A nurse is caring for an infant who has heart failure and vomited following administration of digoxin. Which of the following actions should the nurse take?
Mix the medication with 8 oz of formula.
Give an antiemetic.
Increase fluid intake.
Administer the next dose as prescribed.
The Correct Answer is D
A. Mixing the medication with formula may not be appropriate as the infant has vomited, and re-administering the medication immediately may result in overdosing.
B. Giving an antiemetic is not indicated unless ordered by the healthcare provider. It is important to follow specific orders in this situation.
C. Increasing fluid intake may not be advisable immediately after vomiting, especially in the context of heart failure. The infant may require evaluation for fluid status before increasing intake.
D. Administering the next dose as prescribed is the appropriate action unless contraindicated by specific circumstances or healthcare provider orders.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. No head lag when pulled to a sitting position is a normal finding at 4 months of age.
B. They should not have doll's eye reflex intact, which means that their eyes move in the opposite direction of their head when turned. This reflex normally disappears by 3 months of age and its persistence may indicate brain damage.
C. The presence of tears when crying is a normal finding at 4 months of age.
D. They should also have positive Babinski reflex, which means that their toes fan out when their sole is stroked. This reflex normally disappears by 12 months of age.
Correct Answer is B
Explanation
A. Placing the child prone (face down) is not appropriate for a lumbar puncture.
B. Placing the child in a lateral position (lying on their side) with knees flexed is the correct position for a lumbar puncture as it allows for optimal access to the lumbar area.
C. Placing the child supine (on their back) is not ideal for a lumbar puncture as it does not provide the necessary access to the lumbar area.
D. Placing the child in semi-Fowler's position (lying on their back with the head of the bed elevated) is not typically used for lumbar puncture procedures.
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