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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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Correct Answer is B

Explanation

A. Using 1-word sentences is more characteristic of a child's speech development at around 12-18 months, and by age 3, children are expected to use more words in their sentences.

B. Speaks in simple sentences with four or more words.

At the age of 3, children typically progress in their speech and language development. Speaking in simple sentences with four or more words is considered a normal developmental milestone at this age. It reflects the child's growing ability to form more complex and coherent sentences.

C. Recognizing most letters and numbers is not typically a developmental milestone for a 3-year-old. This skill often develops later, closer to the preschool and kindergarten years.

D. Using gestures with 1 to 2-word sentences may be seen in younger children, but by age 3, children should be progressing to longer and more complex sentences as part of their language development.

It's important to remember that there can be some individual variation in language development, but by the age of 3, children are generally expected to speak in simple sentences with more words and demonstrate growing language skills.

A. Regular syringe feedings promote rapid weight gain. B. Breast milk provides adequate calories for the child. C. Fruit juice increases the child's daily vitamin intake. D. High-calorie formula encourages increased growth.

Correct Answer is B

Explanation

A. Regular syringe feedings alone do not necessarily promote rapid weight gain, and their appropriateness depends on the underlying cause of FTT and the healthcare provider's recommendations.

B. Breast milk provides adequate calories for the child.

Breast milk is an excellent source of nutrition for infants, providing essential nutrients and calories needed for healthy growth and development. It is generally well-tolerated and suitable for most infants. Encouraging breastfeeding, especially if the infant is not exclusively breastfed, can be a valuable approach in managing FTT.

C. Fruit juice, particularly in excess, may not be recommended for infants with FTT as it can be high in sugars and low in essential nutrients. It is not a primary intervention for FTT.

D. High-calorie formula can be considered for infants with FTT, but it should be prescribed and monitored by a healthcare provider. Simply using high-calorie formula without proper guidance is not an appropriate intervention.

Breast milk is a valuable and appropriate source of nutrition for infants with FTT, and the nurse should support and encourage its use while monitoring the infant's growth and progress closely.

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Naxlex Comprehensive Predictor Exams

The nurse is assessing the growth and development of a 3-year-old child. Which speech and language skills should the nurse identify as normal developmental milestones for this child?

Correct Answer is B

Explanation

The nurse is providing nutrition education to the parents of an infant with failure to thrive (FTT). Which statement made by the parent should the nurse recognize as an appropriate understanding of interventions?

Correct Answer is B

Explanation

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