A nurse is caring for a 2-year old who has a heart defect and is scheduled for a cardiac catheterization. Which of the following actions should the nurse take?

Check for iodine or shellfish allergies prior to the procedure

Place an NPO status for 12 hours prior to the procedure

Elevate the affected extremity following the procedure.

Limit fluid intake following the procedure.

Answer and Explanation

The Correct Answer is A

A. Check for iodine or shellfish allergies prior to the procedure: Cardiac catheterization often involves the use of a contrast dye that contains iodine. If the child has an allergy to iodine or shellfish, there is an increased risk of an allergic reaction to the dye.

B. Place an NPO status for 12 hours prior to the procedure: NPO status typically is required for a few hours before a procedure involving anesthesia or sedation, but not necessarily for 12 hours. The specific time frame should be determined by the healthcare provider.

C. Elevate the affected extremity following the procedure: After cardiac catheterization, the affected extremity should typically be kept straight and immobilized to prevent bleeding or hematoma formation. Elevating the extremity may not be advisable.

D. Limit fluid intake following the procedure: After cardiac catheterization, the child should be encouraged to drink fluids to help flush the contrast dye from their system, unless contraindicated by other factors.

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Correct Answer is ["C","D","G"]

Explanation

A. Provide oxygen at 6 L/min via nasal cannula: Oxygen is only used if the patient has hypoxemia (O2 saturation below 92%), which is not indicated in this scenario.
B. Perform passive ROM exercises: Not appropriate during a sickle cell crisis due to the risk of exacerbating pain.
C. Administer IV fluids: Essential to reduce blood viscosity and prevent further sickling.
D. Obtain consent for a blood transfusion: Necessary in severe anemia (e.g., hemoglobin of 5 g/dL).
E. Restrict fluid intake to 1,400 mL/day: Fluid restriction is contraindicated; hydration is key to management.
F. Administer meperidine IV: Meperidine is generally avoided due to the risk of neurotoxicity; other opioids (e.g., morphine) are preferred.
G. Encourage bedrest: Reduces oxygen demand during a crisis.

A. A 12-year-old client who had an appendectomy and refuses to ambulate B. An 18-month-old client who had a cleft palate repair and is crying in pain C. An 8-year-old client who had a tonsillectomy and is swallowing frequently D. A 15-year-old client who has an IV infusion and reports pain at the insertion site

Correct Answer is C

Explanation

A. A 12-year-old client who had an appendectomy and refuses to ambulate: Refusal to ambulate post-appendectomy may be concerning for complications like constipation or post-operative discomfort, but it is not an immediate emergency unless accompanied by other signs of complications like infection or bleeding.

B. An 18-month-old client who had a cleft palate repair and is crying in pain: Pain is expected following surgery, and while it should be addressed promptly, it does not constitute an immediate emergency unless there are signs of distress or complications.

C. An 8-year-old client who had a tonsillectomy and is swallowing frequently: Frequent swallowing after a tonsillectomy can indicate bleeding, which is a potential complication requiring immediate attention. It is important to assess for signs of bleeding, such as increased swallowing or a change in respiratory status.

D. A 15-year-old client who has an IV infusion and reports pain at the insertion site: Pain at the IV insertion site could indicate a complication like infiltration or phlebitis, but it is not an immediate emergency unless associated with other severe symptoms (e.g., swelling or systemic infection).

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A nurse is caring for a 2-year old who has a heart defect and is scheduled for a cardiac catheterization. Which of the following actions should the nurse take?

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