A 9-year-old is in a spica cast and complains of pain one hour after receiving IV opioid analgesia. What should the nurse do first?
Give more pain medication.
Perform a circulation assessment.
Call the surgeon for orders.
Change the child's position.
The Correct Answer is B
Rationale:
A. Administering more pain medication without assessing the cause of unrelieved pain could mask serious complications, such as compartment syndrome.
B. A circulation (neurovascular) assessment should be the first action to rule out complications such as impaired circulation or compartment syndrome, which can cause unrelieved or worsening pain even after analgesia.
C. The surgeon should be notified after an assessment has been completed and abnormal findings are confirmed.
D. Changing position might help with general discomfort but is not the priority when pain persists after opioid administration, which could indicate a serious issue.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. This is a common type of incomplete fracture in children but typically heals well without affecting growth.
B. While painful, it generally does not interfere with growth or development.
C. Describes a fracture where the skin is intact, but this alone doesn't determine the risk to bone growth.
D. The epiphyseal (growth) plate is responsible for bone growth, and damage here can impair future bone development and lead to deformities.
Correct Answer is A
Explanation
Rationale:
A. Physical activity increases glucose utilization by muscles, which can lower blood glucose levels. To prevent hypoglycemia, children with diabetes often need additional carbohydrate intake before or after exercise.
B. Decreasing food intake during activity may worsen the risk of hypoglycemia.
C. Physical activity actually increases the risk of insulin shock (hypoglycemia) unless managed appropriately.
D. Exercise generally lowers blood glucose levels, reducing the risk of hyperglycemia, not increasing it.
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