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. Avoid giving the child live virus vaccines. Children with heart failure can receive live vaccines unless they are immunocompromised (e.g., from immunosuppressive therapy).
B. Weigh the child every other day. Daily weights are necessary to monitor fluid retention, a key concern in heart failure.
C. Ensure that the child sleeps in an air-conditioned room. While a cool environment may be comfortable, this is not a priority intervention for heart failure management.
D. Consolidate activities to promote the child's rest. Children with heart failure experience fatigue easily due to reduced cardiac output. Grouping activities together minimizes energy expenditure and promotes adequate rest.
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A","dropdown-group-3":"B"}
Explanation
Gastrointestinal: Iron is better absorbed when the stomach is empty, so administering it between meals is the best approach to enhance its effectiveness.
Dental: Iron supplements can cause staining of the teeth, so brushing after taking the supplement will help prevent this issue.
Hematological: After a month of treatment with iron supplements, a follow-up blood test is necessary to evaluate the improvement in hemoglobin levels and to ensure the treatment is effective.
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