A child has experienced several episodes of vomiting. After the nurse reviews the need to provide only clear liquids, the parent of the child reports making clear liquid popsicles out of flavored gelatin for the child. Which information should the nurse obtain about the popsicles?
How many popsicles are available.
If the popsicles are completely frozen.
The color and flavor of gelatin used.
Whether they contain pulp or fruit.
The Correct Answer is D
A. How many popsicles are available.
This information might be helpful for logistical purposes or to assess how much the child has consumed, but it's not directly relevant to ensuring the appropriateness of the popsicles for a clear liquid diet.
B. If the popsicles are completely frozen.
While it's important that popsicles are properly frozen to avoid potential choking hazards, this does not address whether the popsicles meet the dietary requirement of clear liquids.
C. The color and flavor of gelatin used.
While this might be of interest, the key concern is whether the popsicles contain any non-clear components like fruit or pulp.
D. Whether they contain pulp or fruit.
For a child who needs clear liquids, it is important to ensure that the popsicles do not contain any solids like fruit or pulp. Clear liquids are meant to be easily digestible and not irritate the stomach further. Popsicles with pulp or fruit can be too heavy and might not be appropriate in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Switch to a non-rebreather mask:
A non-rebreather mask delivers a higher concentration of oxygen (typically 10-15 L/min) compared to a nasal cannula. However, switching to a non-rebreather mask is a more drastic step that might not be necessary immediately. Other, simpler interventions should be considered first.
B. Verify placement of pulse oximeter:
Before making any changes, it's crucial to verify the accuracy of the oxygen saturation reading. The pulse oximeter might be misplaced or malfunctioning, leading to an inaccurate reading. This is an appropriate first action to ensure the reading is correct before deciding on further interventions.
C. Remove nasal cannula:
Removing the nasal cannula would decrease the client’s oxygenation further, worsening the situation. This is not an appropriate action when oxygen saturation is already low.
D. Increase the oxygen to 3 L/minute:
Increasing the oxygen flow rate is a reasonable intervention to improve oxygen saturation. However, this should typically be done after verifying the accuracy of the oxygen saturation reading. If the reading is correct, this is a valid next step to improve the client’s oxygenation.
Correct Answer is A
Explanation
A. Inject in abdominal area at least 2 in (5.1 cm) from the umbilicus:
This instruction is accurate and appropriate for the administration of low molecular weight heparin subcutaneously. Injecting into the abdominal area at least 2 inches (5.1 cm) away from the umbilicus is a commonly recommended site for subcutaneous injections due to the availability of subcutaneous tissue and the reduced risk of injury to underlying structures.
B. Rotate injections between the abdomen and gluteal areas:
While rotation of injection sites is important to prevent tissue damage and lipodystrophy, for subcutaneous injections of low molecular weight heparin, the abdomen is typically the preferred site due to better absorption and reduced risk of complications. Therefore, rotating between the abdomen and gluteal areas may not be necessary or recommended for this specific medication.
C. Expel the air in the prefilled syringe prior to injection:
Expelling air from the prefilled syringe is a standard practice to ensure accurate dosing and prevent air embolism, but it is not specific to the administration of low molecular weight heparin. This instruction should be included in general injection technique education but is not specific to the administration of this medication.
D. Massage the injection site to increase absorption:
Massaging the injection site after administration of low molecular weight heparin is not recommended, as it can increase the risk of bleeding or hematoma formation at the injection site. Massaging the site is generally contraindicated for anticoagulant injections to avoid disrupting the clotting process.
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