A nurse is educating the parent of an 18-month-old toddler on how to administer otic drops.
Which of the following parent statements indicates an understanding of the teaching?
I should pull the pinna down and back.
I should insert the dropper into the ear canal.
I should administer the ear drops right out of the refrigerator.
I should massage the area behind the ear.
The Correct Answer is A
Choice A rationale
The external auditory canal in a toddler is shorter and has an upward curve compared to an adult. Pulling the pinna down and back straightens this canal, allowing the medication to flow more effectively and reach the eardrum. This maneuver optimizes drug delivery by aligning the auditory canal for better access and absorption. This is a crucial anatomical consideration for medication administration in young children.
Choice B rationale
Inserting the dropper into the ear canal can cause significant trauma to the delicate tympanic membrane or the canal walls. The dropper tip may be sharp or firm, and forceful insertion can lead to pain, bleeding, or perforation of the eardrum. This action is contraindicated as it poses a significant risk of injury to the child's auditory structures. The drops should be instilled just inside the opening.
Choice C rationale
Administering cold ear drops can cause a caloric reaction, leading to dizziness, nausea, and vertigo. The sudden temperature change stimulates the vestibular system in the inner ear, causing a temporary imbalance. The drops should be warmed to body temperature by holding the container in the hands for a few minutes before administration to prevent this adverse physiological response.
Choice D rationale
Massaging the area behind the ear, over the mastoid bone, can be painful and is not an effective method for distributing otic medication. The drops are meant to act locally within the ear canal. Gentle pressure on the tragus, the small cartilage flap in front of the ear canal, can help to push the medication deeper into the canal after instillation, but massaging behind the ear is not indicated.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
An air embolism occurs when air enters the bloodstream, travels to the heart, and becomes trapped in the pulmonary circulation. This blockage obstructs blood flow to the lungs, leading to symptoms like sharp chest pain, sudden shortness of breath, and signs of respiratory distress. Sharp pain is a key indicator of this event.
Choice B rationale
Severe itching of the hands is a common symptom of a mild allergic reaction to a blood transfusion. It is caused by the release of histamine from mast cells and basophils in response to an immune reaction to plasma proteins or other components in the donor blood. This is not indicative of an air embolism.
Choice C rationale
Distended neck veins are a sign of circulatory overload, where the heart is unable to handle the increased fluid volume from the transfusion. This causes blood to back up in the venous system, increasing central venous pressure. This is a different type of transfusion reaction and not a symptom of an air embolism.
Choice D rationale
A decreased temperature, or hypothermia, is an uncommon finding during a blood transfusion. It may occur if a large volume of cold blood is administered too rapidly, which is especially a risk in pediatric patients. An air embolism typically presents with signs of cardiovascular and respiratory compromise, not a drop in temperature.
Correct Answer is D
Explanation
Choice A rationale
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with antiplatelet effects, which can increase the risk of bleeding. Following a cardiac catheterization, a puncture site has been created in a blood vessel. Giving aspirin could inhibit platelet function and increase the risk of bleeding or hematoma formation at the insertion site.
Choice B rationale
The pressure dressing applied after a cardiac catheterization is crucial for hemostasis and preventing bleeding at the puncture site. It should be left in place for an extended period to ensure the vessel has sealed. Typically, a small adhesive bandage replaces the pressure dressing after 24 hours, not 8 hours, to provide adequate compression.
Choice C rationale
Soaking the child in a bathtub should be avoided for several days to prevent water from entering the catheterization site. Introducing water to the site increases the risk of infection. The site should be kept clean and dry. A sponge bath is the recommended bathing method for the first few days following the procedure.
Choice D rationale
Following a cardiac catheterization, the insertion site, typically in the groin, is at risk for bleeding and hematoma formation. Strenuous activities increase blood pressure and could put stress on the healing blood vessel. Avoiding these activities for several days allows the vessel to heal and significantly reduces the risk of complications.
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