A caregiver calls the pediatrician’s office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6°F (39.2°C). The caregiver has tried to get the child to nap but the child gets panicky, sits back up, and leans forward with her mouth open and tongue out when the caregiver encourages her to lie down. The nurse suspects the child has which condition?
Epiglottitis
Mild asthma
Spasmodic laryngitis
Acute laryngotracheobronchitis
The Correct Answer is A
A. Epiglottitis:
Epiglottitis is an inflammation of the epiglottis, which can result in rapid onset of symptoms such as severe sore throat, high fever, and difficulty breathing. The characteristic position described, with the child preferring to sit up, lean forward, and keep the mouth open, is known as the "tripod position." This is a protective mechanism to maintain a patent airway.
B. Mild asthma:
Asthma is a chronic respiratory condition characterized by recurrent episodes of wheezing, coughing, and shortness of breath. However, the scenario does not describe typical asthma symptoms, and the child's preference for sitting up and leaning forward is more indicative of an airway obstruction.
C. Spasmodic laryngitis:
Spasmodic laryngitis is characterized by sudden episodes of severe respiratory distress, a barking cough, and sometimes stridor. It often occurs at night and is usually not associated with high fever. The child's behavior in the scenario, particularly the preference for sitting up and leaning forward, is not a common feature of spasmodic laryngitis.
D. Acute laryngotracheobronchitis:
Acute laryngotracheobronchitis, or croup, typically presents with a barking cough, stridor, and respiratory distress. It does not usually cause the preference for sitting up and leaning forward as described in the scenario. Croup is more commonly associated with a distinctive cough sound.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["-195"]
Explanation
The water intake is half of 900 mL, which is 450 mL. The soft drink intake is 12 oz, which is equivalent to 355 mL. Therefore, the total fluid intake is 450 + 355 = 805 mL.
The urine output is the sum of the two voids, which is 600 + 350 = 950 mL. The drainage output is 50 mL. Therefore, the total fluid output is 950 + 50 = 1000 mL.
The net I/O is the difference between the fluid intake and output, which is 805 - 1000 = -195 mL. This means that the patient had a negative fluid balance of 195 mL during the night.
Correct Answer is ["612.375"]
Explanation
To calculate the ordered dose of Ceftriaxone in mg/kg/day, we can follow these steps:
Convert the weight to kg:
Weight in kg= Weight in lbs /2.2046
Weight in kg= 18lbs/2.2046≈8.165 kg
Calculate the daily dosage range:
Using the recommended dosage range of 50-75 mg/kg/day:
Minimum daily dosage= 50mg/kg/day × Weight in kg
Maximum daily dosage =75mg/kg/day×Weight in kg
Calculate the ordered dose:
Ordered dose=Dosage per administration × Frequency per day
Ordered dose= 300mg×2times per day= 600mg/day
Now, let's calculate the daily dosage range:
Minimum daily dosage=50mg/kg/day×8.165kg=408.25mg/day
Maximum daily dosage=75mg/kg/day×8.165kg=612.375mg/day
The ordered dose of 600 mg/day falls within the calculated range of 408.25-612.375 mg/day, so the ordered dose is within the recommended dosage range for a serious infection.
Therefore, the ordered dose of Ceftriaxone 300 mg IV Q12H for a 6-month-old infant weighing 18 lbs is considered safe based on the calculated dosage range.
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