)
- C. Flumazenil (Romazicon)
- D. Octreotide acetate (Sandostatin)
Correct Answer: C
Rationale: The antidote for diazepam (Valium) poisoning is flumazenil (Romazicon). Succimer (Chemet) and EDTA (Versenate) are antidotes for heavy metal poisoning. Octreotide acetate (Sandostatin) is an antidote for sulfonylurea poisoning.
A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect?
- A. Unintentional injury
- B. Shaken baby syndrome
- C. Congenital neurologic problem
- D. Sudden infant death syndrome (SIDS)
Correct Answer: B
Rationale: Shaken baby syndrome causes internal bleeding but may have no external signs. Unintentional injury would not cause these injuries. With unintentional injuries, external signs are usually present. Congenital neurologic problems would usually have signs of abnormal neurologic anatomy. SIDS does not usually have identifiable injuries.
A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?
- A. Reassure the father that Visine is harmless.
- B. Direct him to seek immediate medical treatment.
- C. Recommend inducing vomiting with ipecac.
- D. Advise him to dilute Visine by giving his daughter several glasses of water to drink.
Correct Answer: B
Rationale: Visine is a sympathomimetic and if ingested may cause serious consequences. Medical treatment is necessary. Inducing vomiting is no longer recommended for ingestions. Dilution will not decrease risk.