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. Apply plastic covering to the cast until dry. Covering the cast with plastic can cause moisture accumulation, which can delay drying and increase the risk of infection and skin irritation. The cast should be allowed to dry naturally and in a well-ventilated area.
B. Apply pieces of moleskin around the edges of the cast. Applying moleskin around the edges of the cast helps to protect the skin from irritation and potential injury from the rough edges of the cast. This is an appropriate intervention.
C. Use tips of fingers to reposition the cast until dry. Using the tips of fingers to handle the cast while it is drying can create indentations, leading to pressure points and potential skin breakdown. The cast should be handled with the palms of the hands to avoid indentations.
D. Maintain casted extremity below heart level. The casted extremity should be elevated above heart level, especially in the first 24-48 hours, to reduce swelling and promote venous return. Keeping it below heart level can increase swelling.
Correct Answer is D
Explanation
A. "Your child might need to have their tonsils and adenoids removed." Removal of tonsils and adenoids is not typically related to cystic fibrosis management. This statement is not accurate in the context of cystic fibrosis home care.
B. "Your child will take isoniazid for 9 months." Isoniazid is used for the treatment or prevention of tuberculosis, not cystic fibrosis. This statement is not relevant to cystic fibrosis.
C. "Your child will have chest x-rays periodically to monitor for disease reactivation." Periodic chest x-rays are more commonly used to monitor lung infections and complications in cystic fibrosis patients, not specifically for disease reactivation.
D. "Your child should take pancreatic enzymes with meals and snacks." Children with cystic fibrosis often have pancreatic insufficiency, requiring pancreatic enzyme supplements with meals and snacks to aid digestion and nutrient absorption.
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