A 24-month-old recently had routine lead testing done. A venous sample confirmed a blood lead level of 48 µg/dL. From history and physical exam, the nurse knows that the patient is asymptomatic. What is the best statement from the nurse to the parent regarding management for this patient?
Your child will need immediate hospitalization for chelation therapy
We will monitor the lead levels and provide nutritional counseling
No treatment is needed since the child is asymptomatic
Environmental changes are sufficient to manage this level
The Correct Answer is A
Choice A reason: A blood lead level of 48 µg/dL in a 24-month-old is significantly elevated, requiring immediate chelation therapy to remove lead from the body. Even asymptomatic children are at risk for neurological damage, developmental delays, and organ toxicity, necessitating urgent hospitalization for chelating agents like EDTA or succimer to prevent long-term harm.
Choice B reason: Monitoring lead levels and providing nutritional counseling (e.g., calcium, iron) are appropriate for lower lead levels (10-20 µg/dL). A level of 48 µg/dL indicates acute toxicity, requiring immediate chelation therapy rather than monitoring alone, as untreated high levels can cause irreversible neurological and developmental damage in young children.
Choice C reason: No treatment is incorrect for a blood lead level of 48 µg/dL, even if asymptomatic. Lead is neurotoxic, causing subtle cognitive and developmental impairments without immediate symptoms. Levels above 45 µg/dL require urgent chelation therapy to prevent long-term brain damage, making this statement inappropriate for management.
Choice D reason: Environmental changes, such as removing lead sources (e.g., paint, water), are critical for preventing further exposure but are insufficient alone for a blood lead level of 48 µg/dL. This level indicates significant toxicity requiring immediate medical intervention like chelation therapy to reduce lead burden and prevent neurological damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Viral infections are caused by viruses, which do not respond to antibiotics targeting bacterial cell walls or metabolic processes. Administering intravenous antibiotics for a viral communicable disease is inappropriate, risks promoting antibiotic resistance, and provides no therapeutic benefit. Analgesics may relieve symptoms, but their combination with antibiotics is incorrect for viral management.
Choice B reason: Supportive care, including pain management and comfort measures, is essential for pediatric patients with viral infections. These interventions alleviate symptoms like fever, myalgia, or headache, promote rest, and support the immune system’s natural response to the virus, making this a standard and appropriate approach in managing viral illnesses effectively.
Choice C reason: Administering intravenous fluids and monitoring hydration and nutrition are critical for pediatric patients with viral diseases. Fever, vomiting, or reduced oral intake can lead to dehydration and malnutrition, compromising recovery. Maintaining fluid balance and nutritional status supports the immune system, making this intervention necessary and appropriate for viral infection management.
Choice D reason: Implementing isolation precautions is vital for viral communicable diseases to prevent transmission to other patients, staff, or visitors. Depending on the virus, precautions like droplet or airborne isolation (e.g., masks or negative pressure rooms) are used, making this a critical intervention to control disease spread in healthcare settings effectively.
Correct Answer is ["A","D","E"]
Explanation
Choice A reason: Persistent or frequent angry mood is a common symptom of depression in children and adolescents, often presenting as irritability rather than sadness. This reflects neurochemical imbalances affecting mood regulation, disrupting emotional stability, and is a key diagnostic criterion, making it a correct choice for depression symptoms.
Choice B reason: Grandiose thinking is characteristic of mania or bipolar disorder, not depression. Depression in children typically involves low mood, anhedonia, or irritability, not inflated self-esteem or grandiosity, making this an incorrect symptom for depression and more aligned with other psychiatric conditions.
Choice C reason: A sudden increase in energy and speech suggests mania or hyperactivity, not depression. Depression in children and adolescents is marked by low energy, fatigue, and reduced activity, making this an incorrect symptom, as it contrasts with the typical presentation of depressive disorders in this age group.
Choice D reason: Loss of interest in previously enjoyed activities (anhedonia) is a hallmark of depression in children and adolescents. It reflects diminished pleasure due to altered brain reward pathways, particularly involving dopamine, and is a core diagnostic criterion, making this a correct and common symptom of depression.
Choice E reason: Changes in sleep patterns and increased fatigue are common in pediatric depression, often presenting as insomnia or hypersomnia. These reflect disruptions in circadian rhythms and neurotransmitter imbalances, impacting energy levels and emotional regulation, making this a correct and frequently observed symptom in depressed children and adolescents.
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