A nurse in a provider's office is caring for an infant who has developmental dysplasia of the hip (DDH). The nurse should include which of the following instructions when teaching the parents about the Pavlik harness?
Remove the Pavlik harness when bathing the infant.
Adjust the length of the straps once a week.
Massage the infant's skin under the straps twice a day.
Place the diaper under the straps of the harness.
The Correct Answer is D
Choice A reason: This is not a correct instruction for the nurse to include in the teaching. The Pavlik harness is a device that holds the infant's hips in a flexed and abducted position to allow the femoral head to fit into the acetabulum. The harness should not be removed by the parents, as this may interfere with the treatment and cause complications. The nurse should instruct the parents to sponge bathe the infant while wearing the harness.
Choice B reason: This is not a correct instruction for the nurse to include in the teaching. The length of the straps of the Pavlik harness should not be adjusted by the parents, as this may affect the alignment and stability of the infant's hips. The nurse should instruct the parents to bring the infant to the provider's office regularly for check-ups and adjustments of the harness.
Choice C reason: This is not a correct instruction for the nurse to include in the teaching. Massaging the infant's skin under the straps of the Pavlik harness may cause irritation, friction, or pressure on the skin, which may lead to skin breakdown or infection. The nurse should instruct the parents to keep the infant's skin clean and dry, and to check for any signs of redness, swelling, or drainage.
Choice D reason: This is a correct instruction for the nurse to include in the teaching. Placing the diaper under the straps of the Pavlik harness prevents the diaper from interfering with the position and function of the harness. The nurse should instruct the parents to change the diaper frequently and to avoid using bulky or cloth diapers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Bacterial meningitis is a probable condition, as it is an infection of the membranes that cover the brain and spinal cord, caused by various bacteria, such as Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae. The adolescent has many signs and symptoms of bacterial meningitis, such as fever, headache, and neck stiffness.
Choice B reason: Viral meningitis is not a likely condition, as it is an infection of the membranes that cover the brain and spinal cord, caused by various viruses, such as enteroviruses, herpes simplex virus, or mumps virus. The adolescent has some signs and symptoms of viral meningitis, such as fever, headache, and neck stiffness, but they are usually less severe than bacterial meningitis.
Choice C reason: Encephalitis is not a probable condition, as it is an inflammation of the brain tissue, usually caused by viral infections, such as herpes simplex virus, West Nile virus, or rabies virus. The adolescent has some signs and symptoms of encephalitis, such as fever, headache, and altered mental status, but they are usually accompanied by focal neurological deficits, such as seizures, paralysis, or cranial nerve palsies.
Choice D reason: Brain abscess is not a definite condition, as it is a collection of pus within the brain tissue, usually caused by bacterial infections that spread from other parts of the body, such as the ear, sinus, or lung. The adolescent has some signs and symptoms of brain abscess, such as fever, headache, and altered mental status, but they are usually accompanied by focal neurological deficits, such as seizures, paralysis, or cranial nerve palsies.
Correct Answer is B
Explanation
Choice A reason: Placing the client in a private room is not necessary for a client who has a high WBC count, unless they have other indications for isolation, such as an infectious disease. A high WBC count may indicate inflammation, infection, or other conditions that affect the immune system.
Choice B reason: Monitoring the client's temperature every 4 hr is an appropriate action for a nurse to take for a client who has a high WBC count. A fever is a common sign of infection or inflammation, and it may require further intervention, such as antibiotics or antipyretics.
Choice C reason: Administering an antihistamine as prescribed is not related to a high WBC count. Antihistamines are used to treat allergic reactions, which may cause a low WBC count due to the release of histamine from mast cells.
Choice D reason: Encouraging the client to increase fluid intake is not specific to a high WBC count. Fluid intake should be based on the client's hydration status, urine output, and other factors. Increasing fluid intake may help flush out toxins or bacteria, but it is not a priority action for a client who has a high WBC count.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today