Nokea
Your child will need to increase his calcium intake to 3,000 milligrams daily. A nurse is reinforcing teaching with a parent of an 8-year-old child who has a fracture of the epiphyseal plate. Which of the following statements should the nurse include in the teaching?
- A. Bone marrow can be lost through the fracture.
- B. Fractures in a child take longer to heal than fractures in an adult.
- C. Normal bone growth can be affected by the fracture.
- D. The child will need to increase his calcium intake to 3,000 milligrams daily.
Correct Answer: C
Rationale: While it's true that bone marrow can be lost through a fracture, this is not specific to fractures of the epiphyseal plate. The healing time for fractures in children and adults can vary depending on many factors, but it's not accurate to say that fractures in children take longer to heal than fractures in adults. Normal bone growth can indeed be affected by a fracture of the epiphyseal plate. The epiphyseal plate, or growth plate, is the area of growing tissue near the ends of the long bones in children and adolescents. When a fracture occurs at the epiphyseal plate, it can disrupt the normal growth of the bone and lead to deformities. While calcium is important for bone health, increasing a child's calcium intake to 3,000 milligrams daily is not typically recommended as part of the treatment or management of a fracture.
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A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following home care actions should the nurse recommend? (Select all that apply)
- A. Use cold compresses for joint pain.
- B. Take ibuprofen on an empty stomach.
- C. Perform range of motion exercises.
- D. Consider homeschooling.
- E. Provide extra time for completion of ADLs.
Correct Answer: A,C,E
Rationale: Choice A rationale: Cold compresses can help relieve joint pain associated with juvenile idiopathic arthritis. Cold therapy can reduce inflammation and numb the affected area, providing temporary relief. Choice B rationale: This is incorrect. Ibuprofen should not be taken on an empty stomach because it can cause stomach upset or even lead to ulcers or bleeding. It is generally recommended to take ibuprofen with food or milk. Choice C rationale: Performing range of motion exercises can help maintain joint flexibility and muscle strength in children with juvenile idiopathic arthritis. Regular exercise can also improve overall physical function and well-being. Choice D rationale: While homeschooling may be a consideration for some families, it is not a general recommendation for all children with juvenile idiopathic arthritis. Many children with this condition can attend regular school with some accommodations as needed. Choice E rationale: This is correct. Providing extra time for completion of activities of daily living (ADLs) can help children with juvenile idiopathic arthritis manage their symptoms and maintain their independence. It is important to allow children to perform tasks at their own pace to avoid causing unnecessary pain or fatigue.
A nurse is assisting with collecting data from a 10-month-old in the emergency department. Medical History: Guardians brought the infant to the emergency room after witnessing the infant's arms and legs shaking. The infant did not respond to the guardians' voices during that time. The episode lasted approximately 5 min and the infant was sleeping soundly afterwards. On the way to the emergency department, the infant had another episode of shaking of the extremities and drooling. The infant was asleep when they arrived for evaluation. The infant has no prior medical or surgical history. Born full-term at 40 weeks to a birth mother who had regular prenatal visits. Actions to Take: Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
- A. Potential Condition
- B. Parameters to Monitor 1
- C. Parameters to Monitor 2
- D. Vitamin
- E. Blood pressure
Correct Answer: A
Rationale: The infant's symptoms suggest a possible seizure disorder. Seizures can cause symptoms such as shaking of the extremities and unresponsiveness. The fact that the infant was sleeping soundly after the episode and had another episode of shaking and drooling on the way to the emergency department further supports this. The nurse should monitor the infant's neurological status and vital signs, and administer anticonvulsant medication as ordered by the physician.
A nurse is providing teaching to a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates a need for additional teaching?
- A. I will test my blood sugar before meals and at bedtime.'
- B. I should not take my regular insulin when I am sick.'
- C. I will rotate injection sites within my abdominal area.'
- D. I should eat a snack before I play soccer.'
Correct Answer: B
Rationale: Regular blood sugar testing is crucial for managing type 1 diabetes. It helps the child and their caregivers monitor the child's blood sugar levels and make necessary adjustments to their insulin doses or diet. This statement indicates a need for additional teaching. Even when sick, it's important for individuals with type 1 diabetes to continue taking their insulin. Illness often causes blood sugar levels to rise, so insulin is still needed. Rotating injection sites can help prevent skin problems, such as lipodystrophy (a lump under the skin caused by the accumulation of extra fat at the site of many subcutaneous injections of insulin). Therefore, this is a correct practice. Physical activity can lower blood sugar levels. Eating a snack before physical activities like playing soccer can help prevent hypoglycemia (low blood sugar). This is a correct understanding of managing physical activity with type 1 diabetes.
A nurse is preparing a 4-year-old child for discharge following a bilateral myringotomy with tympanostomy tube placement. The mother asks what to do if the tubes fall out. Which of the following instructions should the nurse give the parent?
- A. Gently reinsert the tubes.
- B. Call the health care clinic to report that the tubes have fallen out.
- C. Reassure the mother that the tubes will not fall out.
- D. Take the child to an emergency department.
Correct Answer: B
Rationale: It is not advisable for a parent to attempt to reinsert the tubes if they fall out. This could potentially cause harm to the child's ear. If the tubes fall out, the parent should call the healthcare clinic to report this. The healthcare provider can then decide on the appropriate next steps. It is not accurate to reassure the mother that the tubes will not fall out. Tympanostomy tubes are designed to fall out on their own after a certain period of time. Taking the child to an emergency department is not necessary unless there are signs of infection or other complications.
A nurse is caring for a client who is postoperative immediately following a tonsillectomy. Which of the following snacks should the nurse offer the client?
- A. Lime ice pop
- B. Cranberry juice
- C. Ice cream
- D. Apple juice
Correct Answer: A
Rationale: An orange ice pop is a good choice because it is cold and soothing for the throat, and it is also clear liquid which is usually recommended after tonsillectomy. Cranberry juice is not the best choice because it is acidic and can cause discomfort to the surgical site. Ice cream is not recommended immediately after surgery because dairy products can increase mucus production which can lead to coughing and discomfort. Apple juice is not the best choice because it is acidic and can cause discomfort to the surgical site.