A nurse is assessing a school-age child prior to administering digoxin. For which of the following findings should the nurse withhold the medication?

Urine output 25 mL/hr

Oxygen saturation 88%

Heart rate 64/min

Respiratory rate 18/min

Answer and Explanation

The Correct Answer is C

A. Urine output 25 mL/hr – This is an adequate urine output for a school-age child and does not require withholding digoxin.
B. Oxygen saturation 88% – While low, this does not directly indicate digoxin toxicity or require withholding the medication. The underlying cause should be evaluated.
C. Heart rate 64/min – Digoxin can cause bradycardia, and a heart rate of 64/min is too low for a school-age child. Generally, digoxin should be withheld if the heart rate is below 70 bpm in children or below 90 bpm in infants.
D. Respiratory rate 18/min – This is within the normal range for a school-age child and does not warrant withholding digoxin.

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Correct Answer is B

Explanation

A. "It is okay to blame others for your feelings." Blaming others is a negative coping mechanism that does not help the child manage emotions in a healthy way.
B. "When you feel angry and overwhelmed, take some deep breaths." Deep breathing is a positive coping strategy that helps reduce stress and manage emotions effectively.
C. "Take a break from group activities when you are stressed." Social support is an important stress reliever, and withdrawing from activities may lead to isolation and worsen stress.
D. "Keep your strong feelings to yourself." Bottling up emotions can lead to increased stress and anxiety. Children should be encouraged to express their feelings in a healthy way.

A. Increased urine output B. Bradycardia C. Increased blood pressure D. Tachypnea

Correct Answer is D

Explanation

A. Increased urine output. Infants with congestive heart failure (CHF) often have decreased urine output due to reduced kidney perfusion caused by poor cardiac function.
B. Bradycardia. CHF is more likely to cause tachycardia as the heart compensates for poor circulation.
C. Increased blood pressure. CHF in infants typically leads to hypotension or normal blood pressure rather than an increase.
D. Tachypnea. Increased respiratory rate (tachypnea) is a common sign of CHF in infants because of fluid overload and pulmonary congestion, which make breathing difficult.

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