A 3-year-old child with a complex cardiac defect is admitted with infective endocarditis. Management (in what order) would be:
Watch for signs of cyanosis and administer high dose steroids
Obtain blood cultures, administer high dose antibiotics, assess for cardiac decompensation
Start high dose antibiotics, obtain serial blood cultures, put the child on high flow oxygen
Obtain CBC, CXR and start child on high dose aspirin
The Correct Answer is B
Choice A reason: This is not a good choice. Watching for signs of cyanosis and administering high dose steroids are not the first steps in managing infective endocarditis. Cyanosis is a late sign of hypoxia and steroids are not indicated for this condition.
Choice B reason: This is the correct choice. Obtaining blood cultures, administering high dose antibiotics, and assessing for cardiac decompensation are the priority interventions for a child with infective endocarditis. Blood cultures are needed to identify the causative organism and guide antibiotic therapy. High dose antibiotics are needed to eradicate the infection and prevent further damage to the heart valves. Cardiac decompensation is a serious complication of infective endocarditis that can lead to heart failure and shock.
Choice C reason: This is not a good choice. Starting high dose antibiotics, obtaining serial blood cultures, and putting the child on high flow oxygen are not the best order of management for infective endocarditis. Blood cultures should be obtained before starting antibiotics to avoid false negative results. High flow oxygen may not be necessary unless the child has signs of hypoxia or respiratory distress.
Choice D reason: This is not a good choice. Obtaining CBC, CXR and starting child on high dose aspirin are not the first steps in managing infective endocarditis. CBC and CXR are useful tests to monitor the infection and the cardiac function, but they are not as urgent as blood cultures. High dose aspirin is not recommended for infective endocarditis as it can increase the risk of bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This statement is incorrect, as Tanner staging is not based on chronological age, but on the physical development of the child. Children may enter and progress through puberty at different ages, depending on their genetic, environmental, and nutritional factors.
Choice B reason: This statement is incorrect, as Tanner staging is not based on the sexual behavior of the child, but on the appearance of the external genitalia, breasts, and pubic hair. Sexual behavior is influenced by many factors, such as social, cultural, and psychological factors, and does not necessarily correlate with the stage of puberty.
Choice C reason: This statement is incorrect, as Tanner staging is not based on the increase in height and weight, but on the maturation of the reproductive organs and secondary sex characteristics. Height and weight are affected by many factors, such as nutrition, health, and genetics, and do not necessarily reflect the stage of puberty.
Choice D reason: This statement is correct, as Tanner staging is based on the predictable stages of puberty that are based on primary and secondary sexual characteristics. Primary sexual characteristics are the development of the internal and external reproductive organs, such as the ovaries, testes, uterus, penis, and vagina. Secondary sexual characteristics are the changes that occur in other parts of the body, such as the breasts, pubic hair, axillary hair, voice, and body shape.
Correct Answer is A
Explanation
Choice A reason: The squeeze bottle and ESSR method of feeding are recommended for infants with cleft lip and palate as they allow for better control of the flow and volume of the formula, prevent air swallowing and aspiration, and promote oral stimulation and development.
Choice B reason: Supplemental feeding through an N/G tube is not usually necessary for infants with cleft lip and palate unless they have severe feeding difficulties, failure to thrive, or other complications. The goal is to promote oral feeding as much as possible.
Choice C reason: Adding rice cereal to the formula is not advised for infants with cleft lip and palate as it can increase the risk of aspiration, choking, and infection. Rice cereal can also interfere with the absorption of iron and other nutrients from the formula.
Choice D reason: Infants with cleft lip and palate usually have a hard time breastfeeding as they cannot create a proper seal and suction with the nipple. Breastfeeding may be possible with some modifications and support, but it is not the norm.
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