Nokea
When a patient participates in a research study, the pediatric nurse's primary concern is to ensure that the:
- A. parent or guardian has given verbal consent for the patient's participation.
- B. quality of care that the patient receives will not be affected if the patient chooses to withdraw from the study.
- C. research meets the developmental needs of the patient.
- D. research will directly benefit the patient.
Correct Answer: B
Rationale: Ensuring that the quality of care remains unaffected regardless of the patient's participation status is paramount to ethical research practices.
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Katie is admitted to the intensive care unit of Nurseslabs Medical Center for diabetic ketoacidosis; which of the following is of primary importance when caring for the child?
- A. Giving I.V. NPH insulin in high doses
- B. Evaluating the child for cardiac abnormalities
- C. Limiting fluids to prevent aggravating cerebral edema
- D. Monitoring and recording the child's vital signs for hypertension
Correct Answer: B
Rationale: When caring for a child with diabetic ketoacidosis in the intensive care unit, evaluating the child for cardiac abnormalities is of primary importance. Diabetic ketoacidosis can lead to electrolyte imbalances, such as hypokalemia, which can result in cardiac complications, such as arrhythmias and cardiac arrest. Monitoring the child's cardiac function, including obtaining an electrocardiogram (EKG) and assessing for signs of heart failure, is essential in managing and preventing potential cardiac complications in this critical condition. While the other options are important considerations in the care of a child with diabetic ketoacidosis, evaluating the child for cardiac abnormalities takes precedence due to the life-threatening implications of cardiac complications in this setting.
Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?
- A. Gradual increase
- B. Widening pulse pressure
- C. Rapid drop followed by gradual increase
- D. Rapid fluctuations
Correct Answer: B
Rationale: Widening pulse pressure is indicative of increasing intracranial pressure (ICP) and must be reported immediately. Pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure. An increasing pulse pressure can suggest a rise in ICP due to factors like cerebral edema or hemorrhage. This change indicates increased pressure exerted on blood vessels within the brain, potentially leading to serious consequences like brain herniation. Thus, recognizing and promptly reporting a widening pulse pressure is crucial to prevent further complications and enable appropriate interventions for the patient.
A patient returns from surgery ff. a TURP with a three-way Foley catheter and continuous bladder irrigation. Postoperative orders include Meperidine (Demerol) 75 mg IM q3h as needed for pain, belladonna and opium (B&O) suppository q4h as needed, and strict I&O. the patient complains of painful bladder spasms, and the nurse observes blood-tinged urine on the sheets. Which action should the nurse take?
- A. Give Demerol
- B. Give B&O suppository
- C. Warm the irrigation solution to body temperature
- D. Notify the physician stat
Correct Answer: D
Rationale: The nurse should notify the physician stat in this situation. The presence of blood-tinged urine and painful bladder spasms in a patient with a three-way Foley catheter and continuous bladder irrigation post TURP could indicate a potential complication such as hemorrhage or clot retention. It is crucial to ensure prompt medical evaluation and intervention to address these issues effectively. Waiting or administering pain medication without further assessment could delay necessary treatment and lead to worsening of the patient's condition. Therefore, notifying the physician immediately is the most appropriate action in this scenario.
a definitive diagnosis of sickle cell disease is based on which diagnostic result
- A. complete blood count (CBC )
- B. bone marrow aspiration
- C. blood chemistry test
- D. hemoglobin electrophoresis 128
Correct Answer: D
Rationale: A definitive diagnosis of sickle cell disease is based on hemoglobin electrophoresis. This test separates the different types of hemoglobin based on their electrical charge, allowing for the detection of abnormal hemoglobin variants such as hemoglobin S, which is characteristic of sickle cell disease. A complete blood count (CBC) can show various abnormalities seen in sickle cell disease, but it is not specific for confirming the diagnosis. Bone marrow aspiration is not routinely used for diagnosing sickle cell disease. Blood chemistry tests may reveal some complications associated with sickle cell disease but do not confirm the condition itself. Hemoglobin electrophoresis is the gold standard for diagnosing sickle cell disease by identifying the specific hemoglobin variant characteristic of the disorder.
Pulmonary edema is characterized by:
- A. Elevated left ventricular and-diastolic
- B. Increased hydrostatic pressure
- C. All of the above alterations
- D. A rise in pulmonary venous pressure
Correct Answer: C
Rationale: Pulmonary edema is characterized by increased hydrostatic pressure in the pulmonary capillaries and a rise in pulmonary venous pressure, which leads to fluid leaking out of the pulmonary capillaries and into the alveoli. This results in elevated left ventricular end-diastolic pressure, which is a key characteristic of pulmonary edema. Therefore, all of the above alterations (increased hydrostatic pressure, a rise in pulmonary venous pressure, and elevated left ventricular end-diastolic pressure) are seen in pulmonary edema.