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1330

Cardiac catheterization performed; ventricular septal defect closed with mesh

Admit to the pediatric floor for observation

Check pedal pulses every 4 hours

Nothing by mouth

Place the child on a continuous cardiopulmonary monitor

The nurse reviews the post-catheterization orders.

What two orders would the nurse question?

Point of care blood glucose

Check pedal pulses every 4 hours

Give lactated Ringers intravenously at 66 ml/hr while NPO

Vital signs every 4 hours

Nothing by mouth

Admit to the pediatric floor for observation

Check dressing every 15 minutes for 1 hour and then every hour for

Answer and Explanation

Correct Answer : B,C

B. Check pedal pulses every 4 hours: This order should be questioned because after a ventricular septal defect closure, it is essential to assess and monitor peripheral pulses frequently, especially in the immediate post-catheterization period. Checking pedal pulses every 4 hours may not provide adequate monitoring and could potentially lead to delayed detection of complications.

C. Give lactated Ringers intravenously at 66 ml/hr while NPO: This order should be questioned because it specifies a continuous intravenous infusion of lactated Ringer's solution, but the patient is listed as "Nothing by mouth" (E). In cases where a patient is NPO, it's important to clarify the rationale for the intravenous fluid rate and consider whether it's appropriate, especially after a cardiac catheterization procedure.

The other orders are appropriate or necessary for the post-catheterization care of a child with a closed ventricular septal defect:

A. Point of care blood glucose: Monitoring blood glucose levels is relevant in post-catheterization care.

D. Vital signs every 4 hours: Monitoring vital signs is standard post-catheterization care.

F. Admit to the pediatric floor for observation: This order is appropriate for post-catheterization observation.

G. Check dressing every 15 minutes for 1 hour and then every hour: Frequent dressing checks are important for assessing and preventing bleeding or other complications at the catheterization site.

H. Place the child on a continuous cardiopulmonary monitor: Continuous monitoring is important for early detection of any cardiopulmonary issues in the post-catheterization period.

In summary, monitoring peripheral pulses and the appropriateness of intravenous fluids in relation to NPO status should be questioned in this context.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Discontinue the ointment once drainage resolves.The ophthalmic antiinfective ointment should be used for the full prescribed duration, even if symptoms improve, to ensure the infection is completely treated and to prevent recurrence or resistance.

B. Remove secretions by wiping toward the opposite eye.Secretions should be removed by wiping away from the eye, from the inner canthus (near the nose) outward, to prevent spreading infection to the unaffected eye.

C. Use a disposable moist wipe to remove eye crusts.While it is important to keep the eye clean, the primary discharge instruction in this context should focus on the expected side effect of blurry vision.

D. Prepare child for blurry vision after ointment application:Ophthalmic antiinfective ointments can cause temporary blurry vision due to their consistency. Caregivers should be informed about this expected effect and reassured that it is temporary. This helps manage expectations and ensures adherence to the treatment plan.

Correct Answer is ["1.5"]

Explanation

To determine how many 10 mg tablets of amphetamine sulfate are needed to provide a 15 mg dose, you can use the following calculation:

Number of tablets = Desired dose / Tablet strength

Number of tablets = 15 mg / 10 mg/tablet = 1.5 tablets

Since the nurse is administering a half tablet, it would be important to ensure that the half tablet can be accurately measured and that the mother is aware of this when providing the medication.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a school-age child with crusting and swollen eyelids, purulent drainage, and inflamed conjunctiva. The child receives a prescription for an ophthalmic antiinfective ointment. Which instruction should the nurse provide the child's caregivers during discharge education?

Correct Answer is D

Explanation

Correct Answer is ["1.5"]

Explanation

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