A nurse is caring for a toddler who had a cleft lip and palate repair and is trying to touch the incision site. Which of the following provider prescriptions is recommended for the toddler?

Swaddle the toddler in a blanket.

Place the toddler in bilateral elbow restraints.

Place the child in a mummy restraint.

Obtain a prescription for lorazepam.

Answer and Explanation

The Correct Answer is B

A. Swaddle the toddler in a blanket. While swaddling may be comforting, it does not effectively prevent the toddler from reaching the incision site. Elbow restraints are a more appropriate choice for limiting arm movement and protecting the incision site.

B. Place the toddler in bilateral elbow restraints. Bilateral elbow restraints are commonly used after cleft lip and palate repair to prevent the toddler from touching or disrupting the incision site. These restraints help protect the surgical area while allowing the child to maintain some mobility.

C. Place the child in a mummy restraint. A mummy restraint (wrapping the child tightly) may be too restrictive and can cause distress, as it limits the child's ability to move freely. Elbow restraints are typically a better choice to prevent injury to the surgical site while still allowing some movement.

D. Obtain a prescription for lorazepam. Lorazepam is a sedative and would not be the first-line approach to managing the child's need to prevent touching the incision site. Using physical restraints is a safer and more effective option.

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Correct Answer is A

Explanation

A. "Apply a light blanket if the child begins to shiver." Shivering can increase body temperature, so a light blanket can provide comfort while preventing excessive heat retention. Over-bundling should be avoided.

B. "Wake the child every 4 hr during the night to drink 118.3 mL (4 oz) of apple juice." Encouraging fluid intake is important, but waking a sleeping child is unnecessary unless there are concerns about dehydration. Instead, fluids should be offered frequently while the child is awake.

C. "Take the child's temperature every 10 min after administering acetaminophen." Checking the temperature this frequently is not necessary and could cause unnecessary stress for the child. Acetaminophen typically takes 30–60 minutes to take effect, so temperature checks should be spaced appropriately.

D. "Place ice packs on the child's armpits and groin." Using ice packs can cause shivering, which increases body temperature. Instead, cooling measures like a lukewarm sponge bath or removing excess clothing are preferred.

A. Mild hematuria B. Hyponatremia C. Absent urine protein D. Decreased blood potassium

Correct Answer is A

Explanation

A. Mild hematuria. One of the hallmark signs of glomerulonephritis is hematuria (presence of blood in the urine). Mild hematuria is common and is often associated with glomerular injury, which allows red blood cells to pass through the glomerular filtration barrier.

B. Hyponatremia. Hyponatremia (low sodium levels) is not typically associated with glomerulonephritis. However, in severe cases of kidney dysfunction, fluid retention can lead to dilutional hyponatremia, but it is not a primary finding in glomerulonephritis.

C. Absent urine protein. Proteinuria (presence of protein in the urine) is a common finding in glomerulonephritis due to damage to the glomerular filtration barrier. It is typically present, though the amount may vary.

D. Decreased blood potassium. Hyperkalemia (increased potassium levels) is more commonly seen in acute kidney injury and glomerulonephritis due to decreased kidney function. Decreased potassium levels are not typical in this condition.

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A nurse is caring for a toddler who had a cleft lip and palate repair and is trying to touch the incision site. Which of the following provider prescriptions is recommended for the toddler?

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