Nokea
When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?
- A. Impaired Gas Exchange
- B. Risk for Infection
- C. Anxiety (parental)
- D. Acute Pain
Correct Answer: A
Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.
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A pediatric client is admitted to the emergency department with a traumatic brain injury (TBI) that caused a loss of consciousness. The last set of vital signs showed heart rate 48, blood pressure (BP) 148/74 mmHg, respiratory rate 28 and irregular. What does the nurse suspect based on these data?
- A. Spinal cord injury
- B. Increased intracranial pressure
- C. Typical for sleep
- D. Improvement
Correct Answer: B
Rationale: The vital signs of bradycardia, hypertension, and irregular respirations indicate increased intracranial pressure. Bradycardia (heart rate of 48), hypertension (blood pressure of 148/74 mmHg), and irregular respirations are typical signs of increased intracranial pressure in a pediatric client with a traumatic brain injury and loss of consciousness.
In Langerhans cell histiocytosis (LCH), which organ is LEAST likely affected?
- A. skin
- B. ear
- C. bone
- D. middle nodes
Correct Answer: E
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Renal cell carcinoma (RCC) is rare in children, accounting for <5% of all renal tumors. All the following are true regarding RCC in children EXCEPT
- A. patients may present with frank hematuria, flank pain, and/or a palpable mass
- B. it can be asymptomatic and detected incidentally
- C. it has a propensity to metastasize to the lungs, bone, liver, and brain
- D. it can be associated with von Hippel-Lindau disease
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is providing care for a pediatric client in the emergency department (ED) with a diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?
- A. Passive range-of-motion exercises to promote hip flexion
- B. Oxygen at 2 L nasal cannula to maintain saturation above 95%
- C. Hourly vital signs and neurologic checks
- D. Elevate head of bed 30 degrees
Correct Answer: A
Rationale: In a pediatric client with increased intracranial pressure (ICP) and decreased level of consciousness (LOC), passive range-of-motion exercises to promote hip flexion should be questioned as they can potentially increase intracranial pressure. This action may not be safe for the client's condition. The other options are appropriate interventions for managing a pediatric client with increased ICP and decreased LOC.
When teaching an adolescent about managing tinea pedis, which statement indicates an understanding of the teaching?
- A. I should buy some plastic shoes to wear at the swimming pool
- B. I should wear sandals as much as possible
- C. I should place the permethrin cream between my toes twice daily
- D. I should seal my non-washable shoes in plastic bags for a couple of weeks
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.