A nurse is caring for a child who has had a lumbar puncture. The nurse should monitor the child for which of the following complications?
Double vision
Nuchal rigidity when standing
Pain in the posterior iliac crest
Headache
The Correct Answer is D
A. Double vision: Double vision is not a common complication of a lumbar puncture. Complications typically involve symptoms related to cerebrospinal fluid (CSF) leakage or infection.
B. Nuchal rigidity when standing: Nuchal rigidity (stiff neck) can indicate meningitis, but it is not specifically a complication of a lumbar puncture. Nuchal rigidity is more likely to be associated with an underlying condition that prompted the lumbar puncture rather than the procedure itself.
C. Pain in the posterior iliac crest: Pain at the posterior iliac crest is not typical after a lumbar puncture, as the procedure is performed in the lower back at the lumbar spine region.
D. Headache: Headache is a common complication following a lumbar puncture, often due to a CSF leak. The headache typically worsens when the patient is in an upright position and improves when lying down.
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Related Questions
Correct Answer is B
Explanation
A. Hypotension: Hypotension is not a common adverse effect of cefazolin. While severe allergic reactions can cause hypotension, it is not a typical side effect to monitor for with cefazolin specifically.
B. Stevens-Johnson syndrome: Correct. Stevens-Johnson syndrome (SJS) is a rare but serious adverse effect of many antibiotics, including cefazolin. SJS is a severe skin reaction that requires immediate medical attention.
C. Prolonged wound healing: Cefazolin is an antibiotic and would not typically cause prolonged wound healing; instead, it is used to prevent or treat infections that might impair healing.
D. Bradypnea: Bradypnea is not associated with cefazolin. Respiratory depression is not a common side effect of this antibiotic.
Correct Answer is {"dropdown-group-1":"B"}
Explanation
The nurse should first: b. Keep the child NPO.
Rationale:
In this scenario, the child may have ingested a battery, which can cause serious complications such as chemical burns if it gets stuck in the esophagus. Keeping the child NPO (nothing by mouth) helps prevent further movement of the battery and reduces the risk of complications.
Other responses:
a. Obtain informed consent: While obtaining informed consent may be necessary for certain diagnostic or treatment procedures, the immediate priority is to ensure the child's safety and prevent complications from the suspected battery ingestion.
c. Teach the child's parents the importance of inspecting the child's play area: While this is an important aspect of preventing accidents, it is not the immediate priority when the child is at risk of battery ingestion. Ensuring the child's safety and preventing further harm take precedence.
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