A nurse is caring for a preschool-aged child who presents with manifestations of epiglottitis. Which of the following actions is the nurse's priority to perform?
Insert an intravenous catheter
Initiate droplet precautions
Provide blow-by humidified oxygen for the child
Place resuscitation equipment at child's bedside
The Correct Answer is D
D. Place resuscitation equipment at the child's bedside. This is because epiglottitis can lead to a life- threatening emergency requiring immediate intervention, and having resuscitation equipment readily available is essential for rapid response.
A. Establishing intravenous access may be necessary for administering fluids and medications but it is not the nurse's priority action when caring for a child with suspected epiglottitis.
B. Droplet precautions help reduce the risk of transmission of respiratory pathogens to others. However, the priority is to address the child's respiratory distress and potential airway compromise.
C. Providing blow-by humidified oxygen can be beneficial in managing the child's respiratory status. However, securing the airway takes precedence over other interventions, as indicated by the guidelines for managing epiglottitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The sweat chloride test is considered the most definitive diagnostic test for cystic fibrosis. In this test, sweat is collected from the skin and analyzed for chloride content. Elevated levels of chloride in the sweat are indicative of cystic fibrosis. This test is highly sensitive and specific for diagnosing the condition.
B. Stool fat content analysis can help assess pancreatic function and malabsorption, which are common manifestations of cystic fibrosis. However, it is not considered the most definitive test for diagnosing cystic fibrosis. Elevated stool fat content can be suggestive of cystic fibrosis but is not specific to the condition.
C. Sputum culture may be performed to identify respiratory pathogens and guide antibiotic therapy in individuals with cystic fibrosis, but it is not the most definitive test for diagnosing the condition. It helps identify infections and monitor lung health but does not confirm the diagnosis of cystic fibrosis.
D. Pulmonary function tests are used to assess lung function and airflow, which can be affected in individuals with cystic fibrosis. While these tests provide valuable information about lung health, they are not the most definitive test for diagnosing cystic fibrosis. They are used for monitoring disease progression and response to treatment rather than confirming the diagnosis.
Correct Answer is D
Explanation
D. An oxygen saturation level of 85% is significantly below the normal range and indicates hypoxemia (low blood oxygen levels). This finding is concerning, especially in a child with cystic fibrosis, which can lead to respiratory complications such as airway obstruction, infection, or mucus plugging.
A. A blood glucose level of 140 mg/dL is within the normal range for children, so this finding would not typically require immediate reporting to the provider.
B. A serum sodium level of 156 mEq/L is significantly elevated and above the normal range. However, hypoxia is the priority.
C. A red blood cell (RBC) count of 3.2 million/µL falls within the normal range for children, so this finding would not typically require immediate reporting to the provider.
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