A nurse is caring for a school-age child following a femoral venous cardiac catheterization. Which of the following actions should the nurse take?

Perform a sterile dressing change 8 hr after the procedure.

Keep the affected extremity straight for 4 hr.

Assess the pulses above the catheterization site.

Maintain NPO status for 24 hr following the procedure.

Answer and Explanation

The Correct Answer is B

A. "Perform a sterile dressing change 8 hr after the procedure." The initial dressing should be left in place for at least 24 hours, and any dressing changes should be performed per facility protocol.

B. "Keep the affected extremity straight for 4 hr." After a femoral venous cardiac catheterization, the child should keep the affected extremity straight for about 4 to 6 hours to prevent bleeding or hematoma formation at the insertion site.

C. "Assess the pulses above the catheterization site." The pulses below the site (distal pulses) should be assessed, not above. This is important to check for adequate circulation and potential complications such as clot formation or arterial obstruction.

D. "Maintain NPO status for 24 hr following the procedure." The child should typically resume oral intake as soon as they are fully awake and able to tolerate fluids, usually within a few hours post-procedure.

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Correct Answer is B

Explanation

A. "Offer your child foods that are low in calories." Children with cystic fibrosis (CF) require a high-calorie diet because their bodies have difficulty absorbing nutrients due to pancreatic insufficiency.
B. "Offer your child foods that are high in fat." A high-fat diet (35%-40% of total calories from fat) is recommended because fat malabsorption is common in CF, and they need additional fat to meet their energy needs.
C. "Offer your child foods that are high in vitamin C." While vitamin C is important, fat-soluble vitamins (A, D, E, and K) are the primary concern since CF patients struggle to absorb them.
D. "Offer your child foods that are low in protein." Children with CF require adequate protein intake to support growth and maintain muscle mass, so protein restriction is not recommended.

A. Apply pressure to the puncture site following the procedure. B. Limit the child's fluid intake following the procedure. C. Position the child in a prone position during the procedure. D. Ensure the guardian has signed the consent form prior to the procedure. E. Ensure the child voids prior to the procedure. F. Insert an indwelling urinary catheter during the procedure. G. Monitor for paresthesia and tingling in extremities following the procedure.

Correct Answer is ["A","D","E","G"]

Explanation

A. Apply pressure to the puncture site following the procedure. Applying pressure helps prevent cerebrospinal fluid (CSF) leakage and reduces the risk of complications.

B. Limit the child's fluid intake following the procedure. Fluids should be encouraged to help replenish lost CSF and reduce the risk of post-lumbar puncture headache.

C. Position the child in a prone position during the procedure. The correct positioning for a lumbar puncture is the side-lying fetal position or sitting with the back curved forward to widen the space between the vertebrae.

D. Ensure the guardian has signed the consent form prior to the procedure. A lumbar puncture is an invasive procedure, so informed consent is required before proceeding.

E. Ensure the child voids prior to the procedure. Having the child empty their bladder before the procedure helps prevent discomfort and reduces the risk of bladder distention during positioning.

F. Insert an indwelling urinary catheter during the procedure. A urinary catheter is not necessary for a lumbar puncture unless there is another medical indication.

G. Monitor for paresthesia and tingling in extremities following the procedure. Paresthesia or tingling could indicate nerve irritation or injury, which requires prompt assessment and intervention.

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A nurse is caring for a school-age child following a femoral venous cardiac catheterization. Which of the following actions should the nurse take?

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