Nokea
You are the nurse caring for a 3-year-old, 33-pound child on digoxin. The safe dose range for digoxin is 20-40 mcg/kg/day. The order is for digoxin to be given IV every 12 hours, what is the maximum safe single dose the child should receive?
- A. 300 mcg
- B. 600 mcg
- C. 660 mcg
- D. 1320 mcg
Correct Answer: A
Rationale: The correct answer is A: 300 mcg. To determine the maximum safe single dose, we first need to calculate the total daily safe dose range for the child. The child's weight is 33 pounds, which is approximately 15 kg (1 kg = 2.2 lbs). The safe dose range is 20-40 mcg/kg/day, so for a 15 kg child, the total daily safe dose range would be 300-600 mcg/day. Since the medication is given every 12 hours, the maximum safe single dose would be half of the total daily dose, which is 300 mcg. This ensures that the child stays within the safe dose range for digoxin. Choice B (600 mcg) exceeds the maximum daily safe dose, choice C (660 mcg) exceeds the daily safe dose range, and choice D (1320 mcg) is way above the safe dose range for the child's weight.
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A complication of hemophilia is:
- A. Mucositis
- B. Hemoarthritis
- C. Thrombocytopenia
- D. Acute Chest Syndrome
Correct Answer: B
Rationale: The correct answer is B: Hemoarthritis. Hemophilia is a bleeding disorder where blood does not clot properly. Hemoarthritis is a common complication, characterized by bleeding into joints leading to pain, swelling, and limited range of motion. Mucositis (A) is inflammation of mucous membranes, not specific to hemophilia. Thrombocytopenia (C) is a low platelet count, not directly related to hemophilia. Acute Chest Syndrome (D) is a complication of sickle cell disease, not hemophilia.
When caring for a newborn with Down syndrome, what should the nurse be aware is the most common congenital anomaly associated with Down syndrome?
- A. Diabetes insipidus
- B. Pyloric stenosis
- C. Congenital heart disease
- D. Congenital hip dysplasia
Correct Answer: C
Rationale: The correct answer is C: Congenital heart disease. Down syndrome is commonly associated with congenital heart defects, such as atrioventricular septal defects or ventricular septal defects. This is important for the nurse to be aware of because these heart anomalies can impact the newborn's health and require monitoring or intervention.
Choice A: Diabetes insipidus is not a common congenital anomaly associated with Down syndrome.
Choice B: Pyloric stenosis is not typically associated with Down syndrome.
Choice D: Congenital hip dysplasia is not a common anomaly seen with Down syndrome.
In summary, the nurse should prioritize monitoring for congenital heart disease in a newborn with Down syndrome due to its high prevalence and potential impact on the baby's health.
An 18-month-old patient with Down's Syndrome has a history of mild pulmonary hypertension which requires a daily dose of Furosemide (Lasix). The mother is questioning if the new dose is correct after an adjustment at the child's last Cardiology visit. The child weighs 22 pounds and the dosing for furosemide (Lasix) for this child 2mg/kg/dose. What is the appropriate dose of Furosemide Lasix for this child?
- A. 44 mg/dose
- B. 28 mg/dose
- C. 20 mg/dose
- D. 10 mg/dose
Correct Answer: C
Rationale: The correct dose of Furosemide (Lasix) for this child is 20 mg/dose. To calculate the appropriate dose, we first convert the child's weight from pounds to kilograms (22 lbs ÷ 2.2 = 10 kg). Then, we multiply the weight by the recommended dose of 2 mg/kg (10 kg x 2 mg/kg = 20 mg/dose). This calculation ensures proper dosing based on the child's weight. Choices A, B, and D are incorrect because they do not reflect the correct dosage calculation based on the child's weight.
Signs of digoxin toxicity include of the following (Select all that apply):
- A. Vomiting
- B. Poor feeding
- C. Constipation
- D. Bradycardia
Correct Answer: A,B,D
Rationale: The correct signs of digoxin toxicity are vomiting, poor feeding, and bradycardia. Vomiting is a common early sign due to the drug's effect on the gastrointestinal system. Poor feeding can occur as a result of nausea and anorexia. Bradycardia is a classic sign of digoxin toxicity due to its effect on cardiac function. Constipation is not typically associated with digoxin toxicity. In summary, A, B, and D are correct as they align with the expected symptoms of digoxin toxicity, whereas C is incorrect as constipation is not a common sign.
A nurse is caring for an adolescent with a closed femur fracture who also has HIV. What type of precautions should the nurse institute?
- A. The patient should be placed on neutropenic precautions due to the risk of osteomyelitis
- B. The patient should be placed on standard precautions to diminish the risk of HIV transmission
- C. The patient should be placed on contact precautions to prevent contact with blood or bloody fluid
- D. The patient should be placed on isolation once the HIV status is suspected
Correct Answer: B
Rationale: The correct answer is B: The patient should be placed on standard precautions to diminish the risk of HIV transmission. Standard precautions are used for all patients to prevent the transmission of infection. In this case, the adolescent has a closed femur fracture and HIV, so the nurse should follow standard precautions, which include hand hygiene, wearing gloves, and using personal protective equipment as needed. Neutropenic precautions (choice A) are not necessary unless the patient has a low white blood cell count. Contact precautions (choice C) are used for specific infections that are spread by direct contact with the patient or their environment. Isolation (choice D) is not required solely based on HIV status.