A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet.
Which intervention should the nurse instruct the mother to implement first?
Apply lotion to hands and feet.
Encourage the child to rest when possible.
Place the child in a quiet environment.
Make a list of foods that the child likes.
The Correct Answer is C
The nurse should instruct the mother to place the child in a quiet environment first. Kawasaki disease is an illness that can cause inflammation in the blood vessels and can lead to symptoms such as irritability and skin peeling. Placing the child in a quiet environment can help reduce stimulation and promote rest, which can help improve the child's symptoms. The other options (A, B, and D) may also be helpful, but placing the child in a quiet environment is a key intervention in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Information about the child's reactions to any previous hospitalizations would be particularly helpful in planning care for this six-year-old girl who is being admited for repair of an umbilical hernia. This information can help the nurse anticipate and address any fears or concerns the child may have about the hospitalization and procedure.
A list of achievement timeline for developmental milestones is not particularly relevant in this situation.
A history of rubella, rubeola, or chicken pox is not particularly relevant in this situation.
Information about the mother's use of alcohol, drugs, or cigaretes during pregnancy is not particularly relevant in this situation.
Correct Answer is C
Explanation
The nurse should report chest pain to the healthcare provider immediately when caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Chest pain can be a sign of acute chest syndrome, a potentially life-threatening complication of sickle cell disease that requires prompt treatment.
Swelling in the hands or feet, ulcers on the legs, and jaundice are common symptoms of sickle cell disease and do not require immediate reporting to the healthcare provider.
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