A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first?
Apply pressure just above the insertion site.
Monitor the pulse distal to the insertion site.
Obtain vital signs.
Reinforce the dressing.
The Correct Answer is A
A. This is the first step to control bleeding and prevent further blood loss.
B. Monitoring the distal pulse is important, but controlling bleeding takes precedence.
C. Vital signs can wait momentarily until the bleeding is under control.
D. Reinforcing the dressing may be necessary, but controlling bleeding is the immediate priority.
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Related Questions
Correct Answer is C
Explanation
A. Allowing the infant to cry before feeding increases energy expenditure and may worsen fatigue in infants with heart failure.
B. A recumbent position can increase the risk of aspiration; a semi-upright position is preferred.
C. Implementing a 3-hour feeding schedule ensures the infant receives adequate nutrition without excessive fatigue.
D. Feedings should be limited to 30 minutes to prevent excessive energy expenditure.
Correct Answer is B
Explanation
D. Renal failure Correct Answer: B Rationale:
A. Stevens-Johnson syndrome is a severe allergic reaction that can occur with various medications, but it is not a common adverse effect of prednisolone.
B. Prolonged wound healing is a potential adverse effect of corticosteroids like prednisolone due to their immunosuppressive effects.
C. Hypotension is not a common adverse effect of prednisolone; rather, it can cause fluid retention and hypertension.
D. Renal failure is a rare adverse effect of prednisolone and is not typically monitored for in school-age children unless there are preexisting renal issues.
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