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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Maintaining extended eye contact may be challenging for children with autism spectrum disorder, as they may have difficulty with social interaction and communication.
B. Establishing a reward system is beneficial for children with autism spectrum disorder as it provides positive reinforcement for desired behaviors, helping to encourage and maintain them.
C. Engaging in cooperative play might be difficult for a child with autism spectrum disorder due to challenges in social interaction and communication.
Correct Answer is D
Explanation
A. A heart rate of 54/min is within the normal range for a 5-year-old child and does not specifically indicate hemorrhage.
B. Flushing of the face is not a direct indicator of hemorrhage.
C. A blood pressure of 95/56 mm Hg may be within the normal range for a 5-year-old child and does not specifically indicate hemorrhage.
D. Continuous swallowing can indicate bleeding in the postoperative period following a tonsillectomy and adenoidectomy, as blood may be pooling in the throat and swallowed rather than expectorated.
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
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.