A 4-year-old child with a history of cystic fibrosis is hospitalized with an acute pulmonary exacerbation. His prescription includes chest physiotherapy four times a day, antibiotics via IV, and pancreatic enzymes. Which time is best for the nurse to plan for chest physiotherapy?
An hour before meals and at bedtime.
Every six hours around the clock.
Upon awakening and within an hour after meals.
Evenly spaced when the patient is awake.
The Correct Answer is A
An hour before meals and at bedtime.
Choice A rationale:
Scheduling chest physiotherapy an hour before meals and at bedtime is optimal. This timing helps prevent aspiration during meals and aids in clearing secretions before sleep. It complements the patient's meal schedule and sleep routine.
Choice B rationale:
Every six hours around the clock could disrupt the patient's sleep and meal times. Chest physiotherapy might not align well with the patient's daily activities, potentially affecting treatment compliance and effectiveness.
Choice C rationale:
Performing chest physiotherapy upon awakening and after meals might increase the risk of aspiration during meals. Clearing airways before meals is safer, and performing it right after meals could cause discomfort.
Choice D rationale:
Evenly spaced physiotherapy when awake lacks synchronization with meal and sleep times. This approach might not optimize treatment effects and patient convenience.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Educating caregivers on sensory impairment is important in the care of a child with myelomeningocele, but the priority is to prevent infection. The exposed spinal cord and tissue are at risk of infection.
Choice B rationale:
Preventing infection is the priority for a child with myelomeningocele. The neural tube defect exposes the spinal cord, making the child susceptible to infections that can lead to serious complications.
Choice C rationale:
Correction of joint contractures is important in the overall care of a child with myelomeningocele, but preventing infection takes precedence. Joint contractures can be managed over time, while infection can quickly escalate.
Choice D rationale:
Measuring daily head circumference is essential for assessing hydrocephalus in a child with myelomeningocele, but preventing infection is more urgent. Infection can cause rapid deterioration, while changes in head circumference might be gradual.
Correct Answer is ["C","D"]
Explanation
Choice A rationale:
The varicella vaccine is not contraindicated solely based on Down Syndrome. It is important for these children to receive immunizations due to potential increased susceptibility to infections.
Choice B rationale:
A 6-month-old developmentally appropriate infant should receive the varicella vaccine according to the recommended schedule. There is no contraindication for this population.
Choice C rationale:
The varicella vaccine might be contraindicated for a child with autism due to concerns about adverse reactions, as these children might have sensitivities to certain vaccine components.
Choice D rationale:
The varicella vaccine should be contraindicated for a 10-year-old with acquired immune deficiency syndrome (AIDS) due to their compromised immune system. Live vaccines like varicella are usually avoided in immunocompromised individuals.
Choice E rationale:
A 12-year-old child with an arm fracture can still receive the varicella vaccine as it is not contraindicated based solely on this condition.
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