A 14-year-old girl has returned to the nursing unit after undergoing an appendectomy. To help relieve pain and facilitate drainage, the nurse should place her in what position?

Semi-Fowler's

Supine

Trendelenburg

Prone

Answer and Explanation

The Correct Answer is A

Choice A reason: Semi-Fowler's position is a position in which the head of the bed is elevated to 30 to 45 degrees, and the knees may be slightly bent. This position can help relieve pain and facilitate drainage after an appendectomy, as it reduces the tension on the abdominal muscles and incision, and promotes the flow of blood and fluids away from the surgical site. It can also improve breathing and prevent pulmonary complications.

Choice B reason: Supine position is a position in which the person lies flat on their back, with the head and shoulders slightly elevated. This position is not recommended after an appendectomy, as it can increase the pressure on the abdominal muscles and incision, and cause pain and discomfort. It can also impair breathing and increase the risk of pneumonia.

Choice C reason: Trendelenburg position is a position in which the person lies flat on their back, with the head of the bed lowered and the feet elevated. This position is not advised after an appendectomy, as it can increase the pressure on the abdominal organs and incision, and cause pain and bleeding. It can also reduce the blood flow to the brain and cause dizziness, nausea, or fainting.

Choice D reason: Prone position is a position in which the person lies flat on their stomach, with the head turned to one side. This position is not suitable after an appendectomy, as it can stretch and irritate the abdominal muscles and incision, and cause pain and inflammation. It can also hinder breathing and drainage, and increase the risk of infection.

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Correct Answer is C

Explanation

Choice A reason: This is not a correct statement, as delaying dental visits until the child's heart defect is fully repaired is not advisable. Dental visits are important for maintaining oral hygiene and preventing dental caries, which can increase the risk of infective endocarditis. The child should have regular dental check-ups and follow the dentist's recommendations for oral care¹.

Choice B reason: This is not a correct statement, as administration of daily prophylactic antibiotics is not recommended for prevention of infective endocarditis. Daily antibiotics can cause adverse effects, such as allergic reactions, diarrhea, or yeast infections. They can also lead to antibiotic resistance, which can make the treatment of infective endocarditis more difficult².

Choice C reason: This is the correct statement, as administration of antibiotics one hour prior to any dental procedure is recommended for prevention of infective endocarditis. Dental procedures can cause bleeding and release bacteria into the bloodstream, which can infect the damaged heart valves or tissues. Antibiotics can help prevent or reduce the bacterial growth and prevent infective endocarditis¹².

Choice D reason: This is not a correct statement, as high dose IV antibiotics for 29 weeks is not a preventive measure, but a treatment option for infective endocarditis. IV antibiotics are given to eradicate the infection and prevent complications, such as heart failure or stroke. The duration of treatment depends on the type and severity of the infection, but it usually ranges from 4 to 6 weeks²³.

A. Obtain blood cultures, administer high dose antibiotics, assess for cardiac decompensation B. Watch for signs of cyanosis and administer high dose steroids C. Obtain CBC, CXR, and start child on high dose aspirin D. Start high dose antibiotics, obtain serial blood cultures, put the child on high flow oxygen

Correct Answer is D

Explanation

Choice A reason: This is not the correct order, as obtaining blood cultures should be done after starting high dose antibiotics, not before. This is because antibiotics can interfere with the detection of bacteria in the blood and affect the accuracy of the diagnosis¹.

Choice B reason: This is not the correct order, as administering high dose steroids is not indicated for infective endocarditis, unless there is evidence of severe inflammation or allergic reaction. Steroids can suppress the immune system and increase the risk of infection².

Choice C reason: This is not the correct order, as starting the child on high dose aspirin is not recommended for infective endocarditis, unless there is evidence of thromboembolic complications or Kawasaki disease. Aspirin can increase the risk of bleeding and interfere with the action of antibiotics³.

Choice D reason: This is the correct order, as starting high dose antibiotics, obtaining serial blood cultures, and putting the child on high flow oxygen are the appropriate interventions for infective endocarditis. Antibiotics are the main treatment to eradicate the infection and prevent complications. Serial blood cultures are done to monitor the response to antibiotics and identify the causative organism. High flow oxygen is given to improve the oxygen delivery and tissue perfusion¹².

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A 14-year-old girl has returned to the nursing unit after undergoing an appendectomy. To help relieve pain and facilitate drainage, the nurse should place her in what position?

Nursing Test Bank

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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