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A nurse is caring for a 9-year old child on the pediatric unit

Exhibits

Complete the following sentence by using the lists of options.

The nurse should plan to

followed by .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

  • Inspect the child’s oropharynx: After vomiting bright red blood, inspection can help confirm if bleeding is active in the throat. This assessment is key in identifying post-tonsillectomy hemorrhage.
  • Obtaining a set of vital signs: Vital signs help evaluate the child’s hemodynamic stability, monitor for hypovolemic shock, and guide urgency for provider notification or surgical intervention.

Rationale for Incorrect Choices:

  • Offer the child a red popsicle: Red-colored foods can mask signs of active bleeding. Also, offering oral intake during suspected hemorrhage is unsafe and may increase risk of aspiration.
  • Place the child in a supine position: Supine positioning can increase aspiration risk if bleeding continues or worsens. The child should remain upright to protect the airway.
  • Requesting a prescription for codeine: Codeine is not indicated in this situation and is contraindicated in children post-tonsillectomy due to risk of respiratory depression, especially during bleeding.
  • Encouraging the child to cough and deep breathe: Coughing may dislodge clots and worsen bleeding. This action is inappropriate when bleeding is suspected in the oropharynx.


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Related Questions

Correct Answer is C

Explanation

A. Mild edema to the toes: Mild swelling is a common and expected finding after a cast application due to trauma and immobility. It should be monitored but is not an immediate concern unless it progresses or is accompanied by other symptoms.

B. Ecchymosis at the base of the toes: Bruising near the injury site is also expected following a fracture and cast application. While it should be documented, it does not typically indicate a complication unless associated with worsening symptoms.

C. Numbness in the toes: Numbness may signal impaired nerve function or compromised circulation due to increased pressure from the cast, raising concern for compartment syndrome. This requires immediate evaluation to prevent permanent damage.

D. Pain at the fracture site with movement: Some pain is normal after a fracture and casting, particularly with movement. However, it becomes more concerning if it is severe, unrelieved by medication, or accompanied by signs of neurovascular compromise.

Correct Answer is D

Explanation

A. "Explain what you were doing to get hit." This statement implies blame or justification for the abuse and can cause the child to feel guilt or shame, which is inappropriate and non-therapeutic.

B. "Why do you think that you are being abused?" This question may sound accusatory or suggest that the child is responsible for the abuse. It can discourage open communication and retraumatize the child.

C. "I am sure everything will work out just fine." This is a false reassurance. It dismisses the child’s emotions and does not validate their experience, which can hinder trust-building.

D. "Can you tell me how you are feeling?" This open-ended, nonjudgmental question encourages the child to express emotions and builds therapeutic rapport. It provides emotional support in a safe, respectful manner.

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