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A nurse is caring for a child who received partial -thickness burn s to over 50% of his body 10 days ago and has splints over his joints to prevent contractures.
Which of the following action should the nurse take? (select all that apply.).

provide a high-calories diet

Administer analgesics IM.

monitor intake and output

remove splints during sleep.

change dressing using aseptic technique.

Answer and Explanation

Correct Answer : A,C,E

Choice A rationale

Providing a high-calorie diet is a recommended action for a child who has received partial-thickness burns to

over 50% of his body. After a burn injury, the body needs extra calories and protein to heal, fight infection, and maintain its functions. A high-calorie diet can help meet these increased nutritional needs.

Choice B rationale

Administering analgesics intramuscularly (IM) is not a recommended action for a child with partial- thickness burns. Pain management is crucial in burn care, but analgesics should be given orally or intravenously, not IM, to avoid additional pain and tissue damage.

Choice C rationale

Monitoring intake and output is a recommended action for a child who has received partial-thickness burns to over 50% of his body. This can help assess the child’s hydration status, kidney function, and response to fluid replacement therapy.

Choice D rationale

Removing splints during sleep is not a recommended action for a child with partial-thickness burns. Splints are used to prevent contractures by keeping the joints in a functional position. They should be worn as prescribed by the healthcare provider, which often includes during sleep.

Choice E rationale

Changing dressings using aseptic technique is a recommended action for a child who has received partial- thickness burns to over 50% of his body. This can help prevent infection, promote healing, and assess the burn’s progress.

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Correct Answer is ["A","B"]

Explanation

Choice A rationale

Placing gates at the top and bottom of stairs is an important safety measure for infants. This can prevent falls, which are a common cause of injury in this age group.

Choice B rationale

Ensuring the crib mattress is in the lowest position is another important safety measure. As infants grow and begin to sit, stand, and climb, a high mattress position can increase the risk of falls.

Choice C rationale

Removing labels from containers that contain toxic substances is not recommended. It’s important to keep these substances out of reach of children, and the labels provide important information about the contents and potential hazards.

Choice D rationale

Keeping toilet lids in the upright position is not recommended. Infants can be curious and may try to explore or play with water in the toilet, which can lead to accidents or injuries.

Choice E rationale

Selecting a toy chest that has a heavy, hinged lid is not recommended. This could pose a risk of injury if the lid were to close unexpectedly, and small fingers could get caught.

A. Osteomyelitis B. Compartment syndrome C. Volkmann ischemic contracture D. Renal calculi

Correct Answer is B

Explanation

Choice A rationale

Osteomyelitis is an infection of the bone, typically caused by bacteria. While it can occur as a complication of a fracture, it is not the most immediate concern within the first 24 hours after injury.

Choice B rationale

Compartment syndrome is a serious condition that involves increased pressure in a muscle compartment. It can lead to muscle and nerve damage and problems with blood flow. It can develop within hours of a severe injury like a fracture. Therefore, it is crucial to monitor for signs of compartment syndrome, such as severe pain, paleness, numbness, or decreased strength, in the first 24 hours after a fracture.

Choice C rationale

Volkmann ischemic contracture is a condition that can occur if there is prolonged or severe muscle ischemia (lack of blood flow) following a fracture. However, this condition is not typically seen within the first 24 hours after injury.

Choice D rationale

Renal calculi, or kidney stones, are hard deposits made of minerals and salts that form inside your kidneys. They are not a complication that would arise within the first 24 hours after a fracture.

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A nurse is caring for a child who received partial -thickness burn s to over 50% of his body 10 days ago and has splints over his joints to prevent contractures. Which of the following action should the nurse take? (select all that apply.).

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A nurse is caring for a child who received partial -thickness burn s to over 50% of his body 10 days ago and has splints over his joints to prevent contractures.
Which of the following action should the nurse take? (select all that apply.).