A nurse is caring for a toddler who drinks 946 mL (32 oz) of whole milk per day and has a poor appetite. The nurse should identify the toddler as being at risk for which of the following conditions?

Iron deficiency anemia

Vitamin A toxicity

Impaired carbohydrate metabolism

Lactose intolerance

Answer and Explanation

The Correct Answer is A

A. Iron deficiency anemia: Whole milk is a poor source of iron, and excessive consumption of whole milk can displace iron-rich foods from the diet. Therefore, a toddler who consumes a large amount of whole milk and has a poor appetite is at risk for iron deficiency anemia due to inadequate iron intake. Iron deficiency anemia is characterized by low levels of iron in the body, leading to decreased production of red blood cells and impaired oxygen transport.

B. Vitamin A toxicity: While excessive intake of vitamin A can lead to toxicity, it is unlikely to occur from consuming whole milk alone. Vitamin A toxicity is more commonly associated with excessive intake of vitamin A supplements or foods that are rich in preformed vitamin A, such as liver. Therefore, vitamin A toxicity is not a significant risk for a toddler who drinks whole milk.

C. Impaired carbohydrate metabolism: There is no direct relationship between whole milk consumption and impaired carbohydrate metabolism. Impaired carbohydrate metabolism is typically associated with conditions such as diabetes mellitus or metabolic syndrome, rather than dietary factors like milk consumption.

D. Lactose intolerance: Lactose intolerance is the inability to digest lactose, the sugar found in milk and dairy products, due to a deficiency of the enzyme lactase. While excessive consumption of whole milk may exacerbate symptoms in a child with lactose intolerance, it is not a risk factor for developing lactose intolerance itself. Lactose intolerance is more commonly observed in individuals of certain ethnic backgrounds or those with a genetic predisposition.

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Correct Answer is B

Explanation

A. A child who is postoperative following a tonsillectomy and reports moderate throat pain.

While postoperative pain management is important, moderate throat pain in a child who has undergone a tonsillectomy is expected. This client's condition is stable, and their pain can be managed with appropriate interventions. It is not the most urgent situation among the options provided.

B. A child who had a cardiac catheterization using the femoral artery and has blanching of the toes.

Blanching of the toes following a cardiac catheterization using the femoral artery can indicate compromised circulation, potentially leading to ischemia or necrosis. This requires immediate assessment to prevent further complications.

C. A child who has bacterial pneumonia and is due for their initial dose of IV antibiotics.

While timely administration of antibiotics is important in the treatment of bacterial pneumonia, missing the initial dose by a short period of time is not likely to result in significant harm compared to a potential circulatory compromise in option B.

D. A child who has juvenile idiopathic arthritis and needs assistance with the application of prescribed splints.

While providing assistance with splint application is necessary for comfort and mobility, it is not as urgent as assessing potential circulatory compromise or initiating antibiotic therapy for pneumonia.

A. FACES B. COMFORT C. CRIES D. FLACC

Correct Answer is D

Explanation

A. FACES: The FACES pain scale is a visual analog scale commonly used with older children who can point to or select a facial expression that best represents their pain level. It may not be suitable for infants who may not have the cognitive or motor skills to use the scale effectively.

B. COMFORT: The COMFORT scale assesses pain in infants and young children based on behaviors such as crying, facial expressions, and body movements. It evaluates parameters such as alertness, calmness, respiratory response, physical movement, and muscle tone. The COMFORT scale is suitable for assessing pain in infants and young children, including those who are postoperative.

C. CRIES: The CRIES scale is a neonatal pain assessment tool that evaluates crying, oxygen saturation, vital signs, expression, and sleeplessness. While it is designed for newborns and infants up to 6 months of age, it may not be as appropriate for a 12-month-old infant who is postoperative and beyond the neonatal period.

D. FLACC: The FLACC scale assesses pain in infants and young children based on five behavioral categories: facial expression, leg movement, activity level, cry, and consolability. It is commonly used in pediatric settings and is suitable for assessing pain in infants who are postoperative.

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A nurse is caring for a toddler who drinks 946 mL (32 oz) of whole milk per day and has a poor appetite. The nurse should identify the toddler as being at risk for which of the following conditions?

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