A nurse is caring for a 15-year-old adolescent who has cellulitis of the left lower calf.
The nurse is assessing the adolescent 24 hr after the initial visit. How should the nurse interpret the findings?
For each finding, click to specify whether the finding is an indication of potential improvement or an indication of potential worsening condition. There must be at least 1 selection in every row. There does not need to be a selection in every column.
Temperature
WBC count
Weight-bearing ability on the affected leg
Wound assessment
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}
Temperature: The temperature decreased from 38.8° C (101.8° F) to 37.6° C (99.7° F), which indicates a potential improvement in the infection response as the body temperature is coming down.
WBC count: The WBC count increased slightly from 14,000/mm³ to 15,000/mm³, which is still elevated compared to the normal range (5,000 to 10,000/mm³). This suggests that the body is still responding to infection and could indicate a worsening condition if the trend continues or remains elevated.
Weight-bearing ability on the affected leg: The improvement in weight-bearing ability suggests that the condition of the leg is improving. This indicates that the condition is improving as the pain or swelling may have decreased.
Wound assessment: The wound culture is still pending, and although there is no specific description provided, a pending culture and the general condition of the wound (which can be assessed for redness, warmth, or exudate) might still indicate a worsening condition if there is continued inflammation or signs of spreading cellulitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is A
Explanation
A. "Share a bedroom with your infant for the first 6 months." The American Academy of Pediatrics (AAP) recommends room-sharing (but not bed-sharing) for at least the first 6 months to reduce the risk of SUID/SIDS.
B. "Place your infant on a soft crib mattress after they are 4 months old." A firm mattress is always recommended, as soft bedding increases the risk of suffocation and SUID/SIDS.
C. "Cover your infant with a nonflammable blanket at bedtime." Blankets should not be used, as they pose a suffocation risk. Instead, parents should use a sleep sack or wearable blanket for warmth.
D. "Use bumper pads around the interior of your infant's crib." Bumper pads increase the risk of suffocation and entrapment and are not recommended for safe sleep.
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