A nurse is caring for a school-age child who has a new plaster cast on her right arm. Which of the following actions should the nurse take?

Place a warm, moist heat pack on the cast.

Position the casted arm in a dependent position.

Move the casted arm with a firm grasp.

Administer diphenhydramine to relieve itching.

Answer and Explanation

The Correct Answer is D

A. Place a warm, moist heat pack on the cast: Incorrect. Moisture can damage the integrity of a plaster cast, and heat can increase swelling.

B. Position the casted arm in a dependent position: Incorrect. Keeping the arm elevated helps reduce swelling and pain.

C. Move the casted arm with a firm grasp: Incorrect. A firm grasp can cause further injury or discomfort. It’s important to handle the casted limb gently.

D. Administer diphenhydramine to relieve itching: Correct. Itching is common under a new cast, and diphenhydramine can help manage this symptom without risking damage to the cast.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"},"F":{"answers":"B"}}

Explanation

Place the infant in a knee-chest position: Indicated: ☑️

The knee-chest position is commonly used during a "tet spell," which involves episodes of cyanosis due to decreased oxygen levels. This position increases systemic vascular resistance, which helps redirect blood flow to the lungs, improving oxygenation.

Administer morphine via IV bolus: Indicated: ☑️

Morphine is used to calm the infant, reduce respiratory effort, and decrease pulmonary vascular resistance. It can help in reducing the severity of the tet spell by promoting better oxygenation.

Provide 100% oxygen by face mask: Indicated: ☑️

Administering 100% oxygen can help increase the amount of oxygen in the blood and reduce the effects of hypoxia. Oxygen is a vasodilator and can reduce pulmonary resistance, making it easier for the infant to oxygenate blood.

Request a prescription for a diuretic: Contraindicated: ☑️

Diuretics are generally not indicated in the acute management of tet spells. While they are used in conditions with fluid overload, their use in this context is not beneficial and could potentially worsen the infant's condition by causing dehydration and further reducing blood volume.

Perform nasopharyngeal suctioning for a maximum of 5 seconds: Contraindicated: ☑️

Nasopharyngeal suctioning can be stressful for the infant and may worsen cyanosis or provoke a tet spell due to increased agitation and respiratory effort. It's typically not recommended unless there's a clear indication for airway clearance.

Prepare to assist with the insertion of a chest tube: Contraindicated: ☑️

Chest tube insertion is not a treatment for tet spells or ToF. It is usually indicated for pneumothorax or significant pleural effusions, which are not related to the acute cyanotic episodes seen in ToF. Preparing for this procedure would be inappropriate in this scenario.

A. Maintain medical asepsis during dressing changes. B. Administer pain medication 30 min to 1 hour before physical therapy. C. Allow the child to set her own schedule for care. D. Provide low-calorie snacks.

Correct Answer is B

Explanation

A. Maintain medical asepsis during dressing changes: While cleanliness is important, aseptic (sterile) technique is typically required for burn care to prevent infection.

B. Administer pain medication 30 min to 1 hour before physical therapy: Pain management is crucial to facilitate participation in physical therapy and improve outcomes.

C. Allow the child to set her own schedule for care: A structured schedule is necessary to ensure regular treatment and care for burns.

D. Provide low-calorie snacks: High-calorie, protein-rich foods are necessary to meet increased metabolic demands for healing.

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A nurse is caring for a school-age child who has a new plaster cast on her right arm. Which of the following actions should the nurse take?

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"},"F":{"answers":"B"}}

Explanation

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