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 A
Explanation
Choice A reason: This statement is correct, as most infants are ready to start solid foods when they are 4 to 6 months old, depending on their individual growth and readiness. The nurse should explain to the parents that some signs of readiness include being able to hold the head up, sit with support, show interest in food, and move food from the spoon to the throat.
Choice B reason: This statement is incorrect, as 2 to 3 months is too early to introduce solid foods to infants, as their digestive system and swallowing skills are not mature enough to handle them. The nurse should advise the parents to avoid giving solid foods before 4 months of age, as it can increase the risk of choking, allergies, obesity, and iron deficiency.
Choice C reason: This statement is incorrect, as 1 year is too late to introduce solid foods to infants, as they need more nutrients and calories than breast milk or formula alone can provide. The nurse should inform the parents that delaying solid foods beyond 6 months of age can lead to growth faltering, micronutrient deficiencies, and feeding difficulties.
Choice D reason: This statement is incorrect, as 10 to 11 months is too late to introduce solid foods to infants, as they need more nutrients and calories than breast milk or formula alone can provide. The nurse should inform the parents that delaying solid foods beyond 6 months of age can lead to growth faltering, micronutrient deficiencies, and feeding difficulties.
Correct Answer is A
Explanation
Choice A reason: This statement is correct, as atopic dermatitis (eczema) is a chronic inflammatory skin disorder that is often linked to allergic conditions, such as asthma, hay fever, or food allergies. It also has a genetic component, as it tends to run in families.
Choice B reason: This statement is incorrect, as atopic dermatitis (eczema) is not associated with upper respiratory tract infections, but rather with lower respiratory tract infections, such as bronchitis or pneumonia. Upper respiratory tract infections affect the nose, throat, and sinuses, while lower respiratory tract infections affect the lungs and airways.
Choice C reason: This statement is incorrect, as atopic dermatitis (eczema) is not easily cured, but rather a chronic and relapsing condition that requires long-term management. There is no cure for eczema, but the symptoms can be controlled with medications, moisturizers, and avoidance of triggers.
Choice D reason: This statement is incorrect, as treatment for atopic dermatitis (eczema) does not include keeping the skin dry, but rather keeping the skin moist and hydrated. Dry skin can worsen the itching and inflammation of eczema, so the nurse should advise the parents to apply emollients to the infant's skin after bathing, use mild and fragrance-free soaps and detergents, and avoid excessive heat and sweating.
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